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OBJECTIVES: The objectives of this analysis were to 1) estimate prevalence of contraceptive use among women at risk for unintended pregnancy and 2) identify correlates of contraceptive use among women with ongoing or potential need for contraceptive services in Puerto Rico during the 2016 Zika virus (ZIKV) outbreak. STUDY DESIGN: We conducted a cell-phone survey July-November, 2016. Women aged 18-49 years living in Puerto Rico were eligible. We completed 3059 interviews; the overall response rate was 69.2%. After weighting, the data provide population-based estimates. For this analysis, we included women at risk for unintended pregnancy, and assessed ongoing or potential need for contraceptive services in this group, excluding women using permanent contraceptive methods. RESULTS: Most women reported using contraception (82.8%), and use increased with age. Female sterilization and male condoms were most frequently reported (40.8% and 17.1%, respectively). Among women with ongoing or potential need for contraceptive services, 24.7% talked to a healthcare provider about ZIKV, and 31.2% reported a change in childbearing intentions due to ZIKV. Most women were at least a little worried about getting infected with ZIKV (74.3%) or having a baby with a birth defect (80.9%). Being very worried about getting infected with ZIKV and already having Zika were significantly associated with use of any contraception (adjusted prevalence ratio: 1.19, 95% CI: 1.03-1.38 and 1.32, 95% CI: 1.01-1.72, respectively). CONCLUSIONS: These findings underscore the need for regular contraceptive prevalence studies to inform programs about contraceptive needs, especially during public health emergencies. IMPLICATIONS: When the 2016 Zika virus outbreak began in Puerto Rico there were no recent population-based data available on contraceptive prevalence. To fill this information gap, we conducted a population-based survey. Our findings provided baseline contraceptive prevalence estimates to support response planning and allocation of health resources.

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OBJECTIVES: This article examines the impact of disability, cognitive status, and social support on nursing home use in a sample of older Mexican Americans. METHOD: We used four waves of the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE), a longitudinal study of 3,050 older Mexican Americans living in the Southwest initially contacted in 1993 to 1994. RESULTS: The findings reveal that advanced age, being a man, activities of daily living disability, and cognitive impairment are strong predictors of institutionalization and death. Living with family, arriving in the United States in late life, and access to social support independently decreased the probability of dying in a nursing home. DISCUSSION: Although it is clear that adequate social support can make it possible for an impaired older person to remain in the community serious impairment can eventually overwhelm even a supportive network and result in the institutionalization of an impaired older person.

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OBJECTIVES: To measure prevalence and characteristics of urinary incontinence in older Mexican-American women. DESIGN: Cross-sectional analysis of a longitudinal survey of a representative sample of older Mexican Americans. SETTING: Five southwestern states in the United States. PARTICIPANTS: A total of 1589 Mexican-American women, aged 65 and older who were part of the Hispanic Established Population for the Epidemiologic Study of the Elderly. MEASUREMENTS: Self-reported psychosocial, demographic, and health variables; self-reported history of symptoms of urinary incontinence. RESULTS: Two hundred thirty-nine (15%) of the 1589 Mexican-American women reported having urinary incontinence. Almost 33% reported urge incontinence symptoms, 10% reported stress incontinence symptoms, and 42% had symptoms suggestive of mixed incontinence. Thirty-five percent of subjects reported incontinence episodes with moderate to large amounts of urine loss, and 15% reported that their urinary symptoms kept them from engaging in social activities. Age and body mass index were risk factors for incontinence (P=.02 and P=.03, respectively). CONCLUSION: This is the first community-based survey examining rates of urinary incontinence in Mexican-American women. The prevalence of urinary incontinence may be lower in older Mexican-American women than in the general population. They may also have a higher percentage of urge as opposed to stress incontinence symptoms and may suffer from moderate to large volumes of urine loss associated with their incontinence episodes.

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OBJECTIVE: To determine sociodemographic characteristics associated with the initial presentation of Mexican-American elders to a community-based memory evaluation clinic. METHODS: Retrospective review of the charts of 89 Mexican Americans presenting consecutively to an outpatient memory evaluation clinic in San Antonio, Texas. PRINCIPAL FINDINGS: Mexican Americans presented for evaluation with more moderate-to-severe cognitive impairment than previously reported. They also tended to have high levels of IADL (83.1%) and gait/balance (52.3%) impairment, as well as high levels of depressive symptoms (63.1%). CONCLUSIONS: Mexican Americans present for initial evaluation for memory decline with moderate-to-severe cognitive decline and significant dementia-associated co-morbidities. In Mexican Americans, caregiver burden, fall risks, depressive symptoms, and need for IADL support should be addressed on the initial visit for memory decline.

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