Alzheimer's Disease and its Related Dementias among Asian Americans, Native Hawaiians, and Pacific Islanders: A Scoping Review

BACKGROUND

The Asian American, Native Hawaiian, and Pacific Islander (AANHPI) aging population is rapidly growing and the burden of Alzheimer's disease and its related dementias (ADRD) will likely mirror this demographic growth. AANHPIs face significant barriers in obtaining timely ADRD diagnosis and services; yet little is known about ADRD in this population.

OBJECTIVE

The study objective is to conduct a systematic review on the published literature on ADRD among AANHPIs to identify gaps and priorities to inform future research and action plans.

METHODS

The systematic review was conducted following the PRISMA Protocol for Systematic Reviews. Co-author (TR), an experienced Medical Librarian, searched PubMed, EMBASE, PsycINFO, Cochrane Central of Clinical Trials, Ageline, and Web of Science for peer-reviewed articles describing ADRD among AANHPIs. The search was not limited by language or publication date. Each citation was reviewed by two trained independent reviewers. Conflicts were resolved through consensus.

RESULTS

The title/abstract and full texts of 1,447 unique articles were screened for inclusion, yielding 168 articles for analysis. Major research topics included prevalence, risk factors, comorbidities, interventions and outreach, knowledge and attitudes, caregiving, and detection tools. A limited number of studies reported on national data, on NHPI communities generally, and on efficacy of interventions targeting AANHPI communities.

CONCLUSION

To our knowledge, this is the first systematic review on ADRD among AANHPI populations. Our review provides a first step in mapping the extant literature on ADRD among this underserved and under-researched population and will serve as a guide for future research, policy, and intervention.

Internet Recruitment of Asian American Breast Cancer Survivors

The purpose of this article is to identify practical issues in Internet recruitment of racial/ethnic minorities by analyzing an Internet intervention study conducted with Asian American breast cancer survivors, and to propose directions for recruitment of racial/ethnic minorities for future Internet research. Six practical issues were identified: (a) a relatively fewer number of Internet communities/groups; (b) hindrances in establishing authenticity;

Group disparities and health information: a study of online access for the underserved

The Internet is an oft-cited learning resource, useful to consumers who seek to educate themselves on specific technical issues or knowledge-intensive topics. Availability of public-access Internet portals and decreasing costs of personal computers have created a consensus that unequal access to information, or a "Digital Divide", presents a like problem specific to information for uninsured or under-insured healthcare consumers. Access to information, however, is now an essential part of consumer-centric healthcare management. To date little research has been done to differentiate levels of health information access on the Web by different subgroups, linking online socioeconomic characteristics and health seeking behaviors. This analysis of a landmark Pew Foundation survey seeks to differentiate and delineate information access, or lack of desired access, across targeted, "digitally underserved" subgroups.

A study of peer-to-peer information in a domain of uncertainty: the case of epilepsy

As increasing amounts of complex health information become available via the Internet, providers frequently advise that it is important for health consumers to carefully consider the source of lay information, as well as discuss the clinical information they find with their healthcare provider. Beyond clinical indicators and standards, however, there exist few evaluative frameworks for assessing health information, especially within peer-to-peer networks. Traditional methods of analyzing online discussion content, such as keyword examination or network structure analysis, have proven largely unsatisfactory for unstructured health data analysis. Using a disease-specific illustration, this study proposes a theoretical framework that is broad enough to encompass a variety of poorly understood healthcare domains, and provides one example of an often misunderstood and ambiguous disease that lends itself to online patient-centered discussion, which can serve to supplement traditional clinical information exchange.

Examining online chat within a domain of uncertainty: the case of Asperger's syndrome

OBJECTIVE

To determine whether grounded theory can be applied as a cross-disciplinary evaluative framework for assessing health information, especially within domain-specific peer-to-peer networks.

METHODS

Using a grounded-theory approach, we seek to identify recurring themes of peer-based interaction, without the ongoing management of clinical experts, as a way to determine stakeholder concerns and interests in a domain of frequent clinical uncertainty and treatment, Asperger's syndrome.

RESULTS

We find that users of web-based information in such areas often report reliance on information for medical decision making and disease management, at times to the point where interaction becomes a form of 'cybertherapy.' Further, such groups often evolve into disease-specific, 'virtual support groups', even where discussions highlight a lack of consensus regarding the role, function and quality of information within this unique domain.

CONCLUSION

A grounded theory approach can successfully be applied in a domain-specific setting to identify themes in unstructured peer-to-peer discussion of ill-defined diseases and treatments.