kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2015.15.2.63 kjhp-15-63 Original Article Analysis of Factors Affecting the Need for Health Education Programs in Middle-aged Women KimYo Jin 1 BaeChang Oh 2 Educational Administration Major, Kangnam University the Graduation School of Educate, Yongin, Korea Department of Education, Kang Nam University of Teacher's College, Yongin, Korea Corresponding author：Chang Oh Bae, PhD Department of Education, Kang Nam University of Teacher's College, 40 Gangnam-ro, Giheung-gu, Yongin 446-702, Korea Tel: +82-31-280-3919, Fax: +82-31-280-3919 E-mail: chango@kangnam.ac.kr 122015 19122015 152 6374 24082014 23032015 Copyright © 2015 The Korean Society of Health Promotion and Disease Prevention 2015 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. Background

This study aimed to analyze the factors affecting health education program needs as defined by the World Health Organization (WHO) for promoting health in middle-aged women.

 Methods

Study subjects included 203 middle-aged women ranging in ages between 40 and 59 years, living in S-city. Data were collected from September 10 to 24, 2011. Descriptive statistics, independent t-test, and one-way ANOVA were used to analyze general characteristics and the need for health education programs related to the general characteristics. Hierarchical multiple regression was used to access the factors influencing the need for health education programs. All data were analyzed by SPSS/WIN 17.0 program.

 Results

The average score of the health promotion behaviors was 3.46 (±0.74). The average score of the need for health education programs (including physical, psychological, and social health education programs) was 3.88 (±0.13); and this was affected by age (psychological health education programs β=-0.21), self-actualization (physical, psychological, social health education programs β=0.28, β=0.30, β=0.30), health responsibility (social health education programs β=0.21), interpersonal support (physical health education programs β=0.18), and stress management (social health education programs β=0.18).

 Conclusions

Based on the study results, health education for middle-aged women should be impacted less by monthly income and educational background, and should have more specialized, accessible contents considering not only programs that middle-aged women prefer but also the factors influencing the needs of health education.

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Research model.

General characteristics

(n=203)
Characteristics Categories Valuesa
Age, y 40's (40-49) 132 (65.0)
50's (50-59) 71 (35.0)
Marital status Yes 187 (92.1)
(does living with a spouse) No 16 (7.9)
Educational level, y ≤High school 103 (50.7)
≤College 92 (45.3)
≥Graduate school 8 (3.9)
Monthly income, mo Less than 1.5 million won 17 (8.4)
1.51-3 million won 87 (42.9)
3.01-5 million won 79 (38.9)
More 5.01 million won 20 (9.9)
Job Yes 86 (42.4)
No 117 (57.6)
Menstruous status Menopausal transitionb c 31 (15.3)
Natural menopausec 31 (15.3)
Artificial menopaused e 16 (7.9)
Menstruatione 125 (61.5)
Female hormone therapy Yes 15 (7.4)
No 188 (92.6)

Values are presented as N (%).

Defined as irregular menstruation and period of up to one year after the last menstrual.

Defined as more than 12 months of amenorrhea status.

Defined as menopause due to surgical obstetrics and gynecology.

Defined as regular menstruation.

Level of health promoting behaviors

Categories Number of question Valuesa
Self-actualization 11 3.88 (±0.62)
Health responsibility 10 3.10 (±0.77)
Exercise & nutrition 12 3.15 (±0.75)
Interpersonal support 7 3.83 (±0.59)
Stress management 7 3.36 (±0.65)
Total 47 3.46 (±0.74)

Values are presented as mean±SD unless otherwise indicated.

Need of health education programs (n=203)

Category Valuesa Total
Physical health care programs Disease management Menopausal care and successful aging 4.34 (±0.74) 4.26 (±0.51) 3.95 (±0.39) 3.88 (±0.13)
Prevention ․ management of cancer 4.53 (±0.69)
Prevention of osteoporosis and exercise therapy 4.32 (±0.69)
Prevention of urinary incontinence and exercise therapy 4.20 (±0.71)
Prevention ․ management of adult disease 4.36 (±0.72)
Menopausal management of oriental medicine 3.86 (±0.84)
Sport for all Physical fitness program 4.11 (±0.83) 3.86 (±0.03)
Dance 3.58 (±0.91)
Sport 3.88 (±0.87)
Alternative therapy Type of western medicine 3.70 (±0.80) 3.73 (±0.08)
Type of oriental medicine 3.80 (±0.85)
Type of oriental-western medicine 3.70 (±0.82)
Psychological health care programs Disease management Counseling Prevention of depression․suicide 4.37 (±0.83) 4.38 (±0.01) 3.92 (±0.58)
Prevention of dementia 4.38 (±0.85)
Group counseling 3.60 (±0.93) 3.58 (±0.03)
Art therapy (mandala) 3.56 (±0.88)
Stress management Singing 3.99 (±0.79) 3.80 (±0.46)
Laughter therapy 4.07 (±0.78)
Aromatherapy 3.58 (±0.91)
Mindfulness-based stress reduction (MBSR) 3.56 (±0.91)
Social health care programs Interpersonal relations Marital relationship enhancement program 4.03 (±0.93) 3.91 (±0.37) 3.78 (±0.25)
Role playing 3.61 (±0.87)
Communication for conflict management 4.08 (±0.78)
Protection of the environment Making related to eco-friendly household items 3.55 (±0.91) 3.58 (±0.05)
Eco-activism (NGO activities) 3.62 (±0.86)
Citizenship Women-related legal and welfare policy 3.92 (±0.82) 3.85 (±0.15)
Gender Equality volunteer activity 3.73 (±0.85)
3.91 (±0.94)

Abbreviation: NGO, non-governmental organization.

Values are presented as mean±SD.

Need of health education program related to general characteristics (n=203)

General characteristics Physical Psychological Social
Disease management Sport for all Alternative therapy Disease management Counseling Stress management Interpersonal relation Protection of the environment Citizenship
Mean (SD) t/F (Pa) Mean (SD) t/F (Pa) Mean (SD) t/F (Pa) Mean (SD) t/F (Pa) Mean (SD) t/F (Pa) Mean (SD) t/F (Pa) Mean (SD) t/F (Pa) Mean (SD) t/F (Pa) Mean (SD) t/F (Pa)
Age, y 1.78 (0.077) 1.94 (0.053) -0.02 (0.982) 2.87 (0.005b) 2.08 (0.039c) 1.48 (0.141) 1.80 (0.073) 2.25 (0.026) 2.33 (0.021c)
40-49 4.32 (0.53) 3.93 (0.72) 3.74 (0.72) 4.50 (0.73) 3.67 (0.82) 3.85 (0.68) 3.99 (0.68) 3.65 (0.76) 3.94 (0.76)
50-59 4.18 (0.51) 3.73 (0.64) 3.74 (0.62) 4.17 (0.87) 3.42 (0.79) 3.71 (0.67) 3.76 (0.76) 3.48 (0.71) 3.69 (0.66)
Marital status 2.25 0.54 0.55 2.30 1.23 1.78 1.76 1.36 3.53
(does living with a spouse) (0.026c) (0.589) (0.583) (0.023c) (0.221) (0.076) (0.080) (0.175) (0.001b)
Yes 4.29 (0.50) 3.87 (0.69) 3.74 (0.65) 4.45 (0.69) 3.60 (0.80) 3.83 (0.64) 3.95 (0.69) 3.60 (0.74) 3.91 (0.69)
No 3.99 (0.69) 3.77 (0.84) 3.60 (1.02) 3.63 (1.42) 3.34 (0.98) 3.52 (0.97) 3.50 (1.00) 3.44 (0.81) 3.25 (0.96)
Educational level, y 7.57 (0.001b) 5.43 (0.005b) 3.11 (0.047c) 10.56 (p ＜ 0.0001) 2.90 (0.057) 4.87 (0.009b) 3.88 (0.022c) 3.46 (0.033c) 3.77 (0.025c)
≤ High school 4.25 (0.50) 3.71 (0.67) 3.63 (0.67) 4.39 (0.67) 3.46 (0.83) 3.68 (0.71) 3.78 (0.72) 3.49 (0.73) 3.73 (0.73)
≤ College 4.35 (0.51) 4.03 (0.69) 3.87 (0.71) 4.48 (0.75) 3.73 (0.78) 3.96 (0.62) 4.07 (0-67) 3.71 (0.76) 4.01 (0.69)
≥Graduate school 3.63 (0.46) 3.50 (0.85) 3.58 (0.53) 3.19 (1.67) 3.44 (0.82) 3.63 (0.52) 3.71 (1.00) 3.50 (0.80) 3.75 (1.05)
Monthly income, mo 1.46 (0.226) 2.36 (0.073) 3.39 (0.019c) 3.78 (0.011c) 3.08 (0.028c) 4.34 (0.005b) 2.52 (0.059) 1.73 (0.162) 1.40 (0.243)
Less than 1.5 million won 4.06 (0.83) 3.51 (0.97) 3.31 (1.15) 3.88 (1.05) 3.32 (0.97) 3.46 (0.97) 3.55 (1.00) 3.38 (0.99) 3.59 (1.15)
1.51-3 million won 4.28 (0.47) 3.87 (0.61) 3.74 (0.65) 4.53 (0.63) 3.51 (0.89) 3.79 (0.63) 3.94 (0.62) 3.56 (0.68) 3.81 (0.73)
3.01-5 million won 4.27 (0.49) 3.87 (0.67) 3.76 (0.58) 4.30 (0.84) 3.60 (0.69) 3.79 (0.63) 3.88 (0.75) 3.64 (0.73) 3.92 (0.64)
More 5.01 million won 4.42 (0.55) 4.12 (0.85) 4.02 (0.59) 4.46 (0.87) 4.05 (0.67) 4.23 (0.57) 4.25 (0.65) 3.68 (0.89) 4.03 (0.67)
Job -0.22 (0.823) -0.97 (0.332) -1.09 (0.277) 0.08 (0.936) 0.89 (0.376) 0.90 (0.368) -1.47 (0.142) -0.11 (0.916) -0.78 (0.436)
Yes 4.26 (0.54) 3.81 (0.69) 3.67 (0.75) 4.39 (0.90) 3.50 (0.80) 3.71 (0.69) 3.82 (0.81) 3.62 (0.76) 3.81 (0.76)
No 4.28 (0.51) 3.90 (0.71) 3.78 (0.64) 4.38 (0.72) 3.65 (0.83) 3.87 (0.65) 3.98 (0.65) 3.57 (0.74) 3.89 (0.72)
Menstruous status 6.08 (0.001b) 5.27 (0.002b) 0.24 (0.869) 3.63 (0.014c) 0.11 (0.957) 0.33 (0.807) 0.22 (0.884) 1.60 (0.190) 6.36 (p< 0.0001)
Menopausal transition 3.93 (0.65) 3.46 (0.85) 3.71 (0.94) 4.03 (1.08) 3.57 (0.84) 3.79 (0.72) 3.82 (0.85) 3.36 (0.80) 3.52 (0.97)
Natural menopause 4.26 (0.50) 3.82 (0.61) 3.77 (0.67) 4.26 (0.55) 3.52 (0.85) 3.73 (0.75) 3.84 (0.67) 3.63 (0.79) 3.69 (0.68)
Artificial menopause 4.26 (0.53) 3.73 (0.57) 3.85 (0.38) 4.28 (1.00) 3.63 (0.56) 3.70 (0.41) 3.94 (0.53) 3.44 (0.51) 3.54 (0.69)
Menstruation 4.36 (0.46) 3.99 (0.66) 3.71 (0.65) 4.52 (0.71) 3.60 (0.82) 3.84 (0.68) 3.95 (0.73) 3.66 (0.75) 4.02 (0.64)
Female hormone therapy -0.96 (0.339) -0.10 (0.920) 0.12 (0.908) -1.41 (0.159) 0.24 (0.807) -0.51 (0.608) 0.13 (0.898) 0.29 (0.776) -1.47 (0.144)
Yes 3.93 (0.65) 3.46 (0.85) 3.73 (0.94) 3.97 (1.22) 3.63 (0.74) 3.72 (0.87) 3.87 (0.86) 3.70 (0.92) 3.47 (1.10)
No 4.26 (0.50) 3.82 (0.61) 3.77 (0.67) 4.28 (0.75) 3.58 (0.82) 3.81 (0.66) 3.92 (0.71) 3.58 (0.74) 3.89 (0.70)

Abbreviation: SD, standard deviation.

Calculated by independent t-test or one-way ANOVA.

P ＜ 0.01.

P ＜ 0.05.

Factors affecting for need of health education programa (n=203)

Physical Physical Psychological Social
Model I Model II Model I Model II Model I Model II
β t P β t P β t P β t P β t P β t P
General characteristics
Age (ref.=40'sb), y -0.08 -0.82 0.413 -0.11 -1.22 0.224 -0.17 -1.85 0.066 -0.21 -2.29 0.023c -0.11 -1.23 0.222 -0.14 -1.62 0.107
Marital status (ref.=don't live with spouse) 0.06 0.89 0.374 0.00 0.03 0.976 0.15 2.12 0.035c 0.11 1.62 0.106 0.16 2.31 0.022c 0.11 1.71 0.089
Education level, y 0.01 0.06 0.952 -0.02 -0.32 0.749 0.03 0.47 0.973 0.01 0.07 0.947 0.13 1.75 0.081 0.09 1.45 0.147
Monthly income degree, mo 0.12 1.60 0.111 -0.05 -0.72 0.472 0.14 1.78 0.076 -0.01 -0.09 0.925 0.06 0.74 0.459 -0.10 -1.35 0.179
Job -0.05 -0.74 0.460 -0.11 -1.63 0.105 -0.07 -1.02 0.309 -0.11 -1.58 0.115 -0.05 -0.67 0.507 -0.09 -1.42 0.160
Menstruous status (ref=regular menstruationd)
Menopausal transition -0.21 -2.60 0.010c -0.12 -1.74 0.083 0.01 0.13 0.899 0.08 1.09 0.275 -0.12 -1.50 0.135 -0.04 -0.50 0.618
Natural menopause 0.01 0.00 1.000 0.06 0.69 0.491 0.08 0.82 0.413 0.13 1.45 0.147 0.01 0.09 0.922 0.05 0.58 0.565
Artificial menopause -0.01 -0.10 0.920 0.04 0.60 0.579 0.04 0.51 0.610 0.08 1.15 0.250 -0.04 -0.44 0.658 0.01 0.18 0.857
Female hormone therapy 0.05 0.61 0.543 0.03 0.48 0.632 -0.01 -0.13 0.897 -0.02 -0.29 0.770 0.01 0.18 0.860 -0.01 -0.07 0.947
Health promoting behaviors
Self-actualization 0.28 3.54 <0.001 0.30 3.61 <0.001 0.30 3.79 < 0.001
Health responsibility 0.11 1.34 0.182 0.16 1.84 0.068 0.21 2.52 0.013c
Exercise & nutrition -0.05 -0.50 0.618 -0.13 -1.39 0.170 -0.16 -1.76 0.080
Interpersonal support 0.18 2.31 0.022c 0.07 0.87 0.384 0.02 0.22 0.830
Stress management 0.14 1.69 0.093 0.09 1.06 0.289 0.18 2.09 0.037c
R2 0.087 0.293 0.087 0.222 0.104 0.268
AdjR2 0.044 0.240 0.045 0.164 0.062 0.214
F(P) 2.03 (0.044c) 5.57(P＜0.001) 2.05 (0.043c) 3.83 (P ＜ 0.001) 2.49 (0.014c) 4.92 (P＜0.001)

Assessed by hierarchical multiple regression analysis.

Reference group for comparison was the 40's group

P ＜ 0.05.

Reference group for comparison was the group with regular menstruation.