A Review of Theory and Health Promotion Strategies for New Immigrant Women
Hyman, Ilene, Guruge, Sepali, Canadian Journal of Public Health
Background: There has been little empirical research on the best ways to influence women's health behaviour, particularly among women who are recent immigrants to Canada.
Methods: This paper presents information from a literature review conducted for the Ontario Women's Health Council on effective theoretical models and health promotion strategies for women.
Findings: Health promotion activities for all women should address theoretical variables as well as the broader determinants of women's health. New immigrant women represent a diverse group who often face multiple cultural, linguistic and systemic barriers to adopting and maintaining healthy behaviour.
Interpretation: Many theoretical constructs of potential importance to recent immigrant women have not been adequately researched. More research is also needed on the relevancy and the applicability of commonly used health promotion approaches for this group.
Canadian health survey data suggest that recent immigrants to Canada, particularly from non-European countries, are in better health than their Canadian-born counterparts.1,2 This is partly attributable to self-selection factors and partly to Canada's immigration process that selects the 'best' immigrants on the basis of education, language ability and job skills. Recent immigrant women are also less likely to engage in health risk behaviours or be overweight than native-- born Canadians.3-5 Over time, however, this profile changes. Immigrants who have lived in Canada for more than 10 years experience a similar prevalence of chronic conditions and long-term disability as the Canadian-born population. 1,2 The long-- term process of immigration and resettlement may negatively influence critical determinants of health, such as income and social status, working conditions, the social and physical environments, and health practices. Many studies have found that health risk behaviours, such as the consumption of a high-fat diet, smoking and alcohol use, increase over time to resemble those of the majority culture.3,4,6-16 Furthermore, recent immigrant women are less likely to be screened for cervical and breast cancer and to participate in regular physical activity than their Canadian-born counterparts.4,17.18
These findings present an obvious challenge for public health professionals and new immigrant communities, i.e., how to help new immigrants: maintain health-- promoting behaviours, such as the consumption of a low-fat diet; adopt preventive health behaviours, such as regular cervical and breast cancer screening; and avoid the adoption of health risk practices (e.g., heavy alcohol use and smoking). This challenge is compounded by the fact that most of the theoretical models used in health promotion today are grounded in majority culture-based research and may not be appropriate for diverse subgroups in the population, such as new immigrant women.
This paper presents information from a recently completed literature review conducted for the Women's Health Council of the Ontario Ministry of Health and Long-Term Care. The main objective of the review was to identify best mechanisms to favourably influence health risk behaviours among women in Ontario. In the review, specific attention was placed on the identification of health promotion strategies appropriate to newcomers. The first part of this paper describes major theoretical models and presents our findings on the characteristics of successful health promotion programs for Ontario women in general. The second part of this paper highlights issues related to health promotion for new immigrant women in particular.
Between May-September 1999, the University Health Network Women's Health Program (UHNWHP) conducted an appraisal of the published literature in the areas of health promotion and disease prevention to identify best mechanisms to influence health risk behaviour in women. …