Tsu-Yin Wu

Gender differences in the psychosocial and cognitive correlates of physical activity among taiwanese adolescents: A structural equation modeling approach

This study examined gender differences in the factors related to physical activity in 832 Taiwanese adolescents. Differences in psychosocial and cognitive correlates were noted by gender group. Taiwanese adolescent girls reported lower physical activity self-efficacy and less perceived benefits and more perceived barriers to being active than boys. Girls compared to boys reported significantly more positive social support, modeling, and norms from parents to be active but significantly less social support and norms from their peers. Structural equation modeling was used to test the direct and indirect paths of a model of proposed correlates and physical activity. The results indicated that peer influences had both direct and indirect paths to physical activity for both genders. Among all examined variables, perceived self-efficacy was the strongest correlate of physical activity for these adolescents. The findings of this study provide information relevant to designing physical activity interventions targeted to Taiwanese adolescents.

Factors Influencing Mammography Screening of Chinese American Women

OBJECTIVE To explore factors influencing breast cancer screening behavior among Chinese women residing in the United States. DESIGN A descriptive study guided by the health belief model adapted for Chinese American women. An English-language questionnaire was modified, translated, and pretested before use in the study sample. Data were analyzed using descriptive and multivariate analysis techniques. SETTING An urban area in Michigan in 2001. PARTICIPANTS A consecutive nonprobability sample of 206 Chinese American women age 40 and older. MAIN OUTCOME MEASURE The percentage of women age 40 and older who received a mammogram in the past year. RESULTS Access to health care, perceived barriers to mammography screening, need for breast health care, and information-seeking behavior had direct effects on Chinese American womens mammography screening utilization. Cultural affiliation had an indirect effect on breast cancer screening behavior, moderated through access to health care. The variance in mammography screening explained by these factors was 51%. CONCLUSION Effective strategies for promoting breast cancer screening among Chinese American women should address ways to improve information-seeking behaviors and access to health care. Cultural affiliation and beliefs should be considered when counseling Chinese American women regarding breast cancer screening.

An Integrative Review on Breast Cancer Screening Practice and Correlates Among Chinese, Korean, Filipino, and Asian Indian American Women

Abstract Breast cancer is the leading cancer diagnosed among Chinese, Filipino, and Korean women. Despite the efficacy of breast cancer screening, Asian American women have one of the lowest rates of mammography and clinical breast exam (CBE) of all U.S. ethnic groups. I provided a systematic overview to document factors related to three modalities of breast cancer screening (breast self-exam [BSE], CBE, and mammography) among four subgroups of Asian American women (i.e., Chinese, Korean, Filipino, and Asian Indian). Results showed that the existing studies provided evidence of demographic correlates to screening practice; however, fewer studies focused on cognitive and social–cultural correlates, and limited results were available with Filipino and Asian Indian groups.

A panel study of physical activity in Taiwanese youth: testing the revised health-promotion model.

The rate of inactivity among young people in Taiwan remains high. However, few studies have explored physical activity patterns with a longitudinal approach in this population. Based on the revised health-promotion model, this study used 2-wave panel data to test a structural model of how individual characteristics, cognitions, and interpersonal influences predicted physical activity of Taiwanese adolescents. The findings suggest that gender, social support, modeling, self-efficacy, and perceived benefits and barriers to performing physical activity directly and indirectly influence the behavior of physical activity in Taiwanese adolescents. The hypothesized model explained 25% of the variance in physical activity. The implications for parents and policy are discussed.

Gender Differences in Health Risk Behaviors and Physical Activity Among Middle School Students

Adolescence is a period of accelerated growth and change, bridging the complex transition from childhood to adulthood. This period offers adolescents an opportunity to begin planning for their futures and to adopt healthy attitudes about risk behaviors that can continue into adulthood, thus setting the stage for a lifetime of desirable health behaviors. This study used the Youth Risk Behavior Survey on middle school students and examined the gender differences of health risk behaviors among 674 8th-graders from an urban setting. The results showed that males were more likely to be involved in fights, to initiate alcohol use, and to participate in physical activity; whereas females were more likely to try to lose weight with unhealthy practices, such as fasting and laxatives. School nurses are in a prime position to promote adolescent health in the school setting by providing health-related services and teaching to help students initiate and maintain healthy lifestyles.

Filipino American women's perceptions and experiences with breast cancer screening.

PURPOSE/OBJECTIVES To determine information about Filipino American womens perceptions of breast cancer, the most frequently diagnosed cancer and number-one killer of Asian American women, and their experiences with screening. DESIGN A qualitative, exploratory approach with focus groups. SETTING Suburban Filipino American communities in the midwestern United States. SAMPLE 11 Filipino American women aged 45-80 years who shared their experiences with breast cancer screening. METHODS Focus groups were conducted, and the meetings were recorded on audiotape, transcribed, and analyzed using constant comparison techniques. MAIN RESEARCH VARIABLES Breast cancer screening, experiences, motivators, and barriers. FINDINGS Avoidance was the main theme for Filipino American women in dealing with a cancer diagnosis in the Filipino American culture. Facilitators of Filipino American womens screening practices were support from family members, recommendations from familiar physicians, health insurance reinforcement, and personal attributes of physical symptoms, family history, past diagnosis, and health literacy. Barriers identified were different mind-sets and healthcare systems in the Philippines in regard to early detection, unpleasant experiences with mammography, cultural beliefs, and difficulties accessing services. CONCLUSIONS Results of the focus group discussions provide useful information about facilitators and barriers that affect Filipino American womens screening practices. IMPLICATIONS FOR NURSING The findings of the study can be used to develop tailored interventions for addressing culturally specific barriers and promoting screening practices in the Filipino American community.

Mammography stage of adoption and decision balance among Asian Indian and Filipino American women.

Cancer is the leading cause of death among Asian American women, and the death rate has increased almost 200% since 1990. Previous research has applied the transtheoretical model constructs to examine cancer screening behavior; however, to our knowledge, this is the first such investigation to examine relationships between stages of mammography adoption and decision balance among Asian American women. This article presents study findings from a convenience sample of 228 women aged 40 to 81 years (mean = 55.0, SD = 9.6) residing in southeastern Michigan. The current study demonstrates excellent support for the psychometric properties of a pros and cons measure, with promising Cronbach alphas above .70. Results from confirmatory factor analysis also support the factor structure derived from exploratory factor analysis with good model fit indices. This study also provides some support on transtheoretical model-hypothesized relationships in this sample of Asian American women that, as the stages of adoption of mammography proceeded from earlier to later ones, the decisional balance would become more favorable. The specific beliefs (both positive and negative) associated with the various stages of mammography adoption have implications for health professionals in developing stage-matched interventions to motivate women in adopting regular mammography.

Cultural Affiliation and Mammography Screening of Chinese Women in an Urban County of Michigan

The aim of this study is to explore the relationship of culturally based attitudes on breast cancer screening behavior of Chinese women currently residing in the United States. This cross-sectional study used a survey instrument that was administered to a consecutive nonprobability sample of 202 Chinese women residing in an urban Michigan county. Mood’s strength of cultural affiliation scale (SCAS) was modified for cultural appropriateness prior to being translated into Chinese, back-translated, and pretested prior to use for this study. Data were analyzed using descriptive, correlational, and multivariate analysis techniques. Statistical analyses revealed that cultural diversity within the Chinese sample was associated with differing health behaviors and that the SCAS had indirect effects, through access to health care, on women’s mammography screening use (R 2 = 28.3%). These study’s findings reveal that cultural affiliation and beliefs are related to the breast cancer screening behavior of immigrant Chinese women.

Correlates of recent and regular mammography screening among Asian-American women

TITLE Correlates of recent and regular mammography screening among Asian-American women. AIM This paper is a report of a study of the health beliefs, knowledge and selected demographic variables that influence mammography utilization among Asian-American women. BACKGROUND Breast cancer is the most frequently occurring cancer in Asian-American women and its incidence is increasing at a greater rate than for other racial and ethnic groups in the United States of America (USA). Compared to White women, breast cancer also is more likely to be diagnosed at a later stage with larger tumours in Asian-Americans. METHOD A self-administered questionnaire was used with Asian-American women residing in the USA. Data were collected in 2005 and 315 women participated in the study. RESULTS Fifty-five per cent of participants reported having their last mammogram within the past 13 months, and 33% reported having annual mammograms in each of the past 5 years. Based on multivariate logistic regression analyses, clinical breast examination, barriers and knowledge of recommendations of the frequency of mammography screening were associated with both recent and regular mammography practice after controlling for all other demographic, psychosocial and behavioural variables in the model. CONCLUSION Intervention strategies tailored to knowledge, language and cultural factors associated with mammography use should target at-risk subgroups, particularly those who are recent immigrants and those with limited English language ability. Culturally appropriate strategies should be developed to promote lifelong mammography screening for this rapidly growing and diverse population.

A Prospective Study on Changes of Cognitions, Interpersonal Influences, and Physical Activity in Taiwanese Youth.

The decline of physical activity during adolescence is not well understood. This prospective study followed 969 Taiwanese students from eighth to ninth grade and examined their physical activity-related cognitions, interpersonal influences, and behavior of physical activity across the grade transition. Gender differences were found in the effects of the grade transition on physical activity and its related cognitions. The correlation coefficients showed moderate tracking for physical activity, cognitions, and interpersonal influences for both genders. The results also indicated that cognitions are more stable than behavior. The present study provides evidence of the decline in physical activity in Taiwanese youth across the grade transition as well as gender differences in the variables cognitions and interpersonal influences.