This article reports the development of a short (12-item) acculturation scale for Hispanics. Separate factor analyses of the responses of 363 Hispanics and 228 non-Hispanic whites produced three factors: "Language Use," "Media," and "Ethnic Social Relations." The 12-item scale (explaining 67.6% of the variance for Hispanics) correlated highly with the following validation criteria: respondents' generation, length of residence in the U.S., age at arrival, ethnic self-identification, and with an acculturation index. The first factor consists of only five items and explains 54.5% of the variance while maintaining strong correlations with the various criteria. The validity and reliability coefficients for this new short scale are comparable to those obtained for other published scales. Separate validations for Mexican Americans and Central Americans showed similar results.

This investigation studied the effects of acculturation on attitudinal familism in 452 Hispanics compared to 227 white nonHispanics. Despite differences in the national origin of Hispanics, Mexican-, Central -and Cuban-Americans reported similar attitudes toward the family indicating that familism is a core characteristic in the Hispanic culture. Three basic dimensions of familism were found: Familial obligations, perceived support from the family and family as referents. The high level of perceived family support, invariable despite changes in acculturation, is the most essential dimension of Hispanic familism. Familial obligations and the perception of the family as referents appear to diminish with the level of acculturation, but the perception of family support doesn't change. Although these two dimensions of familism decrease concurrently with the level of acculturation, the attitudes of persons with high levels of acculturation are more familistic than those of white nonHispanics.

Four broad groups of factors have been linked with self-management behavior in type 2 diabetes over time: (1) characteristics of patients, (2) amount and management of stress, (3) characteristics of providers and provider-patient relationships, and (4) characteristics of the social network/context in which disease management takes place. Of these four, social network/context has received the least amount of study and has been described in terms not easily applicable to intervention. In this paper, we identified the social network/context of diabetes management as residing within the family. We defined the family for clinical purposes, reviewed the literature concerning what is known about the link between properties of the family context of care and outcomes in type 2 diabetes and other chronic diseases, and identified areas of family life that are relevant to diabetes management. This information was then used to demonstrate how a family context of care can serve as a clinical framework for integrating all four groups of factors that affect disease management. Implications of this approach for practice and research are described.

To identify access, attitudes, and health practices of Latina women undergoing regular mammography and Pap smear screening, 977 Latinas aged 40 to 74, residing in four California cities, answered a telephone interview. Forty-one percent of women had regular mammography, and 73% had regular Pap smear screening. Cancer screening maintenance was associated with having health insurance, a regular place of care, and fewer fatalistic attitudes about cancer. Regular mammography and Pap smear screening were also associated with ever being married, attending church, and having taken hormone replacement therapy. Being older than 50, residing in the United States a long time, and having had a hysterectomy predicted mammography maintenance. Pap smear screening maintenance was negatively associated with poverty, old age, and negative attitudes toward physicians. There are structural and attitudinal barriers to regular cancer screening among Latinas. Interventions that increase access to care and address women's attitudes about cancer are needed.

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