Biomedical subjects

Hae-Ra Han

Publications and source records attributed to Hae-Ra Han.

15 recordsLinked to original sources

PubMed2007

Barriers to and strategies for recruiting Korean Americans for community-partnered health promotion research.

While increasing numbers of researchers are targeting ethnic minorities in order to address their health disparities, the unique health needs of Korean Americans are not well known to the mainstream community, and only relatively few systematic research studies have been conducted in this "hard-to reach" population. The purpose of this paper is to describe the barriers to recruiting participants for health promotion research and to identify facilitators in the community that can contribute to this effort. We have analyzed data pertaining to the 14 studies we have conducted since 1998, which included a total sample of about 2,400 Korean Americans. We describe in detail the unique recruitment challenges that we have faced in regard to the culture, language, sociodemographic characteristics of the participants, such as gender and age, and other community level barriers. Multiple strategies at different levels (individual and community) to address these issues are discussed.

Adolescent↗

PubMed2006

Correlates of depression in the Korean American elderly: focusing on personal resources of social support.

Today's Korean American elderly are predominantly first-generation immigrants who face stern challenges of acculturation, which is often associated with depression. Social support has been identified as an effective personal resource for alleviating acculturative stress and achieving better mental health outcomes. The purposes of this study were to describe available sources of social support utilized by Korean elders and to examine the relationships among acculturative stress, social support, and depression. In particular, social support was operationalized as an integrative concept encompassing the size of the social network, satisfaction with the support received, and appraisals of the level of social support. This study was a secondary data analysis of an existing survey of 205 elderly Korean immigrants (>or=60 years) in a major metropolitan city on the East coast. Adult children were found to be the main source of support utilized by elders, even when the elder had a living spouse. Hierarchical multiple regression analysis revealed that higher acculturative stress and lower social support were associated with higher depression scores after demographics and health status were controlled for, whereas network size and satisfaction with support were not. Future interventions should address the cultural/social needs of these immigrants, not only by reinforcing their existing social network but also by providing additional support for their family members to prevent social isolation and depression in the population.

Acculturation↗

PubMed2006

Evaluation of the training of Korean community health workers for chronic disease management.

The use of community health workers (CHWs) or lay health advisors has been increasingly popular as an effective means of secondary prevention for cardiovascular health in hard-to-reach, underserved populations. Yet, published evaluations of the CHW training programs are rare. The purpose of this article is to report the results of an evaluation of a CHW training program for hypertension and diabetes management for Korean-American seniors. Forty-eight hours of training was developed and delivered to 12 Korean CHWs. Evaluation of the training program involved CHW surveys, trainer observation and debriefing and CHW focus groups. Testing of CHW knowledge showed that all CHWs met the minimum required knowledge level of 70%. Independent ratings by two trainer observations revealed that the overall CHW performance was satisfactory. Both CHW ratings and focus group data indicated that the training program met their expectation (average 9.3 on a 10-point scale) and was successful in empowering them to assume their role as a 'health initiator', 'health advertising agent' or 'health role model'. While this course is judged to be effective in general, future research is warranted to determine whether CHW provision of care and support will affect health outcomes in the target population.

Asian↗

PubMed2006

Predictors of psychological well-being amongst Korean immigrants to the United States: a structured interview survey.

BACKGROUND: As international migration becomes a common phenomenon in many countries, the health issues of immigrants are becoming an important area of concern among health care professionals worldwide. OBJECTIVE: Adopting the stress-health outcome framework, this study examined risks and resources of both positive and negative affect (i.e., happiness and depression) among Korean Americans who experienced acculturative and recent life stresses. METHODS: Hierarchical multiple regression analyses were performed to examine correlates of positive and negative outcomes in the stress process on a final sample of 147 Korean immigrants from a cross-sectional study. RESULTS: For happiness, lower levels of acculturative stress and recent life stress, a greater sense of mastery, and greater social support were associated with an increased level of happiness. None of the individual characteristics were significant. R(2) for the full model was .53. For negative affect, acculturative stress and recent life stress explained a significant portion (41%) of the total variance associated with depression (R(2)=.51). As with the happiness variable, individual characteristics failed to add to the predictiveness of the equation, while sense of mastery and social support functioned as significant resources in reducing depression. CONCLUSION: Increased mastery and greater social support were consistently predictive of greater happiness and less depression. Implications for future immigrant research are discussed.

Acculturation↗

PubMed2006

Effects of stressful life events in young black men with high blood pressure.

OBJECTIVES: 1) To describe stressful life events as experienced by a sample of young Black men with high blood pressure (HBP) living in inner-city Baltimore, Maryland; and 2) to examine the effect of cumulative stressful life events on substance use, depression, and quality of life. METHODS: Data were obtained over 48 months by interview from 210 men in an HBP management study. RESULTS: Stressors repeatedly occurring over time included death of family member or close friend (65.2%), having a new family member (32.9%), change in residence (31.4%), difficulty finding a job (24.3%), and fired or laid off from work (17.6%). Involvement with crime or legal matters was reported at least twice during the 48 months by 33.3% of men. When a cumulative stressful life events score was calculated by summing the number of events experienced at 6-month points over 48 months and tested for its relationship with the health outcomes, the findings of multivariate analyses revealed significant associations between cumulative life stressors and depression and quality of life. No significant relationship was found between stressful life events and substance use. CONCLUSIONS: The results suggest that cumulative stressful life events have a negative effect on mental health and quality of life in young Black men with HBP. Future study should focus on developing interventions to assist individuals in managing distress related to stressful events with necessary community resources.

Adolescent↗

PubMed2006

Barriers to care and control of high blood pressure in Korean-American elderly.

OBJECTIVES: To identify barriers to achieving optimal management of high blood pressure (HBP) among hypertensive Korean-American elderly (KAE). METHODS: This study used data on a subsample of 146 hypertensive KAE from a total of 205 KAE in Maryland who participated in a cardiovascular health assessment study. The study group consisted of 56 males and 90 females with a mean age of 69.8 +/- 6.6 years. The PRECEDE-PROCEED model guided selection of study variables. RESULTS: Many KAE with HBP had no regular HBP care (66%) and did not achieve HBP control (92.5% of KAE with HBP and 77.6% of KAE on HBP medications). Lack of health insurance emerged as a strong barrier to receiving adequate HBP care. Other barriers to HBP care included not having a Korean doctor and not having a regular medical checkup. While 22.4% of KAE on HBP medication had controlled blood pressure (BP), those with more visits to traditional Asian medicine doctors were less likely to have achieved HBP control. CONCLUSIONS: The study unveils some of the multilevel barriers to care and control of HBP uniquely experienced by KAE and suggests the need for developing interventions to assist KAE in managing HBP.

Aged↗

PubMed2005

Factors associated with depression experience of immigrant populations: a study of Korean immigrants.

A correlational, cross-sectional study with multivariate analysis was conducted to identify factors that influence the depression experience in 154 Korean immigrants. Based on the stress-health outcome framework, four variables (i.e., sense of mastery, socioeconomic status, social support, and acculturation) were tested for their mediating effects between stress and depression experienced by Korean Americans. Path analyses showed that the negative effect of life stress on depression was buffered by higher levels of sense of mastery and social support in the Korean sample. Implications for future cross-cultural depression research and preventive strategies against depression in immigrant populations are discussed.

Adult↗

PubMed2003

Hypertension care and control in underserved urban African American men: behavioral and physiologic outcomes at 36 months.

BACKGROUND: African American men with hypertension in low socioeconomic urban populations achieve poor rates of hypertension control and suffer early from its complications. METHODS: In a randomized clinical trial with 309 hypertensive urban African American men aged 21 to 54 years, we evaluated the effectiveness of a more intensive comprehensive educational-behavioral-pharmacologic intervention by a nurse practitioner-community health worker-physician (NP/CHW/MD) team and a less intensive education and referral intervention in controlling blood pressure (BP) and minimizing progression of left ventricular hypertrophy (LVH) and renal insufficiency. Changes in BP, left ventricular mass (LVM), and serum creatinine from baseline to 36 months were compared between groups. RESULTS: At 36 months, the mean systolic BP/diastolic BP change from baseline was -7.5/-10.1 mm Hg for the more intensive group and +3.4/-3.7 mm Hg for the less intensive group (P =.001 and.005 for between-group differences in systolic BP and diastolic BP, respectively). The proportion of men with controlled BP (<140/90 mm Hg) was 44% in the more intensive group and 31% in the less intensive group (P =.045). The LVM was significantly lower in the more intensive group than in the less intensive group (more intensive, 274 g; less intensive, 311 g; P =.004). There was a trend toward slowing of the progression of renal insufficiency (incidence of 50% increase in serum creatinine) in the more intensive group compared to the less intensive group (more intensive, 5.2%; less intensive, 8.0%; P =.08). CONCLUSIONS: During 36 months, the more intensive intervention led to a lower BP and decreased progression of LVH in a sample of hypertensive young African American men.

Adult↗

PubMed2003

Korean mothers' psychosocial adjustment to their children's cancer.

BACKGROUND: During the course of adjustment to their child's illness and medical treatment, parents of children with cancer may experience numerous challenges and difficulties. Although parental adjustment has been a research topic for many years, little research has been conducted among families in different cultures and countries. AIM: To identify factors that influence maternal psychosocial adjustment to childhood cancer using a new cultural group: Korean. METHODS: A sample of 200 Korean mothers of children with cancer was included in the study. Guided by the double ABCX model of family adjustment and adaptation, a series of variables (i.e. maternal stress, coping, social support and selected illness-related and demographic questions) were examined for their relationships with maternal psychosocial adjustment to childhood cancer. RESULTS: Using a hierarchical multiple regression, we found perceived level of stress, coping, social support, and time since diagnosis to be significant correlates of maternal psychosocial adjustment. Stress accounted for most (50%) of the total variance explained (56%) in maternal adjustment. CONCLUSION: The results suggest that the stress-coping framework may be appropriate in explaining maternal responses to childhood cancer across cultures.

Adaptation, Psychological↗

PubMed2003

Depression, substance use, adherence behaviors, and blood pressure in urban hypertensive black men.

Relationships between depression, alcohol and illicit drug use, adherence behaviors, and blood pressure (BP) were examined in 190 urban hypertensive Black men enrolled in an ongoing hypertension control clinical trial. More than one fourth (27.4%) of the sample scored greater than 16 on the Center for Epidemiological Studies-Depression Scale (CES-D), indicating a high risk of clinical depression. Depression was significantly associated with an increased likelihood of meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for alcohol abuse or dependence (odds ratio = 5.2; 95% confidence interval = 1.897-14.214). The level of depression was significantly correlated with poor medication (r =.301) and poor dietary compliance (r =.164). Both alcohol intake and illicit drug use were significantly correlated with poor dietary compliance (r =.195 and.185, respectively) and smoking (r =.190 and.269, respectively). Although no direct relationship between depression and the level of BP was substantiated by multivariate analysis, findings of descriptive analyses revealed statistically significant associations among depression, substance use, poor adherence, and poor BP outcomes. Given the harsh environment in which a large number of young urban Black men live, the high prevalence of substance abuse might be an attempt to fight off depression. Further in-depth investigation is needed to identify the role of depression and BP control in urban young Blacks in order to construct effective interventions that address their unique needs.

Adult↗

PubMed2002

The use of traditional and Western medicine among Korean American elderly.

With the current wave of Asian immigration to the United States, awareness of their use of traditional medicine, often in combination with Western medicine, is an increasingly salient issue for health care professionals. This paper describes the use of traditional and Western medicine by Korean American elderly and factors that are associated with their health-seeking behaviors and health service utilization. Data were obtained from a convenience sample of 205 Korean elderly immigrants through interview. The findings revealed that health service utilization among Korean American elderly covered a broad spectrum of health resources, including the use of Western medicine, the traditional Korean medicine (hanbang), or both Western and traditional clinics. In addition, health insurance status and the source of health care were found to relate to the types of health service that Korean American elderly chose to utilize. Better understanding of patterns of health service utilization may improve the quality of health care by increasing health providers' cultural sensitivity and facilitating adequate communication between Asian immigrant clients and their care providers. Implications for research and practice are discussed.

Aged↗

PubMedDate not supplied

Women's perceptions of their male batterers' characteristics and level of violence.

This article describes the characteristics of male perpetrators of domestic violence and their relationship to the level of violence. The data about the male partners obtained from 151 battered women were used for this analysis. Using multiple regression, demographic variables and three behavioral indicators, including use of alcohol before a violent episode, history of arrests, and the generality of violence, were examined together for their relationship with the violence scores. With the level of violence as measured by the Conflict Tactics Scale (CTS) as the dependent variable, demographic variables explained 19.1% of the variability, with the behavioral indicators accounting for an additional 4.6% of the variability. Several research and clinical implications are addressed.

Adolescent↗

PubMedDate not supplied

Constructing and testing a self-help intervention program for high blood pressure control in Korean American seniors--a pilot study.

Although significant progress has been made in the reduction of overall cardiovascular risk factors in the United States during the last decade, controlling high blood pressure (HBP) remains a difficult task for many individuals. In particular, socially disadvantaged groups, such as new immigrants, and ethnic minority groups, such as Korean Americans, continue to struggle with this chronic disease and suffer unnecessary complications. We conducted a quasi-experimental study to test the efficacy of a self-help intervention program for HBP control in first-generation Korean American seniors with HBP. The intervention consisted of 3 concurrently administered components: (1) structured behavioral education on HBP management, (2) home blood pressure (BP) monitoring, and (3) monthly support groups facilitated by a bilingual nurse. Of the 49 Korean American seniors (> or =60 years old) who agreed to participate, 31 received the intervention and completed the follow-up interviews at 6 months. Final analysis of BP outcomes using repeated measures and postintervention data suggested that the self-help intervention was effective in significantly improving the proportion of individuals who achieved BP control (<140/90 mm Hg) and in lowering both systolic and diastolic BP in the sample. Specifically, the BP control rate, which was 29% at baseline, increased at 6 months to 69%. Likewise, the mean systolic and diastolic BP values of 142.7 and 87.1 mm Hg at baseline decreased to 129.3 and 75.3 mm Hg, respectively, after 6 months of follow-up. This improvement of the HBP control rate in the sample highlights the clinical efficacy of the self-help intervention for this traditionally underserved immigrant group.

Aged↗

PubMedDate not supplied

The psychometric evaluation of Korean translation of the Personal Resource Questionnaire 85-Part 2.

BACKGROUND: Although the Personal Resource Questionnaire (PRQ 85-Part 2) has been widely used to measure perceived level of social support, results of psychometric evaluation of the measure with a Korean population are not currently available in the literature. OBJECTIVE: To assess the psychometric properties of the Korean language version of the PRQ 85. METHOD: An empirical validation of the theoretical relationships among the construct, social support, as measured by the PRQ 85, and other related constructs was conducted. In addition, factor structure comparison with a cross-validation technique was utilized on a combined sample of 555 Korean adults from three independent studies. RESULTS: Construct validity for the Korean PRQ 85 was evidenced by statistically significant correlations of perceived social support with the theoretically relevant variables such as depression and psychosocial adjustment. Using principal axis factoring with an oblique rotation, the two-factor solution was found to be most satisfactory in the first random sample and was cross-validated in the second sample, accounting for 52% and 54.1% of the total variance, respectively. Inspecting the distribution of variables within the factors, however, only the first factor appeared to be a construct-related factor; the second factor, which was exclusively represented by negatively keyed items, was method-related. CONCLUSION: The findings suggest that a one-factor solution can be used to accurately describe a substantive (or construct-related) factor pattern of the Korean version of the PRQ 85. Although researchers generally agree that negatively worded questions are important in order to minimize the "response bias," this approach appeared to be problematic for Koreans who used the translated PRQ 85. Further research is warranted to explicate this important methodological issue in cross-cultural instrumentation.

Adult↗

PubMedDate not supplied

Metric equivalence assessment in cross-cultural research: using an example of the Center for Epidemiological Studies--Depression Scale.

Metric equivalence is a quantitative way to assess cross-cultural equivalences of translated instruments by examining the patterns of psychometric properties based on cross-cultural data derived from both versions of the instrument. Metric equivalence checks at item and instrument levels can be used as a valuable tool to refine cross-cultural instruments. Korean and English versions of the Center for Epidemiological Studies-Depression Scale (CES-D) were administered to 154 Korean Americans and 151 Anglo Americans to illustrate approaches to assessing their metric equivalence. Inter-item and item-total correlations, Cronbach's alpha coefficients, and factor analysis were used for metric equivalence checks. The alpha coefficient for the Korean-American sample was 0.85 and 0.92 for the Anglo American sample. Although all items of the CES-D surpassed the desirable minimum of 0.30 in the Anglo American sample, four items did not meet the standard in the Korean American sample. Differences in average inter-item correlations were also noted between the two groups (0.25 for Korean Americans and 0.37 for Anglo Americans). Factor analysis identified two factors for both groups, and factor loadings showed similar patterns and congruence coefficients. Results of the item analysis procedures suggest the possibility of bias in certain items that may influence the sensitivity of the Korean version of the CES-D. These item biases also provide a possible explanation for the alpha differences. Although factor loadings showed similar patterns for the Korean and English versions of the CES-D, factorial similarity alone is not sufficient for testing the universality of the structure underlying an instrument.

Adolescent↗