Determinants of health-promoting lifestyle behaviors in rural older women.

The purpose of this study was to: (a) describe the health-promoting lifestyle behaviors and attempts at change among 102 community-dwelling rural women aged 65 and older, and (b) determine the extent to which personal influences (demographics, definition of health, and perceived health status) and contextual influences (sources of health information and provider counseling) explain health-promoting lifestyle behaviors and attempts at change among those women. They scored highest on frequency of nutrition behaviors and lowest on frequency of physical activity behaviors. They had attempted change in from zero to five areas of health-promoting lifestyle within the past year. Multiple regression analyses revealed that younger age, living with other(s), defining health as wellness, better perceived mental health, more sources of health information and provider counseling were significantly associated with health-promoting lifestyle behaviors. Only younger age and more sources of health information were significantly associated with attempts at change. These findings provide information that is relevant in designing interventions to enhance health-promoting lifestyle behaviors among rural older women.

Determinants of preventive services utilization in rural older women.

Research describing preventive services utilization and determinants of preventive services utilization for rural older women is scant. The purpose of this study was to: (a) describe the prevalence of preventive services utilization in compliance with the U.S. Preventive Services Task Force (USPSTF) recommendations for screening, counseling, and immunizations among rural older women in four Nebraska counties and (b) determine the extent to which personal influences (e.g., demographics, definition of health, perceived health status) and contextual influences (e.g., access to care, sources of health information, provider recommendations) explain preventive services utilization among those women. A sample of 102 community-dwelling rural women age 65 and older participated in the study. The prevalence of receipt of USPSTF-recommended preventive services utilization among these rural women was alarmingly low. Multiple regression analyses revealed that provider recommendations, access to care, sources of health information, and perceived health status were significantly associated with preventive services utilization. These findings provide information that is relevant in designing interventions to increase preventive services utilization among rural older women.

Actual and perceived risk for chronic illness in rural older women.

Little is known regarding the risk perceptions of older women for the chronic illnesses for which they are at highest risk. The purpose of this study was to explore the actual and perceived risk for six chronic illnesses: coronary heart disease, cerebrovascular disease (stroke), breast and colorectal cancer, osteoporosis, and depression. In addition, the relationship of demographic characteristics of the women and their perceived and functional health status to actual risk factors and risk perception was studied. A convenience sample of 102 rural women aged 65-91 answered a questionnaire on their actual and perceived risk for the chronic illnesses. As in younger samples, these older women generally underestimated their risk of disease. There was no relationship between demographics and risk perception, but there was a significant correlation between perceived health and functional status and risk perception. Only those actual risk factors associated with life experience were associated with increased perceived risk, supporting earlier findings that life experience has more influence on risk perception than the presence of actual risk factors per se. Based on the results of this study, clinicians should assume that older women patients are likely to underestimate their risk for common health problems. Clinicians are advised, therefore, in addition to regular evaluation of actual risk based on epidemiologic data, to probe their patients for information regarding their perception of risk and the basis of that perception. Combining information regarding perceived risk with actual risk data, the clinician can work with the patient to develop and implement an effective personalized risk management program.