An empirical evaluation of social support and psychological well-being in older Chinese and Korean immigrants

Dementia Caregiving Experiences Among Korean Americans: Qualitative Inquiry Using the Stress Process Perspective

Dementia caregiving involves a challenging and complex process, especially for immigrant families. Using a qualitative method, this study provides an in-depth exploration of caregiving experiences among Korean American caregivers of people living with dementia. Based on various sampling strategies, 16 Korean American caregivers of family members/relatives with dementia were recruited in the greater Los Angeles area. Guided by the stress process model and the constant comparative method, themes and subthemes were derived and categorized into four domains: (1) background/context; (2) perception/appraisal; (3) resources/coping, and (4) caregiver burden/reward. Findings suggest that intervention efforts should focus on educating and training dementia caregivers.

Relationship of Living and Eating Arrangements to Mental Distress Among Older Korean Immigrants: Gender Difference in the Mediating Role of Loneliness

This study examined how different living/eating arrangements were associated with loneliness and depressive symptoms among older Korean immigrants. We examined gender differences considering: (1) patterns of living/eating arrangements and their relations with loneliness and mental distress and (2) indirect effect of living/eating arrangements on mental distress through feeling lonely. Data were drawn from the Study of Older Korean Americans that surveyed older; Korean immigrants during 2017-2018 (N = 2150). Living/eating arrangements were classified in the combination of four categores. Using the PROCESS macro, we tested gender differences in the mediation effect of loneliness on the relationship between living/eating arrangements and mental distress while controlling for background/health characteristics and social connectedness-related variables. The mediating role of loneliness was manifested differentially between men and women. By administering simple measures of living/eating arrangements, practitioners could potentially identify key targets to improve social and mental well-being, particularly among older immigrants with limited resources.

Acculturation and self-rated health among Chinese and Korean immigrants aged 49 to 75

Background

Given the rapidly growing Asian populations in the U.S. due to immigration, and the aging demographic of Asian immigrants, it is crucial to understand how acculturation shapes health among older adult Asian immigrants. We study the relationship between acculturation and self-rated health (SRH) and moderating roles of age and Asian subgroup.

Methods

Our cross-sectional study consisted of 200 Chinese and 200 Korean immigrants aged 49-75 living in Baltimore-Washington DC metropolitan area, who were recruited from primary care physicians' clinics in Maryland and Northern Virginia. The participants completed the survey either in-person or by phone in their preferred language. Multidimensional proxies were used to measure acculturation: years living in the U.S. (≥23 years, <23 years), English proficiency (fluently/well, so-so, poorly/not at all), and ethnic identity (very Asian, mostly Asian, bicultural/westernized). SRH was measured using the question "How would you rate your general health?" (excellent/very good/good, fair/poor). Poisson regression models with robust error variance examined associations between acculturation and SRH, accounting for socioeconomic and health insurance factors.

Results

Speaking English so-so and fluently/well had 0.73 (95% confidence intervals (CI): 0.55-0.97) and 0.51 (95% CI: 0.30-0.87) times the prevalence of having fair or poor SRH compared to speaking English poorly/not at all, respectively. The magnitudes and statistical significance of these associations were stronger among Chinese participants than Korean participants. Moreover, individuals who self-identified as bicultural/westernized had 0.63 times the prevalence of having fair or poor SRH (95% CI: 0.43-0.92) as those who self-identified as very Asian. The association was more pronounced among older participants (≥58) compared to younger participants (<58).

Conclusion

Further research should identify the possible mechanisms linking acculturation with health to find effective strategies to enhance health among aging Asian immigrant populations.

Psychometric evaluation of the Social Support Questionnaire for Transactions in Turkish gender-based violence sample

AIM

This study aims to investigate the reliability and predictive validity of the Social Support Questionnaire for Transactions (SSQT) scale.

DESIGN

A psychometric design using cross-sectional data.

METHOD

This cross-sectional descriptive study was conducted between February-June 2021 using snowball sampling through an online survey panel. 204 Turkish survivors of gender-based violence (GBV) participated in the research.

RESULTS

The mean age of participants was 35.66 ± 12.50. Exploratory and confirmatory factor analysis examined the construct validity of the SSQT scale. The principle axis factoring (PAF) estimation method was performed, including oblique rotation (Promax) for EFA, and the diagonally weighted least squares (DWLS) estimation method was used for CFA. Test-retest reliability coefficients (r) were moderate to excellent, ranging from 0.48 to 0.88. The analyzes supported the 5-factor solution, and the reliability was evaluated with Cronbach's Alpha coefficients for Social Friendship, Daily Emotional Support, Problem-Oriented Emotional Support, Daily Instrumental Support, and Problem-Focused Instrumental Support sub-dimensions, and the total score of SSQT showing 0.87, 0.84, 0.90, 0.73, 0.83, and 0.93, respectively. The relationships between sub-dimensions of SSQT showed moderate positive correlations ranging from 0.40 to 0.60. There were weak negative correlations between SSQT and PHQ-9, PHQ-15 and GAD-7, ranging from -0.20 to -0.34, which shows the external validity of the SSQT.

CONCLUSION

The relationships between sub-dimensions of SSQT and PHQ-9, PHQ-15, GAD-7 are given in the results support using the SSQT scale as a research and clinical instrument for assessing women who had experienced GBV and have/have not received social support in Turkish culture.

Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources

BACKGROUND

Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community.

OBJECTIVE

This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults.

METHODS

A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources.

RESULTS

The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services.

CONCLUSIONS

A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.

Adapting to a new home: resettlement and mental health service experiences of immigrant and refugee youth in Montreal

Resettlement and mental health services are critical support systems for refugee and immigrant youth (RIY) as they navigate the complexities of settling into their new homes. These services play a vital role in meeting the needs of RIY and helping them feel welcomed into Canadian society. The purpose of this study is to provide insight into RIY's experiences with resettlement and mental health service providers in Montreal, Canada. Adopting a descriptive quantitative research approach, this study utilized online surveys to gather data. The findings indicate that cultural and linguistic barriers are the major obstacles faced by refugee and immigrant youth when accessing resettlement and mental health services in Montreal. Protective resources, such as family, friends, and ethnic communities, were identified as important facilitators of successful integration into Canadian society. To improve services, cultural sensitivity should be a priority for providers, as recommended by this study. By acknowledging the significance of cultural barriers in accessing resettlement and mental health services, this study emphasizes the need for service providers to prioritize cultural sensitivity in their efforts to improve services.

Relationship of social isolation with mental distress among older Korean Americans: The moderating role of social cohesion

Social isolation has been associated with poor mental health outcomes, particularly for older immigrants who do not have a protective social environment. The purpose of this study was to investigate the relationship of social isolation (living alone, marginal family ties and marginal friend ties) with mental distress and to examine the moderating role of social cohesion (family cohesion and community cohesion). We hypothesised that social isolation and social cohesion would be directly associated with mental distress and that social cohesion would buffer the influence of social isolation on mental distress. Data were drawn from the Study of Older Korean Americans (SOKA), which included 2150 older Korean Americans aged 60 or over in multiple areas, collected during 2017-2018. A series of hierarchical regression models of mental distress examined the direct and interactive role of social isolation and social cohesion. Approximately one-third of the sample lived alone, 20% had marginal family ties and 27% had marginal friend ties. All three indicators of social isolation had a significant direct effect on mental health; however, living alone lost its statistical significance with the inclusion of social cohesion variables. Both indicators of family and community cohesion were significantly associated with lower levels of mental distress. In addition, family cohesion buffered the negative effects of marginal ties to family and friends on mental distress. The significant role of a positive social environment must be considered when addressing the needs of older immigrants who are socially isolated.

The Psychological Well-Being of Older Chinese Immigrants in Canada amidst COVID-19: The Role of Loneliness, Social Support, and Acculturation

This study examined the effects of loneliness, social support, and acculturation on psychological well-being, as indexed by general emotional well-being and life satisfaction, of older Chinese adults living in Canada during the COVID-19 pandemic. A total of 168 older Chinese adults, recruited via WeChat and the internet, completed an online study through a facilitated Zoom or phone meeting, or through a website link, individually or in a group. The testing package included demographic information, The UCLA Loneliness Scale, The Multidimensional Perceived Social Support Scale, Vancouver Index of Acculturation, The Satisfaction with Life Scale, and The World Health Organization’s Five Well-Being Index. The results showed that the psychological well-being (both general emotional well-being and cognitively perceived life satisfaction) was positively predicted by perceived social support but negatively predicted by loneliness. Acculturation was not predictive of both outcomes, and it did not moderate the predictive relationships of social support or loneliness. The results shed light on the importance of community services that target enhancing social support and reducing loneliness in promoting psychological well-being of older Chinese immigrants in Canada amidst and post the pandemic.

Coping repertoires and psychological well-being of Chinese older immigrants in the United States

OBJECTIVES

This study examines (1) the overall structures of multifaceted coping resources, that is, coping repertoires, among Chinese older immigrants in the United States, (2) the optimal coping repertoire that is associated with best psychological outcomes of these older immigrants, and (3) the most effective coping repertoire in different adversities.

METHOD

Using data from 2,923 Chinese older immigrants in Chicago, Latent Class Analysis (LCA) was performed to identify the overall coping repertoires of U.S. Chinese older adults. Negative binomial and logistic regressions were used to examine associations between coping repertoires and depression and Quality of Life (QoL), respectively. We further tested whether coping repertories moderate the relationships between adversities in health, economic, and social domains, and the two psychological outcomes.

RESULTS

LCA revealed four types of coping repertories: low-resource (43%), spouse-oriented (32%), community-oriented (15%), and multi-source coping (10%). Overall, Chinese older immigrants who had the multi-source coping repertoire reported the best psychological outcomes. The community-oriented and multi-source coping repertories had significantly stronger buffering effects on psychological well-being among individuals with IADL difficulties or low acculturation. However, spouse-oriented coping intensified the association between ADL difficulties and depression, and community-oriented coping intensified the association between poorer subjective health and lower quality of life.

CONCLUSION

This study revealed overall low coping repertories of Chinese older immigrants, suggesting the most optimal coping repertories should consist of both intrinsic and extrinsic coping sources. The findings further show that relying on limited sources might be harmful to older immigrants' mental health.

Meaning of Respect for Older People in Family Relationships

Background: Older people have various physical and mental health needs and often receive help from their family members to perform their daily life activities. This research aimed to explore the meaning of respect for older people in family relationships. Methods: A qualitative study using a content analysis approach was conducted. Semi-structured interviews were performed with sixteen older people and four family members. Results: Three main categories were developed: “respect for personal interests”, “kind and sincere respect” and “respect for autonomy”. Understanding of the meaning of respect for older people was influenced by special expectations from family members in terms of meeting personal needs, consideration of preferences and interests and empowerment and support to help preserve older people’s independence and autonomy. Conclusions: Family members should be informed and educated with regard to their expected roles in family relationships, and should consider respect as an important factor affecting older people’s well-being.

Suicidal ideation associated with depression and social support: a survey-based analysis of older adults in South Korea

BACKGROUND

This study examined the effect of depression on suicidal ideation among older adults in South Korea. Furthermore, this study investigated how social support, as a factor that reduces depression among older adults, mediates the relationship between depression and suicidal ideation.

METHODS

Based on a survey of 260 older adults in Seoul and Gyeonggi Province, suicidal ideation, depression, and social support were evaluated using the Beck Scale for Suicidal Ideation, the Center of Epidemiological Studies Depression Scale, and the Measurement of Social Support in the Elderly, respectively.

RESULTS

A multiple regression analysis confirmed that depression and social support were significantly associated with suicidal ideation. Based on path analysis, we found that social support mediated the relationship between depression and suicidal ideation.

CONCLUSIONS

Therefore, this study provides concrete insights for policymakers and social workers about how suicidal ideation among older adults may be diminished. Particularly, the role of depression and social support in suicidal ideation is a matter of concern for older adults in South Korea.

The isolation paradox: A comparative study of social support and health across migrant generations in the U.S

Social isolation and international migration have potentially adverse effects on physical and mental health, and may compound each other when migrants have limited access to supportive social networks. This problem may be particularly serious in older age groups, who are more vulnerable to illness and isolation. We analyze population representative data from a detailed survey of social networks and health in the San Francisco Bay Area, U.S., to compare access to different types of social support and health outcomes among first-generation migrants, second-generation migrants, and nonmigrants between 50 and 70 years old (N = 674). We find that first-generation migrants report systematically lower levels of social support and poorer self-rated health compared to nonmigrants, even after controlling for sociodemographic characteristics. While social support is strongly and positively associated with health in the general population, this relationship is null or, in some cases, reversed among migrants in the first and second generations. These results provide further evidence that migration operates as an adverse social determinant of health, and suggest an isolation paradox: migrants are healthier than nonmigrants only at very low levels of social support, and they do not experience the same beneficial health effects of social support as nonmigrants.

Acculturation, social support and suicidal ideation among Asian immigrants in the United States

This study examined suicidal ideation among Asian immigrant adults in the United States, with consideration of the roles of acculturation and social support. Using the 2002-2003 National Latino and Asian American Study (NLAAS), I conducted latent class analysis with measures of U.S. cultural orientation and Asian ethnic affiliation to create a multidimensional construct of acculturation. Three acculturation groups were identified (assimilated, integrated, separated) that showed different associations with suicidal ideation. Then I analyzed how the association between acculturation status and suicidal ideation is moderated by social support, distinguishing between perceived versus received support. Findings revealed that the buffering role of social support is gender-specific, with perceived support from friends reducing the risk of suicidal ideation only among assimilated women. Implications for future research include further application of acculturation as a multidimensional construct to various health outcomes and behavior as well as to other immigrant subgroups. Public health intervention efforts aimed at preventing suicide should endeavor to promote perceptions of an available social support system among immigrants and aid in establishing sources of support outside the family particularly for immigrant women.

Vegetarian diet is inversely associated with prevalence of depression in middle-older aged South Asians in the United States

Objective: To investigate associations between a vegetarian diet and depression among South Asians in the United States.Design: Data from 892 South Asians (age range 40-83 y, 47% women) enrolled in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study were included. A vegetarian diet was defined as no intake of meat, poultry or fish in the previous year as reported on a validated food frequency questionnaire. Depressive symptomology was assessed using the Center for Epidemiologic Studies-Depression Scale (CES-D) and depression was classified as CES-D score ≥16. Multivariable logistic regression was used and covariates included age, sex, study site, education, smoking, body mass index, acculturation, intentional exercise, alcohol and energy intake, and antidepressant medication use.Results: Our study demonstrated 43% lower odds of depression among vegetarians (p = 0.023).Conclusions: Vegetarian diet was found to be inversely associated with the prevalence of depression. Longitudinal examinations confirming these findings are needed.

A Global Meta-analysis of the Immigrant Mortality Advantage

A large body of research on the “Healthy Immigrant Effect” (or “Paradox”) has reported an immigrant mortality advantage. However, other studies do not find such significant effects, and some even present contradictory evidence. This article is the first systematic meta-analysis that investigates the immigration-mortality relationship from a global perspective, examining 1,933 all-cause and cardiovascular mortality risk estimates from 103 publications. Our comprehensive analysis allows us to assess interactions between origin and destination regions and to reexamine, on a global scale, some of the most notable explanations for the immigrant mortality advantage, including suggestions that this paradox may be primarily the result of selection effects. We find evidence for the existence of a mild immigrant mortality advantage for working-age individuals. However, the relationship holds only for immigrants who moved between certain world regions, particularly those who immigrated from Northern Africa, Asia, and Southern Europe to richer countries. The results highlight the need in the broader migration literature for an increased focus on selection effects and on outcomes for people who chose not to migrate or who were denied entry into their planned destination country.

The Relationship Between Big Five Personality and Social Well-Being of Chinese Residents: The Mediating Effect of Social Support

Previous studies have noted that personality traits are important predictors of well-being, but how big five personality influences social well-being is still unknown. This study aims to examine the link between big five personality and five dimensions of social well-being in the Chinese cultural context and whether social support can play the mediating effect in the process. This study included 1,658 participants from different communities in China, and regression analyses were conducted. Results revealed that five personality traits were significantly related to overall social well-being; extraversion was significantly related to social integration; agreeableness was positively related to all five dimensions of social well-being; conscientiousness was positively related to social actualization, social coherence, and social contribution; neuroticism was negatively related to social integration, social acceptance, social actualization, and social coherence; openness was positively related to social integration, social acceptance, social coherence, and social contribution. Social support plays mediating roles in the relationships between extraversion/agreeableness/conscientiousness/neuroticism/openness and social well-being, respectively.

Acculturation and Self-rated Health Among Asian Immigrants: The Role of Gender and Age

Using the 2002–2003 National Latino and Asian American Study (NLAAS), we examine the relationship between acculturation and poor-to-fair self-rated health (SRH) among Asian immigrants (N = 1639). Using latent class analysis, we construct a multidimensional measure of acculturation that considers dimensions of involvement in U.S. culture as well as attachment to Asian ethnic cultures and identify three classes of Asian immigrants: the assimilated, who most strongly adhere to U.S. culture; the integrated, who align with both U.S. and Asian ethnic cultures; and the separated, who are almost exclusively attached to Asian ethnic cultures. Logistic regression results revealed that among the pooled sample of Asian immigrant adults, the separated are significantly more likely to report poor-to-fair SRH than the assimilated. We then tested for gender and age differences in the acculturation–SRH relationship, and found that stratifying by gender yields noticeably different patterns. Among Asian immigrant women, the probability of reporting poor-to-fair SRH increases with age for the separated and the integrated, while it declines with age for the assimilated. Conversely, among Asian immigrant men, the probability of reporting poor-to-fair SRH increases most steeply with age for the assimilated, while it is shallower for the separated and the integrated. Future research should continue to develop a dynamic understanding of acculturation and examine its association with other health outcomes, including how these relationships differ across subsets of immigrant groups.

The contribution of physical and social activity participation to social support and happiness among people with physical disabilities

BACKGROUND

Prior studies have suggested that certain leisure activities provide health benefits to people with physical disabilities. Participation in social activities has been identified as a strong predictor of active coping strategies and social support from others. In addition, leisure-time physical activity (LTPA) has been found to be positively associated with health perceptions and quality of life.

OBJECTIVES

The purpose of this study was to investigate the relationships between social activity and LTPA to social support and life satisfaction among people with physical disabilities.

METHODS

Data were collected from Korean Association of Persons with Physical Disabilities. A total of 351 surveys were used.

RESULTS

Results indicated that social activity, emotional and informational support, and tangible and affectionate support were significantly associated with happiness. However, there were no direct effects of LTPA and positive social interaction support on happiness. The study results showed significant direct effects of LTPA on emotional and informational support and positive social interaction.

CONCLUSION

This study shows that it is important for people with physical disabilities not only to participate in LTPA, but also to be provided with opportunities for social activities. In particular, the importance of social activity to Korean people with physical disabilities as a means of receiving social support and increasing happiness was confirmed. The results suggest that practitioners need to create a variety of social activity opportunities, such as online social participation programs, community-based social programs, and social events for health.

Social Support, Activities of Daily Living, and Depression among Older Japanese and Koreans Immigrants in the U.S

This study investigates the relationship between social support, activities of daily living (ADL), and depression among older Japanese and Koreans living in the U.S. Data were collected from 207 older Japanese and 210 older Koreans in various long-term care settings in Honolulu and Los Angeles. A hierarchical regression analysis indicated that social support was a significant factor of depressive symptoms in both groups and ADL was significantly associated with depressive symptoms among older Japanese. Based on our findings, we recommend means for social workers to address depression among older Japanese and Korean immigrants by improving social support and ADL.

The Role of Social Networks on Depressive Symptoms: A Comparison of Older Koreans in Three Geographic Areas

The purpose of this study was to examine the correlates of depressive symptoms among older Korean adults in three geographic locations with varying densities of the Korean population: mainland Korea (mostly Koreans), New York metropolitan area (high Korean density), and west central Florida (low Korean density). The study focused on the role of family and friend networks. Data were drawn from three sources: (1) a multistage national sample of Koreans in South Korea (n = 403); (2) a survey conducted in the western/central Florida area that used a variety of culturally sensitive sampling strategies (n = 672); and (3) a survey in the New York metropolitan area (n = 420) that replicated the Florida study. For those living in Korea, living alone and lower perceived financial status were independently associated with higher levels of depressive symptoms. For the New York and Florida samples, fair or poor self-rating of health, lower levels of acculturation, and weaker ties with family were related to higher levels of depressive symptoms. Similar to the older Korean sample, lower perceived financial status was linked with greater depressive symptoms in the New York sample. The overall results suggest that it is important to consider the interplay of the social network, personal, and cultural resources when working with older adults in diverse contexts. Intervention efforts should address mental health issues tailored to cultural and social settings.

The refugee post-migration stress scale (RPMS) - development and validation among refugees from Syria recently resettled in Sweden

Background

Despite the growing recognition of the impact of post-resettlement factors on the mental health of refugees, a clear definition of the concept of post-migration stress, as well as an updated, valid instrument for assessing the construct, are still lacking. The aim of the current study was to develop and validate the Refugee Post-Migration Stress Scale (RPMS), a concise, multi-dimensional instrument for assessing post-migration stress among refugees.

Results

Based on a review of previous research and observations from a refugee trauma clinic, a preliminary 24-item instrument was developed, covering seven hypothesized domains of post-migration stress: perceived discrimination, lack of host country specific competences, material and economic strain, loss of home country, family and home country concerns, social strain, and family conflicts.

In the context of a population-based survey of mental health among refugees from Syria recently resettled in Sweden (n = 1215), the factorial structure of the RPMS was investigated. Confirmatory Factor Analysis revealed slightly insufficient fit for the initial theorized multi-domain model. Exploratory Factor Analysis in four iterations resulted in the omission of three items and an adequate fit of a 7-factor model, corresponding to the seven hypothesized domains of post-migration stress. To assess concurrent validity, correlational analyses with measures of anxiety, depression, post-traumatic stress disorder (PTSD), and mental wellbeing were carried out. All domains of post-migration stress showed significant correlations with anxiety, depression, and PTSD scores, and significant negative correlations with mental wellbeing scores.

Conclusions

The newly developed RPMS appears to be a valid instrument for assessing refugee post-migration stress. Our findings that post-migration stress primarily relating to social and economic factors seems to be associated with mental ill health among refugees is in line with previous research.

Built and social environmental factors influencing healthy behaviours in older Chinese immigrants to Australia: a qualitative study

Background

Neighbourhood environments influence older adults’ health and health-enhancing behaviours, such as physical activity, eating a healthy diet and socialising. However, little is known about the effects of the neighbourhood environment on the health of older immigrants, the number of which is rapidly increasing in developed countries. Using Nominal Group Technique (NGT) sessions, this study of older Chinese immigrants to urban Melbourne, Australia, examined built and social environmental facilitators of and barriers to regular engagement in physical activity, eating a healthy diet and regular contact with other people.

Methods

Participants were recruited from four types of neighbourhoods stratified by walkability and proportion of Chinese dwellers. Twelve NGTs, four specific to each of physical activity, healthy diet and social contacts were conducted in Mandarin or Cantonese (91 participants). NGT responses from groups addressing the same questions were aggregated, similar items were combined, and scores combined across groups. Inductive thematic analysis was used to categorise answers into higher-order themes of factors associated with each behaviour.

Results

For physical activity, 29 facilitators and 28 barriers were generated with the highest ranked facilitator and barrier being “proximity to destinations” and “poor/inadequate public transport”, respectively. For healthy diet, 25 facilitators and 25 barriers were generated, the highest ranked facilitator and barrier were “high food safety standards/regulations” and “lack of family/household members’ social support for a healthy diet”. The social contacts NGTs generated 23 facilitators and 22 barriers, with the highest ranked facilitator and barrier being “proximity to destinations and activities” and “poor public transport”, respectively.

Discussion

Independent living arrangements and the accessibility of destinations of daily living (e.g., bilingual health services, libraries, places of worship and grocery stores / supermarkets), recreational facilities, affordable public transport, and community centres and activities for Chinese people are key elements for promoting regular engagement in physical activity, healthy eating and socialising in older Chinese immigrants. Governments should plan for the provision of this basic infrastructure of community facilities for older immigrants.

Positive Influences of Social Support on Sense of Community, Life Satisfaction and the Health of Immigrants in Spain

The main objective of this study was to investigate the association of social support and the sense of community (SOC) with satisfaction with life (SWL) and immigrant health. We propose a model in which perceived social support from close sources (family and friends), as mediated by SOC and life satisfaction, would be positively associated with mental and physical health. Limited evidence exists from multivariate models that concurrently examine the association of both factors with SWL and health-related outcomes. We investigate the hypothesized association in a structural equations model (SEM) analysis. The participants consisted of 1131 immigrants (49% men and 51% women) (age 18-70, M = 33). The study was conducted in Malaga (Spain). Cross-sectional data were collected using a random-route sampling and survey methodology. In this model, greater social support from native friends was associated with a greater SOC. Social support from family and native friends was associated with greater SWL. Also, a greater SOC was associated with greater SWL. No association was found between SOC and mental health symptoms, whereas, greater SWL was associated with fewer mental health and illness symptoms. These results suggest that among immigrants, support networks involving family and native friends, and integration into the community are important influences for immigrants to achieve life satisfaction. These results are widely applicable and have implications that are relevant to the design of health promotion interventions.

Understanding the neighbourhood environment and the health and wellbeing of older Chinese immigrants: a systematic literature review

Neighbourhood environment has a significant impact on the health and wellbeing of older people. In recent years, the increase in older Chinese immigrants globally has attracted a growing amount of research which has investigated the health and wellbeing of these elderly residents. The aim of this study is to provide a systematic literature review of empirical findings on the health and wellbeing of older Chinese immigrants and the ways in which the neighbourhood environment impacts them. A systematic search was conducted using online databases where 52 articles met specific criteria and were subsequently reviewed critically. An inductive approach was undertaken to analyse the data extracted from the selected articles. The review was categorised according to the following themes: neighbourhood social environment, neighbourhood physical environment and place attachment. The findings show that the majority of research has investigated the health status of older immigrants, and in particular, the impacts related to the social environments in which they live. The literature review indicated that there is scope for future studies to investigate the impact of the physical neighbourhood environment on this group of people.

Is Migration at Older Age Associated With Poorer Psychological Well-Being? Evidence from Chinese Older Immigrants in the United States

BACKGROUND AND OBJECTIVES

The migrating age of an individual has far-reaching implications for their acculturation experience, social integration, and well-being. This study addressed two questions: Is migrating at older age associated with poorer psychological well-being? If so, what factors account for such differences?

RESEARCH DESIGN AND METHODS

Using data of 3,138 Chinese elderly people in Chicago, we compared the levels of depression and quality of life among individuals who migrated in young adulthood (before 35), adulthood (35-49), midlife (50-64), and later life (65+). Negative binominal and logistic regressions were performed to examine the associations between age at migration and the two outcomes, controlling for demographics and four sets of explanatory variables (socioeconomic status, health status, acculturation level, and family/social relations).

RESULTS

The findings revealed mixed results. Migrating in later life was associated with more depressive symptoms, but also a higher chance of reporting good quality of life. Late-life immigrants' greater depression was partially contributed to their low income, lack of access to health care, poor physical health, and weak social relations. In contrast, regardless of the explanatory variables, migrating at middle age was associated with lower quality of life.

DISCUSSION AND IMPLICATIONS

Acknowledging that the older immigrant population is segmented with unique susceptibilities improves understanding of heterogeneity among the older immigrant populations and allows for targeted intervention. Gerontological practitioners should include migration history during their intakes and more actively screen for depression with socially isolated Chinese older immigrants who migrated at a later age.

Understanding Social Network and Support for Older Immigrants in Ontario, Canada: Protocol for a Mixed-Methods Study

Background

Older adults are the fastest growing age group worldwide and in Canada. Immigrants represent a significant proportion of older Canadians. Social isolation is common among older adults and has many negative consequences, including limited community and civic participation, increased income insecurity, and increased risk of elder abuse. Additional factors such as the social, cultural, and economic changes that accompany migration, language differences, racism, and ageism heighten older immigrants’ vulnerability to social isolation.

Objective

This mixed-methods sequential (qualitative-quantitative) study seeks to clarify older immigrants’ social needs, networks, and support and how these shape their capacity, resilience, and independence in aging well in Ontario.

Methods

Theoretically, our research is informed by an intersectionality perspective and an ecological model, allowing us to critically examine the complexity surrounding multiple dimensions of social identity (eg, gender and immigration) and how these interrelate at the micro (individual and family), meso (community), and macro (societal) levels in diverse geographical settings. Methodologically, the project is guided by a collaborative, community-based, mixed-methods approach to engaging a range of stakeholders in Toronto, Ottawa, Waterloo, and London in generating knowledge. The 4 settings were strategically chosen for their diversity in the level of urbanization, size of community, and the number of immigrants and immigrant-serving organizations. Interviews will be conducted in Arabic, Mandarin, and Spanish with older women, older men, family members, community leaders, and service providers. The study protocol has received ethics approval from the 4 participating universities.

Results

Quantitative and qualitative data collection is ongoing. The project is funded by the Social Sciences and Humanities Council of Canada.

Conclusions

Comparative analyses of qualitative and quantitative data within and across sites will provide insights about common and unique factors that contribute to the well-being of older immigrants in different regions of Ontario. Given the comprehensive approach to incorporating local knowledge and expert contributions from multilevel stakeholders, the empirical and theoretical findings will be highly relevant to our community partners, help facilitate practice change, and improve the well-being of older men and women in immigrant communities.

International Registered Report Identifier (IRRID)

DERR1-10.2196/12616

Is family relations related to health service utilisation among older immigrants: Evidence from Chinese elderly in the United States

The family is the key for survival and success of the 4.6 million older immigrants in the United States. It is also an overlooked context to understand older immigrants' health service utilisation. Most prior studies on this topic either focus on individual or institutional factors that affect how older immigrants use formal health services. Using data from 2011 Population Study of Chinese Elderly in Chicago (N = 3,159), this study examined potential linkages between family relationships and health service utilisation among US Chinese elderly. Negative binomial and logistic regressions were carried out to investigate whether health service use of these older immigrants are related to positive family relations, negative family relations, and health-related communications among family members. The findings showed that positive spousal or family relations were not associated with either physician visits or hospital stays. However, respondents with more negative family relations had more doctor visits (β = 0.065, p < 0.05) and were marginally more likely to use inpatient services (OR = 1.15, CI: 0.88-1.04, p = 0.08). Respondents who talked to their spouse for medical concerns were less likely to use inpatient services (OR = 0.68, CI: 0.46-0.99, p < 0.05). The findings showed that family relations play a role in Chinese older immigrants' health service use. In addition, family conflict seems to be more influential than close family relations in predicting service use. Practitioners need to thoroughly assess family dynamics to fully understand the resources and barriers for health service utilisation among the older immigrant populations.

A systematic review of correlates of depression among older Chinese and Korean immigrants: what we know and do not know

OBJECTIVES

Guided by the stress and coping theory, this study provides a systematic review of existing research on acculutration, family support, and social support related correlates of depression among older Chinese and Korean immigrants in the United States.

METHOD

A comprehensive literature search was conducted in CINAHL Plus, Abstracts in Social Gerontology, AgeLine, Social Work Abstracts, PubMed, PsychINFO, and Social Science Citation Index databases to identify relevant articles that presented multivariate analysis results.

RESULTS

A total of 55 articles were identified, with the vast majority focusing on older Korean immigrants. The overall evidence showed that length of residence was largely unrelated to depression, and poor Enligsh proficiency also had a weak correlation with depression. However, a low level of acculturation measured by multidimensional scales was consistently associated with more depressive symptoms. Overall, living arrangements and the size and frequency of contact of both kin and non-kin networks were weak correlates of depression. In contrast, negative family and social interactions seem to be more consequential for depression in the two groups than positive relations and support.

CONCLUSION

The findings show that established acculturation instruments are useful tools to identify at-risk older Chinese and Korean immigrants. Future studies need to further examine which aspects of acculturation experience are more influential for immigrants' mental health. Although often conceptualized as important coping resources, family and social networks could present significant stressors for older immigrants. Future research and services could focus on these contexts to improve the mental health of these two rapidly increasing Asian populations.

A cross-sectional study of coping resources and mental health of Chinese older adults in the United States

OBJECTIVES

This study examined the potential influence of coping resources at individual (sense of mastery), family (spousal and family support, children's filial piety), and community levels (community cohesion) on the mental health (depression, anxiety) of U.S. Chinese older adults.

METHODS

The data were derived from the Population Study of Chinese Elderly in Chicago (N= 3,159). Negative binomial regressions were performed to predict depression and anxiety, respectively, by entering the three sets of coping resources separately and jointly, controlling for socio-demographic and acculturation variables.

RESULTS

Stronger sense of mastery and greater perception of children's filial piety were associated with better mental health outcomes. Spousal support was not associated with any mental health outomes, and family support was actually assciated with greater depression and anxiety. Stronger community cohesion was associated with fewer depressive symptoms but greater anxiety.

CONCLUSION

Older immigrants' sense of control and perception that children adhere to traditional family norms are important mental health protective factors. Whereas depending on families for support may compromise their well-being, community cohesion could be a double-edged sword for their mental health. Future studies shall further disentangle the associations among sense of mastery, reliance on family and ethnic enclaves for support, and older immigrants' well-being.

Health Services Utilization Among Chinese American Older Adults: Moderation of Social Support With Functional Limitation

In this study, we aimed to examine the relationship of social support with hospitalizations and emergency department (ED) visits among older Chinese adults in the United States and its possible mechanism. This was a secondary analysis of data from the Population Study of Chinese Elderly (July 2011-June 2013; N = 3,157). After adjusting for demographic, clinical, and functional covariates in logistic regression analyses, significant interaction between social support from spouse and the number of functional limitations in (instrumental) activities of daily living was related to lower odds of hospitalization (odds ratio [OR] = 0.97 [0.95-0.99]) and ED visits (OR = 0.98 [0.96-0.99]). This finding suggests that among older Chinese American adults with functional limitations, more spousal support was related to lower odds of hospitalizations and ED visits. Future studies should comprehensively measure social support (e.g., content, amount) from other sources and investigate how unnecessary acute health service utilization in this population may be reduced by social support interventions.

Estimating Mortality Levels and Patterns among Natives, Immigrants, and Selected Ethnic Groups in Greece: 2010–2012

This study addresses for the first time in Greece the issue of levels and patterns of mortality among natives and immigrants, using vital statistics and census data by citizenship. Life tables are constructed for the two most numerous communities, Albanians and Bulgarians as well as for all immigrant populations combined; standardized mortality ratios are estimated for smaller migrant groups. Albanian males have a slight mortality advantage compared to natives; all other groups experience higher mortality. Some support for the “selectivity of migrants” hypothesis is provided as immigrants in several cases have significantly lower mortality compared to their countries of origin. Implications for public health policy in Greece are discussed.

Loneliness, Depressive Symptoms, and Cognitive Functioning Among U.S. Chinese Older Adults

Objective: Loneliness has been associated with cognitive functioning in the general older adult population. Previous studies further indicate that loneliness has a strong association with depressive symptoms and the two constructs can reinforce each other to diminish well-being. However, such relationships have not been examined in U.S. Chinese older adults. This study attempts to bridge this knowledge gap. Method: Data were drawn from a population-based study of 3,159 U.S. Chinese older adults in the Greater Chicago area. Stepwise multivariate regression analyses were conducted to examine the relationship between loneliness, depressive symptoms, and global cognitive functioning. Results: Loneliness was associated with poor global cognitive functioning in U.S. Chinese older adults, though the relationship became nonsignificant after adjustment for depressive symptoms. The interaction term between loneliness and cognitive functioning was statistically significant (p < .01). The findings further highlight the importance of age, education, number of children, number of people in household, and length of residence in the U.S. in cognitive functioning among U.S. Chinese older adults. Discussion: The study findings indicate that loneliness and depressive symptoms act together to influence cognitive functioning in U.S. Chinese older adults. Research and clinical implications of the findings are discussed.

Associations Between Acculturation and Oral Health Among Older Chinese Immigrants in the United States

Background: The aim of this study was to understand the associations between acculturation and oral health among older Chinese immigrants in the United States. Method: We used data from the PINE study, which included the foreign-born older Chinese immigrants (N = 3,128). We measured acculturation by measuring participants' length of stay and behavioral acculturation. Participants' tooth and gum symptoms were the outcome variables. Results: Longer stay in the United States was significantly associated with fewer gum symptoms but not with tooth symptoms. Behavioral acculturation was not significantly associated with either tooth or gum symptoms. The middle tertile of behavioral acculturation, compared with its upper and lower tertiles, deemed to be a more significant risk factor of tooth/gum symptoms. In addition, older immigrants with more social interactions with the Americans were more likely to have tooth symptoms. Discussion: In the future, we will conduct a study using longitudinal data to help us better understand the relationship between acculturation and oral health in Chinese American population.

Factors Influencing Suicide Behaviours in Immigrant and Ethno-Cultural Minority Groups: A Systematic Review

This paper reviews recent literature on factors influencing suicide behaviours, including thoughts, plans, and attempts, in immigrant and ethno-cultural minority groups, to inform a more comprehensive understanding of suicide behaviours in increasingly culturally diverse populations. Thirty-three studies published between 2002 and 2013 were identified through digital databases searches and included in this review. Analysis of study findings focused on impacts of ethno-cultural identity and acculturation, other cultural and immigration influences, and family and community supports on suicide behaviours. Policy, practice, and research recommendations are identified, to inform relevant suicide prevention efforts and enhance mental health supports for immigrant and ethno-cultural minority populations.

Social Relatedness and Physical Health Are More Strongly Related in Older Than Younger Adults: Findings from the Korean Adult Longitudinal Study

Previous research indicates that social relatedness is beneficial to physical health; however, findings on the relative strength of the relationship between these variables have been inconsistent. The present study employed cross-sectional survey (Study 1) and a daily diary survey (Study 2) to examine the link between social relatedness and physical health by age. Using a representative sample of Korean adults (N = 371) aged from 20 to 69, Study 1 examines the link between social relatedness (loneliness, perceived social support) and physical health (physical symptoms, chronic health conditions) using age as a moderator. The results show that participants' age moderates the association between social relatedness and physical health. Study 2 (N = 384) further corroborated the findings from Study 1 by showing that when controlling for the physical symptoms experienced prior to the daily diary reports, the level of loneliness experienced over a 13-day period exacerbates the age differences in the physical symptoms. The present study thus provides converging evidence that social relatedness plays a significant role in physical health, particularly in the older population.

Willingness to use mental health counseling and antidepressants in older Korean Americans: the role of beliefs and stigma about depression

OBJECTIVES

Despite a high prevalence of mental health problems, racial/ethnic minorities are often reluctant to seek mental health services. Their reluctance may be shaped by cultural beliefs and stigma about mental health. The present study examined how beliefs and stigma about depression (e.g. disbelief in depression as a health-related condition, perception of depression as a normal part of aging, and/or depression as a sign of personal weakness/family shame) pose barriers to older Korean Americans' willingness to use mental health counseling and antidepressants.

METHOD

Data were drawn from surveys with 420 Korean American older adults (M_age= 71.6, SD = 7.6) living in the New York City metropolitan area in 2010. Using a separate logistic regression model, the role of beliefs and stigma about depression in predicting participants' willingness to receive mental health counseling and to take antidepressants was tested. Based on Andersen's behavioral health service use model, the analysis was conducted in consideration of predisposing characteristics (age, gender, marital status, education, and acculturation), mental health needs (anxiety, depressive symptoms, and self-rated mental health), and enabling/hindering factors (beliefs and stigma).

RESULTS

Similar proportions of the sample (69-70%) indicated their willingness to use mental health counseling or antidepressants. Willingness was more likely among participants who had beliefs about depression as a health-related concern (OR = 1.94, 95% CI = 1.15-3.27 for mental health counseling; OR = 4.47, 95% CI = 2.59-7.70 for antidepressants) and less likely among those who associated depression with family shame (OR = .55, 95% CI = 0.33-0.91 for mental health counseling; OR = .56, 95% CI = 0.33-0.95 for antidepressants).

CONCLUSION

In addressing mental health problems and promoting the use of mental health services, cultural beliefs and stigma shared within an ethnic community should be considered. Given that disbelief in the medical model of depression and family shame reduced willingness to use mental health counseling and antidepressants, promoting mental health literacy for older immigrants could be beneficial.

Prevalence of mental ill health, traumas and postmigration stress among refugees from Syria resettled in Sweden after 2011: a population-based survey

OBJECTIVES

To estimate the prevalence of and associations between anxiety, depression, post-traumatic stress disorder (PTSD), low subjective well-being (SWB), potential traumas and postmigration stress among refugees from Syria resettled in Sweden.

DESIGN

A cross-sectional and population-based questionnaire study based on a known and complete sample frame. The survey included multiple measures of mental ill health and factors of particular relevance for refugees. Weighted analyses were conducted to calculate representative prevalence rates and associations. Associations were investigated through a series of logistic regression analyses. All analyses were supplemented with robust 95% CIs.

SETTING

Sweden.

PARTICIPANTS

A random sample of 1215 individuals (response rate 30.4%) from Syria aged 18-64 years that were granted residency in Sweden on grounds of asylum between 2011 and 2013.

MAIN OUTCOME MEASURES

Anxiety, depression, PTSD and low SWB were assessed through Hopkins Symptom Checklist, Harvard Trauma Questionnaire and WHO-5 Well-being Index, using established cut-offs.

RESULTS

A majority of the participants met the criteria for at least one of the studied types of mental ill health, and the comorbidity was high. Depression was the most the common type with 40.2% (95% CI 36.9% to 43.3%), followed by low SWB with 37.7% (95% CI 34.8% to 40.1%), anxiety with 31.8% (95% CI 29.2% to 34.7%) and PTSD with 29.9% (95% CI 27.2% to 32.6%). Refugee-related potentially traumatic events (PTEs) experienced before or during migration was common as was substantial levels of postmigration stress. Most types of refugee-related PTEs, especially being exposed to interpersonal violence, and postmigration stress were associated with increased risks for anxiety, depression, low SWB and PTSD.

CONCLUSIONS

Mental ill health, in terms of anxiety, depression, low SWB and PTSD, are highly elevated and comorbid among refugees from Syria. Increased attention from multiple societal sectors to adequately support Syrian refugees' mental health needs, promoting recovery and reducing postmigration stress are needed.

Vietnamese Refugee Elderly Women and Their Experiences of Social Support: A Multiple Case Study

This study sought to address the gaps in the literature on Asian American gerontology with a multiply marginalized group in terms of gender, immigration status, and context. Guided by a multiple case study approach, we sought to explore how social support was experienced by four Vietnamese elderly refugee women residing in different living arrangements (i.e., alone, with spouse, with adult children, or in a multigenerational household). Within-case analyses were conducted to yield descriptive information about each individual. Additionally, three overarching themes emerged across each of the living arrangements: (1) Burden of care-taking, (2) Distinguishing family from nonfamily help, and (3) Ambivalence toward government-sponsored services. Our findings provide a contextualized understanding of social support to explain the inconsistencies that have been found in the literature on Asian American gerontology and family support. The benefits of living alone are described, along with the potential risks of coresidency.

The "Hispanic mortality paradox" revisited: Meta-analysis and meta-regression of life-course differentials in Latin American and Caribbean immigrants' mortality

The literature on immigrant health has repeatedly reported the paradoxical finding, where immigrants from Latin American countries to OECD countries appear to enjoy better health and greater longevity, compared with the local population in the host country. However, no previous meta-analysis has examined this effect focusing specifically on immigrants from Latin America (rather than Hispanic ethnicity) and we still do not know enough about the factors that may moderate the relationship between immigration and mortality. We conducted meta-analyses and meta-regressions to examine 123 all-cause mortality risk estimates and 54 cardiovascular mortality risk estimates from 28 publications, providing data on almost 800 million people. The overall results showed that the mean rate ratio (RR) for immigrants vs. controls was 0.92 (95% CI, 0.84-1.01) for all-cause mortality and 0.73 (CI, 0.67-0.80) for cardiovascular mortality. While the overall results suggest no immigrant mortality advantage, studies that used only native born persons as controls did find a significant all-cause mortality advantage (RR, 0.86; 95% CI, 0.76-0.97). Furthermore, we found that the relative risk of mortality largely depends on life course stages. While the mortality advantage is apparent for working-age immigrants, it is not significant for older-age immigrants and the effect is reversed for children and adolescents.

Social Isolation in Chinese Older Adults: Scoping Review for Age-Friendly Community Planning

Chinese older adults may be at increased risk of social isolation and loneliness, and a fragmented understanding exists about the challenges they face for social participation in their neighbourhoods and communities. A scoping review was undertaken to describe the current knowledge on social isolation and loneliness in urban-dwelling Chinese older adults living in Western societies to inform future research, practice, and policy in Canada. Nineteen articles met the inclusion criteria. The World Health Organization's age-friendly community framework contextualized the study findings. Studies identified issues related to (1) social participation; (2) community support and health services; (3) housing; (4) community and information; (5) respect and social inclusion; (6) outdoor spaces and public buildings; (7) civic participation and employment; and (8) transportation. Social isolation and loneliness is a growing concern in this population in Canada, and additional research is needed to identify its scope and effective interventions.

The relation between living alone and depressive symptoms in older Korean Americans: do feelings of loneliness mediate?

OBJECTIVES

As the opposite end of the continuum from social integration, social isolation may put individuals at a greater risk of poor mental health. Conceptualizing living alone as an objective and structural indicator of social isolation and loneliness as subjective perceptions of social isolation, the present study hypothesized that the relation between living alone and depressive symptoms would be mediated by the feelings of loneliness. Using older Korean Americans as the target population, the mediation model was examined in consideration of the contextual factors such as demographics (age, gender, education, perceived income, and length of stay in the USA), health (chronic conditions and functional disability), and general social integration (size of social network and community social cohesion).

METHOD

Date were drawn from surveys with 209 older Korean Americans in Central Texas (M_age = 69.6, SD = 7.5). Multivariate regression models of depressive symptoms were entered in the following order: (1) demographics, (2) health, (3) living alone, (4) social network/community social cohesion, and (5) loneliness. The mediation effect of loneliness in the relationship between living alone and depressive symptoms was separately examined using the bootstrapping method.

RESULTS

Loneliness was found to mediate the relation between living alone and depressive symptoms (indirect effect = 1.03, 95% CI = .05-2.08).

CONCLUSION

The results suggest that subjective perceptions of loneliness may explain the mechanism through which objective social isolation presents risks for depressive symptoms in older Korean Americans.

Relationship Between Ties With Adult Children and Life Satisfaction Among the Middle-Aged, the Young-Old, and the Oldest-Old Korean Adults

One of the important determinants of well-being among aging parents is their relationship with adult children. Using the two waves of the Korean Longitudinal Study of Ageing, this study examined how different types of ties with adult children affect the life satisfaction of the Korean middle-aged, the young-old, and the oldest-old adults. Multigroup analysis was used to see if the effects of ties with adult children differ by the three age-groups. The results showed that frequency of contact had positive effect on life satisfaction for all of the age-groups. However, coresidence with children had a negative effect for the middle-aged, but a positive effect for the oldest-old. Finally, exchanges of support with adult children had significant effects only for the young-old. These results show that the importance of different types of ties with children change according to aging parents' life stages.

A Case Study of Exploring Older Chinese Immigrants' Social Support within a Chinese Church Community in the United States

The number of older Chinese immigrants living in the United States is increasing steadily. They are faced with challenges to meet their needs for social support and are unlikely to turn to formal services. This case study utilizes an ecological framework to analyze social support among Chinese immigrants age 65 year and older within a Christian Chinese church community, and to explore the ways in which a Chinese church functions as the source of social support for older Chinese immigrants. Seven months of participant observation and ten face-to-face, in-depth interviews were conducted with 65+ Chinese adults who attended one Chinese church in the Southern United State and included questions concerning patterns of support and personal relationships within the church. Findings revealed that gender, living arrangements, working experiences, ability to drive, and English language skills were related to support the older Chinese immigrants sought, received, and provided. Although the Chinese church can be a viable source of supplementary support, some participants in this study felt the support they received from the church was insufficient, particularly in terms of emotional support. Therefore, suggestions are outlined that may assist Chinese churches to be more proactive in better understanding and providing services that meet the different needs and desires of older Chinese immigrants.

A mental health intervention strategy for low-income, trauma-exposed Latina immigrants in primary care: A preliminary study

Latinos in the United States face significant mental health disparities related to access to care, quality of care, and outcomes. Prior research suggests that Latinos prefer to receive care for common mental health problems (e.g., depression and anxiety disorders) in primary care settings, suggesting a need for evidence-based mental health services designed for delivery in these settings. This study sought to develop and preliminarily evaluate a mental health intervention for trauma-exposed Latina immigrants with depression and/or posttraumatic stress disorder (PTSD) for primary care clinics that serve the uninsured. The intervention was designed to be simultaneously responsive to patients' preferences for individual psychotherapy and to the needs of safety-net primary care clinics for efficient services and to address the social isolation that is common to the Latina immigrant experience. The resulting intervention, developed on the basis of findings from the research team's formative research, incorporated individual and group sessions and combined evidence-based interventions to reduce depression and PTSD symptoms, increase group readiness, and improve perceived social support. Low-income Latina immigrant women (N = 28), who screened positive for depression and/or PTSD participated in an open pilot trial of the intervention at a community primary care clinic. Results indicated that the intervention was feasible, acceptable, and safe. A randomized controlled trial of the intervention is warranted. (PsycINFO Database Record

Trauma-Exposed Latina Immigrants' Networks: A Social Network Analysis Approach

OBJECTIVE

Trauma exposure among Latina immigrants is common. Social support networks can buffer the impact of trauma on mental health. This study characterizes the social networks of trauma-exposed Latina immigrants using a social network analysis perspective.

METHODS

In 2011-2012 a convenience sample (n=28) of Latina immigrants with trauma exposure and presumptive depression or posttraumatic stress disorder was recruited from a community clinic in Washington DC. Participants completed a social network assessment and listed up to ten persons in their network (alters). E-Net was used to describe the aggregate structural, interactional, and functional characteristics of networks and Node-XL was used in a case study to diagram one network.

RESULTS

Most participants listed children (93%), siblings (82%), and friends (71%) as alters, and most alters lived in the US (69%). Perceived emotional support and positive social interaction were higher compared to tangible, language, information, and financial support. A case study illustrates the use of network visualizations to assess the strengths and weaknesses of social networks.

CONCLUSIONS

Targeted social network interventions to enhance supportive networks among trauma-exposed Latina immigrants are warranted.

Risk Factors for Social Isolation in Older Korean Americans

OBJECTIVE

Given the importance of social ties and connectedness in the lives of older ethnic immigrants, the present study examined the prevalence of social isolation and its risk factors in older Korean Americans.

METHOD

Using survey data from 1,301 participants (Mage = 70.5, SD = 7.24), risk groups for marginal social ties with family and friends were identified and predictors of each type of social isolation explored.

RESULTS

Male gender and poorer rating of health were identified as common risk factors for marginal ties to both family and friends. Findings also present specific risk factors for each type of social isolation. For example, an increased risk of having marginal ties with friends was observed among individuals with perceived financial strain, greater functional impairment, and a shorter stay in the United States.

DISCUSSION

The common and specific risk factors should be incorporated in programs to reduce social isolation in older immigrant populations.