The overall purpose of the proposed study is to understand and describe health promotion behaviors in low-income rural women. Previous research in the area of health protection and promotion behaviors has focused on the middle-class. Poor women living in rural areas are at greater risk of suffering illness or premature death than their more affluent, urban counterparts. Prior to the development of programs that enhance health promotion behaviors, rural, low-income women's experience must be understood to provide a context. Therefore, the specific aims of this one-year study are to: 1) use ethnographic methodology to describe low- income, rural women's perceptions of health and patterns of disease prevention and health promotion behaviors; and 2) develop an instrument relevant to the experience of low-income rural women's health promotion behaviors, and do initial testing for reliability and validity. This is a two-stage project. In Stage I, a total of 60 women, approximately 30 Black and 30 White, will be interviewed by trained, lay outreach workers from the community under guidance of the principal investigator. Data will be analyzed using constant comparative analysis (Glaser & Strauss, 1967). In Stage II, data from Stage I will be used to design a health promotion behaviors instrument. Once the instrument is developed, it will be evaluated by key informants, health care providers, and rural low-income women for meaningfulness and clarity. Then, it will be administered to a non-probability sample of low-income women from rural counties and subjected to initial psychometric testing.
