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This study examines completion of advance directives, highlighting ethnic differences between Korean and non-Hispanic White older adults in relation to health beliefs and knowledge. In this study, 217 community-dwelling older adults (112 Korean Americans and 105 non-Hispanic Whites) were interviewed using structured questionnaires. As compared to only 5.4% (n = 6) of Korean American older adults, more than half of non-Hispanic White older adults (59.2%, n = 61) had completed advance directives. Health beliefs, but not knowledge, significantly mediated the relationship between ethnicity and completion of advance directives; Korean Americans had lower levels of health beliefs toward advance care planning than non-Hispanic Whites, and this in turn led to relatively lower rates of completing advance directives. Thus, it is advised that health care practice needs to encompass older adults' health beliefs, which may be uniquely represented among different ethnic groups. [ABSTRACT FROM AUTHOR]

Objective: This study examined ethnic differences in end-of-life communication between Korean American and non-Hispanic White older adults using the Health Belief Model as a conceptual framework. Method: A cross-sectional design was employed to survey 217 community-dwelling older adults (112 Korean Americans and 105 Non-Hispanic Whites). Results: Half of the participants had never held end-of-life discussions with significant others. Non-Hispanic Whites were more likely to engage in end-of-life communication than Korean Americans, but the ethnicity effect was not evident in a multivariate analysis. Only participants' knowledge, perceived barriers, perceived severity, and experience of illness significantly predicted the likelihood of the end-of-life communication. Higher knowledge, stronger beliefs about the perceived severity and barriers, and greater experience of illness were related to having end-of-life communication. Discussion: Knowledge and health beliefs play an important role in end-of-life communication which differs by ethnicity. Culturally competent health care practitioners need to consider ethnic variation in advance care planning. [ABSTRACT FROM AUTHOR]

PURPOSE: This study aimed to examine compensatory changes in nonexercise energy expenditure (NEEx) and nonexercise physical activity (NEPA) in response to an aerobic exercise training program. METHODS: Ninety-two overweight/obese (body mass index, 25-39.9 kg•m-2) sedentary young adults (18-30 yr) completed a 10-month randomized clinical efficacy trial of aerobic exercise 5 d•wk-1 at either 400 kcal per session (n = 37), 600 kcal per session (n = 37), or control (n = 18). Total daily energy expenditure (TDEE) and resting metabolic rate (RMR) were measured at months 0 and 10. NEPA was measured by an accelerometer at months 0, 3.5, 7, and 10. NEEx was calculated by the following formula: [(total daily energy expenditure × 0.9) - RMR] - net EEEx (EEEx-RMR). Mixed modeling was used to examine differences between groups (group effect), within groups (time effect), and group-time interaction for NEEx and NEPA. RESULTS: Within the exercise groups, there were no significant effects (all P > 0.05) of group, time, or group-time interaction for NEPA. In addition, there were no significant within- or between-group differences for change in NEEx. However, activity counts per minute were significantly higher (P < 0.001) in the 600-kcal-per-session group (346 ± 141 min•d-1) versus controls (290 ± 106 min•d-1) at month 7 and significantly higher (P < 0.001) in both the 600-kcal-per-session (345 ± 163 min•d-1) and 400-kcal-per-session groups (317 ± 146 min•d-1) versus controls (277 ± 116 min•d-1) at 10 months. CONCLUSIONS: A 10-month aerobic exercise training program in previously sedentary, overweight and obese young adults was not associated with compensatory decreases in NEEx or NEPA. Results suggest that overweight and obese individuals do not become less physically active or spend more time in sedentary pursuits in response to exercise. [ABSTRACT FROM AUTHOR]