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. Author manuscript; available in PMC: 2020 Jul 1.
Published in final edited form as: Cultur Divers Ethnic Minor Psychol. 2018 Oct 18;25(3):371–378. doi: 10.1037/cdp0000229

The Use of Cultural Identity in Predicting Health Lifestyle Behaviors in Latinx Immigrant Adolescents

Rhoda Moise 1,*, Alan Meca 2, Seth J Schwartz 1, Jennifer B Unger 3, Elma I Lorenzo-Blanco 4, Miguel Ángel Cano 5, José Szapocznik 1, Brandy Piña-Watson 6, Sabrina E Des Rosiers 7, Lourdes Baezconde-Garbanati 3, Daniel W Soto 3, Monica Pattarroyo 3, Juan A Villamar 8, Karina M Lizzi 9
PMCID: PMC6472997  NIHMSID: NIHMS984978  PMID: 30335406

Abstract

Objectives:

This study explored whether cultural identity predicts health lifestyle behaviors.

Methods:

Participants included 302 recently immigrated (<5 years in US) Latinx adolescents (53% boys; mean age 14.51 years at baseline) from Miami and Los Angeles. Participants completed cultural identity measures at baseline and one-year post baseline. A path analyses was used to estimate associations between cultural identities (ethnic, national, and bicultural) and health lifestyle behaviors (physical activity, diet, and sleep hygiene).

Results:

Ethnic identity positively predicted diet. Results also indicated a significant interaction between ethnic and national identity on sleep hygiene. Specifically, when national identity was high (+1 SD), ethnic identity positively predicted sleep hygiene.

Conclusion:

This study focuses on health lifestyle behaviors such physical activity, diet, and sleep hygiene in this population. Results highlight the need to explore the protective nature of cultural identity retention in relation to health lifestyle behaviors in Latinx adolescents.

Keywords: Culture, Identity, Latinx, Immigrant, Adolescents, Health Lifestyle Behaviors

Latinxs – individuals who identify as Mexican, Puerto Rican, Cuban, or another Spanish origin group – account for 16% of the US population (Ennis, Ríos-Vargas, & Albert, 2011). The Latinx population is young, with 40% under the age of 20 (Ennis et al., 2011). As a result of having to navigating multiple cultural reference points, immigrant youth are faced with the challenge of developing a cultural identity that includes both heritage and immigrant cultural components (Roberts, Phinney, Masse, Chen, Roberts, & Romero, 1999; Umaña-Taylor et al., 2014). Under the heading of cultural identity (Huynh, Devos, & Goldberg, 2014), we include (1) ethnic identity (identifying with one’s cultural heritage), and (2) national identity (identifying with the country in which one resides). Biculturalism results when individuals are able to identify with both their ethnic group and the larger nation in which they reside. Substantial literature has emphasized the protective effects of biculturalism (e.g., Berry, Phinney, Sam, & Paul, 2006; Coatsworth, Maldonado-Molina, Pantin, & Szapocznik, 2005; David, Okazaki, & Saw, 2009). There is evidence that biculturalism is associated with improved health and well-being outcomes (Nguyen & Benet-Martínez, 2013). One way to operationalize biculturalism, then, is as an interaction between ethnic and national identity. As such, we hypothesized a bicultural identity (BI), represented as an interaction between one’s ethnic and national identity, to be protective.

However, limited studies have considered Latinx adolescents’ cultural identity in relation to health lifestyle behaviors, operationalized to include physical activity, diet, and sleep hygiene (Chen, James, & Wang, 2007; Lopresti, Hood, & Drummond, 2013). The immigrant paradox (Alcántara, Estevez, & Alegría, 2017) posits that adolescents migrating to the US tend to be healthier than their US-born counterparts. Foreign-born youth, over time, are likely to gravitate toward “mainstream” US culture and may lose some of their advantage. As such, it may be hypothesized that one’s heritage culture may help to maintain the protective effects, and that identifying with the US may help to erode these effects (cf. Berry, 1997). However, scholars have argued that it is a lack of ones’ heritage culture that is problematic for these immigrant adolescents, deteriorating their familial roots. Accordingly, it is essential to assess both ethnic and national identities in relation to health outcomes.

To inform health promotion efforts targeted for specific immigrant groups, scientists should investigate how cultural identity processes affect health lifestyle behaviors. Social environment and geographic location may also influence health lifestyle behaviors. For instance, Latinx adolescent immigrants’ identities may be shaped by aspects of social environment including context of reception such as stigma, and discrimination (Abraído-Lanza, Echeverría, & Flórez, 2016; Davis et al., 2016). Additionally, an immigrant’s cultural identity relates to sociocultural factors, such as gender norms, that may shape health and health behavior (Airhihenbuwa, Kumanyika, TenHave, & Morssink, 1999; Sallis, Owen, & Fisher, 2008). Further, physical geographic location may influence health due to varying accessibility to safe spaces for physical activity (Brown et al., 2014) as well as climate differences (e.g. obtainability of cultural, heritage produce). Most prior scientific investigations have focused on internalizing and externalizing symptoms (e.g. depression, optimism, anxiety) [Schwartz et al., 2015a; Huynh, Nguyen, & Benet-Martínez, 2011] as outcomes of cultural identity processes, with far less attention to health lifestyle behaviors. We aimed to fill this gap in the present study.

The present study extends the study of cultural identity, which has been used to predict health-risk behaviors (Schwartz et al., 2015a), to focus on health lifestyle behaviors. We focus our examination on the effects of cultural identity processes (ethnic, national, and their interaction) on physical activity, diet, and sleep hygiene (Chen, James, & Wang, 2007). These outcomes were selected given literature portraying US-culture acquisition as a risk factor, and heritage-cultural retention as a protective factor, vis-à-vis poor health outcomes such as obesity in adolescence (Liu, Chu, Frongillo, & Probst, 2012), and related chronic disease in adulthood such as diabetes (Afable & Pérez-Stable, 2017). Prior research (e.g., Schwartz et al., 2014b) has suggested that cultural identity variables can help to explain the immigrant paradox for some health outcomes, such as substance use. We do not know whether the cultural identity variables might also explain the immigrant paradox for health lifestyle behaviors such as physical activity, diet, and sleep hygiene. Indeed, previous studies have called for further examination of cultural identity dimensions in relation to immigrant-paradox patterns for physical activity (Unger, Reynolds, Shakib, Spruijt-Metz, Sun, & Johnson, 2004; Liu et al., 2012), diet (Gordon-Larsen, Harris, Ward, & Popkin, 2003; Liu et al., 2012), and sleep hygiene (Loredo et al., 2010; McHale, Kim, Kan, & Updegraff, 2011) in Latinxs. The present study explores health lifestyle behaviors in Latinx immigrant adolescents due to their vulnerability in transitioning to the US culture, as posited by the immigrant paradox (Alegría et al., 2017), as well as the potential for early intervention to support healthy transition into adulthood (Dixon, Peña, & Taveras, 2012).

Identity Development in Immigrant and Minority Youth

Identity development, occurring primarily in adolescence, entails questioning who one is and how one will apply this knowledge to various life domains (Erikson, 1950; Umaña-Taylor, Yazedjian, & Bámaca-Gómez, 2004). However, for adolescents from immigrant and minority groups, identity may be a more complex and challenging task (Roberts et al., 1999; Syed & Mitchell, 2013). These adolescents are faced with the need to develop a sense of identity as immigrants as well as members of their receiving country (Schwartz et al., 2015a). Latinx immigrant adolescents also must strategize how to develop a cultural identity that encompasses both their national (US) and ethnic identity; however, individuals differ markedly in terms of how they manage the task of cultural identity development (LaFromboise, Coleman, & Gerton, 1993; Nguyen & Benet-Martínez, 2012).

Cultural Identity Development: Ethnic and National Identifications.

As part of developing a cultural sense of self, immigrant and minority adolescents often must consider what membership in their ethnic group, and in the larger nation, means to them (Umaña-Taylor et al., 2014). Research on cultural identity development has focused primarily on ethnic identity, with comparatively little attention to national identity (Schwartz et al., 2012). Perhaps as a result, Latinx-focused studies examining measures of ethnic identity (e.g., affirmation and commitment) have yielded inconsistent findings (Rivas-Drake et al., 2014; Umaña-Taylor, 2011; Schwartz, Zamboanga, Luyckx, Meca, & Ritchie, 2013). Thus, research on recently immigrated adolescents must consider the complex task of forming both national and ethnic identities – and perhaps becoming bicultural as a result (Berry, 1997; Roberts et al., 1999; Umaña-Taylor et al., 2014). Because biculturalism refers to an individual’s endorsement of both ethnic and national values, beliefs, and practices, one may presume that biculturalism, in terms of both national and ethnic identity commitment/affirmation, may serve as a predictor of health behaviors. To our knowledge, no study has examined the relationship between cultural identity, defined by ethnic, national, and bicultural identities; and health lifestyle behavior in Latinx adolescents.

Current Study

The current study explores how cultural identity processes (ethnic identity, national identity, and their interaction, represented as BI) may inform health lifestyle behaviors, specifically physical activity, diet, and sleep hygiene, among recently immigrated Latinx adolescents using a longitudinal dataset from two US cities – Miami and Los Angeles. We utilized a sample of recent Latinx immigrant adolescents, for whom the process of cultural identity is likely to be salient as result of their developmental stage and recent immigration (Schwartz et al., 2015a). Longitudinal data were collected in Miami, Florida where most Latinxs are Cuban (53%; U.S. Census Bureau, 2011); and in Los Angeles, California where Latinxs are predominantly Mexican (68%; U.S. Census Bureau, 2011). Few studies (e.g., Airhihenbuwa et al., 1999) – and to our knowledge, no longitudinal studies – have explored cultural identity in relation to health lifestyle behaviors. Cross-sectional studies are not able to examine predictive relationships (with appropriate statistical controls and temporal precedence) (Maxwell & Cole, 2007), which is critical for determining strategic points of intervention. As such, in the current study we utilized a longitudinal approach to examine the extent to which ethnic identity, national identity, and their interaction (biculturalism) predict (versus correlate with) indices of physical activity, diet, and sleep hygiene.

Additionally, we examine site and gender differences as a sensitivity analysis, to ensure that the results replicate between boys and girls and across two very different US receiving contexts. We consider site differences between Miami and Los Angeles due to their differences geographically, on opposing coasts, as well as contextually, with distinct predominant ethnic group composition (Cuban versus Mexican; Meca et al., 2017). We examine gender differences in light of previous literature suggesting an influence of sociocultural factors, such as gender norms, on health-risk behaviors (Lorenzo-Blanco, Unger, Ritt-Olson, Soto, & Baezconde-Garbanati, 2013). In alignment with literature on identity formation and acculturation in Latinx immigrant adolescents (Berry, 1997; Roberts et al., 1999; Umaña-Taylor et al., 2014), we hypothesized that ethnic identity, national identity, and their interaction (biculturalism) predict health lifestyle behaviors such that ethnic identity serves as a protective factor; national identity serves as a risk factor; and biculturalism serves as a protective factor for health lifestyle behaviors of physical activity, diet, and sleep hygiene. Site and gender differences were included as exploratory research questions, with no a priori hypotheses specified. We examine recent immigrants at baseline and one year follow up, controlling for age and years in the US, to investigate how early cultural identity formation processes following arrival in a new receiving context impact health lifestyle behaviors. The timing of recent arrival for these adolescent immigrants in a longitudinal design allows us to examine the effects of cultural identity on health lifestyle behaviors for youth who may be especially vulnerable.

Method

Participants

The sample consisted of 302 recently (<5 years in the US) immigrated Latinx adolescents (53% boys; Mage=14.51 years at baseline; SD=.88 years, range 14–17 years) from a longitudinal study of acculturation and health outcomes conducted in Miami (n = 152) and Los Angeles (n = 150). Eighty-five percent of the sample was retained across baseline and one year follow up. The Miami sample was primarily from Cuba (61%), the Dominican Republic (8%), Nicaragua (7%), Honduras (6%), Colombia (6%), and other Spanish-speaking countries (12%); and the Los Angeles sample was primarily from Mexico (70%), El Salvador (9%), Guatemala (6%), and other Spanish-speaking countries (15%). The mean annual household income, as reported by parents, was $27,028 (SD = $13,454) in Miami and $34,521 (SD = $5,398) in Los Angeles.

Procedures

The present analyses use data from the baseline and one-year follow up from a longer longitudinal study (Schwartz et al., 2015a). These time points were selected a priori in order to explore how scores on cultural variables predict scores of health behaviors over time. Participants were recruited from randomly selected public high schools whose student bodies were at least 75% Latinx in both Miami and Los Angeles. More details on participants and procedures may be found elsewhere (Schwartz et al., 2014a; Schwartz et al., 2015b). The study was approved by the Institutional Review Boards at the University of Miami and the University of Southern California and by the Research Review Committees for each of the participating school districts. Both adolescents and caregivers completed assessments on laptop computers in English or Spanish, according to their preference (83.8% and 72.5% completed the survey in Spanish at baseline and follow-up, respectively).

Measures

All measures were administered at each time point and developed using a two-step translation process (Sireci, Yang, Harter, & Ehrlich, 2006) whereby measures are translated by one translator from English to Spanish, back-translated by a second translator (Spanish to English), and then evaluated by both translators to resolve discrepancies.

Ethnic and National Identity.

The 7-item affirmation/commitment subscales from the Multi-Group Ethnic Identity Measure-Revised (MEIM-R; Roberts et al., 1999) and from the American Identity Measure (AIM; Schwartz et al., 2012) were used to measure ethnic (α = .84-.93; Sample item: “I have a lot of pride in my ethnic group”) and national identity (α = .87-.90; Sample item: “I feel good about being American.”). The AIM was adapted from the MEIM, with “the United States” inserted in place of “my ethnic group.” Both the MEIM-R and AIM scales ranged from 0 “Strongly Disagree” to 4 “Strongly Agree”. The affirmation and commitment subscales were used because they serve as markers of coherent national and ethnic identity (Schwartz et al., 2013). However, because the affirmation and commitment subscales were extremely highly correlated (r>.90), we created a combined A/C scales for ethnic identity and national identity.

Health Lifestyle Behaviors.

We assessed health lifestyle behaviors across three broad domains: physical activity, diet, and sleep hygiene (Lopresti, Hood, & Drummond, 2013). One item was used to assess each behavior. Items included the following, each referring to the past month: “how many times did you exercise or work out going to the gym, lifting weights, or running or walking for at least 30 minutes,” “how many times did you eat three healthy meals a day,” and “how many times did you sleep at least six hours at night.” The response scale ranged from 0 (Never) to 4 (Always).

Statistical Analyses

A path analysis was conducted in Mplus version 7.2 (Muthén & Muthén, 2010) using a sandwich covariance estimator (Kauermann & Carroll, 2001) to adjust the standard errors and account for nesting of participants within schools. Missing data were handled using a robust full-information maximum likelihood estimator (FIML, operationalized using the MLR estimator in Mplus). Model fit was evaluated using the comparative fit index (CFI), the root mean square error of approximation (RMSEA), and the standardized root mean square residual (SRMR). Good fit is represented as CFI ≥ .95, RMSEA ≤ .06, and SRMR ≤ .06; and adequate fit is represented as CFI ≥ .90, RMSEA ≤ .08, and SRMR ≤ .08 (Little, 2013). The analytic process proceeded in two steps, both of which controlled for age and years in the US. First, ethnic and national identity A/C were mean-centered and an interaction term was created by taking the product term within Mplus. Second, we calculated descriptive statistics and a correlation matrix for all study variables. Ethnic and national identity A/C, and the bicultural interaction term, were then entered as baseline predictors of health lifestyle behaviors at one year follow up. Additionally, for each health lifestyle behavior, we controlled for its corresponding values at baseline (e.g., Physical Activity at T1 -> Physical Activity at FU1). Third, we ascertained whether any of the effects differed across gender and site. To do this, we compared an unconstrained model (with all paths free to vary across site) to a constrained model (with each path constrained to be equal across site) using the Satorra-Bentler scaled Δχ2 difference test (Satorra & Bentler, 2010), the ΔCFI (>.010) and ΔRMSEA (>.010) criteria (Little, 2013).

Results

Step 1: Descriptive Statistics

Table 1 provides means and standard deviations and a zero-order correlation matrix for all study variables.

Table 1.

Descriptive and Correlations Table

1 2 3 4 5 6 7 8 9 10
1. Ethnic Identity A/C (T1) -- .15* .09 .20* .24* .10 .30* .06 .09 −.07
2. National Identity A/C (T1) -- −.03 .09 .06 −.01 .15* .08 −.10 −.01
3. Physical Activity (T1) -- .28* .09 .30* .10* .02 .09 .18*
4. Diet (T1) -- .31* .09* .32* .04 .11 .03
5. Sleep Hygiene (T1) -- .05* .15* .13* .01 −.01
6. Physical Activity (FU1) -- .20* .11 −.01 .11*
7. Diet (FU1) -- .24* .02 .04
8. Sleep Hygiene (FU1) -- −.08 .09
9. Age -- −.05
10. Years in US --
Mean 2.82 2.36 2.64 2.59 3.01 2.89 2.74 3.09 14.51 2.07
Standard Deviation 0.71 0.82 2.11 1.29 1.49 1.98 1.30 1.31 0.87 1.87
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Notes.

*

p<.050.

T1 = Baseline predictors; FU1 = One Year Follow Up; A/C = Affirmation and Commitment;

Step 2: Effects of Cultural Identity on Health Lifestyle Behaviors

The model provided adequate to good fit to the data: χ2(6)=14.706, p=.023; CFI=.912; RMSEA=.069; SRMR=.026. Path estimates are displayed in Table 2. Ethnic identity A/C (B=.403, p<.001, 95% C.I.=.198 to .609) positively predicted diet, whereas the bicultural interaction term (the interaction between ethnic and national identity A/C) positively predicted sleep hygiene (B=.221, p=.011, 95% C.I.=.050 to .392). As displayed in Figure 1, when national identity A/C is high (+1 S.D.), ethnic identity A/C positively predicted sleep hygiene (B=.207, p=.048, 95% C.I.=.008 to .576). In contrast, when national identity A/C was low (−1 S.D.), the effect of ethnic identity A/C on sleep hygiene was non-significant (B=−.050, p=.605, 95% C.I.=−.319 to .178).

Table 2.

Path Estimates for the General Model

Outcome (FU1) Predictor (T1) Estimate p-value 95% C.I.
Physical Activity Physical Activity .278 <.001 .156 to .400
Ethnic Identity A/C .198 .120 −.051 to .448
National Identity A/C −.045 .676 −.258 to .167
Ethnic X National A/C .141 .249 −.098 to .379
Diet Diet .263 <.001 .140 to .385
Ethnic Identity A/C .403 <.001 .198 to .609
National Identity A/C .106 .474 −.058 to .269
Ethnic X National A/C .084 .541 −.147 to .315
Sleep Hygiene Sleep Hygiene .102 .135 −.032 to .235
Ethnic Identity A/C .051 .564 −.117 to .338
National Identity A/C .111 .341 −.123 to .225
Ethnic X National A/C .221 .011 .050 to .392
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Notes. Analysis controlled for age and time in the US. T1 = Baseline predictors; FU1 = One Year Follow Up; A/C = Affirmation and Commitment; Ethnic X National A/C = interaction between ethnic and national identity A/C

Figure 1.

Figure 1.

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Interaction between Ethnic and National A/C on Sleep Hygiene

Note. A/C = Affirmation and Commitment

Step 3: Invariance across Gender and Site

Invariance tests indicated that the constrained model provided better fit than the unconstrained models for site [Δχ2(9)=8.08, p=.526; ΔCFI=.009, ΔRMSEA=.021] (See Table 3). For this reason, we retained the assumption of site invariance. With regards to difference across gender, the unconstrained model was associated with poor fit [χ2(12)=44.00, p<.001; CFI=.718, RMSEA=.133]. Examinations of modification indices indicated a need to add diet at baseline as a control for physical activity among adolescent girl Latinxs. After adding this control, the model was associated with adequate fit [χ2(11)=20.43, p=.040; CFI=.917, RMSEA=.075]. In establishing gender invariance, there was a significant decline in the CFI (ΔCFI=.013) while the RMSEA indicated an improvement in fit [ΔRMSEA=.013]. Additionally, the Δχ2 difference test, which tends to be overly sensitive (Meade, Johnson, & Braddy, 2008), was non-significant [Δχ2(9)=11.14, p=.266]. Taken to together, and consistent with recommendations by methodologists (e.g., Kline, 2015; Little, 2013), we concluded that there was no significant difference between the constrained and unconstrained model – and therefore no gender differences in our findings.

Table 3.

Invariance Test

Model χ2(df) Δχ2(df)1 p-value CFI ΔCFI RMSEA ΔRMSEA
Site
    Unconstrained 21.89(12) .904 .074
    Constrained 28.94(21) 6.87(9) .650 .923 .009 .050 .021
Gender
    Unconstrained2 20.43(11) .917 .075
    Constrained 30.93(20) 11.60(9) .237 .904 .013 .060 .013
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Note. A p<.050 for the Δχ2, a ΔCFI greater than .010, and a ΔRMSEA greater than .010, represents a significant decline in model fit.

1

The Δχ2 Difference test was calculated using the Satorra-Bentler Scaled Δχ2 difference

2

The unconstrained gender model was modified to provide acceptable fit.

Discussion

When studying Latinx immigrant adolescents, researchers have focused primarily on pathology and risk. Thus, the present study focused on health lifestyle behaviors, utilizing a sample of recent Latinx immigrant adolescents to explore how cultural identity impacts physical activity, diet, and sleep hygiene. As hypothesized, reports of healthy diet increased with higher ethnic identity affirmation/commitment (A/C). Similarly, sleep hygiene improved with higher biculturalism (interaction between ethnic and national identity A/C). These findings extend the cultural identity literature, lending insight into the potential protective nature of ethnic and bicultural identifications.

First-generation Latinx immigrant diets have been cited as higher in nutritious content (e.g. higher consumption of fruits and vegetables and lower consumption rates of sugared beverages) as compared to Non-Hispanic White diets in the US (Allen et al., 2007; Ayala et al., 2008). Trends indicate diet quality tends to worsen in Latinxs, with each subsequent generation introducing more energy dense foods, which are typical of the US diet (Allen et al., 2007; Isasi et al., 2015). Our finding, that higher ethnic identity affirmation/commitment positively predicts better diet, not only corroborates theory (Berry, 1997) but provides evidence that retention and endorsement of cultural roots may result in more desired health lifestyle. Thus, it is imperative to develop interventions that support Latinx adolescent immigrants in maintaining their ties to their heritage as it may translate into a protective factor, augmenting health and health behavior.

Notably, the understanding of sleep as an important health indicator appeared in scientific investigation relatively recently, dating to the late 1900s (Loredo et al., 2010). Further, the limited literature considering ethno-cultural association in Latinx sleep hygiene (Hale & Rivero-Fuentes, 2011; McHale et al., 2011), excludes investigations of adolescent biculturalism. Our finding that individuals with higher bicultural identity, indicated by high affirmation and commitment to both national identity and ethnic identity, further illustrates the potential benefit of fluidity in navigating multiple cultural streams. Since the influence of biculturalism predicting sleep hygiene vanished with low levels of national identity endorsement, our findings demonstrate the need to consider the both aspects of bicultural identity and their interaction instead of their integration. Whereas previous approaches to acculturation research may inaccurately condense the construct of biculturalism into one factor referred to as integration, our study provides a methodological approach for more accurate assessment, increasing the efficacy of measurement and analysis.

Given that the primary objective of this study included exploring whether cultural identity informs health behavior overall, future research must consider designing studies to further explicate such differences. Although our results did not indicate site differences, this preliminary study may not have captured unique process related to context of reception (Abraído-Lanza, Echeverría, & Flórez, 2016; Davis et al., 2016; Schwartz et al., 2014c); and differential opportunities for health lifestyle behavior such as built environment walkability and including access to sidewalks, parks, and stores (Brown et al., 2014). Overall, our study highlights the utility of examining distinct aspects of identity, such as ethnic, US, and the interaction between ethnic and national identities (i.e., biculturalism), in Latinx immigrant adolescents to understand how cultural identity may influence health behaviors. To promote physical activity, diet, and sleep hygiene, this study suggests health lifestyle and disease prevention research as well as education and intervention programs should consider the protective effects of cultural identifications on health behaviors.

More work is needed to examine mediating mechanisms that may explain the links between cultural identities and health behaviors. For example, attitudes, beliefs, and motivations regarding health behaviors may serve as possible mediators (Lorenzo-Blanco et al., 2016). Additionally, other factors influence physical activity, diet, and sleep hygiene in adolescents. For instance, youth, parents, or school officials may be primarily responsible for important choices regarding health lifestyle behaviors such as diet and physical activity. As a result, it is important for future research to include family-level and school-level predictors of adolescent health lifestyle behaviors. Future studies also may include more comprehensive measures of physical activity, diet, and sleep hygiene.

Contributions and Limitations

The present findings should be interpreted in light of some limitations. Our measures of health lifestyle behaviors were somewhat broad and open to interpretation (e.g., there may have been individual differences in how participants defined “healthy meals” and “exercise”). However, established literature demonstrates the validity of adolescent self-reported health behavior (Brener, Billy, & Grady, 2003). The present data were drawn from a longitudinal cohort study in which a large number of variables were assessed (as is common in these kinds of studies; Ward, Milfont, & Poortinga, 2017). As such, it was not feasible to include the large battery of questions that would have been required to objectively assess the duration and vigor of physical activity; balance of diet; and length and quality of sleep. Despite the limitations of using single items to measure complex health lifestyle behaviors, this study may help to advance the discourse on how to enhance health lifestyle, as well as mitigate health-risks, through supporting adaptive strategies to acculturation and identity formation in Latinx immigrant adolescents.

The high correlation between affirmation and commitment, and the resulting inability to include these two dimensions of ethnic identity as separate predictor variables serves as another limitation to the study. However, it should be noted that a high correlation between these two processes is common among the MEIM scale (Phinney & Ong, 2007). It is also important to note that national origin and recruitment site were heavily confounded in the current study. Although no site differences were identified, it is possible that there may be differences across national origin that we were not able to detect. Driven by the implications of this study, future studies may consider targeting recently immigrated Latinx adolescents for health lifestyle interventions that encourage cultural identity retention.

Acknowledgements

Preparation of this article was supported by Grants DA026594 from the National Institute on Drug Abuse to Seth J. Schwartz and Jennifer B. Unger. We thank Maria-Rosa Velazquez, Tatiana Clavijo, Mercedes Prado, Alba Alfonso, Aleyda Marcos, Daisy Ramirez, Lissette Ramirez, and Perlita Carrillo for their hard work conducting assessments and tracking families;

Footnotes

Dr. Judy Arroyo for her guidance and wisdom; and the study families for sharing their experiences with us.

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