Variations in racial and ethnic groups' trust in researchers associated with willingness to participate in research.

Low enrollment in U.S. biomedical research by non-White adults has historically been attributed to mistrust, but few studies have simultaneously examined dimensions of trust in three or more racial/ethnic groups. Leveraging the racial/ethnic diversity of New Jersey, we prospectively recruited 293 adults (72% women, 38% older than 54 years of age) between October 2020 and February 2022 to complete two anonymous surveys in English or one of the common languages (e.g., Spanish, Mandarin Chinese). The first consisted of 12 Likert Scale questions related to trust in biomedical researchers (according to safety, equity, transparency), and the second assessed willingness to consider participation in eight common research activities (health-related survey, blood collection, genetic analysis, medication study, etc). Participants self-reported as Hispanic (n=102), Black (n=49), Chinese (n=48), other Asian (n=53), or White (n=41) race/ethnicity. Factor analysis showed three aspects related to trust in researchers: researchers as fiduciaries for research participants, racial/ethnic equity in research, and transparency. Importantly, we observed differences in the relationship between mistrust and willingness to participate. Whereas Chinese respondents' low trust in researchers mediated their low interest in research involving more than health-related surveys, Hispanic respondents' low trust in research equity did not deter high willingness to participate in research involving blood and genetic analysis. We caution that a generic association between trust and research participation should not be broadly assumed, and biomedical researchers should prospectively assess this relationship within each minoritized group to avoid hasty generalization.

Leveraging Technology to Improve Health Disparity Research: Trilingual Data Collection Using Tablets.

Survey research is an essential component of epidemiological research to understand the health of older adults. However, there are several limitations to conventional data collection methods that may serve as barriers for recruitment and retention of research participants, especially from minority populations. With recent technological advancements, our research team developed an innovative data collection and management system to address linguistic and cultural barriers, data quality, data security, and data preparation issues. This platform has been utilized in the Population Study of Chinese Elderly in Chicago since 2011. Future use and improvement of this system will facilitate research among minority older adults and increase research participation and representativeness to ultimately understand and improve the health and well-being of diverse populations. J Am Geriatr Soc 67:S479-S485, 2019.

The Decline of Directly Observed Physical Function Performance Among U.S. Chinese Older Adults.

BACKGROUND: Physical function decline is a major public health concern and can predict later mortality. This study aims to examine the sociodemographic factors associated with physical function decline among U.S. Chinese older adults through a longitudinal population-based study. METHODS: Data were derived from the Population Study of Chinese Elderly (PINE) at two time points: 2011-2013 and 2013-2015. Physical function was measured by observed physical performance testing, including chair stand, tandem stand, and timed walk. Mixed-effect models were used to analyze the demographic risk factors associated with physical function decline. RESULTS: Of the 2,713 participants in waves 1 and 2, their average age was 72.6 years old, 58.4% were female, with 8.7 years of education average, and 85.8% had an annual individual income of less than $10,000. Our findings show subjects of older age, female sex, lower education, lower income, and a greater number of medical comorbidities had lower physical function levels at baseline. Older adults experienced a faster decline in physical function for the overall performance measure (ß = -.02, p < .001). Additionally, elderly adults with higher education have a faster decline of physical function in the overall performance measure (ß = -.03, p < .01). DISCUSSION: As the first to examine physical function decline among U.S. Chinese older adults, our study finds older age and higher education are two factors associated with a faster rate of physical function decline. In future research, long-term follow up and multiple waves of data are needed to investigate risk or resilience factors for disability or recovering from disability.

The Associations and Correlations Between Self-reported Health and Neighborhood Cohesion and Disorder in a Community-dwelling U.S. Chinese Population.

Purpose of the Study: Characteristics of neighborhood have been found to be associated with physical and psychological health status of older adults, especially in relationship to social dynamics like cohesion and disorder. This study aims to examine correlations and associations between sociodemographic characteristics, self-reported health status, cohesion, and disorder among Chinese older adults in the greater Chicago area. Design and Methods: The Population Study of Chinese Elderly in Chicago is a cross-sectional, population-based study with community-dwelling Chinese older adults aged 60 and older, recruited through a community-based participatory research approach. Cohesion was measured through six questions; disorder was measured through eight questions. Correlation and regression analyses were conducted using SAS. Results: Among 3,158 participants enrolled in the study, 92.3% reported any neighborhood cohesion; 69.8% reported any neighborhood disorder. After controlling for age, sex, education, income, marital status, living arrangement, number of children, years in the community, years in the United States, country of origin, language preference, and location, a higher level of cohesion is associated with higher quality of life (odds ratio [OR]: 1.25, 95% confidence interval [CI]: 1.13, 1.39) and a higher level of disorder is associated with lower overall health status (OR: 0.97, 95% CI: 0.95, 0.99) and lower quality of life (OR: 0.96, 95% CI: 0.95, 0.98). Implications: Our findings suggest that neighborhood cohesion and neighborhood disorder are correlated to the health of U.S. Chinese older adults. Future longitudinal research should examine the relationship between community characteristics, both structural and social, and health-related outcomes.

Traditional Chinese Medicine Use and Health in Community-Dwelling Chinese-American Older Adults in Chicago.

Chinese people have practiced traditional Chinese medicine (TCM) for thousands of years, but there is a paucity of research regarding TCM use in Chinese older adult immigrants in the United States. This study aims to provide an overall estimate of TCM use for Chinese older adults in the United States and to examine associations between sociodemographic characteristics, health measures, and TCM use. Data were collected through the Population Study of Chinese Elderly in Chicago, a community-based participant research study that surveyed 3,158 Chinese older adults aged 60 and older. TCM use was measured using an eight-item scale that examined eight kinds of TCM. Seventy-six percent of participants reported any use of TCM within the past year. After adjusting for potential confounding factors, health status was associated with greater use of acupuncture (odds ratio (OR) = 1.33, 95% confidence interval (CI) = 1.06-1.68) and massage therapy (OR = 1.53, 95% CI = 1.21-1.93), and quality of life was associated with less use of prescribed herbal products (OR 0.69, 95% CI = 0.55-0.87), tai chi (OR = 0.62, 95% CI = 0.50-0.78), and other traditional medicine (OR = 0.47, 95% CI = 0.40-0.56). These findings call for further investigation of TCM use by Chinese older adults, especially those with poor health and those with better quality of life. In the clinical setting, physicians should have awareness of TCM when treating Chinese older adults and look toward possible integration with Western medicine for more culturally appropriate, patient-centered care.

Levels of Acculturation of Chinese Older Adults in the Greater Chicago Area - The Population Study of Chinese Elderly in Chicago.

Acculturation is a difficult process for minority older adults for a variety of reasons, including access and exposure to mainstream culture, competing ethnic identities, and linguistic ability and preference. There is a paucity of research regarding overall level of acculturation for Chinese older adults in the United States. This study aimed to provide an overall estimate of level of acculturation of Chinese older adults in the United States and to examine correlations between sociodemographic characteristics, self-reported health measures, and level of acculturation. Data were collected through the Population Study of Chinese Elderly in Chicago (PINE) study. This community-based participatory research study surveyed 3,159 Chinese older adults aged 60 and older. The PINE Study Acculturation Scale was used to assess level of acculturation in three dimensions: language preference, media use, and ethnic social relations. Mean acculturation level for all items was 15.3 ± 5.1, indicating low levels of acculturation. Older age, more offspring, lower income, fewer years living in the United States, lower overall health status, and lower quality of life were associated with lower levels of acculturation. Level of acculturation was low in Chinese older adults, and certain subsets of the population were more likely to have a lower level of acculturation. Future research should investigate causality and effects of level of acculturation.