Chinese Immigrant Women Research Articles

The seven-year struggle: injustices at home for Chinese immigrant women in Hong Kong

In the Second Quarter of 2013, there have been 11,017 one-way permit holders who have entered Hong Kong, a daily average of 121 persons. Among these, 43.3% are migrant women aged 25–44. The main sources of stress for these new arrivals are often described as financial burdens and their poor living environments. Little has been said about the challenges they have to face as second-class citizens, their status in their first seven years in Hong Kong, before they become permanent residents. This paper documents the seven-year struggle of these migrant women with a focus on the discrimination and injustices that they face in their marriage and families. Such discrimination in the “private sphere” (within marriage and family) is a reflection of the bias some migrant women face in the “public sphere” (within the community), which has affected their access to resources and life opportunities as well as their capabilities to meet their various needs and cope with the acculturation stress. Their secondary citizenship has also reinforced their subordinated status at home and thus it is difficult for them to identify and redress injustices and inequalities that they have to face within the private sphere.

Chinese female immigrant entrepreneurs in New Zealand: two brief case studies

With an increasing mobility of populations, particularly through globalisation and international migration, there has been a growth of immigrant entrepreneurs in host countries, including a minority group of female immigrant entrepreneurs. This latter group has not been adequately investigated, even though these female immigrant entrepreneurs contribute significantly to the economy of the host country. This article explores female immigrant entrepreneurship in Aotearoa New Zealand and provides two brief case studies of Chinese immigrant women who have set up their own businesses.

Equol-Producing Status, Isoflavone Intake, and Breast Density in a Sample of U.S. Chinese Women

Differences in ability to metabolize daidzein to equol might help explain inconsistent findings about isoflavones and breast cancer. We examined equol-producing status in relation to breast density, a marker of breast cancer risk, and evaluated whether an association of isoflavone intake with breast density differs by equol-producing status in a sample of Chinese immigrant women. Participants were 224 women, ages 36 to 58 years, enrolled in a study on diet and breast density. All women completed dietary recall interviews, underwent a soy challenge to assess equol-producing status, and received a mammogram assessed for breast density using a computer-assisted method. In our sample, 30% were classified as equol producers. In adjusted linear regression models, equol producers had significantly lower mean dense tissue area (32.8 vs. 37.7 cm(2), P = 0.03) and lower mean percent breast density (32% vs. 35%, P = 0.03) than nonproducers. Significant inverse associations of isoflavone intake with dense area and percent density were apparent, but only in equol producers (interaction P = 0.05 for both). These results support the possibility that equol-producing status affects breast density and that effects of isoflavones on breast density depend on ability to metabolize daidzein to equol. Although these findings warrant confirmation in a larger sample, they offer a possible explanation for the inconsistent findings about soy intake and breast density and possibly breast cancer risk as well. The findings further suggest the importance of identifying factors that influence equol-producing status and exploring appropriate targeting of interventions.

Ethno-cultural diversity in the experience of widowhood in later life: Chinese widows in Canada

This paper utilizes Helena Znaniecka Lopata's concept of life frameworks as a lens through which to understand the experience of widowhood amongst elderly Chinese immigrant women living in Toronto, Canada. While Lopata defined life frameworks as including social supports, social relations and social roles, for these widows, personal resources (framed in Chinese cultural context) were also important aspects of life frameworks. In-depth interviews with 20 widows contacted through a Chinese community center were conducted in Mandarin and Cantonese and then transcribed and interpreted through team-based qualitative analyses. These women ranged in age from 69 to 93years and had been in Canada an average of 17years, with over half of them widowed following immigration. Our analysis framed the widows' narratives in terms of four types of supports defined by Lopata: social, service, financial and emotional supports. They had fairly extensive social and service supports focused primarily around family and the Chinese community. Although norms of filial piety traditionally dictate sons as primary supports, daughters predominated as providers of supports to these widows. Interpreted from a life course perspective, financial supports were deemed sufficient, despite overall limited financial means. Emotional support was more nuanced and complex for these widows. Loneliness and feelings of social isolation were prevalent. Nevertheless, themes of acceptance and satisfaction dominated our findings, as did reciprocity and exchange. The narrative accounts of these widows depict a complexity of experience rooted in their biographies as Chinese women and as immigrants, rather than primarily in widowhood itself.

Culture and Sun Exposure in Immigrant East Asian Women Living in Australia

In this qualitative study, researchers examined cultural and attitudinal factors that might be related to sun-exposure behaviors among East Asian women living in Australia. Researchers asked Chinese (n = 20) and Korean (n = 16) immigrant women who participated in a larger cross-sectional quantitative study of vitamin D blood levels to volunteer to participate in an in-depth interview in 2010. These women reported a number of cultural factors related to their attitudes and behaviors with regard to sun exposure. They expressed preference for fair skin, a tradition of covering skin when outdoors, and no sunbathing culture. They believed that fair skin was more beautiful than tanned skin. They reported that beauty was the reason for active avoidance of sunlight exposure. Although they reported knowledge of the need for sun avoidance due to skin cancer risk, few reported knowledge about the benefits of sun exposure for adequate vitamin D levels. These findings may provide some reasons for vitamin D deficiency previously reported in these populations. Thus, researchers recommend that these attitudes of excessive sun protection and limiting sun exposure be further investigated as they may have implications for planning and delivery of health promotion programs to this growing population of immigrants in Australia.

The experience of Chinese immigrant women in caring for a terminally ill family member in Australia

The Chinese community, a heterogeneous, highly visible non-English speaking ethnic group in Australia, remains mostly hidden and underrepresented in palliative care service delivery along with participation in health research despite being the fastest growing such group in the country. There is a lack of Australian research information concerning the impact of migration on the caregiving experience of women carers within the Chinese cultural framework and the Australian palliative care context. This paper aims to explore the influence of Chinese cultural norms and immigration on the experience of immigrant women of Chinese ancestry caring for a terminally ill family member at home in Sydney. This study also seeks to identify factors that may present access barriers to palliative care support services. A qualitative approach was used in this study. Data were collected from semi-structured interviews with five home-based Chinese women carers and were analysed using thematic analysis. Findings identified that the participants found being a carer is a lonely and isolating experience. Sources of isolation and loneliness included social isolation experienced as a solitary carer without meaningful family and social relationships; loss of familiar cultural understandings and family values; and emotional isolators expressed in response to the physical and emotional role commitment and other constraints. The study results suggest the need for palliative care educational programmes designed to help nurses to understand the impact of cultural background within the palliative care context. Results also indicate that health care professionals should provide culturally appropriate and competent palliative care services, sensitive to the diverse socio-cultural influences and individual needs of Chinese migrants.

Feasibility of a Targeted Breast Health Education Intervention for Chinese American Immigrant Women

To assess the feasibility and acceptability of a targeted educational intervention to increase mammography screening among Chinese American women. One-group pre- and post-test quasiexperimental design. Metropolitan areas of Portland, OR. 44 foreign-born Chinese American women aged 40 years and older. Participants who had not had a mammogram within the past 12 months were recruited and enrolled to a targeted breast health educational program. Before starting the group session, participants completed a baseline survey, which was administered again 12 weeks postintervention. Completion of mammography screening test, movement in stage of readiness, mammography and breast cancer knowledge, perceived susceptibility, perceived benefits, and perceived common and cultural barriers. The study response rate was high (71%). Of the 42 women who completed the study, 21 (50%) had a mammogram postintervention. The top three reasons for not completing a mammogram at the end of the study were no need or no symptom, busy, and reliance on family for assistance. Mean breast cancer susceptibility scores increased significantly at post-test as theorized (t[40] = -2.88, p < 0.01). Participants were more likely to obtain a mammogram when they had been in the United States for 3-15 years. A targeted program that aims to increase breast health knowledge, improve access, and remove barriers may promote mammography screening among Chinese American immigrant women. This promising intervention now being tested under a randomized, controlled design can be adapted to other Asian subgroups. Targeted breast health intervention is feasible for improving mammography screening among Chinese immigrant women. Educating these women about early detection is important, as the first sign of breast cancer usually shows on a woman's mammogram before it can be felt or any other symptoms are present. Immigrant women may be too busy to dedicate proper time to self-care behaviors; therefore, making it easier and faster for them to obtain a mammogram may improve the screening rate.

Factors Associated with Physical Activity among Chinese Immigrant Women

This study was done to assess the level of physical activity among Chinese immigrant women and to determine the relationships of physical activity with individual characteristics and behavior-specific cognition. A cross-sectional descriptive study was conducted with 161 Chinese immigrant women living in Busan. A health promotion model of physical activity adapted from Pender's Health Promotion Model was used. Self-administered questionnaires were used to collect data during the period from September 25 to November 20, 2012. Using SPSS 18.0 program, descriptive statistics, t-test, analysis of variance, correlation analysis, and multiple regression analysis were done. The average level of physical activity of the Chinese immigrant women was 1,050.06 ± 686.47 MET-min/week and the minimum activity among types of physical activity was most dominant (59.6%). As a result of multiple regression analysis, it was confirmed that self-efficacy and acculturation were statistically significant variables in the model (p<.001), with an explanatory power of 23.7%. The results indicate that the development and application of intervention strategies to increase acculturation and self-efficacy for immigrant women will aid in increasing the physical activity in Chinese immigrant women.

Confirmatory Factor Analysis of the Chinese Breast Cancer Screening Beliefs Questionnaire

Chinese women have been consistently reported as having low breast cancer screening practices. The Chinese Breast Cancer Screening Beliefs Questionnaire (CBCSB) was designed to assess Chinese Australian women's beliefs, knowledge, and attitudes toward breast cancer and screening practices. The objectives of the study were to confirm the factor structure of the CBCSB with a new, larger sample of immigrant Chinese Australian women and to report its clinical validity. A convenience sample of 785 Chinese Australian women was recruited from Chinese community organizations and shopping malls. Cronbach α was used to assess internal consistency reliability, and Amos v18 was used for confirmatory factor analysis. Clinical validity was assessed through linear regression using SPSS v18. The 3-factor structure of the CBCSB was confirmed, although the model required respecification to arrive at a suitable model fit as measured by the goodness-of-fit index (0.98), adjusted goodness-of-fit index (0.97), normed fit index (0.95), and root mean square error of approximation (0.031). Internal consistency reliability coefficients were satisfactory (>.6). Women who engaged in all 3 types of screening had more proactive attitudes to health checkups and perceived less barriers to mammographic screening. The CBCSB is a valid and reliable tool for assessing Chinese women's beliefs, knowledge, and attitudes about breast cancer and breast cancer screening practices. The CBCSB can be used for providing practicing nurses with insights into the provision of culturally sensitive breast health education.

Postpartum Cultural Practices Are Negatively Associated with Depressive Symptoms Among Chinese and Vietnamese Immigrant Mothers Married to Taiwanese Men

The objectives of researchers in this study were to examine acceptance and adherence to mainstream Taiwanese postpartum cultural practices and their association with postpartum depressive symptoms among Chinese and Vietnamese immigrant mothers married to Taiwanese men. While the postpartum cultural practices in China are similar to mainstream Taiwanese practices, those of Vietnam differ from Taiwanese practices. This cross-sectional survey was conducted in Taiwan from October 2007 through March 2008, and included190 immigrant mothers from China and Vietnam who had delivered a child within the past year. Immigrant mothers from China had higher levels of acceptance and adherence to mainstream Taiwanese postpartum cultural practices and a lower rate of postpartum depressive symptoms than immigrant mothers from Vietnam, but the association between adherence to “doing-the-month” practices and postpartum depressive symptoms did not vary significantly between Chinese and Vietnamese mothers. Adherence to these practices was negatively associated with postpartum depressive symptoms among immigrant mothers (OR = 0.93, 95% CI: 0.90–0.96) after adjustment for social support, duration between moving to Taiwan and delivery, and country of origin. Adherence to mainstream postpartum cultural practices was negatively associated with postpartum depressive symptoms for both Chinese and Vietnamese immigrant women married to Taiwanese men.

Pregnancy and Childbirth Experiences of Chinese Marriage Immigrant Women

Objectives: This study was done to identify and to describe the experiences of pregnancy and childbirth of Chinese marriage immigrant women. Methods: The participants were 13 Chinese married immigrant women who became pregnant and gave birth within the last six years. Data was collected by focus group interviews and face-to- face in-depth interview with Korean Chinese and Han Chinese. Data was analyzed using Colaizzi's method of phenomenology. Results: Five theme clusters were extracted as follows: 'Running in to double troubles in a strange environment', 'Relying, but becoming lonely and facing difficulties', 'Partially changing and applying traditional culture of pregnancy and childbirth', 'Gaining the joy of life beyond loneliness', 'Suffering less thanks to the expansion of supporting resources'. Conclusions: The results of this study can be used to develop a program that can provide Chinese immigrant women with childbirth education before marriage and prenatal and postpartum manage- ment and to train culturally sensitive nursing skills.

Intervention tailoring for Chinese American women: comparing the effects of two videos on knowledge, attitudes and intentions to obtain a mammogram

This study utilized data from an ongoing randomized controlled trial to compare a culturally tailored video promoting positive attitudes toward mammography among Chinese immigrant women to a linguistically appropriate generic video and print media. Intervention development was guided by the Health Belief Model. Five hundred and ninety-two immigrant Chinese Americans from the metropolitan Washington, DC, and New York City areas completed telephone interviews before and after intervention. Changes in knowledge, Eastern views of health care (fatalism and self-care), health beliefs (perceived susceptibility, severity, benefits and barriers) and screening intentions were measured. Results showed that both videos improved screening knowledge, modified Eastern views of health care, reduced perceived barriers and increased screening intentions relative to print media (all P < 0.05). The generic video increased screening intention twice as much as the cultural video, although subgroup analysis showed the increase was only significant in women aged 50-64 years. Only Eastern views of health care were negatively associated with screening intentions after adjusting for all baseline covariates. These data suggest that a theoretically guided linguistically appropriate video that targets women from various ethnic groups is as efficacious in modifying attitudes toward mammography screening as a video that is exclusively tailored for Chinese immigrant women.

Strategies for Piloting a Breast Health Promotion Program in the Chinese-Australian Population

In Australia, women from non-English-speaking backgrounds participate less frequently in breast cancer screening than English-speaking women, and Chinese immigrant women are 50% less likely to participate in breast examinations than Australian-born women. Chinese-born Australians comprise 10% of the overseas-born Australian population, and the immigrant Chinese population in Australia is rapidly increasing. We report on the strategies used in a pilot breast health promotion program, Living with Healthy Breasts, aimed at Cantonese-speaking adult immigrant women in Sydney, Australia. The program consisted of a 1-day education session and a 2-hour follow-up session. We used 5 types of strategies commonly used for cultural targeting (peripheral, evidential, sociocultural, linguistic, and constituent-involving) in a framework of traditional Chinese philosophies (Confucianism, Taoism, and Buddhism) to deliver breast health messages to Chinese-Australian immigrant women. Creating the program's content and materials required careful consideration of color (pink to indicate femininity and love), symbols (peach blossoms to imply longevity), word choice (avoidance of the word death), location and timing (held in a Chinese restaurant a few months after the Chinese New Year), communication patterns (the use of metaphors and cartoons for discussing health-related matters), and concern for modesty (emphasizing that all presenters and team members were female) to maximize cultural relevance. Using these strategies may be beneficial for designing and implementing breast cancer prevention programs in Cantonese-speaking Chinese immigrant communities.

Intersectionality and the Mental Health of Elderly Chinese Women Living in the UK

In an age of globalisation and increased migration, intersectionality can help us to appreciate the complexity of various forms of structural inequality and the impact of divergent forms of oppression on a person over their lifetime. Focusing on some of the Chinese women who migrated to Britain in the 1950s and 1960s, we use the concept of intersectionality to understand how coalescing forms of structural inequality have affected the lives of many elderly Chinese immigrant women, and how these inequalities have put them at risk of poorer mental health. We acknowledge that many first‐generation Chinese immigrant women have had very different experiences from those of second‐ and third‐generation Chinese women and that each woman's life story is unique. None of the women is simply a victim of inequalities; all are active agents in their own lives, and many women will have found ways to negotiate their lives under pressure and build personal resilience. However, research suggests that many elderly Chinese women living in the UK have spent much of their lives in the borderlands of inequality and, as a result, are often unable to live the lives that they deserve in their old age.

Acculturation in the adaptation of Chinese‐American women to breast cancer: a mixed‐method approach

To explore how and to what extent acculturation and immigration affect Chinese-American immigrant women's breast cancer experience. Acculturation is an important indicator for immigrant health. Less empirical research has been conducted on the association between acculturation and breast cancer experience among Chinese immigrant women in the USA. A mixed methods study. A total of 107 Chinese-American women with breast cancer completed the structured questionnaire survey, and 16 women completed face-to-face in-depth interviews. In the quantitative findings, acculturation was related to health beliefs, social support and life stress. Cultural interpretations of the qualitative information are offered to show that breast cancer experience was intertwined with cultural adaptation in a given immigrant environment. Chinese cultural beliefs persistently, even after years of immigration, guide Chinese-American immigrant women to respond to breast cancer across the meaning of health and illness, family ties and involvement and social interaction. Our findings show that acculturation is related to health beliefs, social support and life stress in the trajectory of breast cancer adaptation among Chinese-American immigrant women. Life stresses derived from immigration bring additional difficulties for immigrant women living with cancer. This study pinpoints that traditional cultural beliefs and immigration stress may influence Chinese-American women to cope with breast cancer. To promote culturally sensitive cancer care for immigrants, healthcare professionals should be aware of and learn intercultural competence. Ethnic social support or outreach healthcare programme may benefit new immigrant families or the immigrant families, who lack social connection, to cope with cancer.

Socio-economic position and lower dietary moderation among Chinese immigrant women in the USA

To examine associations of education and occupation, as indicators of socio-economic position (SEP), with dietary intake and diet quality in a sample of Chinese immigrant women. Cross-sectional. Data collection included four days of dietary recalls and information on education and current occupation for participants and their spouses. Philadelphia, PA, USA. Chinese immigrant women (n 423) recruited from October 2005 to April 2008. In multivariate models, both higher education level and occupation category were significantly associated with higher energy density and intake of energy and sugar. Education was additionally associated with intake of sugar-sweetened beverages (P = 0·01) and lower dietary moderation (P = 0·01). With joint categorization based on both education and occupation, we observed significant trends indicating higher energy density (P = 0·004) and higher intake of energy (P = 0·001) and sugar (P = 0·04), but less dietary moderation (P = 0·02) with higher SEP. In this sample of US Chinese immigrants, higher SEP as indicated by education level and occupation category was associated with differences in dietary intake and with less dietary moderation. While higher SEP is typically linked to healthier diet in higher-income nations, in these immigrants the association of SEP with diet follows the pattern of their country of origin - a lower-income country undergoing the nutrition transition.

Beliefs about Causes of Colon Cancer by English-as-a-Second-Language Chinese Immigrant Women to Canada

Colon cancer is the second leading cause of cancer death for Canadians. Immigrants underutilize screening and may be at greater risk of late stage diagnosis and death from the disease. This mixed-methods study investigated the self-reported causes of colon cancer by 66 English-as-a-Second-Language Chinese immigrant women to Canada after reading a fact sheet which listed two causes of colon cancer (polyps and cause unknown) and six ways to help prevent colon cancer (lifestyle, diet, weight, smoking, alcohol, and screening). Women correctly named or described both causes (6.1%) or one cause (22.7%), could not name or describe either cause (19.7%), or named or described causes not included on the fact sheet (54.5%). The most common causes reported by participants were "risk factors": diet (53.0%), family history (28.8%), and lifestyle (22.7%). Women confused cause with risk factor and infrequently mentioned screening. Possible reasons for their reported beliefs are discussed.

Adolescent Lifestyle Factors and Adult Breast Density in U.S. Chinese Immigrant Women

We examined recalled measures of adolescent diet, physical activity, and body size in relation to adult breast density in 201 U.S. Chinese immigrant women recruited in January 2002 to May 2003 from Philadelphia region screening programs. Mammographic images were classified into 1 of 4 categories ranging from “entirely fatty” to “extremely dense.” Questionnaires assessed diet and physical activity between ages 12–17, relative weight and height at age 10, and weight at age 18. To estimate odds ratios (ORs), we conducted logistic regression analyses using proportional odds models for polychotomous outcomes. Higher adult breast density was significantly associated with adolescent red meat intake (adjusted 3rd vs. 1st tertile OR = 3.0, 95% confidence interval (CI) 1.5–6.4, trend P = 0.003) but not with other adolescent factors. For the association of adult acculturation with breast density, adjustment for adolescent red meat intake attenuated the OR for the highest vs. lowest level of acculturation from 2.5 (95% CI 1.2–5.3) to 1.9 (95% CI 0.9–4.0). Greater adolescent red meat intake may have increased adult breast density and partly accounted for the strong association between acculturation and breast density in this sample of immigrant Chinese women. If confirmed by further study, dietary prevention efforts for breast cancer should be considered earlier in life.

Comparing Written and Oral Measures of Comprehension of Cancer Information by English-as-a-Second-Language Chinese Immigrant Women

The Short Test of Functional Health Literacy for Adults (S-TOFHLA) and Cloze test are commonly used tools to measure comprehension of health information (i.e., health literacy); however, little is known about their use in English-as-a-Second-Language (ESL) populations. In this study, we compared written (Cloze test) and oral (Teach Back) measures of colon cancer information comprehension among ESL Chinese immigrant women to Canada. Performances on colon cancer-specific measures were compared to a general measure of health literacy (S-TOFHLA). On the S-TOFHLA, Cloze, and Teach Back, respectively, the following percentage of participants had adequate comprehension: 62.1%, 14.8%, and 89.7%. Correlation between performance on the Cloze and Teach Back was significant albeit weakly so (r = 0.38, p = 0.04); performances on the S-TOFHLA and Teach Back were not correlated. Measures of health literacy skill that require written English language skills may not be appropriate for measuring understanding of health information for ESL populations.

Stress Is Associated with Unfavorable Patterns of Dietary Intake Among Female Chinese Immigrants

Chinese immigrants experience increased risk for weight gain and chronic disease after US migration. Whether psychosocial stress affects their eating behavior is unknown. The purpose of this study is to examine psychosocial stress and dietary intake among 426 Chinese immigrant women in the Philadelphia region. Participants completed 4 days of dietary recalls and questionnaires assessing positive and negative life events in the past year and migration-related stressors. In hierarchical linear regression models, positive life events were associated with higher energy intake (β = 21.1, p = 0.04). Migration-related stress was associated with lower total gram (β = -11.3, p < 0.0001) and overall grain (β = -0.18, p = 0.03) intake and higher energy density (β = 0.002, p = 0.04) and percent energy from fat (β = 0.06, p = 0.05). Migration-related stress did not increase overall intake in terms of energy and total grams but selectively increased fat intake and energy density. Such dietary habits may have implications for future chronic disease risk in this immigrant population.