The Impact of Mindful Meditation on Health Care Workers During the COVID-19 Pandemic.

Background: The COVID-19 pandemic placed a spotlight on health care workers as the world struggled with mental health crises. As the number of COVID-19 cases rose exponentially, this also paralleled health care workers' perceived stress burden and increased risk for mental health trauma. This research project assessed the impact of a mobile mindful meditation application on health care workers' perceived stress levels during a pandemic. Methodology: Through quasi-experimental design, researchers assessed the effect of using a mobile mindful meditation (Synctuition) app on health care workers' stress levels. Participants listened for 20 to 30 minutes daily for 30 days. Participants perceived stress levels were measured with Cohen's Perceived Stress Scale. Results: Of the 100 participants, there was a statistically significant decrease in perceived stress reduction between the groups across various categories. The pretest perceived stress scores were reduced from moderate to low stress postintervention after using the mindful meditation application. Implications for Practice: Reducing stress in health care workers can potentially increase the quality of life for health care workers. and lowering stress levels can potentially improve the quality of care provided.

Evaluating Indoor Air Phthalates and Volatile Organic Compounds in Nail Salons in the Greater New York City Area: A Pilot Study.

The Greater New York City area ranks highest in the United States in the number of nail salon technicians, primarily Asian immigrant women. Nail salon technicians are exposed to toxic phthalates and volatile organic compounds daily in nail salons. The purpose of this pilot study was to measure a mixture of phthalates and volatile organic compounds in nail salons in the Greater New York City area, and to characterize work-related determinants of indoor air quality in these nail salons. Working with four Asian nail salon organizations in the Greater New York City area, we measured indoor air phthalates and volatile organic compounds at 20 nail salons from February to May 2021 using silicone wristbands and passive samplers, respectively. Nail salon characteristics were also examined. We measured six phthalates and 31 volatile organic compounds. Di(2-ethylhexyl) phthalate and Diethyl phthalate had the highest concentrations among the six phthalates measured. Concentrations of toluene, d-limonene, methyl methacrylate, and ethyl methacrylate were higher than that of the rest. Manicure/pedicure tables, the number of customers per day, and application of artificial nail (acrylic) services were positively associated with the levels of phthalates and volatile organic compounds. Given the large number of people employed in the nail industry and the even larger number of customers visiting such establishments, exposures to these toxic chemicals are likely to be widespread.

Perceived social support and help-seeking among U.S. Chinese older adults who reported elder mistreatment.

This study aimed to examine the associations between perceived social support and help-seeking among U.S. Chinese older adults who reported elder mistreatment (EM). Data were from the Population Study of Chinese Elderly in Chicago. Perceived social support and informal/formal help-seeking intentions and behaviors were measured. Descriptive statistics, multiple linear regressions, and multinomial logistic regression analyses were performed. A total of 450 participants reported EM. Mean age of the sample was 72.73 ± 8.03 years old. Perceived social support was associated with an increase in intentions of seeking help from informal sources. Compared with not seeking help, older Chinese-American adults with any EM who perceived social support were more likely to seek help from informal and formal sources. The potential role of social support in increasing help-seeking was highlighted. Culturally tailored interventions that provide social support might promote help-seeking among U.S. Chinese elder immigrants who experienced EM.

Caregiving and Care Receiving Experiences Among Older Chinese Immigrants and Their Home Health Aide.

INTRODUCTION: There is limited information about how racial and cultural similarities or differences between patient and caregiver may affect quality care. The purpose of this study was to explore caregiving and receiving experiences among older Chinese immigrants and their home health aides by using in-depth interviews in culturally concordant dyads in a community setting. METHODOLOGY: A purposive sample of 10 dyads of older Chinese immigrants and their home health aides were recruited using a snowball sampling method (N = 20). All interviews were audio recorded, transcribed, and coded for qualitative content analysis. RESULTS: The majority of older adults were female (n = 8) and their average age was 76.8 years. The following themes emerged: companionship and rapport, reconciling the need for care services with the expectations of family, the value of matched gender, language, and ethnic foodculture, assisting with daily routines, and experiencing caregiving burden due to a dual role. DISCUSSION: This study elucidated the dynamics between care recipients and their caregivers with shared cultural backgrounds.

Association between physical function and perceived stress among U.S. Chinese older adults.

OBJECTIVES: Physical function impairment can cause great stress to older adults. The purpose of the study is to investigate the association between self-reported and directly-observed physical function on perceived stress among U.S. Chinese older adults. METHODS: Data were from the Population Study of Chinese Elderly in Chicago (PINE) of 3,157 Chinese older adults who were 60 and above in the Greater Chicago Area. Self-reported and directly-observed physical function measures, and Perceived Stress Scale were used. RESULTS: Participants had a mean age of 72.8 ± 8.3 years old (range 60-105). Higher scores of Katz activities of daily living impairments (odds ratio [OR]=1.77), Lawton instrumental activities of daily living impartments (OR=1.10, p<0.01), Rosow-Breslau index of mobility scale (OR=1.39, p<0.05), and Nagi index of basic physical activities scale (OR=1.19, p<0.001) were associated with higher levels of perceived stress. In addition, higher scores of directly-observed physical function measurements, including chair stand (OR=0.93), tandem stand (OR=0.71, p<0.05), timed walk (OR=0.73, p<0.001), and the overall measurement (OR= 0.87, p<0.01) were associated with lower level of perceived stress. DISCUSSION: Findings suggested that poor physical function was associated with perceived stress among U.S. Chinese older adults. Longitudinal studies are needed to obtain a more comprehensive understanding of the pathways between physical function and perceived stress. IMPLICATIONS FOR PRACTICE: Health care professionals could provide personalized physical activity interventions to encourage older adults to engage in regular exercise in order to maintain and promote older adults' physical function and psychological well-being.

Elder mistreatment and psychological distress among U.S. Chinese older adults.

OBJECTIVE: This study aimed to examine the associations between different types of elder mistreatment, anxiety symptoms, and depressive symptoms among U.S. Chinese older adults. METHODS: Data were derived from the Population Study of Chinese Elderly (PINE), a study of Chinese older adults aged 60 years and above in the greater Chicago area from 2011-2013. Measurements include elder mistreatment screening tools, Hospital Anxiety and Depression Scale, and Patient Health Questionnaire-9. Negative binomial regressions and logistic regressions were performed. RESULTS: Participants with any mistreatment, psychological mistreatment, physical mistreatment, financial exploitation, and caregiver neglect were more likely to have anxiety symptoms and depressive symptoms. Sexual mistreatment was not associated with symptoms of anxiety and depression. CONCLUSION AND IMPLICATIONS: The rate of psychological distress differs based on the types of mistreatment among U.S. Chinese older adults. The findings underline the need for public and community awareness and improved education for health care professionals.

Association between personality traits and elder abuse in a community-dwelling Chinese population: findings from the PINE study.

Elder abuse is a pervasive public health issue. The relationship between personality traits and elder abuse remains unclear. This study aims to examine the associations between neuroticism, conscientiousness, and elder abuse. Data were derived from the Population Study of Chinese Elderly (PINE), a community-engaged study of 3,157 US Chinese older adults in the greater Chicago area from 2011-2013. Elder abuse included psychological, physical, and sexual abuse, financial exploitation, and caregiver neglect. The assessments of neuroticism and conscientiousness were derived from the NEO Five-Factor Inventory. Logistic regression was used. Higher neuroticism (score range: 6-30, OR = 1.14, CI = 1.11-1.18) and lower conscientiousness (score range: 16-60, OR = 0.97, CI = 0.96-0.99) were associated with a higher risk of elder abuse. With respect to different forms of elder abuse, higher neuroticism was associated with an increased risk of psychological abuse (OR = 1.14, CI = 1.10-1.17), financial exploitation (OR = 1.03, CI = 1.00-1.07), and caregiver neglect (OR = 1.06, CI = 1.03-1.09). Higher conscientiousness was associated with a higher risk of financial exploitation (OR = 1.02, CI = 1.00-1.05). Intervention programs could reduce neuroticism and raise conscientiousness of elder abuse victims.

Utilization of Mental Health Services Among Older Chinese Immigrants in New York City.

Older immigrants are at risk of developing mental illness. This study aims to examine mental health service utilization among older Chinese immigrants, using a mixed-method design. Andersen's Behavioral Model of Health Services Use informed an examination of predictors of mental health services utilization, and semi-structured individual interviews were conducted to illuminate these findings. Participants who were younger, had less than a high school education, and had a higher level of depressive symptoms were more likely to use mental health services. Stressors of psychological distress included breakdown of support system, language barriers, and financial hardships. Factors influencing mental health services use included information from family/friends, referrals from primary care physicians, perceived needs for help, mental health stigma, and culturally competent mental health professionals. Understanding the factors associated with seeking mental health services for older Chinese immigrants could help health care providers to develop early screening programs and culturally sensitive interventions.

Development of A Patient-Nurse Trust Scale in Underserved Community Setting.

This study developed and evaluated an instrument to measure the patient-nurse trust relationship in a medically underserved community. An exploratory sequential design was employed. In-depth interviews with 20 patients and 15 nurses were conducted to elicit their experiences regarding trust. Interview results were coded, analyzed and formatted into a Likert scale instrument. The instrument was administered to 120 patients. 19 items were retained for the final instrument with item-to-total correlational coefficients greater than 0.5, and a Cronbach's alpha of 0.95. Both construct validity and preliminary criterion validity were confirmed. Psychometric proportions of the instrument were established.

Utilizing a Mobile Health Intervention to Manage Hypertension in an Underserved Community.

This 6-month pilot randomized controlled trial examined the effectiveness of a Mobile Health (mHealth) intervention for hypertension self-monitoring and management in an underserved urban community. The four health outcomes measured included changes in systolic and diastolic blood pressure (BP), BP monitoring adherence, perceived medication adherence self-efficacy, and health-related quality of life. Thirty participants were randomly assigned to the mHealth group or a standard follow-up group; 25 participants completed the study. The mHealth group had statistically significant improvement in systolic BP decrease (p = .01). The mHealth group had better adherence to BP monitoring and improved perceived medication adherence self-efficacy at 6 months, compared with the standard follow-up group. The results suggest that an mHealth intervention has the potential to facilitate hypertension management in underserved urban communities.

Anxiety Symptoms, Depressive Symptoms, and Traditional Chinese Medicine Use in U.S. Chinese Older Adults.

This study examined the association between anxiety symptoms, depressive symptoms, and Traditional Chinese Medicine (TCM) use among U.S. Chinese older adults. Data was obtained from the Population Study of Chinese Elderly in Chicago (N = 3157; mean age = 72.8). Anxiety symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS-A). Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9). TCM modalities included herbal products, acupuncture, massage therapy, Taichi, and other types of TCM. Although not significant, there was a trend indicating that higher levels of anxiety symptoms showed a higher rate of acupuncture use and massage therapy. Older Chinese Americans with depressive symptoms were more likely to use acupuncture and massage therapy; and they were less likely to use other TCM. Future research is needed to identify reasons for TCM use; and how these factors mediate or moderate the relationship between psychiatric symptoms and TCM use.

Fitness and Quality of Life Outcomes of Cancer Survivor Participants in a Community Exercise Program.

Exercise is recommended for cancer survivors, as it mitigates treatment side effects and improves overall wellness. Therefore, survivors attend community-based exercise programs and report positive results, but published evaluations of outcomes of these programs are scarce in the literature. The objective of this study is to validate the anecdotal reports of the physical fitness and quality of life benefits of the LIVESTRONG at the YMCA program. A retrospective analysis of deidentified data consisting of 17 program cohorts of the LIVESTRONG at the YMCA program (n = 88) was conducted. Statistically significant improvements were seen when compared to baseline in the physical fitness measures of the 6-minute walk, the chest and leg presses, the sit-and-reach test, and the one-leg stand test, as well as in the domains of the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS-29) Profile, a health-related quality of life questionnaire. These domains are physical function, anxiety, depression, fatigue, social role satisfaction, and pain. The anecdotal impression that participation in the LIVESTRONG at the YMCA program improves physical fitness and subjective quality of life perceptions was supported by statistical analysis of the subjective and objective pre- and postprogram measurements for this data set. Exercise in this cancer-specific community exercise program is likely to improve physical fitness and quality of life outcomes.

Work-Related Symptoms, Safety Concerns, and Health Service Utilization Among Korean and Chinese Nail Salon Workers in the Greater New York City Area.

The purpose of this study was to determine similarities and differences in health effects, safety concerns, and health service utilization among Korean and Chinese immigrant women working in nail salons in the Greater New York City area. In this cross-sectional study, analyses involved descriptive statistics, t tests, and χ2 tests. Koreans had longer work experience and more work-related health effects and concerns, but were less likely to use personal protective equipment than Chinese workers. Although Koreans reported better socioeconomic status than Chinese workers, they were less likely to have health care access and utilized less health services. To prevent prolonged exposure to toxic chemicals, nail salon employees need education regarding the importance of personal protective equipment use. Reducing structural barriers and increasing health care access for all nail salon workers are especially important in improving their health service utilization.

Frailty and its association with the Mediterranean diet, life-space, and social participation in community-dwelling older people.

Frailty is a common and vulnerable state in older people, which leads to a higher risk of adverse health outcomes. This cross-sectional study examined the association between frailty and its phenotypic components with the Mediterranean diet, life-space, and social participation in community-dwelling older people. 263 community-dwelling older people recruited from three community centers in Hong Kong completed the study (robust = 85, pre-frail = 120, frail = 58). The results showed that the Mediterranean diet (OR = 0.29), life-space (OR = 0.32), and social participation (OR = 0.31) were associated with frailty. All factors were preferentially associated with slowness. The Mediterranean diet and social participation were additionally associated with weakness and low activity, respectively. To reduce the risk of frailty among diverse populations of older people in community settings, eliminating foods considered detrimental in the Mediterranean diet is advocated. Older people's satisfaction with social participation should be taken into consideration. Environmental designs should accommodate slow-walking older people to maximize their life-space.

Factors Influencing Health Service Utilization Among Asian Immigrant Nail Salon Workers in the Greater New York City Area.

Most nail salon workers in the greater New York City area are Asian immigrant women. They are exposed daily to potentially toxic chemicals and hazards in their workplace, making them more vulnerable for possible health problems. The study's primary purpose was to identify factors influencing past year healthcare utilization among Asian immigrant women working in nail salons. A cross-sectional study was conducted based on a modification of Andersen's behavioral model of healthcare utilization in which 148 Korean and Chinese immigrant women currently working in nail salons were surveyed. The questionnaire included: (1) individual health determinants, (2) health service utilization in the past year, and (3) work environment, work-related health concerns, and work-related health problems. Descriptive statistics and multivariate logistic regression models assessed factors related to past year healthcare utilization. Women who had health insurance (p < .01), a usual source of care (p < .01), low educational attainment (p < .05), and more work-related health symptoms (p < .05) were more likely to visit a primary care provider. Women who had health insurance (p < .01), a usual source of care (p < .05), and low educational attainment (p < .05), were also more likely to visit a woman's health provider. Korean (rather than Chinese) women (p < .05) and women who perceived themselves to be in fair/poor health (p < .05) were more likely to see a traditional provider of Eastern medicine. Asian immigrant women who work in nail salons have workplace health and safety concerns. They generally use Western rather than traditional medicine, with different factors related to these two types of medicine.

Cultural Perspectives on Tobacco Use and Cessation Among Chinese American Immigrants: A Community-Engaged Qualitative Study.

INTRODUCTION: Tobacco use is a preventable cause of death among ethnic minorities. Chinese Americans have high smoking rates and underutilize evidence-based cessation therapies. Community members' perspectives on tobacco use and cessation may help bridge treatment gaps and ensure that cessation approaches are aligned with cultural values. METHODS: Focus group methods were used to explore cultural factors influencing tobacco use and cessation among 50 Chinese immigrants. Emerging themes were identified using thematic analysis. RESULTS: The three emerging themes are (a) tobacco use is influenced by Chinese American immigrants' socioecological environment, (b) self-discipline determines the ability to quit, and (c) complex family dynamics influence quitting. DISCUSSION: Cessation approaches framed within cultural perspectives may help bridge treatment gaps. Innovations such as leveraging soft technologies that are widely used in the community may extend the reach of health promotion campaigns and treatments.

Association Between Perceived Social Support and Depressive Symptoms Among Community-Dwelling Older Chinese Americans.

Purpose: This study examined the association between social support and depressive symptoms among U.S. Chinese older adults. Methods: Data were from the Population Study of Chinese Elderly in Chicago (PINE) study. Independent variables were positive and negative perceived social support (PSS). Dependent variable was depressive symptoms. Multinomial logistic regression analyses were performed. Results: A total of participants were 3,157 Chinese older adults with the mean age of 72.8 years (range 60-105 years). After controlling for confounding factors, Chinese older adults with higher positive PSS were 12% (odds ratio [OR] = 0.88, 95% confidence interval [CI] = [0.85, 0.92]) and 18% (OR = 0.82, 95% CI = [0.79, 0.86]) less likely to report mild and moderate-severe depressive symptoms, respectively, compared to reporting minimal depressive symptoms; On the contrary, Chinese older adults with higher negative PSS were 34% (OR = 1.34, 95% CI = [1.24, 1.46]) and 38% (OR = 1.38, 95% CI = [1.26, 1.52]) more likely to report mild and moderate-severe depressive symptoms, respectively. Discussion: The study findings corroborate previous research that social support is significantly associated with depressive symptoms. Our findings reinforce the importance of developing strategies to utilize positive social support and limit negative support in practice for the depressed older adults. Further studies should be conducted to better understand the associations between different dimensions of social support and depression among U.S. Chinese older adults.

A Systematic Review of Culturally Specific Interventions to Increase Physical Activity for Older Asian Americans.

BACKGROUND: Physical activity (PA) is a significant modifiable risk factor for cardiovascular disease. For older adults, engaging in PA is shown to improve cardiac status, reduce cognitive, and functional decline, and improve overall quality of life. However, only 17% of Asian American adults meet the 2008 federal recommended guidelines for aerobic and muscle strengthening activity; and there is a paucity of data reporting on older Asian Americans - a rapidly growing, underserved group. While data pertaining to Asian Americans is frequently reported at the aggregate level, this masks differences (eg, language, culture, income) among Asian ethnic subgroups that may impact health behaviors. The purpose of this review was to identify intervention, and cultural adaptation strategies in studies promoting PA for older Asian Americans. METHODS: A comprehensive literature search was performed to identify interventions published between 1996-2016 focused on improving PA among older Asian Americans (> 60 years old). Data were abstracted to examine intervention study designs, cultural adaptation strategies, theoretical frameworks, and physical activity measures. RESULTS: Nine studies met the review's inclusion criteria. Community-based recruitment approaches were widely used, and all studies employed cultural adaptation to varying degrees. Most studies reported improvements in PA outcomes, focused on Chinese Americans, and relied on self-reports of PA, while few aimed to increase PA using a multi-component approach. CONCLUSIONS: Future studies would benefit from larger sample sizes, a wider representation of Asian ethnic subgroups, and concentrated efforts to implement deep level adaptations that may increase the salience and sustainability of these interventions.

Effects of Exercise Interventions on Depressive Symptoms Among Community-Dwelling Older Adults in the United States: A Systematic Review.

Depression is the most prevalent mental health problem among older adults. Exercise has been found to have a protective and treatable effect on depression in this population. A systematic review of literature published between 2006 and 2015 was performed to examine the influence of exercise interventions in reducing depressive symptoms among community-dwelling older adults in the United States. Ten studies were identified for inclusion. Exercise interventions have positive effects on clinical depression and depressive symptoms among older adults. In addition, exercise interventions alleviated the depressive symptoms among older adults with a diagnosis of chronic disease. Future studies should include a randomized controlled trial with a larger sample, longitudinal design, and culturally sensitive intervention. For long-term benefits, incorporating motivational strategies into community exercise programs and collaborating with community health care providers are recommended to enhance the maintenance of exercise behavior among community-dwelling older adults. [Journal of Gerontological Nursing, 44(3), 31-38.].

The Feasibility of an Exergaming Program in Underserved Older African Americans.

The study tested the feasibility and efficacy of an exergaming program in underserved older African American communities. The study is a single-group with pre- and posttest design. Twelve female participants ( M age = 64.17 ± 6.74 years) completed an exergaming program once or twice a week for 24 sessions over 14 weeks. Community health workers implemented the program through coaching and supporting mechanisms to motivate participants to exercise. A mixed-methods analysis was used to assess the intervention. After the program, participants showed significant improvements in lower body flexibility ( p = .012), and physical health-related quality of life ( p = .005). Four themes were identified related to the self-reported benefits of the exergaming program: (a) improving health, (b) feeling enjoyment, (c) getting connected, and (d) knowing you. The exergaming program provides an easy-to-implement and potentially effective intervention that can be used in community-directed centers to improve health and well-being in the underserved population.