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Park NS, Jang Y, Chung S, Chiriboga DA, Haley WE. Relationship of Living and Eating Arrangements to Mental Distress Among Older Korean Immigrants: Gender Difference in the Mediating Role of Loneliness. Res Aging 2024; 46:153-166. [PMID: 37820385 DOI: 10.1177/01640275231206482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
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.
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Affiliation(s)
- Nan Sook Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, California, CA, USA
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, FL, USA
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Jang Y, Hepburn K, Haley WE, Park J, Park NS, Ko LK, Kim MT. Examining cultural adaptations of the savvy caregiver program for Korean American caregivers using the framework for reporting adaptations and modifications-enhanced (FRAME). BMC Geriatr 2024; 24:79. [PMID: 38245703 PMCID: PMC10800033 DOI: 10.1186/s12877-024-04715-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 01/16/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) is a tool that systematically guides decision-making and reporting of adaptations made to evidence-based interventions. Using FRAME, we documented the process and outcomes of adapting the Savvy Caregiver Program (SCP) for Korean American dementia caregivers. METHODS Sequential adaptation was initiated with linguistic attunement, followed by pilot implementation and full adaptation. Our data-driven adaptation with multiple data sources and a feedback loop among multiple stakeholders yielded a total of 32 modifications, and each was coded according to the eight domains of FRAME: (1) what was modified, (2) who participated in recommending and deciding the modification to be made, (3) when the modification occurred, (4) whether the modification was planned, (5) whether the modification was fidelity-consistent, (6) whether the modification was temporary, (7) at what level of delivery, the modification was made, and (8) why the modification was made. RESULTS The areas of adaptation were evenly distributed across context (37.5%), content (31.2%), and training (31.2%). The primary reasons for modification were for engagement (62.5%), followed by fit with recipients (43.8%) and outcome improvement (31.1%). About 66% of the modifications were applied to the entire target group, and all modifications were fidelity-consistent. CONCLUSIONS The FRAME categorization provided a detailed understanding of the process and nature of adapting the SCP and served as a foundation for further implementation and scale-up. FRAME not only serves as a guide for adapting evidence-based interventions but also promotes their replicability and scalability.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA.
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea.
| | - Kenneth Hepburn
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, USA
| | - Juyoung Park
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, USA
| | - Linda K Ko
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Miyong T Kim
- School of Nursing, University of Texas at Austin, Austin, USA
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Jang Y, Park J, Park NS, Chung S, Kim MT. Safety Concerns for Persons with Dementia in Senior Housing: A Qualitative Study with Korean American Caregivers in Los Angeles. J Gerontol Soc Work 2023; 66:1108-1119. [PMID: 37162322 PMCID: PMC10615861 DOI: 10.1080/01634372.2023.2212715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/25/2023] [Accepted: 05/08/2023] [Indexed: 05/11/2023]
Abstract
Subsidized senior housing helps many socioeconomically disadvantaged older adults pursue independent living and aging in place. However, cognitive impairment or dementia poses a critical challenge to many residents' ability to live independently and safely. Focusing on Korean American dementia caregivers, a group known to be vulnerable to caregiving burden but understudied, we explored the safety of persons with dementia in senior housing from the perspectives of caregivers. Qualitative data from nine caregivers whose care recipients were current or former residents of subsidized senior housing in Los Angeles were analyzed by the constant comparative method. Major concerns emerged were: (1) fire risks, (2) wandering, (3) physical injury (e.g., self-harm, falls), and (4) potential neglect. Caregivers also mentioned errors in the self-administration of medications, potential financial exploitation, and interpersonal conflicts. These concerns provide implications for services and programs for the safety of persons with dementia who live in senior housing.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Juyoung Park
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, USA
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Miyong T Kim
- School of Nursing, University of Texas at Austin, Austin, USA
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Jang Y, Jung J, Park NS, Kim MT, Chung S. COVID-19 health information sources and their associations with preventive behaviors: A typological study with older residents in Seoul, South Korea. PLoS One 2023; 18:e0290824. [PMID: 37651388 PMCID: PMC10471008 DOI: 10.1371/journal.pone.0290824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023] Open
Abstract
Considering that individuals' health information can enable their adoption of health behaviors, we examined the use of health information sources related to COVID-19 and its association with preventive behaviors in a sample of older residents in Seoul, South Korea (N = 400, M age = 76.1 years). Latent profile analysis of 12 sources of health information representing conventional media, online sources, interpersonal networks, and health professionals or authorities yielded a 4-group typology: limited, moderate/traditional, moderate/digital, and diverse. In a multivariate model with the diverse group as a reference, the limited group (B = -4.48, SE = 1.14, p < .001) and the moderate/digital group (B = -2.73, SE = 0.76, p < .001) were associated with lower adherence to COVID-19 preventive behaviors. Our findings support the heterogeneity in the use of health information sources and the hypothesis that groups with restricted sources of health information would report less desirable behaviors. The findings also underscored the importance of proper use of digital health information. Efforts should be made not only to help older adults with low education access diverse sources of health information, including digital sources, but also to empower them to build digital and health literacy.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, United States of America
- Department of Social Welfare, Ewha Womans University, Seoul, Republic of Korea
| | - Jieun Jung
- Department of Social Welfare, Ewha Womans University, Seoul, Republic of Korea
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, Florida, United States of America
| | - Miyong T. Kim
- School of Nursing, University of Texas at Austin, Austin, Texas, United States of America
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, Republic of Korea
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Jang Y, Ko J, Rhee MK, Park NS, Chiriboga DA, Kim MT. Factors Associated With Dietary Risks in Older Korean Americans. Int J Aging Hum Dev 2023; 96:234-247. [PMID: 35313749 DOI: 10.1177/00914150221088545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Given the importance of healthy eating in the later years of life, the present study examined factors associated with dietary risks in older Korean Americans. We hypothesized that dietary risks would be associated with sociodemographic disadvantages, adverse health conditions, and limited sociocultural resources. Dietary risks were assessed with a scale covering five behavioral and situational risk factors (eating alone, skipping meals, functional challenges, oral health problems, and financial difficulties). Analyses of the data from the Study of Older Korean Americans (N = 2,150) showed that the sample on average had 1.13 risks (SD = 1.31), eating alone having the highest frequency (35.6%). Supporting the hypothesis, higher levels of dietary risks were found in individuals with sociodemographic disadvantages, poorer physical and mental health status, smaller social networks, and lower acculturation. Findings suggest concerted efforts to promote dietary behaviors and call attention to older immigrants who are socially and culturally isolated.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Jisook Ko
- School of Nursing, UT Health San Antonio, TX, USA
| | - Min-Kyoung Rhee
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Nan Sook Park
- School of Social Work, 7831University of South Florida, Tampa, FL, USA
| | - David A Chiriboga
- Department of Child and Family Studies, 7831University of South Florida, Tampa, FL, USA
| | - Miyong T Kim
- School of Nursing, 12330University of Texas at Austin, Austin, TX, USA
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Jang Y, Park NS, Park J, Chiriboga DA, Haley WE, Kim MT. The Mental Health Benefit of Friend Networks in Older Korean Americans: The Conditioning Effect of Family Type. J Gerontol B Psychol Sci Soc Sci 2023; 78:143-153. [PMID: 35961306 PMCID: PMC9890900 DOI: 10.1093/geronb/gbac109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES We identified types of family relationships of older Korean Americans and examined how the mental health benefit of friend networks might be conditioned by family type. METHODS Data were from 2,070 participants in the Study of Older Korean Americans, a multistate survey of Korean immigrants aged 60 and older (Mage = 73.3, standard deviation [SD] = 8.01). To identify family types, latent profile analysis (LPA) was performed with marital status, living arrangement, family network, positive and negative interactions with family members, and family mistreatment. Linear regression models examined how mental distress was associated with friend networks and family types, as well as their interactions. RESULTS LPA identified 5 family types: close-knit, intimate but distant, detached, connected but dysfunctional, and dysfunctional. Greater distress was associated with smaller friend networks and belonging to the detached, connected but dysfunctional, and dysfunctional family types in comparison to the close-knit type. The interaction model showed that people in the connected but dysfunctional and dysfunctional groups had a stronger association between friend networks and mental distress than the counterparts in the close-knit group. DISCUSSION We not only confirmed the health-promoting role of friend networks and the value of a close-knit family but also found that the benefit of friend networks was pronounced when quality of the family relationship was impaired. Our findings called renewed attention to older immigrants' social convoys of family and friends, suggesting that the enhancement of friend networks could be particularly advantageous for older immigrants with dysfunctional family relationships.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - Juyoung Park
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Miyong T Kim
- School of Nursing, University of Texas at Austin, Austin, TX, USA
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Jang Y, Cho YJ, Park NS, Chiriboga DA, Hong S, Kim MT. Perceived racial discrimination and mental distress in older Korean Americans: the moderating role of ethnic resources. Ethn Health 2023; 28:1-11. [PMID: 34971333 PMCID: PMC9243182 DOI: 10.1080/13557858.2021.2022105] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To examine associations among perceived racial discrimination, ethnic resources, and mental distress in older Korean Americans. Ethnic resources included ethnic identity (how closely individuals identify themselves with other members of the same ethnic background) and sense of community (individuals' feelings of belonging to their ethnic group). We examined the direct effect of perceived racial discrimination and these ethnic resources, as well as their interactions, hypothesizing that mental distress associated with perceived racial discrimination would be reduced by ethnic resources. DESIGN Using survey data from the Study of Older Korean Americans (N = 2,150), linear regression models of mental distress were examined for direct and interactive roles of perceived racial discrimination and ethnic resources. RESULTS Mental distress was directly associated with perceived racial discrimination (B = 1.90, SE = .20, p < .001), ethnic identity (B = -.41, SE = .13, p < .01), and sense of community (B = -.45, SE = .12, p < .001). Perceived racial discrimination interacted significantly with sense of community (B = -1.86, SE = .28, p < .001). Subgroup analyses suggested that in the context of experiencing racial discrimination, a high sense of community can serve as a buffer against mental distress. CONCLUSIONS Ethnic resources are a benefit in coping with experiences of discrimination. The moderating role of sense of community suggests the value of fostering social capital in ethnic communities to protect and promote older immigrants' mental health.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Yong Ju Cho
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California
| | | | | | - Seunghye Hong
- Thompson School of Social Work & Public Health, University of Hawai’i at Mānoa
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Jang Y, Kim J, Yoon H, Park NS, Chiriboga DA, Rice E, Kim MT. Older Korean Americans' Perceived Burdensomeness to Their Healthcare Partners: An Egocentric Network Assessment. J Aging Health 2023; 35:62-70. [PMID: 35580996 DOI: 10.1177/08982643221103057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives: The objective is to examine how older Korean Americans' perceived burdensomeness to their healthcare partners is associated with the characteristics of older adult participants (egos) and their healthcare partners (alters). Methods:Surveys of 2150 participants in the Study of Older Korean Americans provided ego data. Participants were also asked to list up to three individuals whom they usually asked for help on health-related matters or healthcare use, which generated 3402 alters. Multilevel modeling was conducted to examine the role of the characteristics of egos and alters, as well as their cross-level interactions. Results: Perceived burdensomeness was negatively associated with English-speaking ability and residence in a low Korean density area. Perceived burden was also lowered when emotional support was received from the alters, and this pattern was pronounced among those with multi-comorbidity. Discussion: By identifying older immigrants prone to the sense of burdensomeness, the study suggests strategies to promote their health and healthcare use.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Los Angeles, CA, USA.,Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Jangmin Kim
- School of Social Work, 5116Texas State University, San Marcos, TX, USA
| | - Hyunwoo Yoon
- Department of Social Welfare, 65361Kongju National University, Gongju, South Korea
| | - Nan Sook Park
- School of Social Work, 7831University of South Florida, Tampa, FL, USA
| | - David A Chiriboga
- Department of Child and Family Studies, 7831University of South Florida, Tampa, FL, USA
| | - Eric Rice
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Miyong T Kim
- School of Nursing, 7174University of Texas at Austin, Austin, TX, USA
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Park NS, Jang Y, Chung S, Chiriboga D. COMMUNITY TYPOLOGY IN OLDER KOREAN AMERICANS: IMPLICATIONS FOR MENTAL/COGNITIVE HEALTH. Innov Aging 2022. [PMCID: PMC9767291 DOI: 10.1093/geroni/igac059.2300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The purposes of this study were to: (1) identify community typology in older Korean Americans; and (2) examine the associations of typology with loneliness, mental distress, and cognitive health. Guided by social capital conceptualization, we hypothesized that distinct community groups would be identified and that they would be differentially associated with sociodemographic, immigration-related, health, and social characteristics and mental/cognitive health. Data were drawn from a survey with older Korean Americans aged 60 and older, collected during 2017−2018 in diverse locations (n=2,138). To identify community typology, a series of latent profile analysis (LPA) were conducted using 15 community-related variables in three domains (neighborhood characteristics, social cohesion, ethnic attachment). After examining characteristics of the identified groups in relations with study variables, hierarchical multiple regression models of loneliness, mental distress, and self-rated cognitive health were estimated. Based on several model evaluation criteria, LPA model with five community groups was identified as best-fit (BIC=64,619, Entropy=.94). The five groups were identified as “a. high safety/cohesion/ethnic attachment” (10%), “b. high safety/low cohesion/ethnic attachment” (10%), “c. moderate neighborhood/low ethnic attachment/cohesion” (38%), “d. moderate neighborhood/high cohesion/ethnic attachment” (31%), and “e. low safety/moderate cohesion/ethnic attachment” (11%). In reference to the group with high on all three domains (a), group with low ethnic attachment/cohesion in moderate neighborhood (c) and group in unsafe environment with moderate cohesion/ethnic attachment (e) were consistently associated with elevated loneliness/mental distress and poor rating of cognitive health. The results suggest the need to understand profiles of community characteristics and their relationships with health/well-being among older immigrants.
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Affiliation(s)
- Nan Sook Park
- University of South Florida, Tampa, Florida, United States
| | - Yuri Jang
- University of Southern California, Los Angeles, California, United States
| | - Soondool Chung
- Ewha Womans University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
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Hong S, Park KT, Lee Y, Park ML, Park NS. HEALTH INSURANCE COVERAGE, AGE, AND IMMIGRATION-RELATED FACTORS AMONG KOREAN AMERICANS. Innov Aging 2022. [DOI: 10.1093/geroni/igac059.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Abstract
The purpose of this study was to examine health insurance coverage and its association with demographic and immigration-related factors (English proficiency, generational status, and age at immigration) among Korean Americans (KAs, n=11,462). Data were drawn from the 2017 American Community Survey. KA older adults aged 65+ had significantly higher odds of having any health insurance compared to those aged 41 to 64. KAs who speak English well or only speak English were more likely to have any health insurance compared to those with limited English proficiency (i.e., don’t speak English well or at all). First-generation KAs had lower odds of having any health insurance compared to those born in the U.S. Those who immigrated after 41 years of age were less likely to have health insurance compared to those born in the U.S. These findings underscore the need to consider immigration-related factors in efforts to increase healthcare accessibility for KAs.
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Affiliation(s)
- Seunghye Hong
- University of Hawaii at Manoa, Thompson School of Social Work & Public Health , Honolulu, Hawaii , United States
| | - Ki Tae Park
- Regional Skills Council, Seoul, Seoul, Seoul-t'ukpyolsi, Republic of Korea
| | - Yeonjung Lee
- University of Hawaiʻi at Mānoa , Honolulu, Hawaii , United States
| | - Mei Linn Park
- University of Hawaiʻi at Mānoa, Thompson School of Social Work & Public Health , Honolulu, Hawaii , United States
| | - Nan Sook Park
- University of South Florida , Tampa, Florida , United States
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Jang Y, Park NS, Park J, Chiriboga D, Haley W, Kim M. THE MENTAL HEALTH BENEFIT OF FRIEND NETWORKS IN OLDER KOREAN AMERICANS: THE CONDITIONING EFFECT OF FAMILY TYPE. Innov Aging 2022. [PMCID: PMC9766990 DOI: 10.1093/geroni/igac059.2637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Building on the importance of family and friends as sources of social connectedness in later years of life, we conducted a contextual examination of their independent and interactive roles in predicting mental health, using a compensatory social convoy model. In a sample of older Korean Americans, we anticipated that friend networks would be a more important predictor of mental distress when strong family relationships were absent. Data were from 2,140 participants in the Study of Older Korean Americans, a multi-state survey of Korean immigrants age 60 and older (Mage = 73.4, SD = 7.97). To identify family types, latent profile analysis (LPA) was performed with 17 variables assessing family networks, positive and negative interactions with family members, and incidence of mistreatment by family. Linear regression models of mental distress then examined the direct effects of family type and networks of friends, as well as their interactions. LPA on family-related items identified three family types: close-knit, mixed, and dysfunctional. Membership in the close-knit group and a larger network of friends were associated with lower levels of mental distress. In addition, a significant interaction was found between dysfunctional family type and friend network (B = −.35, SE = .08, p < .001), where the positive effect of friend networks was most pronounced in the context of dysfunctional family relationships. These findings support the use of a compensatory social convoy model. Substituting for family resources, friend networks yielded compensatory mental health protection for those with dysfunctional family relations.
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Affiliation(s)
- Yuri Jang
- University of Southern California, Los Angeles, California, United States
| | - Nan Sook Park
- University of South Florida, Tampa, Florida, United States
| | - Juyoung Park
- University of Southern California, Los Angeles, California, United States
| | | | - William Haley
- University of South Florida, Tampa, Florida, United States
| | - Miyong Kim
- University of Texas at Austin, Austin, Texas, United States
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Park NS, Jang Y, Yoon JW, Chung S, Chiriboga DA. Relationship of social isolation with mental distress among older Korean Americans: The moderating role of social cohesion. Health Soc Care Community 2022; 30:e4909-e4919. [PMID: 35770341 DOI: 10.1111/hsc.13903] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/31/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
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.
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Affiliation(s)
- Nan Sook Park
- School of Social Work, University of South Florida, Tampa, Florida, USA
| | - Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Jung Won Yoon
- Department of Library and Information Science, Jeonbuk National University, Jeonju-si, South Korea
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, Florida, USA
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Jang Y, Park J, Choi EY, Cho YJ, Park NS, Chiriboga DA. Social isolation in Asian Americans: risks associated with socio-demographic, health, and immigration factors. Ethn Health 2022; 27:1428-1441. [PMID: 33550840 DOI: 10.1080/13557858.2021.1881765] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 01/21/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The present study examined the factors associated with social isolation in Asian Americans. Three types of social isolation (social isolation from family, social isolation from friends, and overall social isolation), identified by the Lubben Social Network Scale-6, were examined with a sample of Asian Americans representing diverse ethnic groups (Chinese, Asian Indian, Korean, Vietnamese, Filipino, and other Asians) and a broad age range (18-98). DESIGN Using data from the 2015 Asian American Quality of Life Survey (N = 2609), logistic regression models examined how each type of social isolation was predicted by sociodemographic (age, gender, ethnic origin, marital status, education, and perceived financial status), health-related (chronic medical conditions and self-rated health), and immigration-related (proportion of life in the United States and English proficiency) variables. RESULTS The percentage of the sample that fell into the category of social isolation from family, social isolation from friends, and overall isolation ranged from 18.2% to 19.3%. At 36% in the friend category and 33% in the overall category, the Vietnamese sample showed a heightened risk of social isolation. Regression analyses indicated that, for both family and friend categories, individuals who were in the middle-aged group (40-59 years old) and who had limited English proficiency demonstrated higher odds of being isolated. Reflecting relational differences in family and friend networks, the risk associated with unmarried status was specific to social isolation from family, whereas having unmet financial needs was only associated with social isolation from friends. CONCLUSIONS The study findings expand our understanding of the multiple domains of social isolation in an understudied population and emphasize the importance of developing prevention and intervention programs to foster social connectedness among Asian Americans. Our findings on risk factors and ethnic variations help identify the groups to be prioritized in intervention efforts and suggest ways to approach them.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Juyoung Park
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Eun Young Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Yong Ju Cho
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
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Jang Y, Choi EY, Franco Y, Park NS, Chiriboga DA, Kim MT. Racial and ethnic differences in cognitive health appraisals: a comparison of non-Hispanic White, non-Hispanic Black, and Hispanic older adults. Aging Ment Health 2022; 26:519-525. [PMID: 33710944 DOI: 10.1080/13607863.2021.1899132] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate the relationship between cognitive performance and cognitive health appraisals across non-Hispanic White, non-Hispanic Black, and Hispanic older adults in the United States and to explore within-group variations by examining interactions between cognitive performance and background and health variables. METHOD The sample (N = 3,099) included 2,260 non-Hispanic White, 498 non-Hispanic Black, and 341 Hispanic adults aged 65 or older, from the 2016-2017 Harmonized Cognitive Assessment Protocol. Regression models of cognitive health appraisals, indicated by self-rated cognitive health, were examined in the entire sample and in racial and ethnic subgroups to test direct and interactive effects of cognitive performance, indicated by the Mini-Mental State Examination (MMSE). RESULTS The regression model for the entire sample showed direct effects of cognitive performance and race/ethnicity on cognitive health appraisals, as well as a significant interaction between cognitive performance and being non-Hispanic Black. Cognitive performance and cognitive health appraisals were positively associated in non-Hispanic Whites but not significantly associated in non-Hispanic Blacks. Our subsequent analysis within each racial/ethnic group showed that the effect of cognitive performance in non-Hispanic Blacks and Hispanics became either reversed or nonsignificant when background and health variables were considered. Modification by age or chronic medical conditions in each racial and ethnic group was also observed. CONCLUSION Overall, these findings suggest that perceptions and appraisals of cognitive health vary by race and ethnicity and hold implications for how these differences should be considered in research and practice with diverse groups of older adults.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - E Y Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Y Franco
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - N S Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - D A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
| | - M T Kim
- School of Nursing, University of Texas at Austin, Austin, Texas, USA
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Jang Y, Choi E, Franco Y, Park NS, Chiriboga D, Kim MT. Racial and Ethnic Diversities in Cognitive Health Appraisals: Findings from the HCAP. Innov Aging 2021. [PMCID: PMC8680680 DOI: 10.1093/geroni/igab046.2657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Using data from NHATS Round 9, the present study examines the relationships between environmental factors and self-reported health among older adults with dementia, mild cognitive impairment (MCI), and normal cognition. Based on neighborhood stress process theory, we investigate the following questions: 1) Are there associations between dwelling safety hazards and neighborhood environments and self-reported health? 2) Is cognitive status a moderator between the relationship? 3) How do these associations differ between older adults with varying cognitive status (i.e., dementia, MCI, and normal cognition)? A hierarchical linear regression analyses are conducted. Results indicate that better quality of sidewalk surface and neighborhood social cohesion are associated with better self-reported health, after taking into account sociodemographic, health, and social factors. Interaction terms are then used to examine the moderating effects of cognitive status on the associations; four interactions terms are found to be statistically significant. Lastly, separate linear regression analyses are implemented for the dementia, MCI, and normal cognition groups. Findings show that the predicting power of environmental factors vary by cognitive status of older adults. For individuals with dementia, tripping hazards, cluttered home, and community disconnectedness are associated with poor self-reported health. However, no significant relationship was found for older adults with MCI. For older adults with normal cognition, better quality of sidewalk surface and neighborhood social cohesion predict better self-rated health scores. Findings of this study illuminate the important role of a hazard-free home, community walkability, and socially cohesive neighborhood environments in predicting better health status of older adults.
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Affiliation(s)
- Yuri Jang
- University of Southern California, Los Angeles, California, United States
| | - Eunyoung Choi
- University of Southern California, LA, California, United States
| | - Yujin Franco
- University of Southern California, University of Southern California, California, United States
| | - Nan Sook Park
- University of South Florida, Tampa, Florida, United States
| | | | - Miyong T Kim
- University of Texas at Austin, Austin, Texas, United States
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Park J, Jang Y, Yoon H, Park NS, Chiriboga D, Kim M. Health Risks Posed by Social and Linguistic Isolation in Older Korean Americans. Innov Aging 2021. [PMCID: PMC8679205 DOI: 10.1093/geroni/igab046.1175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Guided by the double jeopardy hypothesis, the present study examined the health risks posed by the coexistence of social and linguistic isolation in older Korean Americans. Using data from the Study of Older Korean Americans (SOKA, n = 2,032), comparisons of four isolation typologies (no isolation, social isolation only, linguistic isolation only, and dual isolation) were made, and their impacts on physical (self-rated health), mental (mental distress), and cognitive health (cognitive performance) were examined. The ‘dual isolation’ group exhibited greater sociodemographic and health disadvantages. The odds of having fair/poor health, mental distress, and cognitive impairment were 2.21-3.17 times higher in the ‘dual isolation’ group than those in the group with no isolation. Our findings confirm that both social relationships and language proficiency are key elements for older immigrants’ social connectedness and integration, deprivation of which puts them at risk in multidimensions of health.
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Affiliation(s)
- Juyoung Park
- University of Southern California, Los Angeles, California, United States
| | - Yuri Jang
- University of Southern California, Los Angeles, California, United States
| | - Hyunwoo Yoon
- School of Social Work, Portland State University, Portland, Oregon, United States
| | - Nan Sook Park
- University of South Florida, Tampa, Florida, United States
| | | | - Miyong Kim
- School of Nursing, The University of Texas at Austin, Austin, Texas, United States
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Park NS, Jang Y, Chung S, Chiriboga D, Haley W. Living/Eating Arrangement, Loneliness, and Mental Distress among Older Korean Immigrants: Gender Difference. Innov Aging 2021. [PMCID: PMC8682511 DOI: 10.1093/geroni/igab046.3313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Structural isolation such as living alone poses a mental health risk in diverse groups of older adults, including older immigrants. Given that those living with others might also be disengaged, the present investigation included eating alone as another source of isolation and examined the impact of the combination of living and eating alone. The proposes of the study were to examine (1) how living and/or eating alone would impact mental distress, (2) whether the impact would be mediated by feelings of loneliness, and (3) if there would be gender differences in the mediation effect. The data were drawn from the Study of Older Korean Americans (SOKA), which surveyed older Korean immigrants in five states during 2017−2018. The living/eating arrangement was classified into four-groups: living/eating with others (57%), living with others/eating alone (12.4%), living alone/eating with others (7.3%), and living/eating alone (23.1%). Using the PROCESS macro, we tested the mediation effect of loneliness and the moderation effect of gender in the relationship between the typology and mental distress controlling for background/health characteristics and social capital related variables. Two groups (living with others/eating alone and living/eating alone) had sociodemographic, health, and social capital disadvantages. Analyses demonstrated that mental distress was linked with living with others/eating alone and living/eating alone, of which relationships were mediated by loneliness only among women. Findings suggest that not only structural isolation (e.g., living alone) but also disengagement with others (e.g., eating alone) need to be considered to understand emotional well-being in older immigrant population and gender difference.
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Affiliation(s)
- Nan Sook Park
- University of South Florida, Tampa, Florida, United States
| | - Yuri Jang
- University of Southern California, Los Angeles, California, United States
| | - Soondool Chung
- Ewha Womans University, Ewha Womans University, Seoul-t'ukpyolsi, Republic of Korea
| | | | - William Haley
- University of South Florida, Tampa, Florida, United States
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Affiliation(s)
- Yuri Jang
- University of Southern California Los Angeles CA USA
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Jang Y, Kim J, Yoon H, Park NS, Chiriboga DA. Bridging Potential in Friend Networks and Cognitive Function in Older Korean Americans. J Aging Health 2021; 34:245-252. [PMID: 34449284 DOI: 10.1177/08982643211041240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To examine the associates of bridging potential in networks of friends and its impact on cognitive function in older Korean Americans. METHODS Data came from 308 participants in Central Florida who were part of the Study of Older Korean Americans (SOKA). Using data from a name generator of three close friends in local Korean communities, non-overlapping networks were quantified for bridging potential. Linear regression models for bridging potential and cognitive function were examined. RESULTS Bridging potential was greater among those with stronger social ties with friends in general and higher levels of activity engagement. The direct benefit of bridging potential on cognitive function was also confirmed. In addition, bridging potential was found to mediate the effect of social ties with friends on cognitive function. DISCUSSION Findings underscore the interconnectedness of older immigrants' social and cognitive function and shed light on interventions.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, USA
| | - Jangmin Kim
- School of Social Work, Texas State University, USA
| | | | - Nan Sook Park
- School of Social Work, University of South Florida, USA
| | - David A Chiriboga
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, USA
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Jang Y, Yoon H, Park J, Park NS, Chiriboga DA, Kim MT. Health risks posed by social and linguistic isolation in older Korean Americans. J Am Geriatr Soc 2021; 69:3258-3266. [PMID: 34263463 DOI: 10.1111/jgs.17367] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/05/2021] [Accepted: 06/15/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Inspired by the notion of double jeopardy positing the dual disadvantage in the coexistence of different sources of vulnerability, the present study examined health risks posed by social and linguistic isolation in older Korean Americans. DESIGN A cross-sectional study, using a four-cell classification to compare isolation types (no isolation, social isolation only, linguistic isolation only, and dual isolation) and to examine their impacts on physical (self-rated health), mental (mental distress), and cognitive (cognitive performance) health. SETTING AND PARTICIPANTS Data are from the Study of Older Korean Americans survey of Korean immigrants aged 60 or older (n = 2032), conducted in five states in the United States (California, New York, Texas, Hawaii, and Florida). MEASUREMENT Social isolation was indexed by the Lubben Social Network Scale-6; linguistic isolation, by a question on English-speaking ability. Physical, mental, and cognitive health were indicated by a single-item self-rating of health, the Kessler Psychological Distress Scale 6, and the Mini-Mental State Examination, respectively. RESULTS The dual-isolation group exhibited notable sociodemographic and health disadvantages. The odds of having fair/poor health, mental distress, and cognitive impairment were 2.21-3.17 times higher in the dual-isolation group than in the no-isolation group. CONCLUSION Our findings confirm that both social relationships and language proficiency are key elements for older immigrants' social connectedness and integration, the deprivation of which puts them at heightened risk in multiple dimensions of health.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Hyunwoo Yoon
- Department of Social Welfare, Kongju National University, Gongju, South Korea
| | - Juyoung Park
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, Florida, USA
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, Florida, USA
| | - Miyong T Kim
- School of Nursing, University of Texas at Austin, Austin, Texas, USA
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Jang Y, Chiriboga DA, Park NS, Yoon H, Cho YJ, Hong S, Nam S, Rhee MK, Bernstein KS, Kim MT. The role of self-rated mental health in seeking professional mental health services among older Korean immigrants. Aging Ment Health 2021; 25:1332-1337. [PMID: 32349527 PMCID: PMC7606462 DOI: 10.1080/13607863.2020.1758908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The gap between mental health needs and service use in racial/ethnic minorities continues to be a major public health concern. Focusing on older Korean immigrants, the present study examined linkages among mental distress, self-rated mental health (SRMH), and the use of professional mental health services. We hypothesized that SRMH would play a mediating role in the relationship between mental distress and the use of professional mental health services. METHOD Using data from the Study of Older Korean Americans (SOKA; N = 2,150, Mean age = 73.4), the direct and indirect effect models were tested. RESULTS Nearly 30% of the sample fell within the category of experiencing mental distress, but only a small proportion (5.7%) had used professional mental health services. Supporting our hypothesis, the pathway from mental distress to the use of professional mental health services was influenced by an individual's subjective perception of mental health status: the indirect effect of mental distress on service use through SRMH (.04 [.01]) was significant (bias-corrected 95% confidence interval for the indirect effect = .02, .06). CONCLUSION The findings of this study not only contribute to our understanding of help-seeking processes in a group at high mental health risk but also suggest avenues to promote their use of mental health services.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA,Corresponding Author: Yuri Jang, Ph.D., Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 West 34th Street, Los Angeles, CA 90089; Telephone number: 213-821-6441;
| | - David A. Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - Hyunwoo Yoon
- School of Social Work, Texas State University, San Marcos, TX, USA
| | - Yong Ju Cho
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Seunghye Hong
- Myron B. Thompson School of Social Work, University of Hawai‘i at Mānoa, Hawai‘i, USA
| | - Sanggon Nam
- Department of Public Health, School of Nursing, Azusa Pacific University, Azusa, CA, USA
| | - Min-Kyoung Rhee
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Kunsook S. Bernstein
- Hunter-Bellevue School of Nursing, City University of New York, New York, NY, USA
| | - Miyong T. Kim
- School of Nursing, University of Texas at Austin, TX, USA
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Abstract
Objectives: The present study examined factors associated with the preference for patient-provider ethnic concordance in Asian Americans.Design: With data drawn from the 2015 Asian American Quality of Life Survey (N = 2535), a logistic regression model of the preference for patient-provider ethnic concordance was tested with demographic (age, gender, ethnicity, marital status, education), health and access (chronic medical conditions, self-rated health, health insurance coverage), immigration-related (place of birth, length of stay in the US, English proficiency, acculturation), and adverse experience (perceived discrimination, communication problems in healthcare settings) variables.Results: Over half (52.4%) of those in the sample preferred to be treated by a healthcare provider from their own ethnic background. In a multivariate model, the odds for preferring ethnic concordance were 1.52-1.64 times higher among individuals in earlier stages of immigration, language acquisition, and acculturation. Individuals who had experienced communication problems in healthcare settings presented 3.74 times higher odds for preferring ethnic concordance than did counterparts without such experience.Conclusions: The results emphasized the value of paying attention to patient-provider concordance when treating Asian Americans either relatively new to the country or who have had previous problems communicating with health professionals. The findings also provide implications for improving workforce diversity in healthcare delivery and medical education.
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Affiliation(s)
- Yuri Jang
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Hyunwoo Yoon
- School of Social Work, Texas State University, San Marcos, TX, USA
| | - Miyong T. Kim
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - David A. Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
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Park NS, Jang Y, Chiriboga DA, Chung S. The Relations of Social Network Types With Mental Distress Among Older Korean Americans: The Interactive Role of Living Arrangement. Res Aging 2021; 44:111-122. [PMID: 33678067 DOI: 10.1177/0164027521999780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study is to identify social network types in older Korean Americans and to examine their direct associations, as well as interactions with living arrangement, on mental distress. Drawn from the Study of Older Korean Americans (SOKA), participants were aged 60 or over and lived in five states. Analyses included 2,140 cases surveyed during 2017-2018. To identify social network types, latent profile analyses were conducted using 10 network-related criterion variables. A model with five social network types was identified as best fit. The groups were labeled as diverse, moderately diverse, family deficit, friend deficit, and restricted. As hypothesized, greater mental distress was associated with belonging to more deprived networks such as family deficit and restricted groups. Interaction effects also suggest that members of the restricted group were more distressed when they lived alone than when they lived with others. Implications based on the results are discussed.
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Affiliation(s)
- Nan Sook Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
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Jang Y, Choi EY, Franco Y, Park NS, Chiriboga DA, Kim MT. Discordance Between Subjective and Objective Cognitive Function in Older Korean Americans. J Aging Health 2021; 33:418-426. [PMID: 33599138 DOI: 10.1177/0898264320988407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: To examine predictors of membership in discordant groups identified by subjective and objective measures of cognitive function. Methods: Participants in the Study of Older Korean Americans (N = 2046) were classified according to their subjective cognitive ratings (excellent/very good/good vs. fair/poor) and Mini-Mental State Examination scores (normal cognition vs. cognitive impairment), yielding two discordant groups: (1) positive ratings but cognitive impairment and (2) negative ratings but normal cognition. Logistic regression models examined how the discordant group membership was associated with personal resources. Results: Among those with positive cognitive ratings, the odds of belonging to the discordant group were associated with low personal resources (advanced age and lower levels of education, acculturation, and knowledge about Alzheimer's disease). However, an opposite pattern was observed among those with negative ratings. Discussion: The pattern of discordance suggests ways to promote early detection of cognitive impairment and close the gap in cognitive health care.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, 5116University of Southern California, Los Angeles, CA, USA
| | - Eun Young Choi
- Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA
| | - Yujin Franco
- Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA
| | - Nan Sook Park
- School of Social Work, 7831University of South Florida, Tampa, FL, USA
| | - David A Chiriboga
- Department of Child and Family Studies, 7831University of South Florida, Tampa, FL, USA
| | - Miyong T Kim
- School of Nursing, 12330University of Texas at Austin, Austin, TX, USA
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Jang Y, Choi EY, Park NS, Chiriboga DA, Duan L, Kim MT. Cognitive health risks posed by social isolation and loneliness in older Korean Americans. BMC Geriatr 2021; 21:123. [PMID: 33593273 PMCID: PMC7885241 DOI: 10.1186/s12877-021-02066-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/27/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND This study examines associations among social isolation, loneliness, and cognitive health risks in older Korean Americans, focusing on the mediating role of loneliness in the relationship between social isolation and objective and subjective measures of cognitive impairment. METHODS Data are from 2061 participants in the Study of Older Korean Americans, a multi-state survey of Korean immigrants age 60 and older (Mage = 73.2, SD = 7.93). Social isolation was indexed with the Lubben Social Network Scale- 6; loneliness, with the short-form UCLA Loneliness Scale. Objective and subjective measures of cognitive impairment included the Mini-Mental State Examination and a single-item self-rating of cognitive health. RESULTS In the logistic regression model for objective cognitive impairment, social isolation was significantly associated, but loneliness was not. In the model for subjective cognitive impairment, both social isolation and loneliness were significant factors. However, the effect of social isolation became non-significant when loneliness was considered, suggesting a potential mediating role of loneliness. The subsequent mediation analysis confirmed that the indirect effect of social isolation on subjective cognitive impairment through loneliness was significant (B = .20, SE = .03, 95% CI = .12, .28). CONCLUSION Our analyses provide evidence for the proposed mediating effect of loneliness in the relationship between social isolation and subjective cognitive impairment. Intervention efforts should focus on reducing feelings of loneliness experienced by older immigrants, possibly by engaging them in socially meaningful and cognitively stimulating activities.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 West 34th Street, CA, 90089-0411, Los Angeles, USA.
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA.
| | - Eun Young Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, USA
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, USA
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, USA
| | - Lei Duan
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA
| | - Miyong T Kim
- School of Nursing, University of Texas at Austin, Austin, USA
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Park NS, Jang Y, Rhee MK, Yoon H, Chiriboga DA. Knowledge About Alzheimer's Disease and Awareness of Alzheimer's Disease-Related Services in Older Korean Americans: The Role of Social Capital. J Appl Gerontol 2021; 40:220-227. [PMID: 32167408 PMCID: PMC7486994 DOI: 10.1177/0733464820911533] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of the study was to investigate factors associated with Alzheimer's Disease (AD)-related knowledge and service awareness in older Korean Americans. Considering the importance of social resources in the lives of older immigrants, the focus was on exploring the role of social capital-related factors (e.g., prior exposure to AD, social network, activity participation, and community social cohesion) on AD knowledge and service awareness. Data were drawn from the Study of Older Korean Americans (SOKA; N = 2,150; Mage = 73.41, SD = 7.97). Findings highlight the critical roles of prior exposure to AD and social network influencing both AD knowledge and service awareness, with activity participation also being associated with the latter. Results suggest that particular attention should be paid to individuals who are culturally and socially isolated when considering interventions.
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Affiliation(s)
- Nan Sook Park
- School of Social Work, University of South Florida, USA
| | - Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, USA
| | - Min-Kyoung Rhee
- Leonard Davis School of Gerontology, University of Southern California, USA
| | - Hyunwoo Yoon
- School of Social Work, Portland State University, USA
| | - David A. Chiriboga
- Department of Child and Family Studies, University of South Florida, USA
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Jang Y, Yoon H, Li M, Park NS, Chiriboga DA, Wu B, Dong X, Kim MT. Self-rated health as a mediator between physical health conditions and depressive symptoms in older Chinese and Korean Americans. PLoS One 2021; 16:e0245136. [PMID: 33417597 PMCID: PMC7793279 DOI: 10.1371/journal.pone.0245136] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/23/2020] [Indexed: 11/24/2022] Open
Abstract
In the present study, we examined self-rated health as a mediator between physical health conditions (chronic diseases and functional disability) and depressive symptoms in older Chinese and Korean Americans. Using harmonized data (N = 5,063) from the Population Study of Chinese Elderly (PINE) and the Study of Older Korean Americans (SOKA), we tested direct and indirect effect models. In both groups, chronic diseases and functional disability were closely associated with negative ratings of health and symptoms of depression. Analyses with the PROCESS macro showed that the effect of chronic diseases and functional disability on depressive symptoms was mediated by self-rated health in both groups; the indirect effect was greater in the Korean American sample than in the Chinese American sample. These findings contribute to the understanding of the psychological mechanisms that underlie the mind–body connection and highlight the potential importance of subjective health assessment as a useful tool for health promotion.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, United States of America
| | - Hyunwoo Yoon
- School of Social Work, Portland State University, Portland, Oregon, United States of America
| | - Mengting Li
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, United States of America.,School of Nursing, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, United States of America
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, Florida, United States of America
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, Florida, United States of America
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York, United States of America
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, United States of America
| | - Miyong T Kim
- School of Nursing, University of Texas at Austin, Austin, Texas, United States of America
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Park NS, Chiriboga DA, Chung S. The Effect of Social Capital and Family Support on Loneliness among Korean Adults: Intergenerational Differences. Journal of Intergenerational Relationships 2021. [DOI: 10.1080/15350770.2021.1868239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Nan Sook Park
- University of South Florida, Tampa, South Florida, USA
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Park NS, Jang Y, Chiriboga D, Chung S. Correlates of Loneliness in Older Korean Americans: Interactive Effects of Negative Family Interactions. Innov Aging 2020. [PMCID: PMC7742285 DOI: 10.1093/geroni/igaa057.2170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This study examined factors affecting the feelings of loneliness among older Korean Americans. Data were drawn from a survey with older Korean Americans aged 60 or over (N = 2,150) in five states (California, New York, Texas, Hawaii, and Florida), conducted during 2017−2018. In hierarchical multiple regression models, loneliness was regressed on five blocks of variables: (1) demographic/health (age, gender, education, financial status, chronic conditions, and physical disabilities); (2) immigration-related (length of stay in the U.S., and acculturation); (3) social engagement (having meals alone, family network, friend network, activity participation, and community engagement); (4) negative family interactions; and (5) interactions of negative family interactions with social engagement variables. A significant interaction was found in the relationship between friend network and negative family interactions: the impact of negative family interactions on loneliness was buffered by friend network. Implications of findings were discussed regarding working with older immigrants with limited social networks.
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Affiliation(s)
- Nan Sook Park
- University of South Florida, Tampa, Florida, United States
| | - Yuri Jang
- University of Southern California, Los Angeles, California, United States
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Jang Y, Rhee MK, Hyeon JC, Choi EY, Park J, Park NS. Oral Health and Dental Care in Older Korean Immigrants: A Qualitative Study. Innov Aging 2020. [PMCID: PMC7741049 DOI: 10.1093/geroni/igaa057.1079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Many segments of the U.S. population continue to experience a disproportionate burden of oral disease and inequities in dental care, and older Asian immigrant populations are among those at high risk. Responding to the needs to attend to ethnic and geographic variations among older Asian Americans and to better understand contextual factors that shape their experiences of oral health and dental care, the present study conducted in-depth interviews with eighteen older Korean immigrants in the Los Angeles Greater area. The qualitative inquiries were theoretically guided by the three core categories of the Andersen’s (1968, 1997) health service model: oral health needs, service barriers, and service outcomes. Using the constant comparison method, themes and sub-themes within each category were derived. The eight themes emerged from the qualitative data were: (1) oral health problems, (2) perceived need, (3) insurance and finance, (4) language barriers, (5) social support, (6) knowledge and belief, (7) satisfaction with service, and (8) areas of improvement. The findings demonstrated varied experiences associated with oral health and dental care of older Korean immigrants and informed the development of services and programs responsive to the identified needs and barriers.
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Affiliation(s)
- Yuri Jang
- University of Southern California, Los Angeles, California, United States
| | - Min-Kyoung Rhee
- University of Southern California, Los Angeles, California, United States
| | - Jeong Chung Hyeon
- University of Southern California, Los Angeles, California, United States
| | - Eun Young Choi
- Leonard Davis School of Gerontology, Los Angeles, California, United States
| | - Juyoung Park
- University of Southern California, Los Angeles, California, United States
| | - Nan Sook Park
- University of South Florida, Tampa, Florida, United States
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Chiriboga D, Park NS, Jang Y, Molinari V. Change Over Time in Linguistic Acculturation: A Comparison Between Cuban and Non-Cuban Hispanic Immigrants. Innov Aging 2020. [PMCID: PMC7741433 DOI: 10.1093/geroni/igaa057.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
While acculturation and its implications for mental health have received extensive attention in studies with older immigrant populations, change over time in acculturation less so. This paper examines change over a two-year period in levels of linguistic acculturation among Cuban (n = 186) and non-Cuban Hispanic (n = 116) immigrants living in Florida. Data came from the waves of the Survey of Older Floridian (SOF), conducted using a statewide sampling frame based on population densities, with a computer-assisted telephone interview strategy. Calls were initiated through random digit dialing, and a follow-up interview was added approximately two years later. Measures included six acculturation items, one dealing with the participant’s language preference for the interview itself and five items dealing with language ability and usage. Results indicated that non-Cuban Hispanics were significantly more acculturated than Cuban Hispanics, and that at least 75% of Wave 2 acculturation was accounted for by Wave 1 status. After controlling for initial levels of acculturation, those who at first interview reported more economic problems and those reporting fewer depressive symptoms were more acculturated at follow-up. It was concluded that while linguistic acculturation is relatively stable, interventions to increase acculturation have implications for mental health service utilization.
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Affiliation(s)
| | - Nan Sook Park
- University of South Florida, Tampa, Florida, United States
| | - Yuri Jang
- University of Southern California, Los Angeles, California, United States
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Kim K, Jang Y, Park NS, Chiriboga D. Acculturation and Healthcare Utilization Among Older Korean Immigrants: A Dyadic Study of Married Couples. Innov Aging 2020. [PMCID: PMC7742463 DOI: 10.1093/geroni/igaa057.1945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Research has focused on the socioeconomic/cultural characteristics of individuals to address health disparities among immigrant populations. Dyadic studies of acculturation and healthcare utilization among older immigrants are rare. Using data from 263 older Korean immigrant couples in the U.S. (Mean_age = 74.75 for husbands; 71.03 for wives), this study examined how each spousal acculturation levels (e.g., English proficiency, familiarity with American culture) are associated with healthcare utilization (e.g., usual source of care, medical checkup) and difficulty in using health services, controlling for sociodemographic characteristics. Overall, husbands showed higher levels of acculturation than their wives, but there was also substantial similarity between spouses (ICC = .58). For healthcare utilization, one’s own acculturation (actor effect) was significant only for wives, but spouse’s acculturation (partner effect) was significant only for husbands. For difficulty in health service use, one’s own acculturation was significant for both spouses, but spouse’s acculturation was significant only for husbands.
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Affiliation(s)
- Kyungmin Kim
- University of Massachusetts Boston, Boston, Massachusetts, United States
| | - Yuri Jang
- University of Southern California, Los Angeles, California, United States
| | - Nan Sook Park
- University of South Florida, Tampa, Florida, United States
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Jang Y, Powers DA, Park NS, Chiriboga DA, Chi I, Lubben J. Performance of an Abbreviated Lubben Social Network Scale (LSNS-6) among Three Ethnic Groups of Older Asian Americans. Gerontologist 2020; 62:e73-e81. [PMID: 33021635 DOI: 10.1093/geront/gnaa156] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The present study examined the measurement quality and performance of an abbreviated Lubben Social Network Scale (LSNS-6) in three ethnic groups (Chinese, Koreans, Vietnamese) of older Asian Americans, addressing both within- and cross-group validations. RESEARCH DESIGN AND METHODS We selected 605 participants aged 50 or above (242 Chinese, 150 Koreans, 213 Vietnamese) from the 2015 Asian American Quality of Life (AAQoL) survey, conducted with self-identified Asian Americans aged 18 or above living in central Texas. We analyzed LSNS-6 data on measurement qualities (internal consistency and corrected item-total correlation), dimensionality (exploratory and confirmatory factor analyses), and correlations with other indicators. RESULTS LSNS-6 showed very good internal consistency in each ethnic group, and the two-factor structure of family and friends were invariant across the groups. The items on friends demonstrated greater homogeneity than those on family and emerged as a first factor. Both subscale and total scores of LSNS-6 were associated in expected directions with the social and health indicators considered. DISCUSSION AND IMPLICATIONS The findings confirm the measurement qualities of LSNS-6 within each group and provide support for measurement invariance across the groups. While the observed difference in family and friend networks warrants further investigation, LSNS-6 serves as a viable option for the assessment of social networks. When using LSNS-6 with older Asian Americans, it is highly recommended to use the family/friend subscales in consideration of cultural and immigration contexts.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Daniel A Powers
- Department of Sociology, University of Texas at Austin, Austin, Texas
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, Florida
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, Florida
| | - Iris Chi
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - James Lubben
- School of Social Work, Boston College, Chestnut Hill, Massachusetts
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Jang Y, Choi EY, Rhee MK, Park NS, Chiriboga DA, Kim MT. Determinants of Self-rated Cognitive Health among Older Korean Americans. Gerontologist 2020; 60:250-258. [PMID: 31618436 DOI: 10.1093/geront/gnz134] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES In response to the dearth of information on cognitive health in older ethnic minorities, in the present study, we examined factors associated with self-rated cognitive health (SRCH) in older Korean Americans. Drawing from the World Health Organization's framework of social determinants of health, we examined how a broad spectrum of factors might influence the way in which older Korean Americans perceive and evaluate their own cognitive health. RESEARCH DESIGN AND METHODS Using data from the Study of Older Korean Americans (SOKA; N = 2,061, mean age = 73.2), a series of hierarchical linear regression models of SRCH was tested with sequential entry of predictors: (1) Mini-Mental State Examination (MMSE) score of cognitive status, (2) demographic variables, (3) physical and mental health status, (4) health behaviors, and (5) socio-cultural and community factors. RESULTS In addition to cognitive screening outcomes, each set of variables made a significant contribution to the predictive model of SRCH. Positive ratings of cognitive health were observed among older individuals with greater education, good physical and mental health, involvement in regular exercise, and socio-cultural resources (social networks, acculturation, and family solidarity). DISCUSSION AND IMPLICATIONS The SRCH of older adults goes beyond cognitive screening outcomes, suggesting a need to incorporate the various sources of social determinants when seeking to promote the cognitive health of older populations.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles
| | - Eun Young Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles
| | - Min-Kyoung Rhee
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa
| | - Miyong T Kim
- School of Nursing, University of Texas at Austin
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Park NS, Jang Y, Chiriboga DA, Chung S. Profiles of Social Engagement and Their Association With Loneliness and Self-Rated Health Among Older Korean Immigrants. Res Aging 2020; 42:300-311. [PMID: 32476605 DOI: 10.1177/0164027520927963] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purposes of this study were to (1) develop a typology of social engagement in older Korean immigrants in the United States and (2) compare the groups in the typology regarding their level of loneliness and self-rated health. Data were drawn from the Study of Older Korean Americans covering the five geographic locations (N = 2,149). Using eight criterion variables concerning the type and frequency of activities, latent profile analysis identified a six-group model as the most optimal with the following groups: diverse, active, moderately social, structured, sedentary, and restricted. When the restricted group was used as the reference, the groups that were more socially engaged were found to have lower levels of loneliness. Additionally, being a member of the active or moderately social group was associated with more favorable self-ratings of health. These findings hold implications for understanding the variability of social engagement and how it relates to health and well-being.
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Affiliation(s)
- Nan Sook Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - David A Chiriboga
- Department of Child & Family Studies, University of South Florida, Tampa, FL, USA
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
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Park NS, Jang Y, Chiriboga DA, Chung S. The Role of Social Networks on Depressive Symptoms: A Comparison of Older Koreans in Three Geographic Areas. Int J Aging Hum Dev 2020; 92:364-382. [PMID: 32054286 DOI: 10.1177/0091415020905553] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Nan Sook Park
- 7831 School of Social Work, University of South Florida, Tampa, USA
| | - Yuri Jang
- 5116 Suzanne Dworak-Peck School of Social Work and Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, USA
| | - David A Chiriboga
- 7831 Department of Child and Family Studies, University of South Florida, Tampa, USA
| | - Soondool Chung
- 26717 Department of Social Welfare, Ewha Womans University, Seoul, South Korea
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Jang Y, Park NS, Chiriboga D, Yoon H, Rhee MK. COGNITION, SELF-RATED COGNITIVE HEALTH, AND CONCERNS ABOUT ALZHEIMER’S DISEASE IN OLDER KOREAN AMERICANS. Innov Aging 2019. [PMCID: PMC6846835 DOI: 10.1093/geroni/igz038.988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Responding to the dearth of research on cognitive health in older ethnic minorities, the present study explored the associations among cognitive performance, self-rated cognitive health, and concerns about Alzheimer’s Disease (AD) in older Korean Americans. We hypothesized that (1) cognitive performance and self-rated cognitive health would be moderately associated; (2) both cognitive performance and self-rated cognitive health would be associated with concerns about AD; and (3) the effect of cognitive performance on concerns about AD would be mediated by self-rated cognitive health. Analyses of the survey data of 2,150 older Korean Americans (mean age = 73.2) residing in five states provided support for the hypotheses. Cognitive performance, measured with a Korean version of the Mini-Mental State Exam (MMSE), and a single item asking respondents to rate their overall cognitive status on a 5-point scale (excellent/very good/good/fair/poor) were moderately associated. Both poor performance in the MMSE and negative ratings of cognitive health status were associated with increased concerns about AD. Mediation analyses using the macro PROCESS showed that the indirect effect of cognitive performance on the concerns about AD through self-rated cognitive health (−.01 [.002]) was significant (bias corrected 95% confidence interval for the indirect effect = −.02, −.01). That is, the effect of cognitive performance on the concerns about AD was mediated by individuals’ subjective evaluations of their cognitive health. Findings not only help better understand the psychological mechanisms that underlie cognitive health and AD concerns but also suggest avenues for interventions.
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Affiliation(s)
- Yuri Jang
- University of Southern California, Los Angeles, California, United States
| | - Nan Sook Park
- University of South Florida, Tampa, Florida, United States
| | | | - Hyunwoo Yoon
- Texas State University, San Marcos, Texas, United States
| | - Min-Kyoung Rhee
- University of Southern California, Los Angeles, California, United States
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Abstract
Abstract
While there is substantial documentation of a positive relationship between objective social engagement and mental health, relatively little is known about how perceived quality of social interactions affects mental health and how men and women differ. Considering the gap, the purpose of this study was to investigate gender difference in how social interactions associate with self-rated mental health in older Korean Americans. Data came from a survey with older Korean Americans aged 60 or over that included 713 men and 1437 women living in five sites (California, New York, Texas, Hawaii, and Florida), conducted during 2017−2018. In multiple regression models run separately for men and women, self-rated mental health on a five-point scale (excellent/very good/good/fair/poor) was regressed on four blocks of variables: socio-demographic characteristics (age, marital status, education, financial status, self-rated health, and region), immigration-related variables (length of stay in the U.S. and acculturation), social engagement (family network, friend network, and activity participation), and perceived quality of social interactions (positive or negative family interactions and negative community interactions). In the final models with all covariates, younger age, more years in education, better physical health, higher levels of acculturation, and more positive family interactions were commonly associated with more positively rated mental health for both men and women. For women, stronger family network and fewer negative family interactions were additional contributors. Results suggest that negative and positive indicators of family interactions differentially affect self-rated mental health for older Korean American men and women.
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Affiliation(s)
- Nan Sook Park
- University of South Florida, Tampa, Florida, United States
| | - Yuri Jang
- University of Southern California, Los Angeles, California, United States
| | - Min-Kyoung Rhee
- University of Southern California, Los Angeles, California, United States
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Jang Y, Park NS, Rhee MK, Yoon H, Cho YJ, Kim MT, Chiriboga DA. PHYSICAL-MENTAL-ORAL-COGNITIVE HEALTH IN OLDER KOREAN AMERICANS: A MULTISITE STUDY. Innov Aging 2019. [PMCID: PMC6840713 DOI: 10.1093/geroni/igz038.1510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Using data from surveys with older Korean Americans (n = 2,150) conducted at five sites in the U.S. (California, New York, Texas, Hawaii, and Florida), the present study explored the status of physical/mental/oral/cognitive health and its determinants. For each health domain, we examined how self-rating (excellent/very good/good/fair/poor) of health was associated with other domain-relevant indicators (e.g., the number of chronic diseases, symptoms of depression, problems with teeth or gums, or cognitive performance) and sociocultural factors (e.g., socioeconomic status, acculturation, social network, and social cohesion). Geographic variation was also considered. The correlations between self-ratings and domain-relevant indicators in all health domains were significant but moderate. A series of multivariate regression models of self-ratings of physical/mental/oral/cognitive health not only confirmed the effect of the domain-relevant health indicators but also demonstrated a critical contribution of sociocultural determinants. Implications for older immigrants were discussed in terms of place, culture, and context.
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Affiliation(s)
- Yuri Jang
- University of Southern California, Los Angeles, California, United States
| | - Nan Sook Park
- University of South Florida, Tampa, Florida, United States
| | - Min-Kyoung Rhee
- University of Southern California, Los Angeles, California, United States
| | - Hyunwoo Yoon
- Texas State University, san Marcos, Texas, United States
| | - Yong Ju Cho
- University of Texas at Austin, Austin, Texas, United States
| | - miyong T Kim
- University of Texas at Austin, Austin, Texas, United States
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Abstract
Objectives: The purposes of this study were to: (1) develop an empirical typology of the social networks in diverse groups of older Asian Americans using both structural and subjective criterion variables; and (2) examine the relationship of the social network types to the measures of the health and well-being (self-rating of health, mental distress, and life satisfaction). Method: The participants included 533 older Asian Americans (Chinese, Asian Indian, Korean, Vietnamese, and other Asians) who participated in the 2015 Asian American Quality of Life Survey in Central Texas. Latent profile analysis (LPA) was conducted using seven social network-related variables. The identified typologies were then regressed on the indicators of health and well-being (poor rating of health, probable mental distress, and dissatisfaction with life). Results: The LPA identified the model with four network types as being most optimal. The groups were named "diverse-integrated" (37.5%), "moderately diverse-integrated" (21.2%), "marginally restricted-noncongregant" (22.1%), and "restricted-congregant" (19.1%). The results suggested that compared to the "diverse-integrated" group, the "marginally restricted-noncongregant type" fared worse than "the restricted-congregant group" in that the former had greater odds of both mental distress and dissatisfaction with life while the latter had higher odds only for dissatisfaction with life. Conclusion: Unlike previous network studies, network types were shaped in the continuum of different social ties and subjective evaluation on strength of social ties. Certain ethnic groups were over-represented in specific network types. Such findings suggest the importance of understanding ethnic group variations in network vulnerabilities when considering interventions.
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Affiliation(s)
- Nan Sook Park
- School of Social Work, University of South Florida , Tampa , FL , USA
| | - Yuri Jang
- Suzanne Dworak-Peck School of Social Work, Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, USA
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida , Tampa , FL , USA
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University , Seoul , The Republic of Korea
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Jang Y, Yoon H, Rhee MK, Park NS, Chiriboga DA, Kim MT. Factors associated with dental service use of older Korean Americans. Community Dent Oral Epidemiol 2019; 47:340-345. [PMID: 31050020 DOI: 10.1111/cdoe.12464] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/02/2019] [Accepted: 04/11/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Based on Andersen's healthcare utilization model, the present study examined factors associated with dental service use in older Korean Americans. Focus was on predisposing characteristics (age, gender, marital status, education and region), oral health needs (problems with teeth or gums and self-rated oral health) and enabling factors (dental health insurance, length of stay in the United States, acculturation and family network). METHODS Using data from surveys with Korean Americans aged 60 or older (N = 2128), a Poisson regression model examined predictors of dental visit in the past 12 months. FINDINGS More than 21% of the sample reported having a problem with teeth or gums, and over half rated their oral health as either fair or poor. Approximately 71% lacked dental health insurance. The number of dental visits in the past 12 months averaged 1.40 (SD = 1.74), with about 38% having no dental visits at all. Multivariate analyses showed that higher levels of education, the presence of a problem with teeth or gums, dental health insurance coverage, longer length of stay in the United States, and larger family networks were associated with 1.01-1.35 times higher number of dental visits. CONCLUSION The findings not only confirmed the critical role of dental health insurance as a service enabler but also highlighted the importance of considering older ethnic immigrants' oral health and dental care from the perspectives of culture and family.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Hyunwoo Yoon
- School of Social Work, Texas State University, San Marcos, Texas
| | - Min-Kyoung Rhee
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, Florida
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, Florida
| | - Miyong T Kim
- School of Nursing, The University of Texas at Austin, Austin, Texas
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Park NS, Lee BS, Chiriboga DA, Chung S. Loneliness as a mediator in the relationship between social engagement and depressive symptoms: Age differences among community-dwelling Korean adults. Health Soc Care Community 2019; 27:706-716. [PMID: 30485596 DOI: 10.1111/hsc.12687] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 10/24/2018] [Indexed: 06/09/2023]
Abstract
The purpose of this study was to examine whether loneliness mediates the relationship between social engagement and depressive symptoms and to determine how age moderates the mediation effect. Data for this study came from the survey with community-dwelling adults aged 18 and older in South Korea, from March to April 2017. The total of 1,017 respondents were drawn from three age groups (18-44, 45-64, or 65 and older). The mediating effect of loneliness was tested between each of three social engagement-related variables (family network, friend network, and perceived community support) and depressive symptoms. The results showed age differences in mediation: the effect was most pronounced in the relationship of family network with loneliness for the older group, whereas the size of friend network significantly predicted loneliness for younger adults. Both younger and older groups felt less lonely when they had a higher level of perceived community support; the middle age group remained uninfluenced by the mediation effects. Our findings confirm that loneliness is one of the mechanisms by which social engagement exerts its effect on depressive symptoms. As the Korean society embraces its growing proportions of older adults, the results of the study provide implications for adaptive strategies for changing social engagement need and mental health associated with ageing.
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Affiliation(s)
- Nan Sook Park
- School of Social Work, University of South Florida, Tampa, Florida
| | - Beom S Lee
- Department of Mental Health Law and Policy, University of South Florida, Tampa, Florida
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, Florida
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
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Abstract
Using data from surveys with Korean Americans aged 60 years or above (n = 2,150), the level of healthcare navigation self-sufficiency was assessed, and its related factors were explored. The overall status of self-sufficiency was low; for example, over half of the sample needed assistance with reading and filling out medical documents, and nearly half needed someone to interpret during medical visits. Diminished self-sufficiency in healthcare navigation was associated with disadvantaged social status (e.g., advanced age, female gender, and low education), early stages of immigration (short length of stay in the U.S. and low English proficiency), and lack of personal health resources (e.g., poor health condition and lack of health insurance). The findings shed light on older immigrants' challenges in the use of health services in a broad sense and help identify areas of patient burden and avenues for interventions.
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Affiliation(s)
- Yuri Jang
- University of Southern California, Los Angeles, USA
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Jang Y, Yoon H, Park NS, Rhee MK, Chiriboga DA. Mental Health Service Use and Perceived Unmet Needs for Mental Health Care in Asian Americans. Community Ment Health J 2019; 55:241-248. [PMID: 30357724 PMCID: PMC6469494 DOI: 10.1007/s10597-018-0348-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 10/19/2018] [Indexed: 12/01/2022]
Abstract
Using data from the Asian American Quality of Life (AAQoL, n = 2609) survey, logistic regression models of mental health service use and perceived unmet needs were estimated with background variables, ethnicity, and mental health status. More than 44% of the participants were categorized as having mental distress (Kessler 6 [K6] ≥ 6) and 6.1% as having serious mental illness (SMI, K6 ≥ 13). About 23% had used services (mental health specialist, general doctor, and/or religious leader) for their emotional concerns during the past year, and about 7% reported that there was a time that they needed mental health care but could not get it. In the multivariate analyses, the presence of mental distress and SMI increased the odds of using any service and having perceived unmet needs. Those who had used services exhibited higher odds of reporting unmet needs, calling concerns about the quality of services and user satisfaction.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, 1150 S. Olive Street, Suite 1400, Los Angeles, CA, 90015, USA.
| | - Hyunwoo Yoon
- School of Social Work, Texas State University, San Marcos, USA
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, USA
| | - Min-Kyoung Rhee
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, 1150 S. Olive Street, Suite 1400, Los Angeles, CA, 90015, USA
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, USA
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Abstract
The purposes of this study were to (a) develop an empirical typology of the social networks in Korean adults aged 18 years or older and (b) examine the relation of network types on depressive symptoms and satisfaction with life. Data for this study were drawn from the survey with 1,017 community-dwelling adults aged 18 years or older in South Korea representing three life stages: young adults, middle-aged adults, and older adults. Latent profile analysis was conducted based on eight social network-related variables: marital status, living arrangement, number of family confidants, number of friend confidants, frequency of contact with friends using phone or social media, frequency of participation in social groups, frequency of conversation with neighbors, and perceived closeness of family. The identified typologies were then regressed on depressive symptoms and satisfaction with life. A model with four network types was identified as being the most optimal, and the groups were labeled as: diverse-family, diverse-friend, solo-restricted, and coresident-restricted. Regression analyses showed that in comparison with the coresident-restricted group referent, diverse-friend and solo-restricted groups exhibited elevated levels of depressive symptoms; diverse-family and diverse-friend type had higher levels of satisfaction with life. Implications of the study findings were discussed in line with current research and intervention efforts.
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Affiliation(s)
- Nan Sook Park
- 7831 School of Social Work, University of South Florida, Tampa, FL, USA
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
| | - Soondool Chung
- 26717 Department of Social Welfare, Ewha Womans University, Seoul, South Korea
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Jang Y, Powers DA, Yoon H, Rhee MK, Park NS, Chiriboga DA. Measurement Equivalence of English Versus Native Language Versions of the Kessler 6 (K6) Scale: An Examination in Three Asian American Groups. Asian Am J Psychol 2018; 9:211-216. [PMID: 30800214 PMCID: PMC6383564 DOI: 10.1037/aap0000110] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The use of languages other than English in population-based surveys is necessitated by the linguistic diversities in the United States. However, inclusion of multiple languages in survey data collection raises concerns about whether an instrument administered in different languages functions equivalently across groups. Using the Kessler Psychological Distress Scale 6 (K6), the present study examined differential item functioning (DIF) between surveys conducted either in English or the native language of the groups of Chinese Americans (n = 622), Korean Americans (n = 471), and Vietnamese Americans (n = 513). DIF analyses using a series of multiple indicator multiple cause (MIMIC) models showed that there were substantial differences between English and non-English versions in the endorsement of the K6 items, with patterns that differed by ethnicity. The K4 (depressed) showed DIF in all three groups: non-English survey users consistently showed a higher degree of endorsement compared to their English using counterparts. It is speculated that its translated expression in Asian languages may carry less associations with illness/disorder than the English word, thereby making it easy to endorse among Asian language survey users. Findings suggest a lack of measurement equivalence between the K6 administered in English and Asian languages and call for caution in cross-linguistic contexts.
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Affiliation(s)
- Yuri Jang
- Steve Hicks School of Social Work, Population Research Center, The University of Texas at Austin
| | - Daniel A Powers
- Department of Sociology, Population Research Center, The University of Texas at Austin
| | | | - Min-Kyoung Rhee
- Steve Hicks School of Social Work, Population Research Center, The University of Texas at Austin
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Abstract
BACKGROUND Responding to the disparities in accessing and obtaining health information and healthcare among immigrant populations, the present study focused on Asian Americans. Using a sample that reflects Asian Americans' cultural and linguistic diversities, the goal was to explore the typologies of health information source and their predictability to unmet healthcare needs (i.e., the experience of not being able to get needed medical care). METHODS Data were drawn from the 2015 Asian American Quality of Life Survey (N = 2,592), conducted using culturally and linguistically sensitive approaches. Latent class analysis on nine sources of health information across interpersonal networks (family members, close friends, acquaintances, and health professionals) and Internet-based communication technologies (mobile apps, email listservs, social networking sites, online communities, and health websites) identified six classes: 'resource-heavy,' 'human-oriented,' 'expertise-focused,' 'family-dominant,' 'resource-scarce,' and 'health professional-dominant.' RESULTS Compared to the resource-heavy group, the odds of having an unmet healthcare need were 2.94 times greater in the family-dominant group and 4.13 times greater in the resource-scarce group. DISCUSSION Findings provide implications for interventions with respect to subgroups to be prioritized and areas to be targeted in efforts to promote access and acquisition of health information and health services in Asian Americans.
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Affiliation(s)
- Yuri Jang
- a Steve Hicks School of Social Work , The University of Texas at Austin
| | - Jungwon Yoon
- b School of Information , University of South Florida , Tampa , USA
| | - Nan Sook Park
- c School of Social Work , University of South Florida , Tampa , USA
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Abstract
OBJECTIVES This study presents an empirical typology of social activity and its association with the depressive symptoms and self-rated health of community-dwelling older adults (n = 464) in South Korea. METHOD Latent class analysis (LCA) was used to classify the types of social activities. Data analyses were conducted using Mplus 7.2 program for LCA and SPSS 22.0 for multiple regression analyses. RESULTS LCA identified people who fell into one of the four activity groups: Diverse, Community Center/Disengaged, Religion Plus, and Friendship/Leisure. Membership in these four groups predicted differences in depressive symptoms and self-rated health. CONCLUSIONS Results indicate that typologies of social activity could enhance practitioners' understanding of activity patterns and their associations with health and well-being.
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Affiliation(s)
- Mi Jin Park
- a Department of Aging and Social Work , Catholic University of Pusan , Busan , South Korea
| | - Nan Sook Park
- b School of Social Work , University of South Florida , Tampa , FL , USA
| | - David A Chiriboga
- c Department of Child and Family Studies, University of South Florida , Tampa , FL , USA
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Park NS, Jang Y, Lee BS, Chiriboga DA, Chang S, Kim SY. Associations of a social network typology with physical and mental health risks among older adults in South Korea. Aging Ment Health 2018; 22:631-638. [PMID: 28290722 DOI: 10.1080/13607863.2017.1286456] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The objectives of this study were to (1) develop an empirical typology of social networks in older Koreans; and (2) examine its effect on physical and mental health. METHOD A sample of 6900 community-dwelling older adults in South Korea was drawn from the 2014 Korean National Elderly Survey. Latent profile analysis (LPA) was conducted to derive social network types using eight common social network characteristics (marital status, living arrangement, the number and frequency of contact with close family/relatives, the number and frequency of contact with close friends, frequency of participation in social activities, and frequency of having visitors at home). The identified typologies were then regressed on self-rated health and depressive symptoms to explore the health risks posed by the group membership. RESULTS The LPA identified a model with five types of social network as being most optimal (BIC = 153,848.34, entropy = .90). The groups were named diverse/family (enriched networks with more engagement with family), diverse/friend (enriched networks with more engagement with friends), friend-focused (high engagement with friends), distant (structurally disengaged), and restricted (structurally engaged but disengaged in family/friends networks). A series of regression analyses showed that membership in the restricted type was associated with more health and mental health risks than all types of social networks except the distant type. CONCLUSION Findings demonstrate the importance of family and friends as a source of social network and call attention to not only structural but also non-structural aspects of social isolation. Findings and implications are discussed in cultural contexts.
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Affiliation(s)
- N S Park
- a School of Social Work, University of South Florida , Tampa , FL , USA
| | - Y Jang
- b School of Social Work, The University of Texas at Austin , Austin , TX , USA
| | - B S Lee
- c Department of Mental Health Law and Policy , University of South Florida , Tampa , FL , USA
| | - D A Chiriboga
- d Department of Child and Family Studies , University of South Florida , Tampa , FL , USA
| | - S Chang
- e Department of Social Welfare , Kyungsung University , Busan , South Korea
| | - S Y Kim
- e Department of Social Welfare , Kyungsung University , Busan , South Korea
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