This study was unique in that it focused on the rural elderly of both Black and White ethnicity's, explored differences between groups by comparing use and knowledge of health services, and controlled for gender, income, educational attainment, health status, age, and health beliefs - the independent variables of the study. Knowledge and use of health services were dependent factors. The Anderson behavioral model (Anderson, 1995) has been extensively used to examine health service utilization. It conceptualizes health care use as the outcome of a complex pattern of interactions between predisposing, enabling, and need-for care characteristics. The literature has supported the utility of the behavioral model for assessing the health care practices of rural older adults. Four questions were posed. These were translated into hypotheses for statistical testing purposes. Black and White elderly residents of one rural county in South Carolina comprised the target population. A sample of 150 elderly residents, 75 Black and 75 White, were randomly selected for participation. The multidimensional health locus of control scales were modified and used in the test instrument to assess health beliefs (both internal and external). Descriptive and background data were gathered from administration of the survey. Data were analyzed using SPSS statistical software. Analysis of variance (ANOVA) and the LSD (least significant differences) test, in addition to regression analysis, were used to compute and identify differences between and among groups of data. This research concluded that there was no correlation between use of services and knowledge of facilities. There were differences in utilization by race, with Whites making greater use of health care facilities. Educational levels, health status, income, household composition, type of insurance, and age influenced health care use. It was not influenced by gender, distance from facilities, and health beliefs. There was a statistically significant difference between knowledge and race, with Blacks having higher knowledge scores. Gender, health status, income, distance from facilities, and health beliefs did not influence knowledge. However, educational attainment, type of insurance, household composition, and age did. Service use and knowledge were adequate, in contrast to findings in the literature. Recommendations for further study were formulated. / Graduation date: 1999

Too many elderly women suffer rapid aging decline, frailty and hypokinetic disease simply because of inadequate levels of physical activity. While the biopsychosocial benefits of regular exercise are now well-known, explanations are lacking for the reluctance of aging Canadian females to take up, or keep up, healthful forms of leisure-time physical activity. The purpose of this study was to examine and explain the variability of participation in health-promoting form sof exercise in elderly women. Several health behavior theories and personal attributes have shown promise in explaining exercise behavior, and thus, a second purpose of the study was to test the utility of a composite theoretical model. The composite model included ten personal and situational attributes as well as five cognitive beliefs about physical activity adapted from Social Cognitive Theory and a belief about personal control over one's health from Health Locus of Control Theory. A city-wide sample of 327 Vancouver women aged 70 and 98 years filled out survey questionnaires providing information on the 16 model variables in addition to kilocalorie estimates of exercise in the past week. Multiple regression analysis was used to explain late life exercise in three stages: 1) regression on the ten personal and situational attributes; 2) regression on the six cognitive beliefs; and 3) combined regression on all the significant predictors. From the life situational variables, health, childhood movement confidence, school location, and age were significant factors explaining 18% of the variability seen in current exercise level. From the cognitive variables, current self-efficacy to exercise and current social support to engage in physical activity were the only significant predictors (R2 = 22%). A full regression model was tested by including the four statistically important situational variables and the two cognitive variables from the previous analyses. The utility of the Composite Model was supported in that both situational variables and self-referent beliefs played significant and independent roles in explaining late life exercise (R2 = 26%). The main reasons that older women were physically active were: 1) they perceived high levels of social support to exercise (b = .239, p< .01); 2) they felt efficacious for fitness-types of activities (b = .185, p< .01), 3) they had satisfactory health (b = .174, p < .01), and 4) they were educated in foreign countries (b = -.125, p < .01). Health locus of control offered some explanation but was not able to demonstrate significance alongside other cognitive beliefs (b = -.106, p < .06). Education, socioeconomic status, work role, family size, and marital status were not able to explain late life exercise. This study found that health difficulties do indeed interfere with women’s activity patterns. However, women are also influenced by perceptions of declining social support, lower levels of movement confidence, and chronological age, to reduce their physical activity. Thus, regardless of their health situation, the explanation of exercise involvement in older women rests to a large degree on the amount of social encouragement they perceive from family, friends and physicians, their self-efficacy for fitness activity, as well as perceptions of age-appropriate behavior. Older women who were educated as children outside of Canada, Britain and the U.S. appear to be culturally advantaged for late life physical activity participation. Moreover, childhood movement confidence stands as a significant predictor among the situational variables. These findings suggest that participation in physical activity, and positive beliefs about exercise in late oo, are rooted in competencies and experiences acquired in childhood. Perceptions of inadequate encouragement appear to be limiting females, from childhood on, to develop and sustain confidence in their physical abilities that would promote a more active lifestyle into their oldest life stage.

Too many elderly women suffer rapid aging decline, frailty and hypokinetic disease simply because of inadequate levels of physical activity. While the biopsychosocial benefits of regular exercise are now well-known, explanations are lacking for the reluctance of aging Canadian females to take up, or keep up, healthful forms of leisure-time physical activity. The purpose of this study was to examine and explain the variability of participation in health-promoting form sof exercise in elderly women. Several health behavior theories and personal attributes have shown promise in explaining exercise behavior, and thus, a second purpose of the study was to test the utility of a composite theoretical model. The composite model included ten personal and situational attributes as well as five cognitive beliefs about physical activity adapted from Social Cognitive Theory and a belief about personal control over one's health from Health Locus of Control Theory. A city-wide sample of 327 Vancouver women aged 70 and 98 years filled out survey questionnaires providing information on the 16 model variables in addition to kilocalorie estimates of exercise in the past week. Multiple regression analysis was used to explain late life exercise in three stages: 1) regression on the ten personal and situational attributes; 2) regression on the six cognitive beliefs; and 3) combined regression on all the significant predictors. From the life situational variables, health, childhood movement confidence, school location, and age were significant factors explaining 18% of the variability seen in current exercise level. From the cognitive variables, current self-efficacy to exercise and current social support to engage in physical activity were the only significant predictors (R2 = 22%). A full regression model was tested by including the four statistically important situational variables and the two cognitive variables from the previous analyses. The utility of the Composite Model was supported in that both situational variables and self-referent beliefs played significant and independent roles in explaining late life exercise (R2 = 26%). The main reasons that older women were physically active were: 1) they perceived high levels of social support to exercise (b = .239, p< .01); 2) they felt efficacious for fitness-types of activities (b = .185, p< .01), 3) they had satisfactory health (b = .174, p < .01), and 4) they were educated in foreign countries (b = -.125, p < .01). Health locus of control offered some explanation but was not able to demonstrate significance alongside other cognitive beliefs (b = -.106, p < .06). Education, socioeconomic status, work role, family size, and marital status were not able to explain late life exercise. This study found that health difficulties do indeed interfere with women’s activity patterns. However, women are also influenced by perceptions of declining social support, lower levels of movement confidence, and chronological age, to reduce their physical activity. Thus, regardless of their health situation, the explanation of exercise involvement in older women rests to a large degree on the amount of social encouragement they perceive from family, friends and physicians, their self-efficacy for fitness activity, as well as perceptions of age-appropriate behavior. Older women who were educated as children outside of Canada, Britain and the U.S. appear to be culturally advantaged for late life physical activity participation. Moreover, childhood movement confidence stands as a significant predictor among the situational variables. These findings suggest that participation in physical activity, and positive beliefs about exercise in late oo, are rooted in competencies and experiences acquired in childhood. Perceptions of inadequate encouragement appear to be limiting females, from childhood on, to develop and sustain confidence in their physical abilities that would promote a more active lifestyle into their oldest life stage. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate