Daphne Hernandez

• PhD, MSEd FAAHB
• Professor (Associate) at The University of Texas Health Science Center at Houston

Background and Objectives Individuals of color and of low socioeconomic status are at greater risk of experiencing community violence and food insecurity, which are both influenced by neighborhood conditions. We evaluated neighborhood collective efficacy as a linkage between community violence exposure and household food insecurity. Methods Mother...

The purpose of the current study was to use Orsmond and Cohn’s feasibility framework to compare two methods of collecting photo elicitation interviews: (1) in-person and (2) online among low-income community college students. We described the feasibility of the recruitment and retention procedures and compared the participants’ characteristics and...

Background: Identifying family environment factors related to food insecurity and maternal mental health could inform additional support for mothers who experience food insecurity. This study seeks to examine the mechanistic roles of co-parenting support and parenting stress on the food insecurity-maternal mental health relationship. Methods: Da...

Underutilization of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and the Supplemental Nutrition Assistance (SNAP) food safety net programs may compromise child nutritional benefits for families with limited incomes. Using a sample of children surveyed before (2003–2006) and after the Great Recession (2007–2009),...

Existing literature discusses challenges in conducting community-engaged health behavior interventions. However, discussions associated with the barriers to executing community-engaged health behavior research with vulnerable populations are limited in the literature. This current issue provides lessons learned for the purpose of improving communit...

Firearm violence in the United States produces over 36,000 deaths and 74,000 sustained firearm-related injuries yearly. The paper describes the burden of firearm violence with emphasis on the disproportionate burden on children, racial/ethnic minorities, women and the healthcare system. Second, this paper identifies factors that could mitigate the...

Using the Orsmond and Cohen feasibility framework, the primary aim of this study was to assess the feasibility of the implementation of recruitment strategies, data collection procedures, and managerial resources needed to assess pro- and anti-inflammatory biomarkers from low-income, younger Hispanic adults. The secondary aim of this study was to d...

Background The purpose of the current study was to use a social determinants of health (SDOH) framework and latent class analysis (LCA) to identify risk classes among mothers with young children. The risk classes were then used to predict food insecurity severity and stability/change of food insecurity over time. Method The secondary data from the...

While research has investigated intimate partner violence (IPV) and food insecurity (FI) as independent experiences on mental health, research is lacking on the possible longitudinal associations of combined experiences of IPV and FI on maternal depression and generalized anxiety disorder (GAD). Using data from the Fragile Families and Child Wellbe...

Pesticides used to control insects, such as pyrethroids, are neurotoxicants, yet adolescent researchers often overlook their potential role in adolescent psychological adjustment. This brief report is guided by bioecological theory and considers the possible independent and interactive effects of environmental pyrethroid pesticide exposure for adol...

Background Evidence is lacking for the longitudinal bidirectional relationship between maternal depression and child anxiety/depressive symptoms through pre-school to adolescence and regarding parenting stress as having a mediating effect on this association. Methods We performed a secondary analysis of data from the Fragile Families and Child Wel...

Objectives and background Social demands of the school-year and summer environment may affect children’s sleep patterns and circadian rhythms during these periods. The current study examined differences in children’s sleep and circadian-related behaviors during the school-year and summer and explored the association between sleep and circadian para...

Objective: The purpose of this qualitative study was to identify perceptions and barriers to physical activity in childhood and adulthood among Latina adults. Methods: Three focus groups, 2 dyadic interviews, and an individual interview were conducted using semi-structured interview guides with 23 Latina women aged 21-35. A thematic analysis app...

While research has investigated intimate partner violence (IPV) and food insecurity (FI) as independent experiences on mental health, research is lacking on the possible longitudinal associations of combined experiences of IPV and FI on maternal depression and generalized anxiety disorder (GAD). The study examined the independent and combined assoc...

Objective To determine if household food insecurity (HFI) is associated with risk of developmental delays. Design Cross-sectional study of a representative sample of children under 2 years old. Risk of developmental delays was assessed with the Denver Developmental Screening Test II. HFI was measured with the Brazilian Food Insecurity Measurement...

Background Household material hardships could have a negative impact on maternal mental health. Understanding mechanisms by which material hardship trajectories affect maternal depression and anxiety could aid health care professionals and researchers to design better interventions to improve mental health outcomes among mothers. Methods The study...

Research is limited on the association between depression and perceived health status and the underlying mechanisms linking these variables among adults experiencing homelessness. The purpose of the current study was to evaluate the association between probable major depressive disorder (MDD) and perceived health status among a sample of adults exp...

In the United States, overweight/obesity is more prevalent among those with low-income; higher income is related to greater leisure time physical activity (LTPA) and sedentary behavior (SB), which are inversely related to overweight/obesity. This study aimed to evaluate the role of LTPA and SB simultaneously in the income-overweight/obesity relatio...

Objective To determine the temporal directionality of the association between food insecurity and maternal depression. Design Food insecurity was measured at two time points using the 18-item USDA Food Security Scale. Maternal depression was measured at two time points using the 15-item Composite International Diagnostic Interview-Short Form. Two...

Few studies have investigated the association between seeing people walk and leisure-time walking, and the role of neighborhood social cohesion among Latinos/Latinx. We examined the association between frequency of seeing people walk within sight of home and leisure-time walking, and whether neighborhood social cohesion explained this association....

Using photo-elicitation, 17 low-income, post-9/11 Veterans with children residing in/near Houston, TX shared experiences getting food to their table. Limited money, time, and disabilities challenged access to healthy meals. Limited resources decreased choice and control over what Veterans fed their children. Affordable, accessible food fell below n...

Objective This study examined the differential impact of Hurricane Harvey on adolescent standardized Body Mass Index (zBMI), physical activity, diet, and perceived stress. Methods Prior to Hurricane Harvey, 175 ethnic minority adolescents were recruited from an independent school district in Houston. Height and weight were directly measured. The S...

Background Low-income, working-age Veterans with children have risk for food insecurity. Less known is extent to which their risk compares to nonveterans. Purpose To evaluate odds of food insecurity for working-age Veterans with children compared to socioeconomically-matched nonveterans with children. Method We constructed a propensity score-matc...

There is a dearth of information on the risk of inadequate and excess gestational weight gain (GWG) among different generations of Hispanic women in the United States. Therefore, the objective of this study was to understand the relationship of GWG and immigration across three generations of Hispanic women. The study was conducted using data from N...

Dietary quality is important for children's growth and development. Poor dietary quality and maternal depression are prevalent among low-income, Hispanic families. Maternal depression likely influences child feeding before and during the meal. This secondary data analysis of an observational feeding study (2007-2008) examined how maternal depressiv...

Background Due to the commonality of material hardship, food insecurity and housing instability are highly correlated. There is a need to assess the bidirectional relationship between food insecurity and housing instability over time. Objectives To examine the potential bidirectional associations between food insecurity and housing instability ove...

There is evidence that poverty is related to adverse child health outcomes. Yet, evidence is lacking on how economic hardship experiences during early childhood are related to adolescent obesity, how the relationship may differ by child sex, in addition to the potential child and maternal behavioral factors that link economic hardship and adolescen...

Objective Economic hardship (EH) may link to poorer child diet, however whether this association is due to resource limitations or effects on family functioning is unknown. This study examines whether parenting stress mediates the association between EH and child consumption of foods high in saturated fats and added sugars (SFAS). Design Data were...

Traditionally, intrapersonal characteristics (distress tolerance) and interpersonal characteristics (social support) have been studied separately rather than simultaneously. In the current study, we address this gap by simultaneously examining these characteristics as potential indirect associations linking established urban stress–depression and u...

Introduction: Latino adults are less likely than their non-Latinos counterparts to meet physical activity recommendations. Perceptions (e.g., physical activity is important for health) and barriers to physical activity (e.g., lack of time, lack of energy) have been examined among Latinos; however, less is known about how perceptions and barriers di...

Introduction: Latino cancer survivors engage in less physical activity than non-Latino cancer survivors. Previous research has shown that higher acculturation is associated with higher leisure-time physical activity among foreign-born Latinos. However, there is limited research on the association of acculturation with leisure-time aerobic and muscl...

Food insecurity results from unreliable access to affordable and nutritious food. Homeless adults are particularly vulnerable to both food insecurity and problematic alcohol use. The current study examined the link between problematic alcohol use and food insecurity among homeless adults. Participants (N = 528; 62.7% men; Mage = 43.6 ± 12.2) were r...

This study examined the effects of food insecurity and housing instability experiences during early childhood on adolescent anxiety and depressive symptoms through maternal depression and parenting stress. This longitudinal study included 4 waves of data from the Fragile Families and Child Well-Being Study (n = 2,626). Food insecurity was measured...

Purpose To examine whether aerobic physical activity mediates the association between neighborhood walkability and overweight/obesity weight status among Latino adults and whether the relative contribution of this pathway linking neighborhood walkability and aerobic activity varies by level of neighborhood social cohesion. Design Cross-sectional....

Household food insecurity (HFI) is a powerful stressor negatively associated with early childhood development (ECD). However, no comprehensive review has examined the association of HFI and ECD. Therefore, this systematic review and meta‐analysis investigated the association between HFI and ECD domains and subdomains in children under 5 years old....

Background: Evidence is limited on the risk of maternal smoking before and during pregnancy across generations of Hispanic immigrants. Purpose: The aim of this study was to determine whether immigration generational status predicts maternal smoking behaviors before and during pregnancy among Hispanic women. Methods: Data on pregnancies in Nati...

The etiology of obesity is complex, and a growing body of research suggests that changing two or more behaviors at the same time will likely have a stronger impact than changing one behavior in isolation. A lack of fruit and vegetable (FV) intake and high sugar-sweetened beverage (SSB) consumption are two behaviors related to childhood obesity in t...

The aim of this study was to determine whether there are meaningful subgroups with different types of sexual risk behaviors among youth experiencing homelessness and examine the associations between potential classes and other risk variables. A latent class analysis was used to identify classes of youth according to sexual risk behaviors and sexual...

Background: Exposure to violence may explain sleep inadequacies reported by homeless adults, with women being potentially more susceptible to violence and sleep disturbances than men. This study examined the association between violence and sleep inadequacies among homeless adults and explored differences by sex. Methods: Adult participants were...

Poverty status influences obesity and dietary quality, and dietary quality influences obesity. How these relationships differ by sex is unclear. The current study aims were to 1) determine whether dietary quality mediates the relation between income-to-poverty ratio (IPR) and overweight/obesity (OV/OB) among men and women, separately, and 2) determ...

Low-income populations are at increased risk for experiencing negative hurricane exposures and food insecurity. However, little is known regarding how pre-hurricane food insecurity experiences are related to youth hurricane exposure. This study examined the types of hurricane disaster exposures low-income, ethnic minority adolescents experienced du...

Food insecurity is related to overweight/obesity among women. However, it is unknown whether food insecurity impacts individuals’ desired body composition, and whether this relationship differs by race/ethnicity similar to perceived ideal weight status. This study aims to evaluate whether food insecurity is related to elevated preferred weight stat...

The purpose of this manuscript is to determine the prevalence of opioid misuse/opioid use disorder (OUD) among adults experiencing homelessness and describe characteristics that account for significant variance in relation to opioid misuse in those who misuse and do not misuse opioids. From six homeless shelters in Oklahoma City, adults participate...

This article provides perspectives about mentorship of undergraduate mentees from directors of formal, externally-funded training programs within the context of the one of the most ethnically diverse national universities. The authors reflect about their mentorship of first generation and underrepresented undergraduate students and offer recommenda...

Background: TV viewing has been associated with children's weight status and is thought to be mediated mostly through children's dietary intake. However, the mechanisms underlying this association are not understood. Objective: Assess the associations of having the TV on and the child watching TV during dinners with the dietary quality consumed...

Objectives To examine the association between neighborhood social cohesion and sleep duration among Latinos, and whether this association varies by Latino subgroup. Design We used cross-sectional data from the 2013–2015 National Health Interview Survey (NHIS) on 13,537 Latino adults aged ≥18 years originating from 5 countries/regions (i.e. Latinos...

C-peptide, insulin, leptin, and other metabolic hormones are assumed to play roles in breast cancer development; though, results are inconsistent. In this prospective case-control study nested within the Mano a Mano Cohort Study, we assessed the risk of breast cancer with regard to plasma levels of c-peptide, gastric inhibitory polypeptide, insulin...

Objective: In this study, we examined neighborhood social cohesion (NSC) as a moderator in the association between neighborhood walkability and meeting the aerobic physical activity guideline among US Latino adults. Methods: We used 2015 National Health Interview Survey cross-sectional data from 4525 adult US Latino participants ≥18 years of age. N...

C-Reactive protein (CRP) is a well-known inflammatory marker, and elevated CRP levels has been reported to be associated with the risk of various cancers. To date, no study has investigated the association between elevated CRP and incidents of cancer among Mexican Americans. In the current prospective cohort study, we measured pre-diagnostic CRP le...

The Comprehensive Feeding Practices Questionnaire (CFPQ)is an important measure to assess parent feeding practices as it encompasses a broad range of feeding behaviors, not just behaviors negatively associated with child weight outcomes. However, parent feeding practices have been shown to differ across ethnicities and the CFPQ has not been tested...

Objectives: Among domiciled samples, racial discrimination is a known stressor linked with poorer quality of life. However, homeless adults may be particularly vulnerable to discrimination due to multiple factors beyond race. In this study, we characterized perceived discrimination and its reported impact on quality of life in a sample of adults wh...

Background: There are evidence of intimate partner violence (IPV) and food insecurity (FI) as independent predictors of maternal depressive symptoms. However, there are a dearth of studies that have examined how both IPV and FI influence depressive symptoms. The objective of this study was to determine whether IPV, food insecurity, or the combined...

Introduction: Research has consistently identified the health benefits of physical activity (PA) and that low-income populations engage in less PA than their more affluent counterparts and may differ by gender. However, research has focused on leisure time PA (LTPA) with less emphasis on PA engagement from employment and transportation. This study...

Introduction: Higher frequency of seeing others exercise is associated with higher leisure-time (LT) physical activity. However, few studies have examined the association between frequency of seeing people walk within sight of home and LT walking among Latino adults. Moreover, the extent to which neighborhood social cohesion mediates the relationsh...

Introduction: There is a dearth of research on the determinants of food insecurity among adults who experience homelessness. According to cumulative risk theory, it is the accumulation of risk factors that places individuals in jeopardy for negative health consequences. Building on the cumulative risk theory, domain specific indices were created t...

Objectives: In this study, we examined the prevalence of modifiable health risk factors (eg, smoking, unsafe sexual practices, at-risk drinking, low fruit/vegetable consumption, inadequate physical activity, and overweight/obesity) and readiness to change among homeless adults in Oklahoma City, OK. A secondary aim was to examine the relationship be...

Food insecurity is associated with mental health outcomes among adults experiencing homelessness. Different theoretical explanations have emerged to account for the negative health outcomes among vulnerable populations. The neomaterial theoretical perspective suggests that nutritional deficiencies from experiencing food insecurity are related to ne...

Positive associations have been found between adherence and weight loss in behavioral weight-management interventions. However, less attention has been given to the level of adherence needed to reach clinically significant weight loss. This study examined the levels of adherence associated with a ≥ 5% – < 10% or ≥ 10% weight loss in a community-bas...

BACKGROUND Research shows that elementary students gain weight over the summer. It is unknown if these findings apply to Hispanic adolescents. We evaluated school and summer standardized body mass index (zBMI) changes in Hispanic middle school students. METHODS Hispanic middle school students were randomly assigned to a weight management program (...

Purpose of Review This article examines how nutritional status is treated throughout the lifecycle. In doing so, the review identifies promising life stages during which intervention may improve nutritional status of future generations. Recent Findings A life course perspective suggests that nutritional changes are most likely to be sustained when...

Background: Parent feeding styles have been linked to child weight status across multiple studies. However, to our knowledge, the link between feeding styles and children's dietary quality, a more proximal outcome, has not been investigated. Objective: The purpose of this study was to examine the relation between parent feeding styles and dietar...

Objectives In this study, we examined how self-reported health is related to low-income, Hispanic women's underestimation and concerns of weight status. Methods Seventy Hispanic women from Houston-area community centers reported their perceptions and concerns about their weight and health. Height and weight were measured to calculate body mass inde...

We examined use of a farmers’ market that leverages community partnerships to provide free produce to lower-income persons. Participants (n = 422) were asked to complete a questionnaire and given an ID number, which was used to track market use from 2014 to 2015. Chi square tests were used to examine associations between 2014/2015 market use and re...

Purpose: Health-related quality of life (HRQoL) is a multidimensional assessment of well-being and health status. Most previous work in this area assumes that HRQoL is a homogenous construct; however, it is possible HRQoL subgroups may exist. The purpose of the study was to characterize common classes of HRQoL among adult, homeless smokers, a part...

Introduction: Neighborhood walkability and neighborhood social cohesion have been shown to contribute to physical activity. However, limited research has examined neighborhood social cohesion as a moderator in the association between neighborhood walkability and aerobic physical activity among Latino adults. We examined associations of neighborhood...

While HIV disproportionately impacts homeless individuals, little is known about the prevalence of HIV risk behaviors in the southwest and how age factors and HIV risk perceptions influence sexual risk behaviors. We conducted a secondary data analysis (n = 460) on sexually active homeless adults from a cross-sectional study of participants (n = 610...

The high prevalence rate of childhood obesity and its related comorbidities is a public health concern. In this chapter, the population-level and developmental trends in childhood obesity are described. In addition, the measurement guidelines and methodologies that have been developed to assist with identifying children at-risk for obesity are disc...

Hispanics are disparately affected by diabetes. Treating socioeconomically disadvantaged Hispanics is challenging due to economic and cultural barriers. Health care providers must understand that cultural beliefs about medicine and disease may have an impact on how diabetes treatment is viewed. Concepts such as susto (fright), coraje (anger), and f...

Objectives: To determine the degree of parent-adolescent concordance in reported household food security, and delineate variation in concordance as a function of selected household and parent-adolescent relationship characteristics. Methods: Cross tabulations and Cohen’s Kappa determined concordance. Multinomial logistic regressions delineated vari...

Introduction Promotoras, Hispanic community health workers, are frequently employed to promote health behavioral change with culturally bound Hispanic lifestyle behaviors. Peer health mentors have been used in schools to promote healthy nutrition and physical activity behaviors among students. This study investigates the efficacy of combining these...

Background: There are variable recommendations regarding initiating monotherapy or dual therapy in patients with newly diagnosed type 2 diabetes (T2D). Clear initial strategies are of particular importance in underserved settings where access to care and financial burdens are significant barriers. Objectives: To provide descriptive data of metab...

Purpose: The purpose of this study was to identify characteristics associated with maternal concerns for her child becoming overweight, and how these concerns are related to her perceptions of her child's weight. Design: A school-based sample of 55 children and their mothers from Houston, Texas, participated in a cross-sectional survey. Mothers...

Individuals commonly seek help for problem health behaviors, such as excessive drinking, smoking, and weight gain. Yet there is a high rate of recidivism in these behaviors because outcome expectancies are either too high, negative outcome expectancies are not considered, or outcome expectancies are not properly addressed. Health care providers are...

Objective: We examined sex and race/ethnicity differences in the association between food insecurity status and prediabetes among adults. Method: We used cross-sectional 2011 and 2012 National Health Interview Survey data on non-Hispanic white, non-Hispanic black, and Hispanic adults aged 18-59 years whose household income was ≤ 299% Federal Pov...

The majority of the food insecurity-obesity research has indicated a positive association among women, especially minority women. Less research has been conducted on men, and the findings are inconsistent. The aim was to assess whether gender and race/ethnic disparities exists between the food insecurity and overweight/obesity relationship among ad...

Study design: Cross-sectional. Objectives: To determine whether frequency of training is related to self-reported lower psychological distress, defined as depressive symptomology and perceived stress, among the US male wheelchair rugby athletes with tetraplegia. Setting: United States. Methods: Survey data were collected on a convenience sam...

Objective: Risk behaviors associated with food insecurity, such as smoking, are a concern. This study examined a potential mechanism that links smoking and food insecurity. Methods: A community sample of 238 adults from Dallas, Texas participated in a cross-sectional survey. Smoking status was self-reported and biochemically-verified. The Financial...

Background: Obesity and obesity-related comorbidities are increasing among older adults. Food insecurity is a nutrition-related factor that coexists with obesity among low-income individuals. The majority of the research on the food insecurity-obesity paradox has been conducted on low-income mothers and children, with research lacking on large div...

Pre-pregnancy maladaptive eating behaviors have predicted inadequate or excess gestational weight gain and poor dietary intake during pregnancy, but little is known about effects of pre-pregnancy adaptive eating behaviors on pregnancy outcomes. The purpose of this study was to produce a valid and reliable measure of adaptive pre-pregnancy eating be...

Emotional eating, or eating in response to negative emotions rather than internal hunger cues, has been related to many maladaptive eating patterns that contribute to weight gain and obesity. The parent feeding practice of use of food as a reward is positively associated with children emotionally overeating. Yet, little is known as to the potential...

The cornerstone to successful aging is maintaining a consistent physical activity routine and healthy diet. This is particular important for aging adults to preserve their independence. However, for low-income aging adults there are significant individual and environmental barriers that reduce their ability to maintain a healthy lifestyle. Understa...