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Original Article

Development and Application of a Health Promotion Program for Marriage Immigrant Women

In Ju Seo1, Jeong Sook Park2
Korean Journal of Adult Nursing 2015;27(2):198-210.
Published online: April 30, 2015

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Corresponding author: Park, Jeong Sook College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 704-701, Korea. Tel: +82-53-580-3907, Fax: +82-53-580-3916, E-mail: jsp544@gw.kmu.ac.kr
• Received: February 18, 2015   • Accepted: April 13, 2015

Copyright © 2015 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This studywas to developahealthpromotionprogram for marriage immigrant womenandto evaluate its efficacy.
  • Methods
    The healthpromotion programwas comprisedof eight 100-minuteweekly sessions. Each sessionincluded understandingof healthresponsibility, nutrition, physical activity, interpersonal relations, stress management, andself actualization. The research was conducted under the principles of nonequivalent control group pretest-post test design. The outcome variables were health promoting behavior, health status, acculturation, self efficacy, and perceived barrier. The participants were 15 immigrant women in theexperimental group and 16 in the control group. Data was analyzed using x2 test, Fisher's exact test, Mann Whitney U-test and Wilcoxonsignedranktest.
  • Results
    Therewas asignificant improvement inhealthpromotingbehaviors (U=-3.08, p=.002), left shoulder flexibility(U=-3.02, p=.003), right shoulder flexibility(U=-3.02, p=.003), low back flexibility (U=-3.37, p=.001), social healthstatus(U=-3.38 p=.001) andsubjective healthstatus (U=-2.17 p=.030) inthe experimental groupcompared to thecontrol group.
  • Conclusion
    The health promotionprogram for marriageimmi-grant womenwas aneffectiveinterventionforimprovinghealthpromotingbehavior, physical healthstatus, social health, and subjective healthstatus. Therefore, the developed healthpromotionprogram needs tobe applied to married immigrant women in other kinds nursing care settings in future research.
  • Key Words: Health promotion; Health status; Immigrants; Women
Table 1.
Contents of Health Promotion Programs for Marriage Immigrant Women
Week HPLP II Contents Min HPB factor
1   Opening Ceremony 10  
Pre-measurement
․ Writing participation agreement, doing pre-survey and checking flexibility
․ Explaining of health promotion behavior checklist 		50  
Personal relations ․ Mentor-mentee inaugural ceremony 40 Social support
2 Health responsibility ․ Health education
- Anemia, hepatitis, digestive disease control and prevention
- Instructions for medical facilities, special lecture for how to use Public Health Center and brochure distribution 		50 Perceived barriers
Physical activities ․ Theory and practice of exercise
- Walk with a correct posture 		50  
3 Nutrition ․ Nutrition management for oneself and family
- Proper eating habits like eating meals on time
- Nutrition knowledge for nurturing infants, how to make baby food
- Taking multi-vitamins 		40 Self efficacy
Stress management ․ Hand massage for managing stress and fatigue 30  
Physical activity ․ Yoga activity for promoting flexibility 30  
4 Self actualization ․ Horticultural therapy for self-actualization
- Smelling the rosemary scent and add a meaning to a living organism, transplant
- Transplanting plants and watch the plant taking roots, find the meaning of life and adapt to Korean culture 		80 Acculturation
Physical activity ․ Yoga activity for promoting flexibility 20  
5 Nutrition ․ Cooking class: combining homeland food and Korean food
- Homeland food: Nasi-goreng, Bulgogi, salad 		180 Acculturation
6 Personal relations ․ Communication skills for promoting personal relations
- Couple communication 		50  
Health responsibility ․ Health care for reproductive system and child spacing
- Contraception, health screening (uterine, breast cancer examination) 		30 Social Support
Physical activity ․ Yoga activity for promoting flexibility 20  
7 Self actualization ․ Role-play
- 'Who am I', 'How to socialize' 		70 Self efficacy
Health responsibility ․ Hygiene health for one-self and family
- Hand-washing education
- Sanitation concept when nurturing baby and cooking 		30  
8 Health responsibility ․ Preview of child health management
- Health management for infants
- Vaccination, first aid, child-related institutions and how to use agencies 		30 Perceived barriers
Stress management ․ Stress reduction by using mother tongue language freely
- Speak in mother tongue language, call someone in peoples' homeland. 		20  
Post-measurement
- Post-survey and biological index measurement 		50  
․ Closing Ceremony
- Honor awards and distributing souvenirs 		10  
Every weeks   ․ 'I can do it' announcement
․ Check list for practicing health promotion behavior 		  Self efficacy
  ․ Mentor-mentee activity   Social support

HPLP II=health promoting lifestyle profile II; Min.=minutes, HPB=health promoting behavior.

Table 2.
Homogeneity Test of the General Characteristics (N =31)
Characteristics Categories Exp. (n=15) Cont. (n=16) Total (n=31) x2 or U p
n (%) n (%) n (%)
Nationality Vietnam 11 (35.5) 9 (29.0) 20 (64.5)   .889†
Others (China, Philippines, etc.) 4 (12.9) 7 (22.6) 11 (35.5)
Age (year) 20~29 8 (25.8) 7 (22.6) 15 (48.4) 0.29 .211
30~39 7 (22.6) 9 (29.0) 16 (51.6)
Education ≤ Middle school 7 (22.6) 4 (12.9) 11 (35.5)   .334†
High school 5 (16.1) 8 (25.8) 13 (41.9)
≥ College 3 (9.7) 4 (12.9) 7 (22.6)
Religion Christianity 5 (16.1) 1 (3.2) 6 (19.4)   .284†
Buddhism 6 (19.4) 9 (29.0) 15 (48.3)
No religion/others 4 (12.9) 6 (19.4) 10 (32.3)
Marriage duration (month) ≤ 50 8 (25.8) 6 (19.4) 14 (45.2)   .580†
51~100 5 (16.1) 5 (16.1) 10 (32.2)
≥ 101 2 (6.5) 5 (16.1) 7 (22.6)
Acquirement of nationality Yes 4 (12.9) 7 (22.6) 11 (35.5)   .169†
No 11 (35.5) 9 (29.0) 20 (64.5)
Korean proficiency Fluent 2 (6.5) 6 (19.4) 8 (25.8)   .083†
Average 8 (25.8) 9 (29.0) 17 (54.8)
Bad or worse 5 (16.1) 1 (3.2) 6 (19.4)
Occupation Yes 0 (0.0) 2 (6.5) 2 (6.5)   .484†
No 15 (48.4) 14 (45.1) 29 (93.5)
Income (10,000 won) ≤ 100 4 (12.9) 4 (12.8) 8 (25.8)   .525†
＞ 100~200 8 (25.8) 6 (19.4) 14 (45.2)
＞ 200 3 (9.7) 6 (19.4) 9 (29.0)

Exp.=experimental group; Cont.=control group;

†Fisher's exact test.

Table 3.
Homogeneity Test of HPLP, Health Status, Acculturation, Self-efficacy, and Perceived Barrier (N=31)
Characteristics Categories Exp. (n=15) Cont. (n=16) U p
M±SD M±SD
HPLP Total 118.73±17.35 126.68±15.42 28.99 .264
Health responsibility 20.06±3.32 21.62±4.57 12.31 .421
Physical activity 14.73±3.01 15.50±3.42 7.51 .757
Nutrition 19.60±3.13 20.87±2.96 5.51 .855
Interpersonal relations 21.80±2.70 24.12±2.60 14.18 .077
Stress management 18.40±4.03 18.81±3.83 11.18 .514
Self actualization 21.86±3.24 23.68±2.96 9.64 .380
Physical health status Shoulder flexibility (Rt.) 4.60±3.40 2.03±4.30 17.12 .145
Shoulder flexibility (Lt.) 0.33±7.72 0.62±4.88 17.52 .131
Low back flexibility 5.98±6.48 2.50±6.17 21.45 .162
Psychologic health status   7.20±3.34 6.06±3.67 14.32 .281
Social health status 41.33±5.98 43.81±6.61 10.98 .811
Perceived health status 9.40±1.88 9.75±1.69 0.97 .965
Acculturation 36.00±4.29 35.87±5.31 13.78 .466
Self-efficacy 26.20±3.87 23.06±4.31 9.79 .635
Perceived barrier 19.80±3.50 18.56±4.57 17.32 .138

Cont.=control group; Exp.=experimental group; HPLP=health promoting lifestyle profile; Lt.=left, Rt.=right,

Table 4.
Comparison of HPLP between Experimental and Control Group (N=31)
Variables Groups Pretest Posttest Difference U p z p
M±SD M±SD Mean
Total Exp. (n=15) 118.73±17.35 138.47±23.40 19.74 -3.08 .002 -2.92 .003
Cont. (n=16) 126.68±15.42 127.25±14.25 0.56     -1.19 .236
Health responsibility Exp. (n=15) 20.06±3.32 23.66±5.85 3.60 -3.24 .001 -2.49 .013
Cont. (n=16) 21.62±4.57 21.43±4.19 0.19     -0.54 .593
Physical activity Exp. (n=15) 14.73±3.01 18.13±3.54 3.40 -3.27 .001 -2.99 .003
Cont. (n=16) 15.62±3.07 16.06±3.07 0.13     -0.56 .557
Nutrition Exp. (n=15) 19.60±3.13 22.13±3.42 2.47 -1.94 .053 -2.60 .009
Cont. (n=16) 20.87±2.96 21.06±2.72 0.19     -0.76 .450
Interpersonal relations Exp. (n=15) 21.80±2.70 24.13±4.05 2.33 -1.91 .057 -2.51 .012
Cont. (n=16) 24.12±2.60 24.25±2.67 0.13     -1.00 .317
Stress management Exp. (n=15) 18.40±4.03 22.33±3.62 3.93 -2.91 .004 -2.82 .005
Cont. (n=16) 18.81±3.83 18.93±3.75 1.25     1.41 .157
Self actualization Exp. (n=15) 21.86±3.24 25.40±3.90 3.53 -2.53 .011 -2.76 .006
Cont. (n=16) 23.68±2.96 23.87±2.80 0.19     -1.34 .180

Exp.=experimental group; Cont.=control group.

Table 5.
Comparison of the Variables between the Experimental and the Control Group (N=31)
Variables Group Pretest Posttest Difference U p z p
M±SD M±SD Mean
Shoulder flexibility (Rt.) Exp. (n=15) 4.60±3.40 6.93±3.93 2.33 -3.02 .003 -3.07 .002
Cont. (n=16) 2.03±4.30 1.81±4,75 -0.22     -1.09 .276
Shoulder flexibility (Lt.) Exp. (n=15) 0.33±7.72 3.33±5.80 3.00 -3.02 .003 -2.81 .005
Cont. (n=16) 0.62±4.88 0.93±5.13 0.31     -0.82 .414
Low back flexibility Exp. (n=15) 5.98±6.48 9.46±6.22 3.48 -3.37 .001 -2.94 .003
Cont. (n=16) 2.50±6.17 2.81±6.27 0.31     -1.19 .236
Psychologic health status Exp. (n=15) 7.20±3.34 8.60±2.35 1.40 -0.95 .342 -1.36 .172
Cont. (n=16) 6.06±3.67 7.63±3.65 1.56     0.34 .001
Social health status Exp. (n=15) 41.33±5.98 44.47±5.65 3.13 -3.38 .001 -2.52 .012
Cont. (n=16) 43.81±6.61 43.31±7.57 -0.50     -1.34 .180
Perceived health status Exp. (n=15) 9.40±1.88 9.73±1.87 0.33 -2.17 .030 -1.89 .059
Cont. (n=16) 9.75±1.69 9.75±1.69 0.00     0.00 1.000
Acculturation Exp. (n=15) 36.00±4.29 36.13±6.32 0.13 -0.62 .532 -0.11 .916
Cont. (n=16) 35.87±5.31 35.62±5.24 -0.25     -1.41 .157
Self-efficacy Exp. (n=15) 26.20±3.87 25.93±3.17 -0.27 -1.30 .195 -0.60 .553
Cont. (n=16) 23.06±4.31 23.06±4.31 0.00     0.00 1.000
Perceived barrier Exp. (n=15) 19.80±3.50 19.80±3.69 0.00 -0.78 .434 -0.17 .863
Cont. (n=16) 18.56±4.57 18.93±5.45 0.38     -0.86 .391

Exp.=experimental group; Cont.=control group; Rt.=right; Lt.=left.

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    Development and Application of a Health Promotion Program for Marriage Immigrant Women
    Korean J Adult Nurs. 2015;27(2):198-210.   Published online April 30, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.2.198
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    Development and Application of a Health Promotion Program for Marriage Immigrant Women
    Korean J Adult Nurs. 2015;27(2):198-210.   Published online April 30, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.2.198
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    Development and Application of a Health Promotion Program for Marriage Immigrant Women
    Development and Application of a Health Promotion Program for Marriage Immigrant Women

    Contents of Health Promotion Programs for Marriage Immigrant Women

    Week HPLP II Contents Min HPB factor
    1   Opening Ceremony 10  
    Pre-measurement
    ․ Writing participation agreement, doing pre-survey and checking flexibility
    ․ Explaining of health promotion behavior checklist     		50  
    Personal relations ․ Mentor-mentee inaugural ceremony 40 Social support
    2 Health responsibility ․ Health education
    - Anemia, hepatitis, digestive disease control and prevention
    - Instructions for medical facilities, special lecture for how to use Public Health Center and brochure distribution     		50 Perceived barriers
    Physical activities ․ Theory and practice of exercise
    - Walk with a correct posture     		50  
    3 Nutrition ․ Nutrition management for oneself and family
    - Proper eating habits like eating meals on time
    - Nutrition knowledge for nurturing infants, how to make baby food
    - Taking multi-vitamins     		40 Self efficacy
    Stress management ․ Hand massage for managing stress and fatigue 30  
    Physical activity ․ Yoga activity for promoting flexibility 30  
    4 Self actualization ․ Horticultural therapy for self-actualization
    - Smelling the rosemary scent and add a meaning to a living organism, transplant
    - Transplanting plants and watch the plant taking roots, find the meaning of life and adapt to Korean culture     		80 Acculturation
    Physical activity ․ Yoga activity for promoting flexibility 20  
    5 Nutrition ․ Cooking class: combining homeland food and Korean food
    - Homeland food: Nasi-goreng, Bulgogi, salad     		180 Acculturation
    6 Personal relations ․ Communication skills for promoting personal relations
    - Couple communication     		50  
    Health responsibility ․ Health care for reproductive system and child spacing
    - Contraception, health screening (uterine, breast cancer examination)     		30 Social Support
    Physical activity ․ Yoga activity for promoting flexibility 20  
    7 Self actualization ․ Role-play
    - 'Who am I', 'How to socialize'     		70 Self efficacy
    Health responsibility ․ Hygiene health for one-self and family
    - Hand-washing education
    - Sanitation concept when nurturing baby and cooking     		30  
    8 Health responsibility ․ Preview of child health management
    - Health management for infants
    - Vaccination, first aid, child-related institutions and how to use agencies     		30 Perceived barriers
    Stress management ․ Stress reduction by using mother tongue language freely
    - Speak in mother tongue language, call someone in peoples' homeland.     		20  
    Post-measurement
    - Post-survey and biological index measurement     		50  
    ․ Closing Ceremony
    - Honor awards and distributing souvenirs     		10  
    Every weeks   ․ 'I can do it' announcement
    ․ Check list for practicing health promotion behavior     		  Self efficacy
      ․ Mentor-mentee activity   Social support

    HPLP II=health promoting lifestyle profile II; Min.=minutes, HPB=health promoting behavior.

    Homogeneity Test of the General Characteristics (N =31)

    Characteristics Categories Exp. (n=15) Cont. (n=16) Total (n=31) x2 or U p
    n (%) n (%) n (%)
    Nationality Vietnam 11 (35.5) 9 (29.0) 20 (64.5)   .889†
    Others (China, Philippines, etc.) 4 (12.9) 7 (22.6) 11 (35.5)
    Age (year) 20~29 8 (25.8) 7 (22.6) 15 (48.4) 0.29 .211
    30~39 7 (22.6) 9 (29.0) 16 (51.6)
    Education ≤ Middle school 7 (22.6) 4 (12.9) 11 (35.5)   .334†
    High school 5 (16.1) 8 (25.8) 13 (41.9)
    ≥ College 3 (9.7) 4 (12.9) 7 (22.6)
    Religion Christianity 5 (16.1) 1 (3.2) 6 (19.4)   .284†
    Buddhism 6 (19.4) 9 (29.0) 15 (48.3)
    No religion/others 4 (12.9) 6 (19.4) 10 (32.3)
    Marriage duration (month) ≤ 50 8 (25.8) 6 (19.4) 14 (45.2)   .580†
    51~100 5 (16.1) 5 (16.1) 10 (32.2)
    ≥ 101 2 (6.5) 5 (16.1) 7 (22.6)
    Acquirement of nationality Yes 4 (12.9) 7 (22.6) 11 (35.5)   .169†
    No 11 (35.5) 9 (29.0) 20 (64.5)
    Korean proficiency Fluent 2 (6.5) 6 (19.4) 8 (25.8)   .083†
    Average 8 (25.8) 9 (29.0) 17 (54.8)
    Bad or worse 5 (16.1) 1 (3.2) 6 (19.4)
    Occupation Yes 0 (0.0) 2 (6.5) 2 (6.5)   .484†
    No 15 (48.4) 14 (45.1) 29 (93.5)
    Income (10,000 won) ≤ 100 4 (12.9) 4 (12.8) 8 (25.8)   .525†
    ＞ 100~200 8 (25.8) 6 (19.4) 14 (45.2)
    ＞ 200 3 (9.7) 6 (19.4) 9 (29.0)

    Exp.=experimental group; Cont.=control group;

    †Fisher's exact test.

    Homogeneity Test of HPLP, Health Status, Acculturation, Self-efficacy, and Perceived Barrier (N=31)

    Characteristics Categories Exp. (n=15) Cont. (n=16) U p
    M±SD M±SD
    HPLP Total 118.73±17.35 126.68±15.42 28.99 .264
    Health responsibility 20.06±3.32 21.62±4.57 12.31 .421
    Physical activity 14.73±3.01 15.50±3.42 7.51 .757
    Nutrition 19.60±3.13 20.87±2.96 5.51 .855
    Interpersonal relations 21.80±2.70 24.12±2.60 14.18 .077
    Stress management 18.40±4.03 18.81±3.83 11.18 .514
    Self actualization 21.86±3.24 23.68±2.96 9.64 .380
    Physical health status Shoulder flexibility (Rt.) 4.60±3.40 2.03±4.30 17.12 .145
    Shoulder flexibility (Lt.) 0.33±7.72 0.62±4.88 17.52 .131
    Low back flexibility 5.98±6.48 2.50±6.17 21.45 .162
    Psychologic health status   7.20±3.34 6.06±3.67 14.32 .281
    Social health status 41.33±5.98 43.81±6.61 10.98 .811
    Perceived health status 9.40±1.88 9.75±1.69 0.97 .965
    Acculturation 36.00±4.29 35.87±5.31 13.78 .466
    Self-efficacy 26.20±3.87 23.06±4.31 9.79 .635
    Perceived barrier 19.80±3.50 18.56±4.57 17.32 .138

    Cont.=control group; Exp.=experimental group; HPLP=health promoting lifestyle profile; Lt.=left, Rt.=right,

    Comparison of HPLP between Experimental and Control Group (N=31)

    Variables Groups Pretest Posttest Difference U p z p
    M±SD M±SD Mean
    Total Exp. (n=15) 118.73±17.35 138.47±23.40 19.74 -3.08 .002 -2.92 .003
    Cont. (n=16) 126.68±15.42 127.25±14.25 0.56     -1.19 .236
    Health responsibility Exp. (n=15) 20.06±3.32 23.66±5.85 3.60 -3.24 .001 -2.49 .013
    Cont. (n=16) 21.62±4.57 21.43±4.19 0.19     -0.54 .593
    Physical activity Exp. (n=15) 14.73±3.01 18.13±3.54 3.40 -3.27 .001 -2.99 .003
    Cont. (n=16) 15.62±3.07 16.06±3.07 0.13     -0.56 .557
    Nutrition Exp. (n=15) 19.60±3.13 22.13±3.42 2.47 -1.94 .053 -2.60 .009
    Cont. (n=16) 20.87±2.96 21.06±2.72 0.19     -0.76 .450
    Interpersonal relations Exp. (n=15) 21.80±2.70 24.13±4.05 2.33 -1.91 .057 -2.51 .012
    Cont. (n=16) 24.12±2.60 24.25±2.67 0.13     -1.00 .317
    Stress management Exp. (n=15) 18.40±4.03 22.33±3.62 3.93 -2.91 .004 -2.82 .005
    Cont. (n=16) 18.81±3.83 18.93±3.75 1.25     1.41 .157
    Self actualization Exp. (n=15) 21.86±3.24 25.40±3.90 3.53 -2.53 .011 -2.76 .006
    Cont. (n=16) 23.68±2.96 23.87±2.80 0.19     -1.34 .180

    Exp.=experimental group; Cont.=control group.

    Comparison of the Variables between the Experimental and the Control Group (N=31)

    Variables Group Pretest Posttest Difference U p z p
    M±SD M±SD Mean
    Shoulder flexibility (Rt.) Exp. (n=15) 4.60±3.40 6.93±3.93 2.33 -3.02 .003 -3.07 .002
    Cont. (n=16) 2.03±4.30 1.81±4,75 -0.22     -1.09 .276
    Shoulder flexibility (Lt.) Exp. (n=15) 0.33±7.72 3.33±5.80 3.00 -3.02 .003 -2.81 .005
    Cont. (n=16) 0.62±4.88 0.93±5.13 0.31     -0.82 .414
    Low back flexibility Exp. (n=15) 5.98±6.48 9.46±6.22 3.48 -3.37 .001 -2.94 .003
    Cont. (n=16) 2.50±6.17 2.81±6.27 0.31     -1.19 .236
    Psychologic health status Exp. (n=15) 7.20±3.34 8.60±2.35 1.40 -0.95 .342 -1.36 .172
    Cont. (n=16) 6.06±3.67 7.63±3.65 1.56     0.34 .001
    Social health status Exp. (n=15) 41.33±5.98 44.47±5.65 3.13 -3.38 .001 -2.52 .012
    Cont. (n=16) 43.81±6.61 43.31±7.57 -0.50     -1.34 .180
    Perceived health status Exp. (n=15) 9.40±1.88 9.73±1.87 0.33 -2.17 .030 -1.89 .059
    Cont. (n=16) 9.75±1.69 9.75±1.69 0.00     0.00 1.000
    Acculturation Exp. (n=15) 36.00±4.29 36.13±6.32 0.13 -0.62 .532 -0.11 .916
    Cont. (n=16) 35.87±5.31 35.62±5.24 -0.25     -1.41 .157
    Self-efficacy Exp. (n=15) 26.20±3.87 25.93±3.17 -0.27 -1.30 .195 -0.60 .553
    Cont. (n=16) 23.06±4.31 23.06±4.31 0.00     0.00 1.000
    Perceived barrier Exp. (n=15) 19.80±3.50 19.80±3.69 0.00 -0.78 .434 -0.17 .863
    Cont. (n=16) 18.56±4.57 18.93±5.45 0.38     -0.86 .391

    Exp.=experimental group; Cont.=control group; Rt.=right; Lt.=left.
    Table 1. Contents of Health Promotion Programs for Marriage Immigrant Women

    HPLP II=health promoting lifestyle profile II; Min.=minutes, HPB=health promoting behavior.

    Table 2. Homogeneity Test of the General Characteristics (N =31)

    Exp.=experimental group; Cont.=control group;

    Fisher's exact test.

    Table 3. Homogeneity Test of HPLP, Health Status, Acculturation, Self-efficacy, and Perceived Barrier (N=31)

    Cont.=control group; Exp.=experimental group; HPLP=health promoting lifestyle profile; Lt.=left, Rt.=right,

    Table 4. Comparison of HPLP between Experimental and Control Group (N=31)

    Exp.=experimental group; Cont.=control group.

    Table 5. Comparison of the Variables between the Experimental and the Control Group (N=31)

    Exp.=experimental group; Cont.=control group; Rt.=right; Lt.=left.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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