CALIFORNIA STATE UNIVERSITY, NORTHRIDGE
IDENTIFYING THE HEALTH EDUCATION NEEDS
OF THE ELDERLY
A graduate project submitted in partial
satisfaction of the requirements
for the degree of
Master of Public Health
by
Jacquelyn Clutter
January, 1982
/
The Graduate Project of Jacquelyn Clutter is approved:
Date
Michael V. Kline,··· Dr.P.H.
G.B. Krishnamurty, Dr.P.H.
Committee Chairperson
Date
California State University, Northridge
ii
ACKNOWLEDGEMENTS
The author wishes to express her gratitude to the
members of her Committee for their interest and assistance
during the course of this study.
Grateful appreciation
is expressed to Dr. Michael Kline, Dr. Norberta Brown,
and particularly to Dr. G.B. Krishnamurty, the Committee
Chairman.
My thanks go, also, to my classmates, Peggy Streid
and Charlotte Laubach, who took time to help me with this
thesis.
Special appreciation is extended to the sixty
senior citizens who completed the questionnaires and thus
made this study possible.
A special thanks to my husband, Jim, for his
patience, cooperation and encouragement which has made
this achievement possible.
iii
TABLE OF CONTENTS
Page
APPROVAL
. . . . . . . . . .
. . . . . . . . . . . .
ii
ACKNOWLEDGE~iliNTS
iii
LIST OF TABLES
vi
ABSTRACT
X
CHAPTER
1.
1
INTRODUCTION
Statement of the Problem
5
Significance of the Problem .
5
Purpose of the Study
9
.
.
.
.
Definition of Terms .
9
Limitations of the Study
2•
3•
11
REVIEW OF LITERATURE
12
Well-Being in Old Age
12
Health Education for the Elderly
14
Findings of Related Studies
16
Summary .
18
.
METHODOLOGY
19
Identification of the problem
19
Survey Instrument .
.
20
Selection of the Sample
.
Administration of Inventory Survey.
.
21
23
Statistical Treatment of the Data .
•
23
iv
Page
Chapter
4.
RESULTS AND DISCUSSION .
Descriptive Data . .
....
5.
26
30
Data Presentation
Rank Order of Health Categories
26
. • •
30
Discussion of Responses to Health
Categories
• • . • • • • . •
33
Implications for Future Curriculum
Planning . . . . . . . . . . . .
38
SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS
Summary
40
Conclusions
41
Recommendations
42
BIBLIOGRAPHY .
44
APPENDICES • •
49
APPENDIX A
APPENDIX B
HEALTH INVENTORY SURVEY
INSTRUMENT • • • . • .
50
CONTINGENCY TABLES FOR RESPONSES
TO HEALTH STATEMENTS . . • . •
58
v
LIST OF TABLES
Table
1.
Page
List of Inventory Items by Health
Category and Mean Score
.
5.
. .
.
Age of Respondents .
. . . . . . .
Sex of Respondents .
. . .
Ethnic Background of Respondents
.
Marital Status of Respondents
. .
6.
Educational Background of Respondents
7.
Work Status of Respondents
8.
Mean Scores of Responses to the Fifty
Health Statements
.
.
9.
Rank Order of Health Category
2.
3.
4.
.
..
25
. .
27
27
. .
. .
28
29
. . . . . .
. . .
28
. . .
29
31
34
10.
Contingency Table for Response to
Statement 1
. .
. . . .
59
11.
Contingency Table for Response to
Statement 2
. .
. . . .
59
12.
Contingency Table for Response to
Statement 3
. . .
. . . .
60
13.
Contingency Table for Response to
Statement 4
. . . .
60
14.
Contingency Table for Response to
Statement 5
. . . .
61
15.
Contingency Table for Response to
Statement 6
.
. ...
61
16.
Contingency Table for Response to
Statement 7
....
62
17.
Contingency Table for Response to
Statement 8
•
...
62
. . . . .
.
. . .. .
.
.
.
.
. .
. . . . . . . .
. . . . . . . .
.....
. .
. . . . . . . .
........
vi
Table
18.
19.
20.
21.
22.
Page
Contingency Table for Response to
Statement 9
63
Contingency Table for Response to
.
Statement 10
63
Contingency Table for Response to
Statement 11 . . .
64
Contingency Table for Response to
Statement 12
.
64
. . . .. . . . . .
. .
. . . . . . .. ...
.
. . . . . . . . ..
. . . . . . .
. . . . .
Contingency Table for Response to
Statement 13
.........
. . . .
65
Contingency Table for Response to
Statement 14
. ... . . . .. . . . .
65
Contingency Table for Response to
Statement 15 .
66
25.
Contingency Table for Response to
Statement 16
66
26.
Contingency Table for Response to
Statement 17
.
.
67
Contingency Table for Response to
Statement 18
.
67
28.
Contingency Table for Response to
Statement 19
68
29.
Contingency Table for Response to
Statement 20
.
68
Contingency Table for Response to
Statement 21
.
69
Contingency Table for Response to
Statement 22
69
23.
24.
27.
30.
31.
32.
33.
. .. . . . .. . . ..
. . . . . . . . . . .. .
. . .
. .
. . .
. . . . .
. . . . . . . . . .
. . . . . . . . . . . . .
. . . . . . . . . . ..
. . ..
........
....
Contingency Table for Response to
Statement 23 . . . . . . . . . . . . .
Contingency Table for Response to
Statement 24
......• .• • ...
. . . . . . . . .
vii
70
70
Page
Table
34.
Contingency Table for Response to
Statement 25
35.
Contingency Table for Response to
.
Statement 26
71
Contingency Table for Response to
Statement 27
72
Contingency Table for Response to
Statement 28
72
Contingency Table for Response to
Statement 29
73
Contingency Table for Response to
Statement 30
73
Contingency Table for Response to
Statement 31
74
Contingency Table for Response to
Statement 32
.
74
Contingency Table for Response to
Statement 33
75
Contingency Table for Response to
Statement 34
. .
75
36.
37.
38.
39.
40.
41.
42.
4 3.
44.
45.
46.
47.
48.
49.
. . . . . . . . .. .
..
.. ........
. .
. . . .. .. . . . . . .
. . . . . . . . . . . . .
. . .. ... . . . . . .
.............
. . ... . . . . . . . .
. . . . . ......
.
. . . . . .. . . ....
.
. . . . . . .. . .
. contingency Table for Response to
Statement 35
. . .
. . . .
.
..
71
. . .
76
Contingency Table for Response to
Statement 36
.
. . . . . . . . .
76
Contingency Table for Response to
Statement 37
•
•
77
Contingency Table for Response to
Statement 38
.
.
77
Contingency Table for Response to
Statement 39
79
Contingency Table for Response to
Statement 40
•
•
79
. . .
...
...
.. ......
.. ......
.............
... ..... ...
viii
Page
Table
50.
Contingency Table for Response to
. .
Statement 41
79
51.
Contingency Table for Response to
Statement 42
. .
79
52.
Contingency Table for Response to
Statement 43
.
80
Contingency Table for Response to
Statement 44
80
Contingency Table for Response to
Statement 45
81
Contingency Table for Response to
Statement 46
. . .
81
Contingency Table for Response to
Statement 47
82
57.
Contingency Table for Response to
Statement 48
.
. .
82
58.
Contingency Table for Response to
Statement 49
83
Contingency Table for Response to
Statement 50
83
53.
54.
55.
56.
59.
. . . . .
.
.....
. .. . . . .
. . . .
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. .
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.....
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.
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......
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ix
ABSTRACT
IDENTIFYING THE HEALTH EDUCATION NEEDS
OF THE ELDERLY
by
Jacquelyn Clutter
Master of Public Health
The purpose of this study was to identify and
analyze the health education needs of a selected group
of elderly people residing in West Los Angeles and
Woodland Hills.
In order to determine what health
education may be necessary, an assessment to identify
needs for meaningful program planning was conducted.
The methodology of this investigation was a
descriptive survey which utilized the DeLeeux MultiDimensional Health Behavior Inventory, and was administered to a total of sixty elderly people:
The health
behavior inventory (HBI) contained questions concerning
the current health practices of each elderly individual
X
in seven health categories and represented the level of
elderly health needs.
Against an optimal/preferred
overall mean score of 5.0, the inventory showed that the
elderly exhibited a reasonably sound health behavior.
To establish a rank order of need for the seven
health categories, the means for each items within each
health category were obtained to find the difference
between the optimal score of 5.0 and the calculated
actual mean score.
The health category with the greatest
variance from the optimal score became the number one
rank order of health needs.
Physical Fitness, Personal
Health, and Mental Health were the health categories
that had the greatest need for health education within
the combined groups surveyed.
The conclusions of this investigation indicated
the number one health education need for the West
Los Angeles group to be Physical Fitness with a rank
order for Mental Health, Personal Health, Nutrition,
Consumer Health, Safety, and Drugs.
The survey for the
Woodland Hills group ranked Personal Health as the
number one need with Physical Fitness, Mental Health,
Nutrition, Consumer Health,
in rank order.
Safet~
and Drugs following
The composite of both groups supported
Physical Fitness as the number one need and then Personal
Health, and Mental Health following as second and third
and the balance unchanged.
xi
Chapter 1
INTRODUCTION
Health is of basic importance to man.
Health has
been defined as "a state of complete physical, mental,
and social well-being, and not merely the absence of
disease or infirmity" (7:29-43).
Health has also been
defined as "the quality resulting from the total functioning of the individual in his environment, that empowers
him to achieve a personally satisfying and socially
useful life"
(23:15).
Health influences one's way of
life, improves personal efficiency, and facilitates
attainment of personal goals.
The fulfillment of life's
broadest and best purposes is aided by health education.
•
Awareness of health needs makes health instruc-
tion effective.
An understanding of the health needs of
the elderly is basic to planning a sound health education
program and is a first step in successful health teaching.
Johns believes that health education cannot take place
without adequate knowledge of current student needs, so
that an education plan could be tailored to fit the
particular needs of the individuals.
According to this
author, the information obtained from an assessment plan
can be valuable in providing criteria for planning
1
2
objectives in health teaching (24:72).
Despite the advancements made in the health
field, millions of Americans are still needlessly ill
and many die unnecessarily.
As a consequence, three
billion working days--or sixteen days for each American-are lost annually (17:18).
Clearly, by fostering
acceptance of scientific knowledge, health education can
bridge the gap between a discovery and its practical
application.
The basic thesis of education has been that the
thinking and behavior of people can be "changed for the
better."
As new demands or situations are created,
needs must be assessed.
Meaningful activity should be
definite, continuous, and constantly evaluated.
The
outcome of effective health education will be to produce
better health practices, beneficial health knowledge,
and increase motivation resulting in behavioral changes
{13:254-60).
Therefore, it is vital to identify the
health education needs of the elderly and to utilize
these findings as guidelines for ultimate curriculum
planning.
The numbers in themselves are enlightening.
There are nearly 24 million Americans aged sixty or
older, 14.7 percent of the United States population.
This segment grew 8.5 percent in 1970-74 while the entire
3
United States population grew at less than half that
rate.
The implications of these figures for health
professionals are striking because the elderly have
multiple medical, social, economic, and other problems.
Because they are high utilizers of health services, and
because they represent an expanding segment of the total
population, the elderly are a particularly appropriate
target for improved health services that are designed to
prevent premature illness and hospitalizations (17:34).
The general goal of the Older Americans Act of
1965 was to maintain the health, dignity and constructive interdependence of older people throughout their
lifetime.
The 1973 Amendments also created a network
of organizations at both state and local levels of
government.
These organizations were responsible for
developing a system of comprehensive, coordinated
services at the local level; their special goal was to
create options that would enable older persons to avoid
inappropriate institutionalizations and to remain in
their own homes (12:21).
The extent of the lack of provisions for the
quality of life of the elderly becomes more apparent as
the nuwber of elderly people in our population increases.
Even after retirement itself, it is still appropriate to
provide educational experiences designed to continue
positive attitudes toward aging.
Most older people have
4
an intense interest in the changes that they see in
themselves and their cohort.
Later life may be a time
for turning inward, of concern for health, of consciously reduced life span; but it is also a time when
knowledge may help one to understand the similarity of
situations and the support that may come from other's
knowledge.
Thus, the development and continuation of
accurate knowledge and a positive disposition toward
aging is one of the necessary functions of life-span
education.
The educational system as one of the major social
institutions of our society with its vast resources should
be deeply concerned with the problems of the elderly.
This is well illustrated by the statement:.
Older persons as a class tend to be faced with
numerous personal and social problems without
adequate resources to meet them. These problems are
usually categorized under such headings as income,
health, housing, medical care, family, education, and
recreation.
Some needs, such as learning a new
vocation, keeping mentally active, and developing
vocational interests can be met directly by educational programs. It is also true that needs in
other areas, such as health, housing, medical care,
and family relationships, cannot be met adequately
without extensive use of educational processes
(18:1).
It is of utmost importance to provide for the
needs of the elderly, but before this can take place we
must be aware of what their needs really are.
It was
evident from reviewing the literature of related health
needs studies that there has been little done in this
5
area.
Hence the focus of this study was determined.
The
justification for this study is substantiated by the fact
that health education needs change with time and, for
health education to be effective, the needs and interests
should be identified regularly.
Statement of the Problem
Despite the advancements made in the health field,
the lack of provisions for the quality of life of the
elderly becomes increasingly apparent.
Education can
play a major part in providing knowledge and awareness
but in order to be optimally effective and successful,
teaching must be based upon, if not identical with, the
needs and interests of the consuming learners.
It was evident from reviewing the literature of
related health needs studies that there has not been any
recent comprehensive inquiry concentrating solely upon
the collection, analysis, and comparison of the health
education needs of the elderly.
There is a critical need
to identify areas of health education needs within the
elderly population.
Significance of the Problem
There are currently 24 million Americans over the
age of sixty.
One of the most dramatic shifts in the
United States population has been the increasing number
of persons reaching age 65.
This proportion has
6
increased from 3 percent in 1900 to over 10 percent of
today's population.
Within the next 40 years, this age
group is projected to expand to 20 percent.
This shift,
coupled with diminishing environmental and economic
resources, will impose a considerable burden on the local
and national agencies who both subsidize and regulate
health and social services for the elderly.
Because of
these trends, national attention is now focused on stepping up research, training, and health policy activities
to improve social conditions and health care for the
elderly.
With an increased number of elderly people in
our population, the notable lack of providing for the
quality of life of the elderly becomes more apparent.
This research was initiated to identify the health education needs of the elderly.
Health educators have long recognized the
importance of being aware of the needs of students.
They
were primarily concerned with the young from kindergarten
through twelfth grade and, more recently, the needs of
college students.
Extensive research has been done to
identify and evaluate those needs but the time is now
favorable to identify the needs of another sector of our
society--the elderly.
The University of California,
Los Angeles, academic program in Geriatric Medicine and
Gerontology provides courses and training to medical
students in the dynamics of the aging process, disease
7
and health maintenance for the elderly, evaluation of
health care needs and the implementation of treatment
strategies.
As the average life expectancy increases, new
challenges emerge for the health educator.
First, all
individuals must be provided basic health and preventive
care concepts relative to aging that will enable the
individual to plan and generate a more enjoyable lifespan.
Second, both society as an entity and each individual
within society must begin to develop more positive values
and attitudes toward aging and the aged.
Eradicating
negativism toward aging will help develop within individuals a more healthy mental perspective throughout their
aging process and will also contribute to the development
of a society more responsive to the special needs and
abilities of the elderly.
Meeting these challenges are
congruent with two contemporary purposes of health
education: to provide health information and to improve
mental health.
As new information relative to the process of
aging is uncovered, factors contributing to longevity and
maintenance of optimal bodily functioning throughout the
lifespan are being documented.
These physiological data
provide an essential core of content for curriculum
development in health education.
8
In the context of health education, the life perspective can be enhanced by aging as part of the K-12
curricula.
The first real push for aging curricula for
elementary and secondary schools carne with the 1961 White
House Conference on Aging.
The report of that conference
stated:
The initial stimulation of educational programs
for, about, and by aging, should be through institutions that have public responsibility for education
•..• These institutions are public schools, institutions of higher learning, and libraries (40:83).
The 1961 policy statement paved the way for a
greater push that came with the 1971 White House Conference, which looked more closely at aging education for
all levels of public schooling.
Volume II of that report
included a resolution requesting funds to form committees
at all levels of public education to develop curricular
materials dealing with all phases of human life and to
develop programs to train teachers at all levels to teach
about aging (41:8).
Theorists today agree that aging is
appropriate matter for students, K-12.
Some work has
also been done to identify appropriate content area
objectives for the various grade levels (33:314-317).
research data increases, we must recognize the need to
take action early to help students develop attitudes
toward aging and the aged which will affect their
behavior now and in later years.
As
9
Purpose of the Study
The purpose of this investigation was to identify
the health education needs of a selected group of elderly
people residing in the West Los Angeles area and Woodland
Hills area.
Definition ·of Terms
To facilitate comprehension of the significance
and importance of the problem, the following terms and
concepts are clarified:
Aging
The process of growing older.
Elderly
People aged sixty years and older.
Gerontology
The systematic study of old age and the aging
process.
Health
A state of complete physical, mental and social
well-being and not merely the absence of disease or
infirmity.
Health Education
A process with intellectual, psychological, and
10
social dimensions relating to activities which increase
the abilities of people to make informed decisions affecting their personal, family, and community well-being.
This process, based on scientific principles, facilitates
learning and behavioral change in both health personnel
and consumers, including children and youth.
Needs
Maslow has divided man's needs into five main
levels.
These five needs appear in man's life in the
following sequence:
physical needs, security needs,
social needs, ego needs and self-fulfillment needs.
Educational Needs of Older People
Five categories of educational needs which can
be~met
by instructional interventions are:
(1)
coping
needs- needs which occur in aging and the obsolescence
of unused skills;
(2) expressive needs- needs for activity
or participation engaged in for their own sake;
(3) con-
tributive needs- the desire of people in assisting others
and in achieving their own developmental tasks;
(4) in-
fluence needs- development of personal or group skills,
knowledge of social supports; and (5) transcendence needsneeds for gaining some deeper understanding of the meaning of life.
11
Limitations of the Study
1.
The study was concerned with a selected
elderly population's health education needs as opposed
to their general health needs.
2.
No attempt was made to determine what health
education had taken place prior to the interview.
3.
No attempt was made to review the person's
medical or health records; health defects were not the
focus of the study.
4.
"Need" was taken to mean a perceived need,
or a want, not a determined deficiency.
Chapter 2
REVIEW OF THE LITERATURE
This chapter will include a review of selected
literature on well-being in old age, health education
for the elderly, and findings of related studies.
Well-Being in Old Age
Well-being in old age is the result of social,
psychological, and physical factors. · Psychological and
physical well-being are not natural accompaniments of
life.
Their achievement requires expenditures of time
and energy.
By adhering to certain rules, practices, and
principles, we can greatly increase the probability that
good physical and mental health will be enjoyed in old
age.
It is generally believed that physical activity,
proper nutrition, precautions against accidents and crime,
interpersonal relationships, and enjoyable activities are
important determinants of well-being in later maturity.
In the pursuit of psychological and physical well-being,
certain behaviors and orientations should be adopted by
the elderly person.
If the older person adheres to a
number of basic "do's and don'ts," feelings of physical
and mental well-being are likely to increase (13:254-60).
12
13
According to Jewett, if a person hopes to live a
long life, energy should be expended in the pursuit and
maintenance of good health, feelings of physical and
psychological well-being, creative leisure activities, and
enjoyment of life (22:91-93).
Most researchers agree that
longevity and feelings of health and well-being are
related to the behaviors and attitudes of the individual.
Psychological and physical well-being and long life do
not just happen, rather, they must be earned (12:36-40).
The majority of adults 60 years of age and older-in fact, between 80 and 90 percent--are in the category of
the well elderly: the healthy, well-functioning, socially
competent people capable of managing their own lives.
Ninety percent live in their own homes or in homes of a
relative or friend (U.S. Bureau of the Census, 1978).
The well elderly comprise a diverse population by age,
sex, race, cultural heritage, socio-economic level,
personality characteristics, intellectual capacity, and
life style (32:112-116).
Many of the well elderly have
maintained good health habits throughout their lives.
They have been subjected to enlightened public health and
nutrition information (33:314-317).
Contrary to some previously held notions, people
who are well and functioning adequately can continue to
learn and improve their intellectual functioning throughout life.
While there is some slackening in some of the
14
intellectual capacities after age 70, even those losses
leave the person with about the same capacities as at age
25, according to some longitudinal studies made over the
past year by Abeles and Riley (1:34).
According to Zarit,
the well elderly are socialized to believe that they cannot remember.
Consequently, they do not make the effort
or set in place the reinforcers to support and facilitate
the functioning of their memories (40:133).
Health Education for the Elderly
To attain and maintain optimal health, it is
necessary that people learn early in life what constitutes sound health habits and diligently practice these
throughout life.
The teaching of good health practices
and the interpretation of community health programs are
among the important functions of adult health education.
"Education" is a widely used word not often
associated with older people, so the concept may be somewhat unfamiliar to many.
Here, "education" is used to
mean planned learning which is generally guided toward a
specified goal by a teacher.
It is designed to bring
about some change in knowledge, behavior, attitude, or
skill on the part of the learner.
The view that learning
and education must continue across the life span has
supported the development of classes for all ages by community colleges and voluntary agencies.
Hiemstra and Alt
15
believe most older persons need help in developing an
awareness of their changing health needs and in coping
with them.
Such assistance most often comes in the form
of teaching (21:100-109, 2:76-78).
Londoner states,
"Older people may respond to a teaching-learning approach
if designed to involve them in the planning for their own
educational needs" (27:113).
Peterson states that life-span education is gaining momentum despite the low priority given by universities to adult education because of low enrollment and
high expenditures.
He suggests that colleges and univer-
sities can contribute to the adult public by offering
courses which focus on:
development,
(1) vocational preparation and
(2) leisure time preparation and usage, and
(3) orientation to the process of aging.
Education in
these areas would help the elderly cope with personal,
vocational, and social change (34:436-441).
Dalles and Hickey suggest that older people can
contribute significantly to the reshaping of the philosophy of higher education.
The time perspective and past
experience of the aging can be constant reminders to
university faculty and other professionals that research
findings must be applied to life experiences and human
values (11:15, 20:431-435).
However, Preston points out
the need to assess the impact of health education programs in colleges compared with local community programs
16
{35:98-99).
A recent national survey by Louis Harris and
Associates indicated the level of educational participation by older people.
This study found that approxi-
mately two percent of individuals enrolled in any type of
instructional program were over the age of 65 {17:10).
Surveys of older persons have indicated that lack of
interest in learning is the most common barrier to participation, but anxiety about learning is also mentioned.
Older people have traditionally not been major
participants in the educational system of this nation.
They do have educational needs which are encouraging them
to change this status.
Beverley predicts that one of the
most significant advances in the coming decade will be
the acceptance by the public of· a major responsibility
for their own health and well-being {4:114-126).
Thus,
it is possible to observe a change in the national orientation toward education.
Educational institutions are
more interested now than ever before in the older
population and in attempting to identify the ways in
which theycan best
s~rve
this new audience.
The develop-
ment of educational offerings for older people provides
bright possibilities for the future.
Findings of Related Studies
Many educators have written about the educational
needs of older people, but Howard McClusky•s "Background
17
and Issues on Education" written for the 1971 White House
Conference on Aging is the best known.
McClusky identi-
fied five categories of educational needs:
needs,
(2) expressive needs,
(1) coping
(3) contributive needs,
(4) influence needs, and (5) transcendence needs {31:16).
He emphasized that these were not the only needs of older
people, but argued that these were the needs which could
be best addressed by instructional interventions.
Hendrickson and Barnes interviewed a sample of
2307 persons over the age of 65 and reported that the
greatest educational interest was in religion, the problems of growing old, gardening, physical fitness, and
grooming (18:25).
Galvin, et al. have reported on a
survey of the elder person's educational wants and found
that coping with the problems of life, health, and
finance were of the greatest interest (12:44-46).
The literature review revealed a lack of comprehensive studies of the specific health education needs of
an elderly population.
There have been related studies,
however, that have identified the health education needs
of various age groups.
Craig used the Lussier Multi-
Dimensional Needs Inventory and found it to be a useful
tool for obtaining the health education needs of college
level students (8).
Other related health rieed studies,
while not using the Lussier inventory, have used similar
descriptive, survey methods of research.
For example,
18
Sutton utilized a health practice inventory to determine
college students health.needs {38).
Redican surveyed a
sample of college students from three California Universities and identified the most critical health education
needs of the students {37).
Bryan utilized a health
behavior inventory to determine the health education
needs of a sample of beginning college students from a
junior college, a four-year state college, and a university (6).
The above studies which identified health
education needs at various age levels demonstrate the
importance of examining health education needs at all
levels.
Summary
The need for health education has been discussed
in many journal articles.
which focus on the elderly.
of well-being in old age.
A number of factors emerge
One factor is the importance
The concept today is one of
enabling the elderly to help themselves by giving them
an understanding of health and the prevention of illness
{3:123-125).
According to Hiemstra, health education
helps the person to accept greater responsibilities for
his own care {21:100-109).
It is necessary to first
determine the educational needs prior to planning
programs, therefore, this study was done with the purpose
of identifying the health education needs of the elderly.
Chapter 3
METHODOLOGY
This Chapter presents the methodology utilized in
the study to identify the health education needs of a
selected group of elderly.
following:
The procedure included the
{1) identification of the problem,
{2) selec-
tion of the health behavior inventory as the test
instrument,
(3) selection of the sample,
{4) administra-
tion of the survey, and (5) the treatment of the
statistical data.
Identification of the Problem
Because growing old and old age are multifaceted
phenomena that involve changes that are psychological,
social, and biological, gerontology is a multidisciplinary study.
In an attempt to
bet~er
understand
what occurs as people age and what factors are significant variables in old age, it is essential that research
be generated from a number of fields.
Although no one knows what causes long life,
certain factors are related to longevity.
A relationship
has been established between longevity and heredity,
marital status, smoking, disease, living environment,
19
20
activity and exercise, obesity, work satisfaction, socioeconomic status, educational level and intelligence.
Certain factors may be related to longevity, but the
relationship is probably not causal.
However, it is
agreed that behaviors and attitudes do influence length
of life.
For continued good health habits, learning and
education should continue across the life span.
Educa-
tional programs must be based on the needs, problems and
interests of those for whom a program is designed, therefore this study was undertaken.
Survey Instrument
The health behavior inventory instrument developed
by John Vance DeLeeux in his doctoral dissertation at
University of California, Los Angeles was utilized in
this survey.
The instrument consists of fifty health
education need statements which the participants were
asked to rate on a scale of never to always, indicating
their present health practices (Appendix A).
The
questions depict seven health categories which include
nutrition, consumer health, personal health, drugs,
safety, mental health, and physical fitness.
DeLeeux's techniques for determining the validity
of his instrument included:
(1) the construction of all
items with five functional alternatives;
(2) inclusion of
21
scientific and expert sources to gather the data for the
item pool;
(3) inclusion of a small group of elderly to
judge the accuracy, readability, and applicability of the
instrument;
(4) the responses of a small group of elderly
were checked as to their actual health behavior before
issuing the large trial test;
(5) inclusion of a panel of
experts in gerontology, health education and evaluation
or measurement to judge the accuracy and applicability of
the instrument;
( 6) the application of the statistical
procedure function of analysis.
The factor analysis
method was used for the purpose of deciding whether or
not the test was unidimensional.
analysis the test
~hewed
From the factor
twenty factors which were
plotted on graph paper using the Screen Test.
This
clearly showed that the test was unidimensional, meaning
that there is only one factor underlying the responses to
the test.
Selection of the Sample
The sample group for the study was comprised of
sixty elderly people.
Thirty from the city of Woodland
Hills, and thirty from West Los Angeles.
The partici-
pants ranged in age from sixty to eighty-nine years of
age.
The selection process included seeking a group of
elderly who could be identified as being in good health.
22
In the search for an elderly population in Woodland Hills,
a friend offered the suggestion of using the Woodland
Hills Episcopalian Church's senior card club members.
During the first social meeting in the month of April,
the group was asked by a friend and a church member that
works with the group if they were willing to participate
in a study identifying the health education needs for the
elderly.
It was explained that the study was a thesis
project of a graduate student from California State
University, Northridge.
It was further explained that
participation was voluntary and all questionnaires would
be kept confidential.
There was total agreement by the
members to answer the survey at the next scheduled
meeting.
The health behavior inventory was administered
to thirty persons prior to the card social and all
questions were answered prior to the survey.
For comparison reasons it was desirous to have
some elderly participants from another geographical area
other than Woodland Hills.
A close associate, who is a
senior citizen living in West Los Angeles, offered her
hospitality to host a coffee for neighbors who were over
sixty and lived in the same area.
The people were in-
vited to attend the coffee and to participate in a
research study of the health education needs of the
elderly.
A total of twenty people attended.
During the
social gathering, the purpose and confidential nature of
23
the study was explained.
Instructions were given out
with each questionnaire, which was then returned to the
researcher after completion of the inventory survey.
Another ten elderly people who were unable to attend the
coffee were approached individually and requested to
participate in the survey.
They were given the same
instruction sheet and questionnaire along with an
addressed envelope to mail the survey back to the
researcher.
Administration of Inventory Survey
Participation in the study was voluntary.
Each
person was assured that the responses would be kept confidential with the data being analyzed on a group basis.
The respondents were requested to complete demographic
information such as year of birth, sex, race, marital
status, educational level and employment status.
The groups were instructed to select the answer
that most nearly indicated their present health behavior
practice, and to circle their response to each item on
the inventory.
There was no time limit and the question-
naire took approximately twenty to thirty minutes to
complete.
Statistical Treatment of the Data
The results of the survey were analyzed for each
group separately and then combined.
The responses to the
24
fifty statements were tallied.
For each item, the per-
centage of "never", "rarely", "sometimes", "usually", and
"always" responses were computed in order to assess the
relative distribution of responses.
The frequencies of
responses to the health statements were expressed in
contingency tables in terms of percentages of row totals
and actual totals (Appendix B) .
were (1) never;
(2) rarely;
The values of responses
(3) sometimes;
(4) usually;
and (5) always.
There were sixteen statements that were negatively
stated.
Accordingly, a reversal treatment was required
in the computations in order to provide all data with the
appropriate statistical baseline.
The values were
reversed in the foilowing manner: value (1)
reversed to a value (5}, value (2)
to a value of (4), value (3)
same, value (4)
"never" was
"rarely" was reversed
"sometimes" remained the
"usually" was reversed to a value of (2),
and the value (5)
"always" was reversed to a value of (1).
This procedure created uniformity in values to all
questions.
are
The statements with the reversal technique
indicated in the list of Inventory Statements by
Health Category (Table 1) .
To establish a rank order of need for the seven
health categories, the means for items within each health
need category were obtained by totaling the mean and taking
the difference from the preferred score and actual score.
I
I
I
I
I
TABLE 1
LIST OF INVENI'ORY STATEMENTS
BY HEALTH CATEOORY
PHYSICAL
PERSONAL
MENTAL
FITNESS
HEALTH
HEALTH
CONSUMER
NlJrRITICN
HEALTH
SAFEI'Y
DRUGS
STATEMENT
STA'l'E11ENT
STATEMENT
STATEMENT
STATEMENI'
STATEMENT
STA'I'EMENI'
#
#
#
#
#
#
#
16
46
47*
10*
12*
17
18
20
26*
27
34
35
36
38
39
40
41
43
48*
50
30
31
32
33
42*
45*
1
2*
3
4*
5
19
21*
15*
9*
13
14*
22*
25
28
11
23*
24
49
6
29
7
37
8
44
*Indicates those statements that have been given a reversal treatment to offset negatively stated
questions in the HBI instrument.
N
U1
Chapter 4
RESULTS AND DISCUSSION
Health education programs are effective when they
are based on the needs of the target group.
The function
of evaluation of needs is not merely to catalogue deficits
or document realms of interest, but rather to specify
areas of needs which can provide the basis for program
planning.
The data obtained as a result of administering
the multi-dimensional health behavior inventory to a
selected sample of elderly was organized and analyzed to
reveal health education needs.
The inventory items were
classified into seven health subjects and the top-rated
categories were determined for the two groups tested.
Descriptive
D~ta
Age, sex, ethnic background, marital status, level
of education and employment status were compiled from the
demographic data.
The age of the sixty sample subjects ranged from
60 years through 89 years (Table 2).
the sample was 68.
26
The mean age for
27
Table 2
Age of Respondents
Age
Frequency
60-65
24
40
66-70
13
22
71-75
9
14
76-80
7
12
over 80
7
12
60
100
Total
Percent
Seventy-five percent of the respondents were
female and twenty-five percent were males (Table 3) .
Table 3
Sex of Respondents
Frequency
Sex
Percent
Female
45
75
Male
15
25
Total
60
100
Ninety-eight percent of those participating were
Caucasian (Table 4).
28
Table 4
Ethnic Background of Respondents
Ethnic Background
Frequency
Percent
White
59
98
Black
1
2
Oriental
0
~can-American
0
other
0
Total
60
100
Fifty percent of the respondents were married.
Forty-two percent were widqwed
(Table 5).
Table 5
Marital Status of Respondents
M:y::"i tal Status
Frequency
Percent
Single
2
3
Married
30
50
3
5
Widowed
25
42
Total
60
100
Divorced
29
Most of the respondents had a high school education, and at least thirty-two percent attended college
(Table 6) .
Table 6
Educational Background of Respondents
Education
Less than high school
High school graduate
College graduate
Post graduate
Total
Frequency
Percent
4
6
31
19
52
32
6
10
60
100
Eighty percent of the participants were retired,
while twenty percent were either employed full-time or
part time (Table 7).
Table 7
Work Status of Respondents
t'brk Status
Frequency
Percent
Retired
Eirployed
48
80
12
20
Total
60
100
30
Data Presentation
The Health Behavior Inventory was administered to
a total of sixty elderly people, thirty of which were from
Woodland Hills, with the remaining thirty from West
Los Angeles.
An overall mean was derived by adding up the mean
scores for each of the fifty questions.
The overall mean
score was 3.68 with the optimal score of 5.0 to indicate
the best behavior.
A mean of 3.0 was calculated as the
median or average, thus anything over three was considered
to be above average.
This inventory indicated the
elderly exhibited reasonably sound health behavior
(Table 8) •
Rank Order of Health Categories
The rank order of health education needs as
derived from the Health Behavior Inventory for the two
groups of elderly were as follows:
West Los Angeles
Rank Order
Woodland Hills
Physical Fitness
1
Personal Health
Mental Health
2
Physical Fitness
Personal Health
3
Mental Health
Nutrition
4
Nutrition
Consumer Health
5
Consumer Health
Safety
6
Safety
Drugs
7
Drugs
31
Table 8
MEAN SCORES FOR RESPONSES TO THE FIFTY
HEALTH STATEMENTS
Staterrent
West los Angeles
X
:-
----------
-----
1
2
3.00
3.33
3
4
5
6
Wcxx:lland Hills
X
Combined
X
2.16
2.73
2.96
2.50
2.86
3.14
2.33
3.06
3.30
4.30
4.36
3.18
4.33
7
8
9
10
4.00
3.33
4.50
3.90
3.53
11
12
13
14
15
16
17
18
4.60
3.76
4.13
4.63
3.86
2.83
2.97
4.50
4.30
3.16
4.23
4.40
3.13
4.57
2.70
4.15
3.24
4.36
4.15
3.33
4.58
3.23
4.20
4.90
3.60
3.53
2.83
4.63
4.16
4.76
3.73
3.18
2.90
19
20
21
3.16
2.63
4.23
2.87
1.67
4.26
2.51
2.15
4.24
22
4.56
4.96
4.76
23
24
4.60
4.66
4.63
4.00
4.10
25
3.96
4.30
4.05
4.13
-
---------
4.56
32
Table 8 (continued)
Staterrent
West Los Angeles
X
26
27
28
29
30
31
32
33
34
3.33
1.37
2.53
4.07
2.53
3.90
3.13
4.27
lrloodland Hills
X
3.43
1.27
3.10
4.00
2.87
4.16
2.57
Caribined
X
3.38
1.32
2.81
4.03
2.70
4.03
2.85
4.27
35
3.73
4.17
4.27
3.43
3.47
3.82
36
3.13
2.97
3.05
37
4. 77
4.83
4.80
38
3.87
3.33
3.60
39
40
3.17
3.53
2.03
4.17
3.80
3.65
3.65
2.43
2.23
4.03
3.77
4.10
3.06
3.83
2.43
4.30
3.87
3.36
3.53
3.80
2.94
3.55
2.58
41
42
43
44
45
46
47
48
49
50
2.70
3.30
3.50
2.83
3.27
2.73
3.96
3.07
4.57
4.10
2.21
4.13
3.47
4.33
33
Based upon the difference between the preferred
selection mean score of S.O.and the survey actual mean
score, the findings indicate Physical Fitness, Personal
Health, and Mental Health to be the top three health
categories which have the greatest need for health education for the combined groups {Table 9).
Discussion of Responses to Health Categories
The Health Behavior Inventory items in the survey
were analyzed for each category and the results of these
need areas briefly discussed for general interest.
Physical Fitness:
For optimal maintenance of psychological and
physical well-being in later years, physical activity is
mandatory.
Regardless of chronological age, physical
immobility accelerates the aging process.
Conversely,
physical activity or exercise slows the aging process.
The extent to which each elderly person can engage in such
activities will depend upon factors such as physical
health, history of exercise and present level of conditioning.
It is recommended that a physician be consulted for
a physical fitness program.
The survey indicates there is a need for health
education for both groups.
The physical fitness questions specifically asked
about exercising regularly, taking regular walks, and
Table 9
RANK ORDER OF HEALTH CATEOORY
West L. A.
Mean Score
Actual
Carbined
Score
Difference
Preferred
& Actual
Health Categocy
Preferred
Score
Physical Fitness
5.0
2.97
3.41
3.19
1.81
1
Personal Health
5.0
3.38
3.26
3.32
1.68
2
Mental Health
5.0
3.22
3.49
3.35
1.65
3
Nutrition
5.0
3.46
3.51
3.48
1.52
4
Consurrer Health
5.0
3.78
3.78
3.78
1.22
5
Safety
5.0
4.09
4.32
4.20
.80
6
Drugs
5.0
4.40
4.44
4.42
.52
7
W. H.
M=an Score
Rank
Order
w
~
-----
-.-----~---
-------
- - -
------
35
planning exercise in the day's activities.
Over fifty
percent of the respondents answered never, rarely or sometimes.
A physical fitness program would be a method of
preventative medicine that would assist in preventing some
diseases such as cardiovascular and respiratory diseases.
Personal Health:
The quality of life of the well elderly depends
upon the capacity
to use all of one's talents, interests,
and abilities to maintain good health.
This may include
medical and dental checkups, immediate attention to
symptoms of illness, taking care of dental problems as
soon as possible and a general interest in personal
health.
The Health Behavior Inventory indicated a combined
group mean of 3.3 in this health category which indicates
that the two groups tested could benefit by health education to promote maintenance programs and reduce illness.
Survey questions 17, 20, 34, 38, 43 and 50 all relate to
visiting a doctor for either medical or dental care.
The
results suggest that over sixty percent of those tested
are not seeing their doctor on an annual or regular basis.
Mental Health:
Friendships or positive interpersonal relationships are important contributors to mental health and
feelings of well-being in later years.
From social
relationships, feelings of self-worth or self-esteem are
36
derived.
In question 30 relating to volunteer or part-
time work, forty percent in Woodland Hills and forty-three
percent stated they rarely or never do volunteer work and
twenty-seven percent stated sometimes.
In question 31
relating to contact with friends and relatives, twentyfive percent of the West Los Angeles group stated never,
rarely or sometimes and twenty percent in the Woodland
Hills group stated sometimes.
Without friendships or
close interpersonal relationships, the probability is high
that the individual will not experience optimal levels of
well-being and satisfaction in later maturity.
Nutrition:
Both groups of participants showed nutrition as
the fourth rank order in the health category.
The ques-
tion on taking calcium supplements or drinking two glasses
of milk daily indicated that the majority of the participants are not doing so.
Only thirteen percent in the West
Los Angeles group and twenty-three percent in the Woodland
Hills group usually or always follow this nutritional
habit.
Calcium is a necessity for bone health and drinking
milk or taking calcium supplements are ways of adding this
essential mineral to the body.
In later maturity many people have restrictions
placed upon their diets, the most common restriction being
that of salt intake.
In most cases the possible relation-
ship between sodium chloride (table salt) and hypertension
37
(high blood pressure) underlies the efforts to reduce salt
intake.
In question 44 relating to salting food, thirty-
three percent of the combined group said they salt their
food before tasting it.
In general, there is no reason
for the extra salt that is added at the table.
Consumer Health, Safety and Drugs:
Consumer health, safety, and drugs rated the
lowest need in the Health Behavior Inventory.
The con-
sumer health area showed each of the two groups had a
mean score of 3.78 and a rank order of 5 which indicates
the behavior practices of the elderly are in safe keeping
or optimal.
Although it is important that a safe environment
be assured at all ages, the provision of such an environment becomes more important as we grow older.
According
to the survey, the sample group acknowledges the cause of
accidents, and the survey of behavior practice demonstrates an awareness of properly crossing the streets,
using seat belts, attending to loose carpets and
adequately lighting hallways.
In the drug category, the combined group had a
mean score of 4.42 out of a preferred 5.0 score on drugs
for this health category which has the least need according to the behavior practices surveyed.
38
Implications For Future Curriculum Planning
The following categories of health reflect the
needs of the elderly population sample who were tested
using the health behavior inventory instrument.
The
Health Education Series I are recommended for a program in
Physical Fitness, Personal Health and Mental Health.
The
Health Education Series II could be incorporated in future
programs of interest to an elderly population.
HEALTH EDUCATION SERIES I
1.
Physical Fitness
. how to achieve and maintain fitness
. the importance of a physical fitness program
• planning a program
2.
Personal Health
the warning signs of cancer
. maintaining oral health
. importance of medical checkups
3.
Mental Health
. the meaning of good mental health
• importance of social relationships
. feelings of self-worth and self-esteem
---- -------
----
-- - - - - - - - - - - -
-
---~-
--~---
-
-----
-
39
HEALTH EDUCATION SERIES II
1.
Nutrition
. importance of a balanced diet
• minerals for bone building
• foods to avoid
2.
Consumer Health
. recognize misleading advertisements for
health products
• problems in diagnosing and treating own
illness
3.
Safety
• the hazards of the environment
. automobile safety habits
4.
Drugs
. the dangers of using unused medications
for other illnesses
Chapter 5
SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS
In this Chapter three essential parts of the
study are discussed: a summary of the investigation, the
conclusions drawn from the findings, and recommendations
for future health education planning.
Summary
The purpose of this study was to identify the
health education needs of a selected group of elderly
people residing in West Los Angeles and Woodland Hills.
A review of the literature revealed that health undoubtedly is one of the major difficulties associated with
aging and education may be a primary mechanism for preventing the physical, psychological, or social decline
of the individual.
In order to determine what health
education is necessary, there should be an assessment of
the needs to determine what should be incorporated into
a program of health education.
A study of health needs
investigations indicated that there had not been a comprehensive inquiry concentrating solely upon ·the elderly.
Hence, the focus of this study was determined.
The methodology of this investigation was a
descriptive survey, utilizing the DeLeeuw Multi-Dimensional
40
41
Health Behavior Inventory, which was administered to
sixty elderly people.
The inventory questions were
weighted on a scale from one to five.
The total score
for each item was tabulated and then divided by the
number of subjects responding to the item to achieve a
mean score.
This represented the level of need for
elderly health education with regard to the area the
item was designed to evaluate, using the same principle
as scoring a Likert attitude scale in which five is
given the most positive response and one for the least
.Positive response.
The overall mean score was 3.68 with
the optimal score being 5.0.
Thus, in this inventory the
elderly exhibited reasonably sound health behavior.
To establish a rank order of need for the seven
health categories the statistical means for items within
each health need category were obtained by totaling the
mean and taking the difference between the preferred
selection of 5.0 and the actual mean score.
Physical
Fitness, Personal Health, and Mental Health were the
health categories that indicated the greatest need for
health education for the combined groups.
Conclusions
Based on the mean score on responses to the
Health Behavior Inventory, the following conclusions were
reached:
42
1.
The health education needs for the thirty
elderly people tested in West Los Angeles according to
rank order were Physical Fitness, Mental Health, and
Personal Health.
2 .•
The health education needs for the thirty
elderly people tested in Woodland Hills according to
rank order were Personal Health, Physical Fitness, and
Mental Health.
3.
The health education needs for the combined
groups reflect the same rank order as for the Woodland
Hills group which strongly supports the need in these
primary categories.
Recommendations
The results of this study provide a tool for
planning and developing a health education program in the
community for the elderly.
1.
It is recommended that:
The development of a health program be based
upon the elderly's needs assessment.
2.
The health education needs inventory be
revised and updated to reflect social, academic, and
current trends in medical knowledge.
3.
Health education needs assessments be con-
ducted periodically and health programs modified accordingly.
4.
Evaluation studies be conducted to determine
43
the effectiveness with which current health education
programs are meeting the health needs of the elderly.
5.
If the study is replicated, it is suggested
that a different variety of socio-economic groups be
tested and comparisons be made of the findings.
BIBLIOGRAPHY
44
45
BIBLIOGRAPHY
1.
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2.
Alt, Richard E., M.D. "Patient Education Program
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3.
Bayne, Ronald.
"Meeting the Many Health and Social
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4.
Beverly, Virginia.
"Lifelong Learning- A Concept
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5.
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Bryan, Ruth Breitwieser.
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7.
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Craig, Wendy Howard.
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9.
Culbert, Pamela and Barbara Kos.
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10.
DeLeeuw, John Vance.
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46
11.
Dallas, James Lee.
"Health Education: Enabler for
a Higher Quality of Life." Health Services
Reports, Vol. 87 No. 10, (December 1972),
111-112.
12.
Galvin, K., et al. "Educational Retraining Needs of
Older Adults." Washington, D.C.: ERIC, 1975.
13.
Gillet, J. A. "Health Education of the Elderly."
Community Health, Vol. 4 No. 5 (March-April
1973), 254-60
0
14.
Goodrow, Bruce. "Limiting Factors in Reducing
Participation in Older Adult Learning Opportunities." The Gerontologist, (October, 1975),
418-422.
15.
Hain, Mary Jeanne and Shu-Pi C. Chen. "Health
Needs of the Elderly." Nursing Research,
Vol. 25 No. 6 (November 1976), 433-439.
16.
Hanna, Lavone and James Quillen.
Social Competence. Chicago:
& Co. , 194 8.
17.
Harris, L., & Associates.
"The Myth and Reality of
Aging in America." Washington, D.C.: The
National Council on the Aging, Inc., 1975.
18.
Hendrickson, A. and R.F. Barnes. The Role of
Colleges and Universities in the Education of
the Aged. Columbus, Ohio: The Ohio State
University Research Foundation, 1964.
19.
Hickey, Torn.
tology."
423-424.
20.
Education for
Scott Foresrnen
"Educational Intervention and GeronThe Gerontologist, (October 1975),
"Aging and Higher Education: The
Institutional Response." The Gerontologist,
(October 1975), 431-435.
21.
Hiemstra, R.P. "Continuing Education for the Aged:
A Survey of Needs and Interests of Older
People." Adult Education, (April 1972),
100-109.
22.
Jewett·, S. P. "Longevity and the Longevity Syndrome."
The Gerontologist, (1973), 13:91~93.
47
23.
Johns, Edward B., Wilfred C. Sutton, and Barbara A.
Cooley. Health for Effective Living. 6th ed.
New York: McGraw-Hill, 1975.
24.
Johns, Edward B.
"Effective Health Teaching."
Journal of School Health, (March 1964), 211-215.
25.
Joint Committee on Health Education Terminology,
New Definitions. Health Education Monographs.
San Francisco: Society for Public Health
Education, Inc., 1973.
26.
Kerlinger, Fred N. Foundations of Behavioral
Research.
2nd ed. New York: Macmillan Co.,
1968.
27.
Londoner, C.A.
"Survival Needs of the Aged:
Implications for Program Planning." Aging and
Human Development, (May 1971), 113-117.
28.
Lussier, Richard.
"A Multidimensional Instrument
to Identify Health Education Needs for College
Students." Unpublished dissertation,
University of California, Los Angeles, 1970.
29.
Managan, Dorothy, et al.
"A Community Survey of
Health Needs." Nursing Research, (SeptemberOctober 1974), 426-432.
30.
Marshall, Carter and Joan Salzer.
"Transmitting
Health Education to the Elderly Via Cable
Television." Geriatrics, (October 1976),
126-127.
31.
McClusky, H.Y.
"Background and Issues in Education." Washington, D.C.: U.S. Government
Printing Office, 1971.
32.
McKenzie, Sheila C. Aging and Old Age.
Scott, Foresman and Co., 1980.
33.
McPherson-Turner, Cherry.
"Education for Aging."
The Journal of School Health, (August 1980),
314-317.
34.
Peterson, David.
"Life-Span Education and Gerontology." The Gerontologist, (October 1975),
436-441.
Illinois:
48
35.
Preston, Caroline.
"Continuing Education for Older
Americans by Colleges." The Gerontologist,
(October 1975), 98-99.
36.
Reader, Georgia G., and Doris Schwartz.
ing Patients' Knowledge of Health."
(March 1973), 47:111-114.
37.
"Identifying the Health EducaRedican, Kerry J.
tion Needs of Present Day Selected College
Students." Unpublished research report,
University of California, Los Angeles, 1972.
38.
Sutton, Wilfred C.
"Determining the Health Education Needs of College Students." Unpublished
doctoral dissertation, University of California,
Los Angeles, 1954.
39.
Walker, Kennett. Living Your Later Years.
New York: Oxford University Press, 1954.
40.
White House Conference on Aging, 1961. Education
and Aging. Department of Health, Education and
Welfare. washington D.C.: U.S. Government
Printing Office.
41.
White House Conference on Aging, 1971. Department
of Health, Education and Welfare. Washington,
D.C.: U. S. Government Printing Office.
42.
Zarit, S.H. Aging and Mental Disorders.
Free Press, 1980.
''DevelopHospitals,
New York:
APPENDICES
49
APPENDIX A
HEALTH INVENTORY SURVEY INSTRUMENT
50
51
IDENTIFYING THE HEALTH EDUCATION NEEDS
OF THE ELDERLY
This research is designed to identify the health
education needs of the elderly.
Your completion of this
questionnaire will assist me in identifying the health
education needs of the elderly and thereby making more
people aware of their specific needs.
The information that you give in this study will
be kept completely and entirely confidential.
All the
data will be analyzed on a group basis, no names will be
used, and no individual profiles will be examined.
DEMOGRAPHIC INFORMATION
Please complete the following questions:
Year of Birth:
Sex:
Male
Employment Status:
Female
Retired
Not Retired
Educational Level:
Elementary (1-8 yrs.)
High School (9-12 yrs.)
College (13-16 yrs.)
Post Graduate (17 + yrs.)
Marital Status:
Married:
Single:
Divorced:
Widowed:
Race:
Oriental
Caucasian
Black
52
QUESTIONNAIRE INSTRUCTIONS
Select the answer that most nearly indicates your
present health behavior practice.
each item on the pages provided.
Circle your response to
For example, if your
answer to Item 1, "Do you eat your meals alone?" is
"Sometimes," then circle "Sometimes" number 3.
1) Never
2) Rarely
3) Sanetines
4) Usually
5)
Always
Proceed in a similar manner for each question of
the questionnaire.
marking.
Read each statement carefully before
State your answers by what you do, not by what
you think you should do.
each item listed.
Remember, "Do you" refers to
53
HEALTH BEHAVIOR INVENTORY
FOR THE ELDERLY
00 YOO:
1.
Eat your meals alone?
1) Never
2.
5) Always
2) Rarely
3) Scrnetirres
4) Usually
5) Always
2) Rarely
3) Sorretirres
4) Usually
5) Always
2) Rarely
3) Sanetilres
4) Usually
5) Always
2) Rarely
3) Saretirres
4) Usually
5) Always
2) Rarely
3) Sorretirres
4) Usually
5) Always
Eat meat, fish, poultry, soybeans or nuts?
1) Never
9.
4) Usually
Take vitamins and minerals in addition to the food you eat
throughout the day?
1) Never
8.
3) Sornetilres
Eat a balanced diet?
1) Never
7.
2) Rarely
Use rrost of your grocery rroney for nutritious foods?
1) Never
6.
5) Always
Eat pastries or candies?
1) Never
5.
4) Usually
Drink two glasses of milk daily or take calcium supplerrents?
1) Never
4.
3) Sorretirres
Eat the sane arrotmt of food you did when you were younger
(30 or 40)?
1) Never
3.
2) Rarely
2) Rarely
3) Sorretirres
4) Usually
5) Always
Buy health products such as aspirin or laxatives on the basis of
advertising?
1) Never
10.
2) Rarely
3) Scrnetilres
4) Usually
5) Always
4) Usually
5) Always
Diagnose your own health problems?
1) Never
2) Rarely
3) Sornetilres
54
00 YOU:
11.
Read the instructions for use on a oontainer f.ran \'tlich you are
alx>ut to take rredi.cine?
1) Never
12.
Go
3) Sometimes
4) Usually
5) Always
2) Rarely
3) ScrrEtimes
4) Usually
5) Always
2) Rarely
3) SorrEtimes
4) Usually
5) Always
2) Rarely
3) Sometimes
4) Usually
5) Always
2) Rarely
4) Usually
5) Always
4) Usually
5) Always
3) Sorneti.rres
2) Rarely
3) Sorneti.rres
2) Rarely
3) Som2ti.rres
4) Usually
5) Always
to a foot doctor {Podiatrist) when foot problems occur?
1) Never
21.
2) Rarely
Purchase your shoes in the afternoon or evening?
1) Never
20.
5) Always
Keep your toenails trimred?
1) Never
19.
4) Usually
Go for rredical checkups twice a year?
1) Never
18.
3) Sonetimes
Take regular walks?
1) Never
17.
2) Rarely
Buy shoes on the basis of price?
1) Never
16.
5) Always
Discuss your personal fina1'1ces with strangers?
1) Never
15.
4) Usually
Ask for identification frcrn salespeople and utility servicerren
before you admit them into your hone?
1) Never
14.
3) ScrrEti.rres
Treat your own health problems?
1) Never
13.
2) Rarely
2) Rarely
3) Sorreti.rres
4) Usually
5) Always
4) Usually
5) Always
Srroke cigarettes 1 cigars 1 or a pipe?
1) Never
2) Rarely
3) Sanetimes
55
00 YOU:
22.
Sroke when you are sleepy?
1) Never
23.
4) Usually
5) Always
2) Rarely
3) Saretimes
4) Usually
5) Always
2) Rarely
3) Sometimes
4) Usually
5) Always
2) Rarely
3) Sanetimes
4) Usually
5) Always
2) Rarely
3) Sanetimes
4) Usually
5) Always
2) Rarely
3) Sometimes
4) Usually
5) Always
2) Rarely
3) Sometimes
4) Usually
5) Always
2) Rarely
3) Sanetimes
4) Usually
5) Always
4) Usually
5) Always
4) Usually
5) Always
Participate in social organizations?
1) Never
33.
3) Sanetimes
Have oontact with a wide range of relatives and friends?
1) Never
32.
2) Rarely
Take advantage of opportunities to do volunteer or part-time
w:::>rk?
1) Never
31.
5) Always
Tack or fasten all loose carpeting and straighten rugs?
1) Never
30.
4) Usually
Fasten your seat belt when riding or driving a car?
1) Never
29.
3) Saretines
Becane intoxicated when you drink aloohol?
1) Never
28.
2) Rarely
Drink alooholic beverages?
1) Never
27.
5) Always
Cross the street at an intersection?
1) Never
26.
4) Usually
'I'lu:cM' away unused nedicines?
1) Never
25.
3) Sarretimes
Take any drugs not prescribed by a physician?
1) Never
24.
2) Rarely
2) Rarely
3) Saretimes
Read newspapers and magazines?
1) Never
2) Rarely
3) Saretimes
56
00 YOU:
34.
Have your eyes examined once a year?
1) Never
35.
2) Rarely
3) Saretimes
5) Always
2) Rarely
3} Sometimes
4} Usually
5} Always
2} Rarely
3) Sometimes
4) Usually
5} Always
2} Rarely
3} Sornetimes
4) Usually
5} Always
2} Rarely
3) Soretimes
4} Usually
5} Always
2) Rarely
3} Sanetimes
4} Usually
5} Always
2} Rarely
3} Sanetirnes
4} Usually
5} Always
Have your blood pressure checked regularly {twice a year} ?
1} Never
44.
4) Usually
to protect your eyes?
Have difficulty in relaxing?
1} Never
43.
5) Always
Diagnose your own oral problems?
1} Never
42.
4} Usually
Have missing teeth replaced with dentures soon after they are
lost?
1} Never
41.
3) Sornetimes
Brush your teeth or dentures after eating?
1} Never
40.
5} Always
Have dental checkups once a year?
1} Never
39.
4} Usually
Properly light bathrocms, hallways, bedrooms, and steps?
1) Never
38.
2} Rarely
Wear sunglasses
1) Never
37.
3} Sometimes
Seek medical attention if you get a foreign particle in your
eye, an eye injury, or an eye inflanmation?
1) Never
36.
2} Rarely
2} Rarely
3} saretimes
4} Usually
5} Always
4) Usually
5) Always
Salt your food before tasting it?
1} Never
2} Rarely
3} Sornetirnes
57
00 YOU;
45.
Feel tense?
1) Never
46.
2) Rarely
3) Saretimes
4) Usually
5) Always
2) Rarely
3) Someti.rres
4) Usually
5) Always
2) Rarely
3) Sanetines
4) Usually
5) Always
Plan your day to include time for work, physical activity,
relaxation, sleep, and meals?
1) Never
50.
5) Always
Expose your body to the sun's rays for long periods of time?
1) Never
49.
4) Usually
Develop and plan your own exercise program?
1) Never
48.
3) Sometimes
Exercise regularly?
1) Never
47.
2) Rarely
2) Rarely
3) Sometimes
4) Usually
5) Always
Report to your physician any of the seven warning signs of
cancer?
cancer's Seven Warning Signals are:
. Change in bc:Mel or bladder habits
• A sore that does not heal
• Unusual bleeding or discharge
. Thickening or lurrp in breast or elsewhere
• Indigestion or difficulty in swallowing
• Obvious change in wart or rrole
• Nagging cough or hoarseness
1) Never
2) Rarely
3) Sanetimes
4) Usually
5) Always
APPENDIX B
CONTINGENCY TABLES FOR RESPONSES
TO HEALTH STATEMENTS
58
TABLE
10
<XNI'~ TABLE FOR RESPONSE TO STATEMENI' 1
Ib you eat your rreals alone?
Geographical
Area
Percentage of Row Totals
Never Rarely Saretirres Usually Always
W. los Angeles
3.33
33.33
26.66
36.66
0.00
1
10
8
11
0
V«::lodland Hills
3.33
40.00
36.66
20.00
0.00
1
12
11
6
0
TABLE
I
I
Actual Totals
Never Rarely Sanetimes Usually Always
11
CCNI'INGENCY TABLE FOR RESPONSE TO STATEMENI'
IX)
2
you eat the same anount of food you did when you were younger (30 or 40) ?
Geographical
Area
W. los Angeles
W:xxlland Hills
Percentage of Row Totals
Never Rarely Sooet.in"es Usually Always
13.33 23.33
6.89
37.93
----
-
-
Actual Totals
Never Rarely Saret.i.rres Usually Always
20.00
40.00
3.33
4
7
6
12
1
20.68
24.13
10.34
2
11
6
7
3
-
U1
"'
TABLE 12
a:NI'I:NGEOCY TABLE FOR RFSPONSE TO Sl'ATEMENI' 3
Do you drink tw:J glasses of milk daily or take rnlciurn supplements?
Geographical
Area
w.
Percentage of Row Totals
Never Rarely Sareti.nes Usually Always
Actual Totals
Never Rarely Screetimes Usually Always
Los Angeles
36.66
26.66
23.33
10.00
3.33
11
8
7
3
1
Wxxlland Hills
30.00
23.33
23.33
13.33
10.00
9
7
7
4
3
---~---------~-
-----------·
------
----------------
---------------------~---
----------------------
TABLE
~~-------~-------~--------------~-----·~-
13
CC.Nl'INGENCY TABLE FOR RESPCNSE TO STATEMENI' 4
I
I
Do you eat pastries or candies?
Geographical
Area
Percentage of Row Totals
Never Rarely Sa:retines Usually Always
Actual Totals
Never Rarely Sa:retirres Usually Always
W. U:>s Angeles
3.00
33.33
40.00
13.33
10.00
1
10
12
4
3
Vb:xlland Hills
3.00
33.33
56.66
3.00
3.00
1
10
17
1
1
~--------------------------------
--
---
--
-
"'
0
TABLE 14
CCNI'~
TABLE FOR RFSPONSE TO STATEMENT 5
IX> you use nost of your groce:ry noney for nutritious f<Xrls?
Geographical
Area
Percentage of Row Totals
Never Rarely Saretiires Usually Always
Actual Totals
Never Rarely Saretimes Usually Always
W. los Angeles
0.00
0.00
3.33
63.33
33.33
0
0
1
19
10
W:xxlland Hills
o.oo
0.00
3.33
56.66
40.00
0
0
1
17
12
TABLE
15
CCNI'INGENCY TABLE FOR RESPCNSE TO STATEMENI' 6
IX> you eat a balanced diet?
Geographical
Area
Percentage of Row Totals
Never Rarely Saretines Usually Always
Never Rarely
Actual Totals
Sareti.rres Usually Always
W. los Angeles 0.00
3.33
16.66
56.66
23.33
0
1
5
17
7
Vb:x:lland Hills
0.00
6.66
56.66
36.66
0
0
2
17
11
0.00
~
--
-
-·-
-
-----
~
1-'
TABLE 16
CCNI'INGEN;Y TABLE FOR RESPONSE TO STATEMENT 7
Do you take vitamins and minerals in addition to the food you eat?
Geographical
Area
Percentage of Row Totals
Never Rarely
sareti.Jres
Actual Totals
Usually
Always
Never Rarely
Satetimes
Usually Always
Wo los Angeles
23.33
l3o33
20.00
23o33
20.00
7
4
6
7
6
W:x:xlland Hills
30.00
6o66
20.00
16.66
26o66
9
2
6
5
8
---
- - -------
-·
--
--··
-----
-
-------···-
------
---
----
---
-----
---------------
---·
--
------ -----------
~
- ---
~-
---
----
-
------·
-
----
--
-~
TABLE 17
CCNI'INGENCY TABLE FOR RESPONSE TO STATEMENT 8
Do you eat rreat, fish, poultry, soybeans or nuts?
Geographical
Percentage of Row Totals
Actual Totals
Usually Always
Rarely
sareti.nes
Wo los Angeles
0.00
OoOO
6.66
40.00
53o33
0
0
2
12
16
Vb:xiland Hills
0.00
0.00
13.33
46.66
40.00
0
0
4
14
12
---------------
----
Never
Rarely Sareti.nes
Never
Area
----
Usually Always
-
0'1
1\J
~you
TABLE 18
<XNI'INGEN:Y TABLE FOR RESPONSE TO STATEMENI' 9
buy products such as aspirin or laxatives on the basis of advertising?
Geographical
Area
Percentage of Row Totals
Never Rarely Sareti.nes Usually Always
Actual Totals
Never Rarely Satetimes Usually Always
W. IDs Angeles
66.66
16.66
3.33
6.66
6.66
20
5
1
2
2
W:xxlland Hills
7.14
17.85
7.14
3.57
0.0
20
5
2
1
0
---·-··
----
19
CXNI'INGENCY TABLE FOR RESPONSE TO STATEMENT 10
TABLE
~you
diagnose your own health problems?
Geographical
Area
Percentage of Row Totals
Never Rarely Saretimes Usually Always
Never
Actual Totals
Rarely Sareti.nes Usually Always
W. IDs Angeles
31.03 17.24
37.93
13.79
0.0
9
5
11
4
0
W:x:xlland Hills
20.00
43.33
26.66
3.33
6
2
13
8
1
6.66
0"1
w
TABLE 20
a:::Nr:INGEN:Y TABLE FOR RFSPOOSE
'IQ
STATEMENI' 11
IX> you read the instructions for use on a oontainer prior to taking rredication?
Geographical
Area
Percentage of Row Totals
Never Rarely Saretimes Usually Always
Never Rarely
Actual Totals
Saretirnes Usually Always
W. IDs Angeles
0.0
3.33
10.00
10.00
76.66
0
1
3
3
23
w:xxlland Hills
0.0
3.34
0.0
17.24
79.31
0
1
0
5
23
TABLE 21
<XNI'INGENCY TABLE FOR RFSPOOSE
'IQ
STATEMENl' 12
IX> you treat your own health problens?
Geographical
Area
Percentage of Row Totals
Never Rarely Saretimes Usually Always
Actual Totals
Never Rarely Saretimes Usually Always
W. IDs Angeles
10.34
20.68
51.72
13.79
3.44
3
6
15
4
1
w:xxlland Hills
10.00
3.33
40.00
40.00
6.66
3
1
12
12
2
--------
-------
0'\
,J:::.
TABLE 22
<XNI'INGEN::Y TABLE FOR RESPONSE 'IO Sl'ATEMENI' 13
IX> you ask for identification from salespeople and utility servicerren before you adrni t them into
your horre?
Geographical
Area
w.
Percentage of Row Totals
Never Rarely Saretirres Usually Always
Actual Totals
Never Rarely Saretimes Usually Always
IDs Angeles
3.33
13.33
6.66
20.00
56.66
1
4
2
6
17
Vbodland Hills
3.44
10.34
0.00
20.68
65.51
1
3
0
6
19
-----------------------
-------~------
TABLE
23
C<Nl'INGENCY TABLE FOR RESPONSE 'IO STATEMENI'
14
IX> you discuss your personal finances with strangers?
Geographical
Area
Percentage of Row Totals
Never Rarely Sanet.irres Usually Always
Actual Totals
Never Rarely
Saretirres
Usually Always
W. IDs Angeles
90.00
3.33
3.33
0.0
3.33
27
1
1
0
1
\'b:xlland Hills
93.33
3.33
3.33
0.0
0.0
28
1
1
0
0
-
-----------
--·
----
0'1
Ln
TABLE
24
CXNI'INGEN::Y TABLE FOR RESPONSE TO STATEMENI' 15
Lb you buy shoes on the basis of price?
----
Geographical
Area
w.
los Angeles
W:x:xi1and Hills
Percentage of Row Totals
Never Rarely Sareti.rrEs Usually Always
Never Rarely
---~
---------
Actual Totals
saretimes Usually Always
16.66
23.33
16.66
0.0
13
5
7
5
0
31.03 13.79
37.93
17.24
0.0
9
4
11
5
0
43.33
-
----------~-
TABLE
25
CXNI'INGENCY TABLE FOR RESPCI-lSE TO STATEMENI'
16
Lb you take regular walks?
Geographical
Area
Percentage of Row Totals
Never Rarely Senetines Usual!y Always
Actual Totals
Never Rarely SenetinEs Usually Always
W. los Angeles
17.24
27.58
17.24
21.03
6.89
5
8
5
9
2
W::x:xlland Hills
10.00 13.33
23.33
23.33
30.00
3
4
7
7
9
0'1
0'\
""
TABLE 26
CXNr:INGE:OCY TABLE FOR RESPONSE TO STATEMENI' 17
Do you go for rredical checkups twice a year?
Geographical
Area
Percentage of Row Totals
Never Rarely Sareti.mes Usually
Always
Never Rarely
Actual Totals
Saretimes Usually Always
W. los Angeles
20.00
30.00
10.00
13.33
26.66
6
9
3
4
8
W:xxlland Hills
26.66
20.00
20.00
10.00
23.33
8
-6
6
3
7
---
~----
----
--------
---~---------------~~-~---.~~------~---
TABLE 27
C<NI'INGENCY TABLE FOR RESPCNSE TO STATEMENr 18
Do you keep your toenails tri:rnred?
Geographical
Area
Percentage of Row Totals
Never Rarely
Saret.irres
Actual Totals
Usually Always
Never
Rarely sateti.mes
Usually Always
W. los Angeles
3.44
3.44
3.44
20.68
68.96
1
1
1
6
20
lbxlland Hills
0.0
0.0
3.33
30.00
66.66
0
0
1
9
20
---~-
-~---
----------
-
0"1
-....1
.,.
TABLE 28
<Xm'INGEN:Y TABLE FOR RESPONSE TO STATEMENI'
19
D.:> you purchase your shoes in the norning or evening?
Geographical
Area
Percentage of Row Totals
Never Rarely Sooet.:i.Ires Usually Always
Never Rarely
Actual Totals
Saretirnes Usually Always
W. los Angeles
7.40
7.40
22.22
51.85
11.11
2
2
6
11
3
WJodland Hills
11.53
7.69
30.76
46.15
3.84
3
2
8
12
1
TABLE
29
20
C<NI'INGENCY TABLE FOR RESPONSE TO STATEMENI'
D.:> you go to a foot doctor (Podiatrist) when foot problems occur?
Geographical
Area
Percentage of Row Totals
Never Rarely Sooet.i.Ires Usually Always
Actual Totals
Never Rarely Sooet.:i.Ires Usually Always
W. IDs Angeles
32.14
17.85
10.71
14.28
25.00
9
5
3
4
7
~and
64.28
24.28
3.57
14.28
3.57
18
4
1
4
1
Hills
~
CX>
TABLE 30
a:Nr~
TABLE FOR RESPONSE TO SI'ATEMENI' 21
0::> you srroke cigarettes, cigars, or a pipe?
Geographical
Area
w.
Percentage of Row Totals
Never Rarely Saretines Usually Always
Never Rarely
Actual Totals
Saretimes Usually Always
los Angeles
79.31
3.44
3.44
3.44
10.34
23
1
1
1
3
Vb:xlland Hills
80.00
3.33
o.oo
3.33
13.33
24
1
0
1
4
-
TABLE 31
<XNI'INGENCY TABLE FOR
RES~SE
TO SI'ATEMENI' 22
0::> you srroke when you are sleepy?
--
-------------
Geographical
Area
Percentage of RDw Totals
Never Rarely Saretirres Usually Always
Actual Totals
Never Rarely
Sareti.nes
Usually Always
W. los Angeles
89.65
3.44
3.44
3.44
0.0
26
1
1
1
0
w:xxlland Hills
96.66
3.33
0.00
0.00
0.0
29
1
0
0
0
~
1..0
TABLE 32
CXN!'INGEN:Y TABLE FOR RESPONSE TO STATEMENr 23
I.b you take any drugs not prescribed by a physician?
Geographical
Percentage of Row Totals
Never Rarely Saretiires Usually Always
Area
W. Los Angeles
73.33 20.00
Wxxll.and Hills 86.66
0.0
Actual Totals
Never Rarely Saretirnes Usually Always
3.33
0.0
3.33
22
6
1
0
1
10.00
0.0
3.33
26
0
3
0
1
TABLE 33
CCNI'INGENCY TABLE FOR RES:~?a;JSE TO STATEMENI' 24
I.b you throw away unused rredicines?
Geographical
Percentage of Row Totals
Never Rarely Saretilres Usually Always
Area
Never Rarely
Actual Totals
Saret.i.nes Usually Always
W. Los Angeles
6.66
3.33
23.33
13.33
53.33
2
1
7
4
16
lb:xlland Hills
6.89
0.0
6.89
34.48
51.72
2
0
2
10
15
---
~
-----··
--
-
-....!
0
TABLE 34
CXNI'INGEN::Y TABLE FOR RESPONSE TO STATEMENI' 25
IX> you cross the street at an intersection?
Geographical
Actual Totals
Percentage of Row Totals
Never Rarely Saretirnes
Usually Always
Never Rarely Saret.irres
Usually
Always
W. los Angeles
6.66
0.0
16.66
43.33
33.33
2
0
5
13
10
\ixxlland Hills
0.0
0.0
6.89
37.93
55.17
0
0
2
11
16
Area
---- - - - - - - - - - - - - -
--
-
-- --
~--
------------
TABLE 35
CCNI'INGENCY TABLE FOR RESP<::NSE TO STATEMENI' 26
Do you drink alcoholic beverages?
Geographical
Area
Percentage of Row Totals
Never Rarely
Sanet:i.nEs
Actual Totals
Usually Always
Never
Rarely
Sarvet.irres
Usually Always
W. los Angeles
13.33
30.00
36.66
16.66
3.33
4
9
11
5
1
W:xxlland Hills
23.33
16.66
40.00
20.00
0.0
7
5
12
6
0
--------
-------------
--
,_.
-...J
TABLE 36
<XNI':rNGE:tel TABLE FOR RESPONSE TO SI'ATEMENI' 27
IX> you becane intoxicated when you drink alcohol?
Geographical
Actual Totals
Percentage of ReM Totals
Area
Never Rarely Sareti.mes
Usually
Always
Never Rarely
Satetimes
Usually Always
W. IDs Angeles
73.33
16.66
10.00
0.0
0.0
22
5
3
0
0
Vb:xlland Hills
73.33
26.66
0.0
0.0
0.0
22
8
0
0
0
---
-
----
-
-
---· ----- -------· - - - - -
-----
TABLE 37
CCNI'INGENCY TABLE FOR RESPCNSE TO STATEMENI' 28
IX> you fasten your seat belt when riding or driving a car?
Geographical
Area
Actual Totals
Percentage of ReM Totals
Never Rarely
Baretines
Usually Always
Never
Rarely
Satetines
Usually Always
W. IDs Angeles
23.33
16.66
23.33
13.33
23.33
7
5
7
4
7
\-bxlland Hills
20.00
16.66
20.00
20.00
23.33
6
5
6
6
7
-..)
N
TABLE 38
CCNI'~
I:Q
TABLE FOR RESPONSE TO STATEMENT 29
you tack or fasten all loose carpeting and straighten rugs?
Geographical
Area
Percentage of Row Totals
Never Rarely Sareti.nes Usually Always
Never Rarely
Actual Totals
Saretimes Usually Always
W. I.os Angeles
6.66
0.0
10.00
50.00
33.33
2
0
3
15
10
l-b:xlland Hills
7.14
0.0
7.14
28.57
57.14
2
0
2
8
16
TABLE 39
CXNriNGENCY TABLE FOR RESPCNSE TO
ST~
30
)):) you take advantage of opportunities to do volunteer work?
Geographical
Area
Percentage of Row Totals
Never Rarely Saret:i.nes Usually Always
Actual Totals
Never Rarely Saret:i.nes Usually Always
W. I.os Angeles
26.66
26.66
26.66
6.66
13.33
8
8
8
2
4
\'b:xll.and Hills
20.00
20.00
20.00
16.66
13.33
6
6
9
5
4
-....!
w
TABLE 40
<XNI'I~
TABLE FOR RESPONSE TO STATEMENT 31
I:b you have contact with a wide range of friends?
Geographical
Area
Percentage of Row Totals
Never Rarely sareti.n:es ·Usually Always
Actual Totals
Never Rarely Satetimes Usually Always
W. IDs Angeles
6.66
3.33
16.66
40.00
33.33
2
1
5
12
10
Vhodland Hills
0.00
0.00
20.00
40.00
20.00
0
0
6
12
12
TABLE 41
CCNI'INGENCY TABLE FOR RESPCNSE TO STATEMENI' 32
Do you participate in social organizations?
Geographical
Area
Percentage of Row Totals
Never Rarely Saret:i.nes Usually Always
Actual Totals
Never Rarely Saretirres
Usually Always
W. IDs Angeles
13.79
13.79
27.58
27.58
17.24
4
4
8
8
5
Woodland Hills
24.13 10.34
48.27
6.89
10.34
7
3
14
2
3
-...J
~
TABLE 42
CXNI'INGEN:Y
TABLE FOR RESPCNSE TO STA'l'EMFNT 33
DJ you read newspapers and nagazines?
Geographical
Actual Totals
Percentage of Row Totals
Never Rarely
Area
Saret:ines
Usually Always
Never Rarely
Saretirnes
Usual!y
Always
W. los Angeles
6.89
0.0
17.24
13.79
62.06
2
0
5
4
18
W:xxlland Hills
0.0
6.66
13.33
16.66
63.33
0
2
4
5
19
-- ---------·
·-
-
-------·
-·
------
TABLE 43
CCNI'INGENCY TABLE FOR RESPCNSE TO STATEMENr 34
Do you have your eyes examined once a year?
Geographical
Area
Actual Totals
Percentage of Row Totals
Never Rarely
Sc:met:i.nes
Usually Always
Never Rarely
Scmeti..nes
Usually Always
W. IDs Angeles
0.0
23.33
16.66
23.33
36.66
0
7
5
7
11
\'b:xil.and Hills
6.66
13.33
20.00
30.00
20.00
2
4
9
9
6
-...)
l.11
TABLE 44
CXNr:rNGE:tCY TABLE FOR RESPONSE TO srATEMENT 35
D.:> you seek nedical attention when you have an eye problem?
Geographical
Never Rarely Saretirres
Area
w.
Percentage of Row Totals
Actual Totals
Usually
Always
Never Rarely
Saretimes
Usually Always
los Angeles
0.0
13.33
10.00
26.66
50.00
0
4
3
0
15
W:xxlland Hills
4.0
12.00
12.00
8.0
64.00
1
3
3
2
16
TABLE
45
CCNI'INGF.NCY TABLE FOR RESPONSE 'ro STATEMENT 36
Ib you wear stmglasses to protect your eyes?
Geographical
Area
Never
W. IDs Angeles
~and
Percentage of Row Totals
Rarely
3.33 10.00
Hills 26.66
13.33
SarEti:mes
Actual Totals
Usually Always
Never
Rarely
SatEtines
Usually Always
26.66
16.66
43.33
1
3
8
5
13
23.33
23.33
13.33
8
4
7
7
4
~-------
-
-
-....J
0'1
TABLE 46
<nn'~ TABLE
FOR RESPONSE 'ro srATEMENl' 37
D::>you properly light bathrocros, hallways, bedrooots
Geographical
Area
and steps?
Actual Totals
Percentage of Row Totals
Never Rarely
Sareti.rres
Usually
Always
Never Rarely
SatEtimes
Usually Always
W. los Angeles
0.0
0.0
0.0
23.33
76.66
0
0
0
7
23
Woodland Hills
0.0
0.0
3.44
13.79
82.75
0
0
1
4
24
-
--
-------
--
-
-------
---- -------
-
-----
-
--
-
-
-
-
--
--
47
C<Nl'INGENCY TABLE FOR RESPCNSE '10 STATEMENT 38
TABLE
D::> you have dental checkups once a year?
Geographical
Area
Percentage of Row Totals
Never
Rarely
Saretines
Actual Totals
Usually Always
Never Rarely
Sareti.rres
Usually Always
W. IDs Angeles
3.33
13.33
13.33
20.00
43.33
3
4
4
6
13
\-bxlland Hills
16.66
20.00
6.66
26.66
30.00
5
6
2
8
9
-----~----------··
--
""
TABLE 48
a:Nl'INGEN:Y TABLE FOR RESPONSE TO STA'l'El-1Em' 39
D:J you brush your teeth or dentures after eating?
Geographical
Area
Actual Totals
Percentage of Row Totals
Never Rarely
Saret::i.lrEs
Never Rarely
Usually Always
W. Los Angeles
10.71
21.42
10.71
32.14
25.00
3
6
W:xxlland Hills
3.33
0.0
20.00
30.00
46.66
1
0
-
--
Usually Always
3
9
7
6
9
14
-------------------------
TABLE
CXNI'INGENCY
'
Saretimes
TABLE
FOR
49
RES~SE
TO
40
STATEM:NI'
I:b you have missing teeth replaced with dentures soon after they are lost?
Geographical
Actual Totals
Percentage of Row Totals
Satetin:es
Usually Always
Rarely Satet::i.lrEs
Usually Always
Never
Rarely
W. Ics Angeles
11.11
3.70
11.11
29.62
44.44
3
1
3
8
12
Vb:xlland Hills
7.40
11.11
7.40
22.22
59.25
2
1
2
6
16
Area
~-------------~-----~
Never
-----~------
-----
·-·-·
-- -
--
-...J
CX>
TABLE 50
o::.Nr!NGEN:Y TABLE FOR RESPONSE TO Sl'A'l'EMENT
41
IX> you diagnose your own oral problems?
Geographical
Area
Percentage of Row Totals
Never Rarely Saretirres Usually Always
Actual Totals
Never Rarely Saret:imes Usually Always
W. lDs Angeles
39.28
25.00
32.14
3.57
3.57
11
7
9
1
1
W:xXlland Hills
35.71 17.85
17.85
25.00
3.57
10
5
5
7
1
------
---------~----
--
---- ·-··-
-
----
TABLE 51
CCNI'INGENCY TABLE FOR RESPONSE TO STATEMENI' 42
Do you have difficulty in relaxing?
Geographical
Area
Never
Percentage of Row Totals
Rarely Scrreti.nes Usually Always
Actual Totals
Never Rarely Scnetirres Usually Always
W. los Angeles
13.33 20.00
43.33
10.00
13.33
4
6
13
3
4
l'b:xlland Hills
30.00
20.00
3.33
0.0
9
14
6
1
0
46.66
----
--
-....)
\.0
TABLE 52
aNI'INGEt-CY TABLE FOR RESPONSE TO srATEMENI' 43
IX> you have your blocx:1 pressure checked regularly?
Geographical
Percentage of Row Totals
Never Rarely Satetines
Area
w.
Usually Always
Actual Totals
Never Rarely Sooetimes Usually Always
IDs Angeles
20.00
6.66
33.33
6.66
33.33
6
2
10
2
10
lb:x1land Hills
10.00
20.00
3.33
16.66
50.00
3
6
1
5
15
-----~
-------
-
-----
----~--~---
TABLE 53
CCNI'INGENCY TABLE FOR RESPCNSE TO STATEMENI' 44
IX> you salt your focx:1 before tasting it?
Geographical
Percentage of Row Totals
Never
Rarely
Saretines
W. los Angeles
43.33
10.00
20.00
6.66
Vb:ldland Hills
50.00
30.00
10.00
0.0
Area
Actual Totals
Usually Always
Never
Rarely
Saret:i.nes
20.00
13
3
6
2
6
10.00
15
9
3
0
3
----------.-
--
-·
Usually Always
--
00
0
TABLE
54
cnn'l:NGEH:Y TABLE FOR RESPONSE 'ro STATEMENT
45
Do you feel tense?
Geographical
Area
w.
Percentage of Row Totals
Never Rarely Saretim:!s Usually Always
Never Rarely
Actual Totals
Saretimes Usually Always
IDs Angeles
3.44
17.24
58.62
10.34
10.34
1
5
17
3
3
WXxlland Hills
3.57
28.57
64.28
0.0
3.57
1
8
18
0
1
TABLE
55
C<Nl'INGENCY TABLE FOR RESPCNSE 'ro .STATEMENI'
46
Do you exercise regularly?
Geographical
Area
Actual Totals
Never Rarely Saretim:!s Usually Always
Percentage of Row Totals
Never Rarely Saret.ines Usually Always
W. Los Angeles
0.0
26.66
30.00
33.33
10.00
0
8
9
10
3
\tb:xlland Hills
3.44
13.79
24.13
34.48
24.13
1
4
7
10
7
------------------------------
-
-------
00
......
....
TABLE 56
CCNI'INGElCl TABLE FOR RESPONSE TO ffi'ATEMENI' 47
Do you develop and plan your
Geographical
Area
awn exercise program?
Percentage of Row Totals
Never Rarely Sareti.Ires Usually Always
Never Rarely
Actual Totals
Saretirnes Usually Always
W. los Angeles
10.00
20.00
23.33
26.66
20.00
3
6
7
8
6
W:xxlland Hills
10.34
6.89
27.58
34.48
20.68
3
2
8
10
6
----
--- ------·
-----~---
-~----·-
----------------
-~-----~------~-----~-~----~-~-
TABLE 57
CCNTINGENCY TABLE FOR RESP<::NSE 'ro STA'l'FM3.NI' 48
Do
you expose your l:x:>dy to the sun's rays for long periods of titre?
Geographical
Area
Percentage of Row Totals
Never Rarely SatetinEs Usually Always
Never Rarely
Actual Totals
SciretinEs Usually Always
W. los Angeles
44.82
34.48
13.79
o.o
6.89
13
10
4
0
2
W::xxlland Hills
58.62
27.58
13.79
0.0
0.0
17
8
4
0
0
----------------
-
-
-
00
N
TABLE 58
CCNI'~
TABLE FOR RESPONSE TO STATEMENT 49
D:> you plan your day to include tirre for '>JOrk, activity, relaxation, sleep and rreals?
Geographical
Area
Percentage of Row Totals
Never Rarely SarEtirres Usually Always
Actual Totals
Never Rarely Saret:i.mes Usually Always
W. I.os Angeles
3.84
26.92
19.23
3.00
19.23
1
7
5
8
5
\'b:xlland Hills
3.44
6.89
17.24
34.48
37.93
1
2
5
10
11
TABLE 59
CCNI'INGENCY TABLE FOR RE'SPCNSE 'ro STATEMENT 50
Do you report to your physician any of the seven warning signs of cancer?
Geographical
1
W.
Area
los Angeles
Percentage of Row Totals
Never Rarely Satet:ilres Usually Always
Actual Totals
Never Rarely Saretirres Usually Always
0.0
3.33
3.33
26.66
66.66
0
1
1
8
20
7.40
3.70
0.0
7.40
81.48
2
1
0
2
22
'
~and
Hills
'
L
~---------~------------~---
00"
w