Arlene Miller

The Effect of a Couples Intervention to Increase Breast Cancer Screening Among Korean Americans

PURPOSE/OBJECTIVES To assess the efficacy of Korean Immigrants and Mammography-Culture-Specific Health Intervention (KIM-CHI), an educational program for Korean American (KA) couples designed to improve mammography uptake among KA women. DESIGN A two-group cluster randomized, longitudinal, controlled design. SETTING 50 KA religious organizations in the Chicago area. SAMPLE 428 married KA women 40 years of age or older who had not had a mammogram in the past year. The women and their husbands were recruited from 50 KA religious organizations. METHODS Couples were randomly assigned to intervention or attention control groups. Those in the KIM-CHI program (n = 211 couples) were compared to an attention control group (n = 217 couples) at baseline, as well as at 6 and 15 months postintervention on mammogram uptake. MAIN RESEARCH VARIABLES Sociodemographic variables and mammography uptake were measured. Level of acculturation was measured using the Suinn-Lew Asian Self-Identity Acculturation Scale. Researchers asked questions about healthcare resources and use, health insurance status, usual source of care, physical examinations in the past two years, family history of breast cancer, and history of mammography. FINDINGS The KIM-CHI group showed statistically significant increases in mammography uptake compared to the attention control group at 6 months and 15 months postintervention. CONCLUSIONS The culturally targeted KIM-CHI program was effective in increasing mammogram uptake among nonadherent KA women. IMPLICATIONS FOR NURSING Nurses and healthcare providers should consider specific health beliefs as well as inclusion of husbands or significant others. They also should target education to be culturally relevant for KA women to effectively improve frequency of breast cancer screening.

Regional Differences in Physical Appearance Identity Among Young Adult Women in Thailand

Physical appearance concerns lead to serious health compromising behaviors among women in Thailand. The purpose of this study was to examine differences in physical appearance identity among young women in four regions of Thailand based on 30 physical appearance characteristics generated and validated in two previous samples of young Thai women. Using Q methodology, 200 Thai young women sorted the physical appearance characteristics in terms of importance. Across-region differences exist for the most important physical appearance characteristics. Regional differences in physical appearance identity may explain the variety of behaviors used by Thai women to enhance their physical appearance. Further research should focus on regional factors that contribute to these aspects of physical appearance becoming a dominant source of self-definition so that effective prevention strategies can be developed and targeted to women at high risk.

Effects of a 12 week self-managed stretching program among Korean–Chinese female migrant workers in Korea: A randomized trial

AIM The purpose of this study was to assess the efficacy of a 12 week, self-managed, community-based stretching program on musculoskeletal fitness, musculoskeletal symptoms, and acculturative stress, in Korean-Chinese female migrant workers in Korea. METHODS This was a randomized controlled trial with random assignment of eligible full-time Korean-Chinese female migrant workers to a stretching exercise intervention (n=40) or an enhanced stretching exercise intervention (n=40) condition. Both conditions received a 6 min stretching exercise program that included an orientation and three work-related musculoskeletal disorder (WMSD) educational classes. Between educational classes, the enhanced stretching exercise condition also received mobile phone text messaging and telephone counseling to increase self-efficacy (confidence in overcoming barriers) and provide social support. Flexibility, muscle strength, musculoskeletal symptoms, and acculturative stress were assessed at baseline and 12 weeks. RESULTS Significant increase in flexibility was noted for both conditions, but acculturative stress was significantly reduced only in the standard intervention condition. Muscle strength and WMSD symptoms had no significant changes at the 12 week follow up in both conditions. CONCLUSION The 12 week, self-managed, community-based, stretching exercise program was effective to increase flexibility. The standard stretching intervention without any enhancements may be a more cost-effective way to increase flexibility. Longitudinal studies, however, are needed to see if the long-term effects are greater in the enhanced intervention for the migrant worker population.

Retention of African American Women in a Lifestyle Physical Activity Program.

The purpose of the article is to examine how well individual characteristics, neighborhood characteristics, and intervention participation predict study retention and staff level of effort needed for retention, using a cohort of African American women enrolled in a physical activity program. Secondary data analysis was conducted from a randomized clinical trial. Participants were aged 40 to 65 years without major signs/symptoms of cardiovascular disease. Assessments were conducted at community sites in/bordering African American communities. Study retention was 90%. Of those retained, 24% required moderate/high level of staff effort for retention. Retention was predicted by being older, having lower perceived neighborhood walkability, living in neighborhoods with greater disadvantage and crime, and having greater program participation. More staff effort was predicted by participants being younger, having more economic hardships, poorer health, or lower intervention participation. We may be able to identify people at baseline likely to require more staff effort to retain.

Multilevel determinants of common mental disorders in migrant and non-migrant wives in Tajikistan

ABSTRACT The purpose of this study was to investigate common mental disorders among Tajik migrant and non-migrant wives in a primary care centre. Using a cross sectional design, quantitative surveys using standard questionnaires were administered to 300 married Tajik women aged 18–45 in Dushanbe. Descriptive and multivariate analyses described the demographic and mental health patterns, and comparison of key sub-groups, using Chi-square, t-test and regression. A total of 26% of women in primary care had moderate or severe depression, 17% had moderate or severe anxiety and 20% had moderate or severe post-traumatic stress disorder (PTSD). Lifetime physical or emotional abuse was reported in 22% and women with lifetime physical or emotional abuse had higher depression, anxiety and PTSD scores. Significant multivariate associations predicted the following risk factors: for depression (R2 = .40): higher number of people you live with, older age of woman, and migrant husband; for anxiety (R2 = .41): more direct trauma and older age of woman; for PTSD (R2 = .48): lower number of people you live with, more direct trauma, older age of woman, higher number of children, non-migrant husband and lifetime emotional or physical abuse. Mental health interventions are needed in primary care settings for women with common mental disorders, including those exposed to trauma and migration.