Factors affecting health promotion behaviors among Korean immigrant women at midlife

Abstract

There are many areas of women's health at midlife in which little is known, such as their health promotion practices and the subsequent effects on their health and longevity. The purpose of this study was to describe the health promotion behaviors of Korean immigrant women at midlife. It examined the relationships among midlife changes, role quality, resources (income, time in the U.S., English proficiency, health care coverage, health services use), knowledge of midlife health, reflection on midlife and health, and health promotion behaviors (lifestyle, health screening, current health practices). The study employed a cross-sectional survey design of 120 Korean immigrant women between 45 to 64 years of age living in Los Angeles County, who were not pregnant and had not had a hysterectomy. Women were recruited from a community health survey list, a health and social services clinic, and a church-sponsored group. They participated by one of three methods: mail survey, phone interview, or face-to-face interview. A subset of 26 women also participated in an exploratory qualitative interview. These women answered additional questions on reflection on midlife and barriers/facilitators to health promotion. Role integration, English proficiency, time in the U.S., health care coverage, and income were significant predictors of reflection on midlife. Role integration, English proficiency, and income were significant predictors of reflection on health. Use of health services and health care coverage were significant predictors of health promotion behaviors. Regardless of menopausal status or whether school-aged dependent children were in the household, women listed mental/psychological health, religious faith, exercise, and regular checkups as most important for midlife women in general. For Korean immigrant women like themselves, however, priorities shifted to the need for free or low cost health services, information on health problems, services available in the community, more time for themselves, and ways to increase their motivation to attend to their health. In order to affect women's reflection on midlife and health and encourage more health promotion practices, nursing interventions must facilitate women's sense of role integration and their access to resources. These will be more influential than interventions focused on assessing midlife changes or increasing knowledge.