ADJUSTMENT AND HEALTH: MODEL FOR MIDLIFE IMMIGRANT WOMEN

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Accommodating cultural diversity due to increasing migration from politically unstable or less economically developed countries is a major challenge for health and social services in the U.S. In 1993, the leading country of origin for individuals approved for entry with refugee status was the former Soviet Union. A growing research literature regarding immigrants and refugees has not addressed the needs of the rapidly increasing number of immigrants from formerly communist countries and the challenges they experience adapting to political, economic, and cultural differences in capitalist society. Research in other ethnic groups suggests that the most significant predictors of successful adaptation are gender and age at the time of immigration. Women and middle-aged immigrants are at high risk for adjustment-related physical symptoms and depression. Recent research also suggest that stress may be a factor in lowering estrogen levels, perhaps contributing to the disproportionately high incidence of depression in women who seek treatment for bothersome menopausal symptoms. The purpose of this study is to explore the impact of migration and resettlement during midlife on the health and psychological well-being of women. Specific aims include (a) to describe-cultural and developmental influences, coping strategies, health practices, and health status for women who immigrated during midlife to the United States from the former Soviet Union; (b) to identify relationships among cultural influences, developmental influences, and health status; (c) to identify mediating effects of coping strategies and health practices on these relationships; and (d) to develop a culturally and develop-mentally sensitive model for studying women's health that will guide longitudinal, cross-cultural research. Participants will be 200 women, aged 40-60, who immigrated tot he United States from the former Soviet Union after age 40. To ensure a sample of pre-, per-, and post-menopausal women, three age group quota cells will be filled:40-46 (66 women), 47-53 (67 women) and 54- 60 (66 women). Volunteers will be recruited through community programs, classes, health centers, posters, and the Russian language newspaper. A bilingual interviewer will assist participants to complete a questionnaire during a 2 hour interview in the participant's home or at designated community sites. participants will be paid a $20 incentive to participate in the study. The questionnaire, administered in Russian, includes demographic, migration, and health information. Independent variables include cultural (acculturation, socioeconomic status, menopausal attitude) and developmental (menopausal status, social roles, social support) influences; dependent variables include physical and psychological symptoms and psychological well-being (depression and anxiety); and intervening variables include coping strategies and health practices (life-long physical activity patterns). Analyses include descriptive statistics, correlations, and hierarchical multiple regressions. The study will provide a much needed description and explanatory model of adjustment and health status of immigrant women. These data can be used to identify women at risk of adjustment difficulties, to develop empirically-based nursing interventions for health promotion and psychological well-being in midlife women, and to guide future nursing research across other developmental stages and ethnic groups.