POST-MIGRATION HEALTH & BEHAVIOR CHANGE: MIDLIFE WOMEN

本前瞻性研究的目的是探讨文化适应对移民后健康的影响，以及可改变的行为对移民后健康的纵向影响。 这项研究将确定战略时间点，在此期间，护理干预措施将是最有效的中年移民妇女从前苏联。 移民是在家庭制度背景下发生的非规范性发展过渡。 移民年龄较大和女性是脆弱性的重要预测因素。随着居住时间的增加，各部门的记录显示，身心健康状况严重恶化。 然而，还没有使用纵向方法系统地研究文化适应和行为危险因素对健康状况的影响。 本研究的具体目的是：1）使用英语语言使用、美国生活方式的采用、文化认同和文化适应态度等指标，跟踪文化适应随时间的变化; 2）跟踪可改变的行为介质的变化，包括压力管理资源、家庭适应、饮食和体育活动; 3）使用生理和心理健康指标跟踪健康状况随时间的变化; 4）确定与健康状况变化相关的背景因素、文化适应特征和行为中介。 参与者将包括225名40至70岁的女性，她们在进入研究时移民后不到6年。 数据收集将包括问卷调查、24小时饮食回忆和身体测量（例如，血压、血清胆固醇和体脂百分比），每9个月（5次）评估一次，持续3年。 样本将按年龄和居住时间分层。 数据分析将采用分层线性模型的创新应用，以记录随时间推移的个体内变化，并估计迁移后前9年的群体变化。审慎的干预目标是至关重要的，以促进有效分配的医疗保健研究，同时改善新移民的健康状况。 本研究验证的资源方法可以应用于其他人群，以确定高风险期和设计多焦点计划，是年龄，性别和文化的具体。

The purpose of this prospective study is to examine the longitudinal influence of modifiable behaviors that mediate the effects of acculturation on post-migration health. The study will identify strategic points in time during which nursing interventions would be most effective for midlife immigrant women from the former Soviet Union. Immigration is a non-normative developmental transition that takes place in the context of the family system. Older age at immigration and female gender are important predictors of vulnerability. Significant deterioration in physical and psychological health has been documented cross- sectionally as duration of residence increases. Longitudinal methods have not been used, however, to systematically study the effects of acculturation and behavioral risk factors on health status. The specific aims of the study are to 1) track changes over time in acculturation, using indicators of English language usage, adoption of U.S. lifestyle, cultural identity, and acculturation attitudes; 2) track changes in modifiable behavioral mediators, including stress management resources, family adaptation, diet and physical activity; 3) track changes over time in health status, using indicators of physical and psychological health; and 4) identify background factors, acculturation characteristics, and behavioral mediators that are correlates of change in health status. Participants will include 225 women, 40 to 70 years old, who are less than 6 years post- migration at entry into the study. Data collection will include questionnaires, 24-hour dietary recalls, and physical measurements (e.g., blood pressure, serum cholesterol and percent body fat), assessed every 9 months (5 times) over 3 years. The sample will be stratified by age and duration of residence. Data analysis will employ an innovative application of hierarchical linear models to document within-individual change over time and estimate group change over the first 9 years post-migration. Prudent targeting of intervention is critical to facilitating effective allocation of health care research while improving health status for new immigrants. The resource methodology validated by this study can be applied to other populations to identify high risk periods and design multifocal programs that are age, gender and culture specific.