Health-promoting lifestyles of English-speaking and Spanish-speaking Mexican-American migrant farm workers

The effect of individual factors on health behaviors among college students: the mediating effects of eHealth literacy

BACKGROUND

College students' health behavior is a topic that deserves attention. Individual factors and eHealth literacy may affect an individual's health behaviors. The integrative model of eHealth use (IMeHU) provides a parsimonious account of the connections among the digital divide, health care disparities, and the unequal distribution and use of communication technologies. However, few studies have explored the associations among individual factors, eHealth literacy, and health behaviors, and IMeHU has not been empirically investigated.

OBJECTIVE

This study examines the associations among individual factors, eHealth literacy, and health behaviors using IMeHU.

METHODS

The Health Behavior Scale is a 12-item instrument developed to measure college students' eating, exercise, and sleep behaviors. The eHealth Literacy Scale is a 12-item instrument designed to measure college students' functional, interactive, and critical eHealth literacy. A nationally representative sample of 525 valid college students in Taiwan was surveyed. A questionnaire was administered to collect background information about participants' health status, degree of health concern, major, and the frequency with which they engaged in health-related discussions. This study used Amos 6.0 to conduct a confirmatory factor analysis to identify the best measurement models for the eHealth Literacy Scale and the Health Behavior Scale. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health behaviors. Additionally, causal steps approach was used to explore indirect (mediating) effects and Sobel tests were used to test the significance of the mediating effects.

RESULTS

The study found that perceptions of better health status (t520=2.14-6.12, P<.001-.03) and greater concern for health (t520=2.58-6.95, P<.001-.003) influenced college students' development of 3 dimensions of eHealth literacy and adoption of healthy eating, exercise, and sleep behaviors. Moreover, eHealth literacy played an intermediary role in the association between individual factors and health behaviors (Sobel test=2.09-2.72, P<.001-.03). Specifically, higher levels of critical eHealth literacy promoted students' health status and their practice of multiple positive health behaviors, including eating, exercise, and sleep behaviors.

CONCLUSIONS

Because this study showed that eHealth literacy mediates the association between individual factors and health behaviors, schools should aim to enhance students' eHealth literacy and promote their health behaviors to help them achieve high levels of critical eHealth literacy. Although some of the study's hypotheses were not supported in this study, the factors that influence health behaviors are complex and interdependent. Therefore, a follow-up study should be conducted to further explore how these factors influence one another.

Validation of the Health-Promoting Lifestyle Profile II for Hispanic male truck drivers in the Southwest

The aims of the study were to validate the English and Spanish Versions of the Health-Promoting Lifestyle Profile II (HPLP II) with Hispanic male truck drivers and to determine if there were any differences in drivers' responses based on driving responsibility. The methods included a descriptive correlation design, the HPLP II (English and Spanish versions), and a demographic questionnaire. Fifty-two Hispanic drivers participated in the study. There were no significant differences in long haul and short haul drivers' responses to the HPLP II. Cronbach's alpha for the Spanish version was .97 and the subscales alphas ranged from .74 to .94. The English version alpha was .92 and the subscales ranged from .68 to .84. Findings suggest the subscales of Health Responsibility, Physical Activities, Nutrition, and Spirituality Growth on the HPLP II Spanish and English versions may not adequately assess health-promoting behaviors and cultural influences for the Hispanic male population in the southwestern border region.

A comparative study of health-promoting lifestyles in agricultural and non-agricultural workers in Japan

OBJECTIVES

To clarify the difference in health-promoting lifestyles between agricultural and non-agricultural workers in Japan, a cross-sectional study was conducted on 627 residents living in a town with a mixed rural-urban population.

METHODS

The subjects were divided into 8 groups by job (agricultural and non-agricultural), age (young and old), and gender (male and female). To evaluate the subjects' lifestyles, the Health Promoting Lifestyle Profile II (HPLP-II) was applied. The Bartlett test and the Kendall rank test were performed for statistical analysis.

RESULTS

There was no significant difference in the overall score of the HPLP-II between the two job groups. However, for the HPLP-II subscales, a significantly higher score for "spiritual growth" and a significantly lower score for "physical activity" were seen in the agricultural group than in the non-agricultural group. In general, the old and female groups showed higher scores than the corresponding groups, regardless of job type.

CONCLUSIONS

It was determined that the major countermeasures to maintain a healthy lifestyle in agricultural workers should be associated with how to introduce daily activities that maintain and enhance "spiritual growth" and improve "physical activity".

Health promotion in nurses: is there a healthy nurse in the house?

The purpose of this pilot study was to examine the health-promoting lifestyle behaviors of acute-care nurses using the Health Promotion Model. Statistical analysis of 149 returned Health-Promoting Lifestyle Profile II surveys indicates areas of weakness in stress management and physical activity. No significant difference is found between unit, demographic factors, and subscale scores at the p < .01 level, but medical-surgical nurses consistently scored better than the critical-care nurses in health promotion. Findings support the need for the development of holistic nursing interventions to promote self-care in the identified areas. Strategies include educational/experiential classes in holistic nursing; individualized unit-based activities fostering stress management, such as massage, reflexology, and imagery; and development of an employee wellness program.

A health protection model for Hispanic adults with Type 2 diabetes

AIMS

The Hispanic Health Protection Model (HHPM) was designed to assist practitioners' systematic assessment of Hispanic people to establish baselines and evaluate the success of early diabetes treatment. This article provides the research basis of the HHPM and related assessment tools.

BACKGROUND

The treatment of diabetes incorporates lifestyle change, and this adjustment is particularly important to follow with vulnerable groups. One such group is the Hispanic population, since the impact of diabetes is greatest on economically disadvantaged segments of this population, who suffer disproportionately higher Type 2 diabetes prevalence and higher levels of morbidity and mortality as compared with other populations. Traditional Hispanic health beliefs are often in conflict with Western medicine, so the adjustments to the lifestyle demands of this disease need to be evaluated.

METHODS

To understand this discrepancy fully in patient outcomes, a culturally sensitive assessment framework was developed based on health protection theories and research with Hispanic people with diabetes and, based on this framework, assessment tools were translated for use during interviews with low literacy, Spanish-speaking patients.

CONCLUSIONS

The HHPM translated measures of premorbid lifestyle, health beliefs, support, self-efficacy, quality of life, knowledge of diabetes, and physiological parameters can be used during consecutive clinic visits during the first six months of therapy to map the success of patients' understanding of and psychological adjustment to diabetes.

RELEVANCE TO CLINICAL PRACTICE

The HHPM is a culturally-relevant, systematic, and holistic approach to assessing adjustment of Hispanic people to a new diagnosis of diabetes, including their psychological, cognitive, and physiological outcomes. Using this type of systematic approach will allow practitioners to target barriers to therapy, such as a lack of self-efficacy or incomplete knowledge of the disease and its treatment in a strategic manner to improve patient success in managing the complex lifestyle changes of diabetes mellitus.

Health promoting behaviors and factors related to lifestyle among Turkish workers and occupational health nurses' responsibilities in their health promoting activities

The purposes of this study were to describe health-promotion lifestyle profile of 264 Turkish workers, to determine the factors which affect their lifestyle and to describe occupational health nurses' responsibilities in their health promoting activities to compare their profile with those published from other studies using Health-Promoting Lifestyle Profile. This is a descriptive study. Study was conducted in a food industry. 530 workers are working in this workplace. Approximately fifty percent of the workers participated in this study. The convenience sample composed of 264 workers. Data were collected using a questionnaire about socio-demographic features developed by the investigators and Health Promoting Lifestyle Profile developed by Walker et al. Subscales with the highest means in this study were interpersonal support and self-actualization. Compared to workers reported from other studies, Turkish workers got low scores of self-actualization, nutrition, interpersonal support and stress management. There was no statistically significant difference between total scores and gender, marital status and education. However, there was a statistically significant difference between age and exercise and nutrition. Moreover, as income increased, so did health promoting behaviors. There was a statistically significant difference between perceived health status and importance placed on health and overall health promoting life style and each health promoting behavior. It is important that occupational health nurses identify health behaviors, perceived health status and cultural aspects likely to affect health behaviors among workers. Thus, they may develop effective tools to protect and promote workers' health.

Health promotion behaviors of Gujurati Asian Indian immigrants in the United States

The purpose of this paper was to examine the health promotion behaviors of Asian Indians, one of the fastest-growing immigrant groups in the United States. The sample consisted of 261 respondents randomly selected from the Charotar Patidar Samaj, a national Gujarati Association membership directory. Health promotion behaviors were obtained using the Health Promotion Lifestyle Profile II. Respondents demonstrated lower scores in physical activity and nutrition and higher scores in the areas of interpersonal skills and spiritual growth domain of the health promotion behaviors. Physical inactivity was the highest among adults of 25-50 years of age. A significant difference existed between males and females in the domain of health responsibility. Females were more responsible for their health and reported medical problems to a physician more often than their male counterparts. They also educated themselves about health promotion behaviors through reading and watching TV programs. Study results support previous research findings and make an important contribution to understanding the Asian Indian's health-promoting lifestyle behaviors.

A Preliminary Study of a Health-Promoting Lifestyle Among Southeast Asian Women in Taiwan

The purpose of this study was to determine and understand the predicting factors of a health-promoting lifestyle (HPL) in Southeast Asian women in Taiwan. One hundred and five Southeast Asian women in Tainan were recruited. Face-to-face interviews with structured questionnaires were used for data collection. The findings showed that, among the six dimensions of HPL, subjects scored highest in self-actualization and lowest in health responsibility. Subjects who could read and write Chinese had a more positive HPL; stepwise regression analysis revealed that the ability to read Chinese could explain 26.2% of the total variance of HPL in Southeast Asian women. The results of this study can help health care professionals understand the HPL and to design appropriate health-promoting educational programs to improve the well-being and overall quality of life of Southeast Asian women in Taiwan.

A Comparison of Health Practices of Canadian and Jordanian Nursing Students

The purpose of this study was to compare health-promoting practices of Canadian (n = 49) and Jordanian (n = 44) first-year nursing students using the revised Health-Promoting Lifestyle Profile II. Results indicated significant differences between the groups on three subscales: health responsibility, physical activity, and interpersonal relations; however, both groups had similarly low scores. Implications for nurse educators are discussed from both curricular and cross-cultural perspective that focuses on health-promotion activities and programs.

Health-promoting lifestyle behaviors of Spanish-speaking Hispanic adults

The study purpose was to determine (a) health-promoting lifestyle behaviors of Spanish-speaking Hispanics, (b) differences in these behaviors by demographics and acculturation, and (c) the extent to which perceived health status, demographics, and acculturation explain health-promoting lifestyles. The Spanish-language Health-Promoting Lifestyle Profile II (HPLPII) and other instruments were completed by a convenience sample of 545 Hispanic adults recruited in several midwestern communities. Of the six behavioral dimension scores of the HPLPII, scores were lowest for physical activity and highest for spiritual growth. They differed by age, gender, employment status, marital status, and acculturation. Perceived health status, demographics, and acculturation explained 12% of the variance in overall health-promoting lifestyle. These findings can help guide culturally appropriate interventions designed to improve this population's overall health.

Health perceptions of Mexican American women

This article describes the health perceptions of a sample of moderately to highly acculturated Mexican American women. Using an ethnographic design, the author interviewed 13 women to determine their health perceptions. The interviews were guided by the domains of health described in the World Health Organization (WHO) definition of health. Three broad categories of health perceptions were identified: the physical body, the emotional component, and finding balance. With the addition of a spiritual component, the WHO definition was a useful tool for uncovering health perceptions. The process of in-depth ethnographic interviewing provided a contextual view of health in which the complexity of intrafamilial relationships was revealed, as were the importance of spirituality as a coping mechanism and the perception of health as an integrated, holistic experience.

The health-promoting lifestyles of undergraduate nurses in Hong Kong

Based on Pender's health promotion model in 1987, this descriptive study of 169 undergraduate nurses in Hong Kong was undertaken to determine any differences in their health-promoting lifestyles, as measured by the Health Promoting Lifestyle Profile II (HPLP II) among different age groups, gender, income, employment status, and levels in undergraduate nursing education. The student nurses performed best in interpersonal relations but worst in physical activity. There were significant differences among the various classes in stress management and spiritual growth, with senior classes (Years 3 and 4) reporting worse in both areas. This was particularly remarkable among the students of the final year, who would soon be graduating as staff nurses and were expected to inspire patients to practice health-promotive behaviors by their example. The older age group also had lower scores in stress management and exercise practice. Because most of the students in the senior classes were older, the findings further reinforce the earlier results. It was also identified that more than half of the students were supported on low parental income with many of them working a part-time job. These outcomes were explored with future recommendations made to improve the weaknesses in the students' health-promoting lifestyles.

An Arabic language version of the health promotion lifestyle profile

The purpose of this study was to assess the validity and reliability of an Arabic version of the Health-Promoting Lifestyle Profile instrument in Jordan, whose society and culture differ from that of North America, where the instrument was developed. The instrument was translated into Arabic, back-translated, and pilot tested to ascertain cultural sensitivity. The Arabic version was then evaluated using a convenience sample of 950 adults in the northern part of Jordan using a principal components factor analysis. The order of factors was not entirely identical to those isolated previously during the psychometric assessment of the English language version. Only the structure of three factors--self actualization, health responsibility--and exercise were the same as those obtained in the English version. The forced, six factor solution explained only 39.3% of the variance in the measure. The alpha reliability coefficients were 0.89 for the total scale and ranged from 0.85 to 0.60 for the subscales. It was concluded that the Arabic version of the Health-Promoting Lifestyle Profile has demonstrated initial reliability and validity. Further testing is recommended.

Community assessment in a suburban Hispanic community: a description of method

The Hispanic population is growing rapidly and is composed of individuals from many countries with varying levels of acculturation, education, income, and citizenship status. The Genesis Health and Empowerment Program was developed locally in 1993 to improve the health status of Hispanics living in Des Plaines, Illinois, USA. Understanding the quality of life and its cultural patterning for the community is an essential aspect of planning and implementing a health care delivery program. Using Leininger's Theory of Culture Care: Diversity and Universality as a framework, adapted the Concerns Report Method was essential for data collection. This paper describes the method used for learning about the Hispanic community. Steps included conducting three focus groups, constructing a structured interview guide, collecting data, analyzing data, and reporting the findings to the community. Some very preliminary findings are presented and implications for transcultural health care are described.

Correlates of health-promotion activities in employed Mexican American women

The purposes of this study were to describe the health-promoting lifestyle behaviors of 397 employed Mexican American women and to compare them with women in other published reports that used the Health-Promoting Lifestyle Profile (HPLP). Mexican American women had the highest HPLP total scores of all minority groups, but lower scores than all predominantly White groups. HPLP self-actualization and interpersonal support were the highest subscale scores. The exercise subscale was the lowest score for all groups, including minorities. Canonical analysis revealed two significant canonical variate pairs explaining 88% of variance. Age, education, self-efficacy, health locus of control (internal and powerful others), and current health status made statistically significant contributions to all HPLP subscale scores. Study results support previous research findings and make an important contribution to understanding the factors that influence Mexican American women's health-promoting lifestyle behaviors.

Determining the adequacy of a health promotion self-care interview guide with healthy, middle-aged, Mexican American women: a pilot study

The Hispanic/Latino population is the second largest and fastest growing minority in the United States, with Mexican Americans comprising 60.4% of the total. Existing research instruments and procedures must be made culturally specific, both theoretically and empirically, for use with this population. Our purpose in the present study was to determine whether one part of the Health Promotion Self-Care Interview Guide (HPSCIG), developed to identify self-care actions that promote well-being in healthy, middle-aged Anglo American and African American women (Hartweg, 1991, 1993), was culturally sensitive for use with Mexican American women. This was a necessary step before the full HPSCIG was translated into Spanish for a larger bilingual study. Twenty Mexican American women identified 232 self-care actions they took to promote well-being as they defined it. More than 81% of the self-care actions were performed to meet the universal self-care requisites, 11% were performed to meet the developmental requisites of middle-age, and 2% were performed to meet health deviation self-care requisites. Six percent of the actions could not be classified using the theoretical coding scheme. Inherent in the study were questions about the congruence and relevance of self-care as a concept in this population. The findings support the use of the HPSCIG with healthy, middle-aged Mexican American women.

Determinants of health-promoting lifestyles in older persons

The purpose of this study was to determine the degree to which selected components derived from Pender's Health Promotion Model (1982) explained engaging in health promotion practices in a sample of 477 persons 65 years and older. One directional hypothesis was tested using canonical correlation analysis. Three significant canonical variates were demonstrated, explaining 88.7 percent of variance. Older healthy persons with high self-esteem and internal locus of control reported practicing five of the six health promotion strategies. Men with higher income and self-esteem but poorer health less often exercised or ate well. Older married subjects with higher incomes who were internally controlled were more likely to engage in exercise, health responsibility and stress management but not in interpersonal support. Findings provide direct multivariate support for the additive nature of the relationships posited in the Health Promotion Model.