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OBJECTIVES: To investigate health beliefs and behaviors among Old Order Amish. METHODS: 87 Old Order Amish adults. Open-ended questions and quantitative measures - Health Promoting Lifestyle Profile (HPLP), Multidimensional Health Locus of Control (MHLC), and Perceived Social Support (PSS) scales. Hermeneutic analysis of qualitative data. Comparison of means of quantitative measures across gender and generation using ANOVA. RESULTS: Support for multidimensional concept of health, 2) Dominance across generations of exercise/physical activity and nutrition as health-maintaining behavior, 3) Definition of health as ability to continue working to provide for family, 4) Work-related physical activity most frequent health-maintaining behavior; 5) Internal-HLOC consistently scored most highly; 6) Chance-HLOC scores were higher than powerful others-HLOC scores; 7) HPLP - nutrition ranked among highest and exercise ranked lowest; and 8) PSS-family scores were higher than PSS-friends scores. CONCLUSIONS: Strong Amish family support system makes family involvement in health maintenance essential, 2) Findings important for clinicians working with persons who prefer natural remedies to complex scientific options, 3) Evidence that health/illness of culturally-diverse rural persons may be unique, and 4) Need for further examination of cultural appropriateness of measures in research with diverse groups.

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