Re-imaging Healthy Aging: Perspectives of Older Black African Immigrant Women

Abstract

University of Washington Abstract Re-imaging Healthy Aging: Perspectives of Older Black African Immigrant Women Sharon G. McRae Chair of the Supervisory Committee: Professor Barbara Cochrane Family and Child Nursing Older Black African immigrant women are among the fastest growing immigrant group in the U.S. Although U.S. and international research reveals functional status, independence, and cognitive functioning as major concepts of aging in older non-African and African American populations, absent from these empirical studies is knowledge about health and aging among Black African immigrants, particularly older women. We do not know to what extent their experience of aging might be unique and defy generalization as older adult women, African Americans, or immigrants. Older Black African immigrant women's perspectives and experiences are particularly important because of their central role in addressing family health care needs, as well as identifying possible perspectives and health practices from their home country that may differ markedly from those in the U.S. Grounded theory was deemed an appropriate approach for addressing the study purpose, given the lack of knowledge about older Black African immigrant women, particularly their views of health and aging, changes they might experience as a result of their transition to the U.S., and the importance of self-identity, social interactions, and contexts in life. Participants were recruited based on my established relationships with churches and other social groups that include older Black African immigrant women, theoretical sampling, and snowballing techniques. Women were eligible if they were born in Africa, were 45 years or older, immigrated to the U.S. as an adult, spoke and understood English. Data for analysis included in-depth interviews that were recorded and transcribed verbatim, field notes, and methodological memos. Constant comparative analysis was used throughout the study. Theoretical sampling and data collection continued until there was saturation of the emerging theory. Atlas.ti 7 was used to facilitate management of the data, analytic codes and categories, and evolving themes. Additional data included responses to self-administered questionnaires, including the Attitudes to Aging Questionnaire, the Successful Aging Inventory, and the World Health Organization Quality of Life- BREF questionnaire. SPSS 19.0 (Statistical Package for Social Science) was used to analyze data from the questionnaires. This original research disaggregated theory derived from older Black African immigrant women, a sub-group, as distinct from the larger African American population. Based on interviews with sixteen participants, the analysis and substantive theory indicated the core phenomenon experienced by the women to be "Re-imaging healthy aging," which was informed by two categories: "Acknowledging images of healthy aging" and "Becoming aware of new images of aging". Action/interaction strategies identified as accepting, adapting and, managing were ways the women negotiated complicated relationships towards re-imaging healthy aging while living in the U.S. The findings of this study reveal how at the intersections of cultures, attitudes, and beliefs, older Black African immigrant women imaged healthy aging in Africa and re-imaged healthy aging for themselves in the U.S. This research can inform clinical practice by enhancing awareness of the meaning of health and aging to older Black African immigrant women. The findings can be used in future research to guide instrument development, interventions, and health policies with aims to support healthy aging for these women.