Psychological Stress and Acculturation Impact on Health Promotion Lifestyle Behaviors' Adoption Among Arab American Women
Repository Posting Date2017-07-26T14:11:20Z
Author DetailsKholoud Hardan-Khalil, PhD, RN; Ahlam Jadalla
Lead Author Sigma AffliationIota Eta
Other Title(s)Psychological Health in Minority Women
Level of EvidenceN/A
Purpose: to explore the association of perceived stress, acculturation, and health promoting behaviors among a group of Arab American Women (AAW) in Southern California.
Methods: A survey study using self-report explored AAW health promoting lifestyle behaviors. The survey was available in Arabic and English languages, participants responded to the questionnaire based on their language preference. Participants responded to the Psychological Stress Measure (PSM-9) (Lemyre & Tessier, 2003), Acculturation Rating Scale of Arab- American II (ARSAA II) (Jadalla & Lee, 2013), and the Health Promotion Lifestyle Profile II (HPLP II) (Walker & Hill-Polerecky, 1995). The PSM-9 consists of 9 items measured on likert scale from 1= not at all to 8= extremely. ARSAAII consists of 30 items, the study sample factor analysis gave two main factors; Arabic acculturation factor (ARF) and American acculturation factor (AMF), the responses are measured on likert scale 1 = “not at all” to 5= “Extremely often, or almost always”. The HPLP II consists of 52 items, it is designed to measure the patterns and frequency of self-reported health-promoting behaviors in six areas: health responsibility (HR), physical activity (PA), nutrition (NU), interpersonal relations (IPR), spiritual growth (SG), and stress management (SM). The scale responses are rated on a 4-point Likert-type scale “1 = never, 2 = sometimes, 3 = often, 4 = routinely”. Descriptive, comparison, and correlational analyses were employed through the Independent samples t-test and Pearson’s Product-Moment Correlations.
Results: A total of 265 women participated, of those 65% responded to the Arabic version of the survey, the participants had age range between 18 and 80 years (M = 38, SD = 13). The length of residency in the U.S. ranged between 1- 47 years (M = 15, SD = 10.15). The majority of the participants were Muslim (95.5%), while Arabic was considered the mother tongue by 93% of participants, only 70 % reported that Arabic was their primary spoken language at home. women completed the Arabic version of the survey reported lower levels of psychological stress compared to women who responded in English language (M= 36.31, SE = .740) t (265)= -3.485, p< .01. Significant correlation found between Acculturation American Factor (AMF) and health promotion lifestyle behaviors II (HPLP II) r = .279, p < 0.01, spiritual growth (SG) r = 0.262, p < 0.01, physical activity (PA) r = 0.326, p < 0.01, interpersonal relations (IPRs) r = 0.302, p < 0.01, nutrition (NU) r = 0.122, p < 0.05, and stress management r = 0.168, p < 0.01. Additionally, significant correlations were found between Acculturation Arabic Factor (ARF) and health promotion lifestyle behaviors II (HPLP II) r = .185, p < 0.01, spiritual growth (SG) r = 0.191, p < 0.01, health responsibility (HR) r = 0.241, p < 0.01, interpersonal relations (IPRs) r = 0.226, p < 0.01, nutrition (NU) r = 0.122, p < 0.05, and stress management r = 0.167, p < 0.05. ARF was negatively correlated with psychological stress measure r = 0.167, p < 0.01. A significant correlations were found between the participants’ length of residency in the U.S. and their responses on HPLP II, PA, SG, and IPRs, r = 0.190, 0.181, 0.177, 0.238 (265) p < 0.01 respectively. However, Physical activity found to be negatively correlated with women completed the Arabic version survey.
Conclusion: Among Arab American women, psychological stress, acculturation and length of residency influence their engagement in healthy lifestyle behaviors. More studies are needed to assess sources and types of stress among AAW. The findings of this study highlight the need for nurses and other health providers to consider the cultural and psychological factors when designing or implementing health promotion and disease prevention programs.