Asian Americans' and Pacific Islanders' preferences in recruitment strategies and messaging for participation in the CARE registry: A discrete choice experiment.

INTRODUCTION: This discrete choice experiment (DCE) identified Asian American and Pacific Islander (AAPI) adults' preferences for recruitment strategies/messaging to enroll in the Collaborative Approach for AAPI Research and Education (CARE) registry for dementia-related research. METHODS: DCE recruitment strategy/messaging options were developed in English, Chinese, Korean, and Vietnamese. AAPI participants 50 years and older selected (1) who, (2) what, and (3) how they would prefer hearing about CARE. Analyses utilized conditional logistic regression. RESULTS: Participants self-identified as Asian Indian, Chinese, Filipino, Japanese, Korean, Samoan, or Vietnamese (N = 356). Overall, they preferred learning about CARE from the healthcare community (vs. community champions and faith-based organizations), joining CARE to advance research (vs. personal experiences), and hearing about CARE through social media/instant messaging (vs. flyer or workshop/seminar). Preferences varied by age, ethnic identity, and survey completion language. DISCUSSION: DCE findings may inform tailoring recruitment strategies/messaging to engage diverse AAPI in an aging-focused research registry.

A scoping review of dementia caregiving for Korean Americans and recommendations for future research.

OBJECTIVES: This scoping review aims to examine the caregiving experiences of Korean American caregivers of persons with dementia. METHODS: A comprehensive electronic search was conducted within 5 databases (PubMed, CINAHL, Web of Science, Embase, PsycINFO-ProQuest) for papers published from 01/01/00 -01/24/22. Seventeen articles met the inclusion criteria. Thematic analysis was used to summarize key findings from these papers. RESULTS: Most Korean American dementia caregivers were immigrants and wives/daughters/daughters-in-law. Two themes emerged: 1) how Korean American caregivers perceived their caregiving experiences, and 2) how Korean American caregivers perceived their caregiving support services. Korean American caregivers often experience poor mental health and burden. Social support and familism were found to be two of the most important factors that determine their attitudes toward caregiving. Most reported barriers to utilizing public services. Challenges in finding culturally relevant resources were common. CONCLUSIONS: Dementia caregiving is a significant public health problem facing Korean Americans. Recommendations for future research are provided.

The Collaborative Approach for Asian Americans and Pacific Islanders Research and Education (CARE): A recruitment registry for Alzheimer's disease and related dementias, aging, and caregiver-related research.

INTRODUCTION: Clinical research focused on aging, Alzheimer's disease and related dementias (ADRD), and caregiving often does not recruit Asian Americans and Pacific Islanders (AAPIs). METHODS: With funding from the National Institute on Aging, we designed and launched the Collaborative Approach for AAPIs Research and Education (CARE), a research recruitment registry to increase AAPIs' participation in ADRD, aging, and caregiving research. We present the design of this novel recruitment program. RESULTS: CARE uses community-based participatory research methods that are culturally and linguistically appropriate. Since CARE's launch, it has enrolled >7000 AAPIs in a 1-year period. The majority enrolled in CARE via community organizations and reported never having participated in any kind of research before. CARE also engages researchers by establishing a recruitment referral request protocol. DISCUSSION: CARE provides a promising venue to foster meaningful inclusion of AAPIs who are under-represented in aging and dementia-related research.

Discrimination Experiences during COVID-19 among a National, Multi-Lingual, Community-Based Sample of Asian Americans and Pacific Islanders: COMPASS Findings.

Reports of escalated discrimination among Asian Americans and Pacific Islanders (AAPIs) due to COVID-19 are alarming, making this a public health priority. However, there are limited empirical studies on the scope and impact of COVID-19-related discrimination among AAPIs. Using the COVID-19 Effects on the Mental and Physical Health of AAPI Survey Study (COMPASS) data (N = 4971; survey period: October 2020-February 2021), which is a U.S.-wide multi-lingual survey, we examined the prevalence of, and factors associated with discrimination experiences attributable to being an AAPI during the COVID-19 pandemic. Overall, 60.7% reported experiencing discrimination; the group prevalence ranged from 80.0% (Hmong) to 40.5% (Native Hawaiians and Pacific Islanders). Multivariable logistic regression models revealed that COVID-19-related factors were associated with many discrimination experiences: having a shelter-in-place order of ≥1 month, living in areas with perceived similar/higher COVID-19 severity, and negative impact in family income/employment due to COVID-19. Additionally, being Asian American (versus Native Hawaiians and Pacific Islanders), females, non-heterosexuals, younger, more severe effect on family income, living in the non-West, and poorer health were significantly correlated with discrimination experiences. Findings may assist in formulating anti-AAPI-discrimination policies and programs at the local, state, and federal levels. Culturally appropriate programs and policies to combat this are urgently needed.

Vaccine willingness: Findings from the COVID-19 effects on the mental and physical health of Asian Americans & Pacific Islanders survey study (COMPASS).

Willingness to get the COVID-19 vaccine is crucial to reduce the current strain on healthcare systems and increase herd immunity, but only 71% of the U.S. public said they would get the vaccine. It remains unclear whether Asian Americans and Pacific Islanders (AAPI), a population with existing inequalities in COVID-19 infection and mortality, are willing to get the vaccine, and the factors associated with vaccine willingness. Given this imperative, we used data from a national, cross-sectional, community-based survey called COVID-19 Effects on the Mental and Physical Health of AAPI Survey Study (COMPASS), an ongoing survey study that is available in English and Asian languages (i.e., Simplified or Traditional Chinese, Korean, Vietnamese) to examine vaccine willingness among AAPI. A total of 1,646 U.S. adult AAPI participants completed the survey. Self-reported vaccine willingness showed the proportion who were "unsure" or "probably/definitely no" to getting the COVID-19 vaccine was 25.4%. The odds for vaccine willingness were significantly lower for were Native Hawaiians and Pacific Islanders (vs. Asian Americans), Korean Americans (vs. Chinese and Vietnamese Americans), women (vs. men), heterosexuals (vs. non-heterosexuals), those aged 30-39 and 50-59 (vs. aged < 30), and those who reported having any vaccine concerns (vs. no concerns). AAPIs' willingness to get COVID-19 vaccine varied by groups, which underscores the need for disaggregated AAPI data. A multi-pronged approach in culturally appropriate and tailored health communication and education with AAPI is critical to achieve the goal of health equity for AAPI as it pertains to COVID-19 mortality and morbidity.

Caregiving for Community-Dwelling Older Persons in South Korea: Current Formal and Informal Care Use and Expectation.

The aim of this study is to examine formal and informal care use among community-dwelling older Korean adults. Older adults aged between 65 and 85 (N = 516) in mid-size city, selected using the probability proportional sampling method, were interviewed in person. One third reported having at least one caregiver. Compared to respondents who did not use any informal/formal care, those who used any formal or informal care were older and were more likely to be prefrail or frail and experienced at least one hospitalization or emergency department use in the past year. Living alone or being experienced with any hospitalization was associated with formal care use. Most care recipients received informal care from families, specifically spouses. Among participants who received no formal/informal care, 19% of them expected to receive formal care support in the future. Substantial support programs for informal caregivers are needed to address the increase in demand and expectation for long-term care.

Promising results from a pilot study to reduce distress in Vietnamese American dementia and memory loss caregivers.

INTRODUCTION: This study developed and examined the feasibility of a culturally tailored, evidence-based skill-building program to reduce stress and depression of Vietnamese American dementia caregivers. METHODS: This pilot randomized controlled trial included pretest and posttest measures using the Center for Epidemiologic Studies-Depression Scale and the Revised Memory and Behavior Problems Checklist. The intervention (n = 30) group participated in a culturally tailored, 4-week Vietnamese-language cognitive-behavioral skills evidenced-based program (Our Family Journey); caregivers in the control condition (n = 30) received dementia-related educational materials (education control condition). RESULTS: Our Family Journey caregivers showed significantly lower somatic scores on the Center for Epidemiologic Studies-Depression Scale and reported lower frequency of care recipients' disruptive behaviors. However, they also reported being more stressed by their care recipients' depressive symptoms on the Revised Memory and Behavior Problems Checklist compared to caregivers in the education control condition. DISCUSSION: These promising results suggest that a culturally adapted program can benefit Vietnamese dementia caregivers. Additional research is needed to develop and evaluate stronger, more impactful interventions for this underserved group.

Vietnamese American Dementia Caregivers' Perceptions and Experiences of a Culturally Tailored, Evidence-Based Program to Reduce Stress and Depression.

Vietnamese American dementia caregivers are at increased risk for adverse mental health compared to the general U.S. population given their sociodemographic and immigration experiences, yet programs that address their needs are lacking. The current article describes Vietnamese American dementia caregivers' perceptions and experiences of a culturally tailored, evidence-based intervention to reduce stress and depression. A convenience sample of caregivers was recruited from the San Francisco Bay area and randomly assigned to intervention ("Our Family Journey"; OFJ) (n = 30) or control (written dementia caregiving information) (n = 30) groups. All intervention and 76.7% of control caregivers reported that the OFJ or educational materials, respectively, were very/somewhat helpful. Three or more skills were refined/learned by 96.7% of OFJ and 36.6% of control participants. Qualitative findings indicated that the intervention had positive effects on well-being and taught new caregiving skills. This first U.S. study to address the mental health needs of Vietnamese American dementia caregivers shows positive perceptions/experiences and demonstrates a model to address a significant need in the community. [Journal of Gerontological Nursing, 45(9), 39-50.].

Chinese American Women's Experiences with Postpartum Depressive Symptoms and Mental Health Help-Seeking Behaviors.

PURPOSE: The objective of this study was to explore the perspectives of postpartum depression (PPD) and mental health help-seeking behaviors among Chinese American women. STUDY DESIGN AND METHODS: Using a qualitative design, Chinese American women, who had given birth in the past year, participated in a semistructured interview (English or Mandarin). Depressive symptoms and mental health services questionnaires were also conducted. RESULTS: All 15 participants were married and between 29 and 39 years of age. Content analysis revealed two main themes including culture-specific postpartum traditions and mental health help-seeking. Nine reported sadness or PPD symptoms, including three who scored above the cutoff of the Edinburgh Postnatal Depression Scale (EPDS score ≥9) for risk of PPD and others who disclosed such information during the interview. Many women shared that they experienced postpartum depressive symptoms, but some did not believe depression was applicable to Chinese women. CLINICAL IMPLICATIONS: Healthcare professionals working with Chinese American women must be aware of culture-specific childbearing traditions to promote maternal-infant well-being outcomes.

Depression and Help-Seeking Among Native Hawaiian Women.

The purpose of this mixed-methods study was to gain insight about Native Hawaiian (NH) women's experiences with, and viewpoints of, depression and help-seeking behaviors (N = 30: 10 from the university and 20 from the community). More women reported depression in the interviews than through their Center for Epidemiologic Studies Depression Scale (CES-D) responses. Quantitative data revealed 57% of the women had ever received mental health help (80% of university vs. 45% of community sample). There was a range of satisfaction reported for various types of mental health care, with satisfaction being the highest for spiritual/religious advisor/folk healer. During the interviews, one woman reported that she is currently receiving professional care and five women are seeking help from their family/social network. Future research should explore reasons for the differences in the quantitative and qualitative findings regarding depression and associated help-seeking as well as in the satisfaction levels by type of help-seeking.

Postpartum Traditions, Mental Health, and Help-Seeking Considerations Among Vietnamese American Women: a Mixed-Methods Pilot Study.

The purpose of this study was to explore Vietnamese American mothers' perceptions and experiences with postpartum traditions, postpartum depression (PPD), and mental health help-seeking behavior. Participants were 15 Vietnamese mothers who had given birth to at least one live infant within the previous year. A screening tool revealed that a third of the mothers had probable PPD. More than half reported having recent/current postpartum "sadness" during the interviews. Postpartum traditions played important roles in their well-being and maintaining strong cultural values. However, some reported feelings of isolation and the desire to be able to carry out postpartum traditions more frequently. Many who had reported sadness said that they would not seek professional help; all had felt that their condition was not "severe" enough to warrant help-seeking. Future PPD interventions should consider the importance of postpartum cultural traditions and address help-seeking barriers as ways to prevent the adverse effects of untreated PPD.

Disparities in intimate partner violence prenatal counseling: setting a baseline for the implementation of the Guidelines for Women's Preventive Services.

Prenatal health care counseling is associated with positive health outcomes for mothers and infants. Moreover, pregnant women are considered a vulnerable population at risk of being victims of intimate partner violence. Pregnancy provides a unique opportunity to identify and refer women experiencing intimate partner violence to community resources; however, in prior research, most women reported that their prenatal care providers did not talk to them about intimate partner violence. Given the importance for providers to offer prenatal health care counseling on intimate partner violence, it is concerning that there is scant knowledge on Asian, Native Hawaiian, and other Pacific Islander mothers' experiences in this area. The study's objectives were (a) to determine the proportion of mothers who received prenatal health care counseling on intimate partner violence; and, (b) to examine racial differences of those who received prenatal health care counseling on intimate partner violence. Hawai'i's Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2004-08 were analyzed for 8,120 mothers with information on receipt of intimate partner violence prenatal health care counseling. Overall, 47.7% of mothers were counseled on intimate partner violence. Compared to Whites, Native Hawaiians, Japanese, Chinese, and Koreans were significantly less likely to report receiving prenatal health care counseling in intimate partner violence, but the opposite association was observed for Samoans. Intimate partner violence continues to be a significant problem for women, thus, this study's findings may be used as important baseline data to measure the progress made given the implementation of the new Guidelines for Women's Preventive Services in intimate partner violence screening and counseling.

Smoking abstinence-related expectancies among American Indians, African Americans, and women: potential mechanisms of tobacco-related disparities.

Research has documented tobacco-related health disparities by race and gender. Prior research, however, has not examined expectancies about the smoking cessation process (i.e., abstinence-related expectancies) as potential contributors to tobacco-related disparities in special populations. This cross-sectional study compared abstinence-related expectancies between American Indian (n = 87), African American (n = 151), and White (n = 185) smokers, and between women (n = 231) and men (n = 270) smokers. Abstinence-related expectancies also were examined as mediators of race and gender relationships with motivation to quit and abstinence self efficacy. Results indicated that American Indians and African Americans were less likely than Whites to expect withdrawal effects, and more likely to expect that quitting would be unproblematic. African Americans also were less likely than Whites to expect smoking cessation interventions to be effective. Compared with men, women were more likely to expect withdrawal effects and weight gain. These expectancy differences mediated race and gender relationships with motivation to quit and abstinence self-efficacy. Findings emphasize potential mechanisms underlying tobacco-related health disparities among American Indians, African Americans, and women and suggest a number of specific approaches for targeting tobacco dependence interventions to these populations.

Prevalence, patterns, and correlates of co-occurring substance use and mental disorders in the United States: variations by race/ethnicity.

OBJECTIVE: This study examines racial/ethnic differences in the prevalence, patterns, and correlates of co-occurring substance use and mental disorders (COD) among Whites, Blacks, Latinos, and Asians using data from the Collaborative Psychiatric Epidemiology Studies. METHOD: We first estimated the prevalence of various combinations of different co-occurring depressive and anxiety disorders among respondents with alcohol, drug, and any substance use (alcohol or drug) disorders in each racial/ethnic group. We then estimated the prevalence of different patterns of onset and different psychosocial correlates among individuals with COD of different racial/ethnic groups. We used weighted linear and logistic regression analysis controlling for key demographics to test the effect of race/ethnicity. Tests of differences between specific racial/ethnic subgroups were only conducted if the overall test of race was significant. RESULTS: Rates of COD varied significantly by race/ethnicity. Approximately 8.2% of Whites, 5.4% of Blacks, 5.8% of Latinos, and 2.1% of Asians met criteria for lifetime COD. Whites were more likely than persons in each of the other groups to have lifetime COD. Irrespective of race/ethnicity, most of those with COD reported that symptoms of mental disorders occurred before symptoms of substance use disorders. Only rates of unemployment and history of psychiatric hospitalization among individuals with COD were found to vary significantly by racial/ethnic group. CONCLUSIONS: Our findings underscore the need to further examine the factors underlying differences between minority and nonminority individuals with COD as well as how these differences might affect help seeking and utilization of substance abuse and mental health services.