The Baby-friendly Hospital Initiative (BFHI) is a key component of the World Health Organization/United Nations Children's Fund Global Strategy for Infant and Young Child Feeding. The primary aim of this narrative systematic review was to examine the impact of BFHI implementation on breastfeeding and child health outcomes worldwide and in the United States. Experimental, quasi-experimental and observational studies were considered eligible for this review if they assessed breastfeeding outcomes and/or infant health outcomes for healthy, term infants born in a hospital or birthing center with full or partial implementation of BFHI steps. Of the 58 reports included in the systematic review, nine of them were published based on three randomized controlled trials, 19 followed quasiexperimental designs, 11 were prospective and 19 were cross-sectional or retrospective. Studies were conducted in 19 different countries located in South America, North America, Western Europe, Eastern Europe, South Asia, Eurasia and Sub-Saharan Africa. Adherence to the BFHI Ten Steps has a positive impact on short-term, mediumterm and long-term breastfeeding (BF) outcomes. There is a dose-response relationship between the number of BFHI steps women are exposed to and the likelihood of improved BF outcomes (early BF initiation, exclusive breastfeeding (EBF) at hospital discharge, any BF and EBF duration). Community support (step 10) appears to be essential for sustaining breastfeeding impacts of BFHI in the longer term.

The authors reviewed the acculturation literature with the goal of identifying measures used to assess acculturation in Hispanic populations in the context of studies of health knowledge, attitudes, and behavior change. Twenty-six acculturation measures were identified and summarized. As the Hispanic population continues to grow in the United States, there is a need to develop rigorous acculturation measures that include health indicators. Findings suggest that multidimensional acculturation scales are robust measurement tools when assessing nationality, cultural awareness, media and language preferences, and health status. Furthermore, aspects of Hispanic cultural lifestyle, such as beliefs about nutrition and physical activity, affect health care utilization, treatment, and prevention. Health communication researchers should consider aspects of cultural values and beliefs, and their impact on health status, for future research and health promotion interventions.

Objective Identify barriers and facilitators to improve prenatal fruit and vegetable (F&V) intake among WIC eligible Latinas using the Health Action Process Approach framework. Design Qualitative data were collected via audiotaped in-depth interviews as part of a larger study to design an intervention to increase prenatal F&V intake. Setting Hartford, Connecticut. Participants Forty-five WIC eligible Latinas completed the study. Included women were: a) ≥ 18 years old; b) in 2nd or 3rd trimester; c) having a singleton pregnancy; d) overweight or obese (i.e. pregravid BMI ≥ 25); e) not on a restricted diet; h) nonsmokers. Phenomenon of Interest Prenatal factors that promote and hinder F&V intake. Analysis Transcripts were independently read, coded, and consensus was reached about emerging themes. Results Ten factors influenced prenatal F&V intake: i) social support, ii) family structure, iii) F&V access, iv) F&V preferences, v) F&V knowledge, vi) F&V health outcome expectations, vii) self-efficacy, viii) intentions, ix) F&V action/coping planning strategies, and x) maternal health status. Conclusions and Implications Social support from family/friends emerged as the primary distal factor driving prenatal F&V intake. Interventions designed to empower pregnant Latinas to gain the access, confidence, knowledge, and strategies necessary to consume more F&Vs need to consider strengthening support to achieve the desired outcome.

This study describes the complex dynamics of the sexual, economic and social interactions between a group of feminized homosexual men and men who have sex with men and self-identify as heterosexual ('mostaceros'), in lower-income peripheral urban areas of Lima and Trujillo, Peru. The study examined sexual risk between these two groups of men, and the significance of the economic exchanges involved in their sexual interactions. Using a Grounded Theory approach, 23 individual interviews and 7 focus groups were analyzed. The results reveal that cultural, economic and gender factors mold sexual and social relations among a group of men who have sex with men in Peru. Compensated sex is part of the behaviors of these men, reflecting a complicated construction of sexuality based on traditional conceptions of gender roles, sexual identity and masculinity. Several factors (e.g. difficulty in negotiating condom use, low self-esteem, low risk perception, alcohol and drug consumption), in the context of compensated sex, play a role in risk-taking for HIV infection.

We conducted a pre–post feasibility trial of Healthy Eating for Life, a theory-based, multimedia English as a second language curriculum that integrates content about healthy nutrition into an English language learning program to decrease cancer health disparities. Teachers in 20 English as a second language classrooms delivered Healthy Eating for Life to 286 adult English as a second language students over one semester. Postintervention data are available for 227 students. The results indicated that Healthy Eating for Life is effective for increasing fruit and vegetable intake as well as knowledge, action planning, and coping planning related to healthy eating. Participants also achieved higher reading scores compared to the state average.