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Oh H, Morey BN, Shi Y, Lee S. Distress, multimorbidity, and complex multimorbidity among Chinese and Korean American older adults. PLoS One 2024; 19:e0297035. [PMID: 38295036 PMCID: PMC10830023 DOI: 10.1371/journal.pone.0297035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/27/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Studies suggest that distress is associated with various health conditions such as hypertension, asthma, diabetes, and coronary heart disease. However, only few studies focused on Asian Americans and little is known about the association with multiple comorbidity. METHODS We conducted a cross-sectional analysis among 400 Chinese and Korean American participants (aged 50-75 years) of the STOP CRC randomized controlled trial. Perceived distress was assessed using the distress thermometer scale (range 0-10). Disease diagnosis was self-reported by the participants. Multimorbidity (MM) was defined as having ≥2 chronic conditions. Complex multimorbidity (CMM) was defined as having ≥3 of the following body system disorders: circulation disorder, endocrine-metabolic disorder, cancer, anxiety or depression, breathing problem, and other health problems. We performed logistic regression for CMM and Poisson regression with robust error variance for MM to estimate associations with distress, adjusting for potential confounders. RESULTS The mean age was 58.4 years and mean distress score was 3.65. One-unit increase in distress score was associated with a 1.22-fold increase in the odds of having CMM (95% CI: 1.04-1.42). The magnitude of association slightly increased after additional adjustment for socioeconomic factors and health insurance status (OR: 1.29; 95% CI: 1.10-1.52). Higher distress score was positively associated with MM but the association was only marginally significant (PR: 1.04; 95% CI: 0.99-1.10), adjusting for socioeconomic factors and health insurance status. CONCLUSION Our data suggest that higher perceived distress may be associated with simultaneous dysfunction of multiple distinct body systems among Chinese and Korean American older adults.
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Affiliation(s)
- Hannah Oh
- Department of Public Health Sciences, Interdisciplinary Program in Precision Public Health, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Health Policy and Management, College of Health Sciences, Korea University, Seoul, Republic of Korea
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, California, United States of America
| | - Brittany N. Morey
- Department of Health, Society and Behavior, Program in Public Health, University of California, Irvine, Irvine, California, United States of America
| | - Yuxi Shi
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, California, United States of America
| | - Sunmin Lee
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, California, United States of America
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Jardon C, Choi KR. COVID-19 Experiences and Mental Health Among Graduate and Undergraduate Nursing Students in Los Angeles. J Am Psychiatr Nurses Assoc 2024; 30:86-94. [PMID: 35034499 DOI: 10.1177/10783903211072222] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Nurses and nursing students are at risk for negative mental health as a result of significant work stressors from the COVID-19 pandemic. AIMS The purpose of this study was to (1) describe the mental health of nursing students during the COVID-19 pandemic, (2) investigate relationships between stressful COVID-19 experiences and mental health, and (3) examine correlates of mental health service use. METHOD This observational study used a web-based survey to assess COVID-19 experiences, self-reported mental health, and mental health service utilization among nursing students in Los Angeles in spring 2021 (N = 174, 30.1% response rate). The survey used measures of stressful COVID-19 experiences (personal COVID-19 illness, hospitalization of close friends or family, and death of close friends or family), loneliness, resilience, depression, anxiety, COVID-19-related traumatic stress, and utilization of campus and noncampus mental health services. RESULTS Students had high levels of depression (30%), anxiety (38%), and traumatic stress (30%). There was no relationship between stressful COVID-19 experiences and mental health, but loneliness was associated with higher odds of mental health problems and resilience with lower odds. Mental health problems were not associated with use of campus or noncampus mental health services. Students with primary caregiving responsibilities (OR = 0.22, 95% CI [0.05, 0.87]) and students who identified as Asian/Pacific Islander (OR = 0.24, 95% CI [0.09, 0.70]) had lower odds of mental health service utilization. CONCLUSIONS Resilience and loneliness affect nursing student risk for negative mental health as a result of the COVID-19 pandemic. Targeted, accessible mental health support within nursing education programs may be warranted.
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Affiliation(s)
- Cecilia Jardon
- Cecilia Jardon, University of California, Los Angeles, CA, USA
| | - Kristen R Choi
- Kristen R. Choi, PhD, RN, FAAN, University of California, Los Angeles, CA, USA
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Hong S, Walton B, Kim HW, Rhee TG. Predicting the Behavioral Health Needs of Asian Americans in Public Mental Health Treatment: A Classification Tree Approach. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:630-643. [PMID: 36988832 PMCID: PMC10052246 DOI: 10.1007/s10488-023-01266-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
Abstract
Given the fact that experiencing pandemic-related hardship and racial discrimination worsen Asian Americans' mental health, this study aimed to identify unique characteristics of behavioral health needs among Asian Americans (N = 544) compared to White Americans (N = 78,704) and Black Americans (N = 11,252) who received publicly funded behavioral health services in Indiana before and during the COVID-19 pandemic. We used 2019-2020 Adults Needs and Strengths Assessment (ANSA) data for adults eligible for Medicaid or funding from the state behavioral health agency. Chi-squared automatic interaction detection (CHAID) was used to detect race-specific differences among demographic variables, the pandemic status, and ANSA items. Results indicated that, regardless of age, gender, or pandemic status, Asian Americans who received behavioral health services, struggled more with cultural-related factors compared to White and Black individuals. Within this context, intersections among behavioral/emotional needs (psychosis), life functioning needs (involvement in recovery, residential stability, decision making, medical/physical health), and strengths (job history, interpersonal, and spiritual) further differentiated the mental health functioning of Asian from White and Black Americans. Classification tree algorithms offer a promising approach to detecting complex behavioral health challenges and strengths of populations based on race, ethnicity, or other characteristics.
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Affiliation(s)
- Saahoon Hong
- Indiana University School of Social Work, Indianapolis, IN, USA.
- Division of Mental Health and Addiction, Indiana Family and Social Services Administration, Indianapolis, IN, USA.
| | - Betty Walton
- Indiana University School of Social Work, Indianapolis, IN, USA
- Division of Mental Health and Addiction, Indiana Family and Social Services Administration, Indianapolis, IN, USA
| | - Hea-Won Kim
- Indiana University School of Social Work, Indianapolis, IN, USA
| | - Taeho Greg Rhee
- Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA
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Jenabi Ghods M, Moghaddam LF, Hosseinabadi-Farahani MJ, Pourebrahimi M. The mediation role of self-esteem and hope on the relationship of quality of life and unmet needs of elderly with psychiatric disorders. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:89. [PMID: 37288421 PMCID: PMC10243421 DOI: 10.4103/jehp.jehp_163_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/11/2022] [Indexed: 06/09/2023]
Abstract
BACKGROUND Self-esteem is one of the factors affecting the quality of life. On the other hand, quality of life decreases in people with psychiatric disorders. The aim of the present study was to evaluate the mediating role of self-esteem and hope on the relationship between unmet needs and quality of life of the elderly with psychiatric disorders. MATERIALS AND METHODS This descriptive-analytical study was performed on 112 chronic psychiatric patients hospitalized in the geriatric ward of (blinded) 2020. Based on the inclusion criteria, a total of 100 samples were entered into the study by census. The World Health Organization (WHO) quality of life questionnaire, Rosenberg Self-Esteem Scale, Snyder Hope Scale, and Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) were used to collect data. The research model was tested using the path analysis technique. Data was analyzed using Statistical Package for the Social Sciences (SPSS) Ver. 26 and LISREL Ver. 2/9. RESULTS Unmet needs were negatively related to the other three variables of the study, namely, self-esteem, hope, and quality of life. There was a significant relationship between unmet needs and quality of life with a mediating role of self-esteem and hope (P < 0.05). Quality of life was also negatively related to unmet needs and directly related to self-esteem and hope. CONCLUSION Based on the findings of this study, it is essential that health-care providers consider planning to provide programs to improve self-esteem and hope in order to reduce unmet needs and increase the quality of life.
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Affiliation(s)
- Mariye Jenabi Ghods
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- PhD Student, Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ladan Fattah Moghaddam
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Li S, Wang Y, Xu L, Ni Y, Xi Y. Mental health service needs and mental health of old adults living alone in urban and rural areas in China: The role of coping styles. Geriatr Nurs 2023; 50:124-131. [PMID: 36774679 DOI: 10.1016/j.gerinurse.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 02/12/2023]
Abstract
This study aimed to explore the level and relationship between the mental health service needs (MHSN), coping styles (CS), and mental health (MH) of old adults living alone in urban and rural, and to explore the moderating effects of coping styles. A cross-sectional study was conducted with 717 older adults living alone. The survey measured MHSN, CS, and MH. Data were analyzed using a structural equation and bootstrapping method. There were significant differences in the MHSN, CS, and MH between urban and rural old adults living alone (P < 0.05). The model of the impact of MHSN on MH in urban and rural old adults living alone showed a good fit. These findings highlighted the importance of high MHSN and positive CS as potential protective factors of mental health in old adults living alone. This provides a theoretical basis for psychological nursing for old adults living alone in the community.
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Affiliation(s)
- Shasha Li
- Department of Nursing, College of Medical Science, Huzhou University, 759 Second Ring Road, Huzhou District, Zhejiang 313000, China.
| | - Yuecong Wang
- Department of Nursing, College of Medical Science, Huzhou University, 759 Second Ring Road, Huzhou District, Zhejiang 313000, China
| | - Lijun Xu
- Department of Nursing, College of Medical Science, Huzhou University, 759 Second Ring Road, Huzhou District, Zhejiang 313000, China
| | - Yingyuan Ni
- Department of Nursing, College of Medical Science, Huzhou University, 759 Second Ring Road, Huzhou District, Zhejiang 313000, China
| | - Yingxue Xi
- Department of Nursing, College of Medical Science, Huzhou University, 759 Second Ring Road, Huzhou District, Zhejiang 313000, China
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Nguyen T, Levkoff S, Nguyen H. 'He is just getting old, you know': the role of cultural and health beliefs in shaping the help-seeking process of family members caring for persons with dementia in Vietnam. ETHNICITY & HEALTH 2022; 27:1630-1651. [PMID: 33951992 DOI: 10.1080/13557858.2021.1922612] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This study aims to examine the help-seeking process of family caregivers for persons with dementia (PWD) in Vietnam, and how health and cultural beliefs shape this process. DESIGN Twenty family caregivers of PWD at a geriatric hospital in Northern Vietnam were recruited. A total of 30 face-to-face, semi-structured interviews, including 10 follow-up interviews, were conducted. Structural coding was used first to guide data analysis through four structural codes consistent with the four stages of the help-seeking model: (1) disease and symptom experience; (2) explanatory models for symptom appraisal; (3) decision to seek help; and (4) contact with the sources of help. Then thematic coding was used for more detailed and data-driven initial codes to emerge from the data. RESULTS Cultural and health beliefs, particularly collectivist values, such as familism and filial piety, shaped each stage of Vietnamese family caregivers' help-seeking process. Caregivers experienced different PWD's symptoms and adopted a mixed explanatory model combining biomedical and folk beliefs to explain the causes of dementia. They highly valued independence, autonomy, devotion to their family, and self-sacrifice, making these values the driving force underlying their self-reliance regime in caregiving. Help-seeking was often delayed until caregivers considered the situation to be beyond their own capacity to manage independently. The family was always the primary informal source of support for caregivers, with additional help sought from friends, neighbors, and religious facilities. Health professionals, if available, were also an important formal source for medical advice. CONCLUSIONS The results highlight the importance of culture and health beliefs in shaping caregivers' help-seeking process, and advocate the needs of service development targeting not only Vietnamese family caregivers for PWD, but also caregivers sharing similar collectivist culture in different areas. Interventions and services that are consistent with their values of self-sacrifice, devotion to family, autonomy, and self-reliance are much needed.
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Affiliation(s)
- Trang Nguyen
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
- University of Social Sciences and Humanities, Vietnam National University, Hanoi, Vietnam
| | - Sue Levkoff
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Huong Nguyen
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
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Kim E, Washington TR, Campbell RD. Community leaders' perceptions of depression and the perceived barriers in seeking mental health services for older Korean Americans. ETHNICITY & HEALTH 2022; 27:1483-1500. [PMID: 33845704 DOI: 10.1080/13557858.2021.1910627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 03/25/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This study explored community leaders' understanding of depression among older Korean Americans and barriers to seeking mental health services. Depression is prevalent among older Korean Americans, but they are less likely to seek help from professionals and prefer to use informal methods. Older Korean Americans strongly prefer to maintain their ethnic traditions and use community service agencies provided by their same ethnicity. In this regard, community leaders who provide services for older adults play a significant role in not only advocating for the population but also in developing services and programs for their communities. DESIGN In this qualitative study, 12 Korean community leaders who provide services for older adults were interviewed. Data were analyzed thematically, and Nvivo 12 was used to organize the data and to detect relevant themes. RESULTS Findings showed that community leaders had an in-depth understanding of the causes of depression from environmental and cultural contexts including isolation, losing independence, cultural factors, and lack of family support. However, although the leaders were aware of the severity of depression among older Korean Americans, they did not understand biologically-based factors; rather, they considered it a natural part of aging. Findings indicated that they were biased towards older adults like older Korean Americans, attributing depressive symptoms to personality issues. They also heavily rely on personal experiences to understand depression instead of on having educational training. Barriers to getting help for older adults include lack of the perceived need of older adults, lack of professionals, and a prevalent stigma against depression that encourages individuals to hide their illness. CONCLUSIONS The findings indicated that community-based educational training is necessary to increase understanding of depression not only for the community leaders but also for individuals and families.
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Affiliation(s)
- Eunhye Kim
- Department of Social Science, Augusta University, Augusta, GA, USA
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Abstract
South Asian American (SAA) youth are culturally diverse with respect to migration patterns, language, religion, and social determinants of health. Culturally specific stressors related to family, acculturation, discrimination, and intersectionality converge during developmentally sensitive periods, impacting mental health and identity development. "Model minority" stereotypes and somatic expressions of distress contribute to underdetection and limited perceived need for treatment. SAA families navigate structural barriers, including limited access to culturally tailored services, limited English proficiency, referral bias, and stigma, resulting in underutilization of services. Cultural considerations must be integrated into diagnostic conceptualization and treatment recommendations to effectively engage SAA youth and families in treatment.
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Nguyen T, Cho YJ, Jang Y. Perceived discrimination, psychosocial resources, and mental distress in Vietnamese Americans. J Migr Health 2021; 3:100039. [PMID: 34405187 PMCID: PMC8352156 DOI: 10.1016/j.jmh.2021.100039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/03/2020] [Accepted: 03/31/2021] [Indexed: 11/23/2022] Open
Abstract
This study examines how the mental health of Vietnamese Americans is influenced by a life stressor (perceived discrimination) and psychosocial resources (social network, religiosity, and acculturation). Data came from 513 Vietnamese Americans who were subsample of the Asian American Quality of Life (AAQoL) survey (total N = 2,614). The AAQoL survey was conducted with self-identified Asian Americans aged 18 or older in Central Texas in 2015. More than 32% of the Vietnamese sample reported perceived discrimination. A higher level of mental distress was associated with younger age, unmarried status, unmet financial status, poorer ratings of health, fewer years of stay in the U.S., perceived discrimination, smaller social network, and lower levels of acculturation and religiosity. In a multivariate analysis, the experience of discrimination (β = 0.16, p < .01), smaller social network (β = −.10, p < .05), and lower acculturation (β = −.17, p < .05) were found to be significant predictors to mental distress. No significant interaction was found. These identified risks and resources should be addressed in developing and implementing culturally sensitive mental health interventions targeted to Vietnamese American communities.
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Affiliation(s)
- Trang Nguyen
- Center for Studies of Displaced Populations, School of Public Health and Tropical Medicine, Tulane University, United States.,Department of Social Work, University of Social Sciences and Humanities, Vietnam National University, Hanoi, Vietnam
| | - Yong Ju Cho
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 West 34th Street, Los Angeles, CA 90089-0411, United States
| | - Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 West 34th Street, Los Angeles, CA 90089-0411, United States
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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] [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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Becerra MB, Rodriquez EJ, Avina RM, Becerra BJ. Experiences of violence and mental health outcomes among Asian American transgender adults in the United States. PLoS One 2021; 16:e0247812. [PMID: 33662045 PMCID: PMC7932064 DOI: 10.1371/journal.pone.0247812] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 02/15/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE We addressed prevalence and factors associated with mental health outcomes (suicidal behavior and psychological distress) among Asian Americans (AA), who identify as transgender, a key group among sexual and gender minorities that is overlooked and understudied. METHODS We used data from 2015 United States Transgender Survey during 2019-2020 with our population as census defined AA. Outcomes included suicidal ideation, suicidal thoughts, and serious psychological distress (SPD). Independent variables included any abuse, partner abuse, bathroom-related abuse, and additional covariates. Adjusted odds ratio and 95% confidence interval (aOR; 95% CI) for each outcome are adjusted for age, marital status, citizenship status, education level, employment status, as well as poverty status. RESULTS Nearly 67% reported experiencing any abuse, 52% reported abuse from romantic/sexual partner(s), while 29% reported harassment/abuse when trying to use bathrooms. Moreover, 82% reported suicidal thoughts, 40% reported suicidal attempts, and 39% had SPD. Results demonstrated that any abuse/violence had higher odds of suicidal thoughts (adjusted odds ratio [aOR] = 2.67, 95% confidence interval (CI):[1.98-3.58], suicidal attempts (aOR = 2.83, 95% CI:[2.18-3.68]), and SPD (aOR = 1.56, 95% CI:[1.20, 2.04]). Abuse from romantic/sexual partners had higher odds of suicidal thoughts (aOR = 2.47, 95% CI:[1.76-3.47]), suicidal attempts (aOR = 2.17, 95% CI:[1.68-2.80]), and SPD (aOR = 2.72, 95% CI:[2.03-3.63]). Experience of harassment/abuse during bathroom use had increased odds of suicidal attempts (aOR = 1.81, 95% CI:[1.41-2.31]). CONCLUSION Exposure to violence is common among AA transgender individuals and related to negative mental health outcomes. Initiatives to reduce exposure to abuse and providing resources for trauma-informed care are imperative to improve health outcomes.
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Affiliation(s)
- Monideepa B. Becerra
- Department of Health Science and Human Ecology, California State University, San Bernardino, California, United States of America
- Center for Health Equity, California State University, San Bernardino, California, United States of America
| | - Erik J. Rodriquez
- Division of Intramural Research, National Heart, Lung, Blood Institute, Bethesda, Maryland, United States of America
| | - Robert M. Avina
- Department of Health Science and Human Ecology, California State University, San Bernardino, California, United States of America
- Center for Health Equity, California State University, San Bernardino, California, United States of America
| | - Benjamin J. Becerra
- Center for Health Equity, California State University, San Bernardino, California, United States of America
- Department of Information and Decision Sciences, California State University, San Bernardino, California, United States of America
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Jiang JJ, Adia AC, Nazareno J, Operario D, Ponce NA, Shireman TI. The Association Between Moderate and Serious Mental Health Distress and General Health Services Utilization Among Chinese, Filipino, Japanese, Korean, and Vietnamese Adults in California. J Racial Ethn Health Disparities 2021; 9:227-235. [PMID: 33452574 DOI: 10.1007/s40615-020-00946-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 12/06/2020] [Accepted: 12/14/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION A growing body of literature has indicated that disaggregated analyses using distinct Asian subgroups allow for identification of varying mental health challenges and health services utilization. In this study, we examined the associations between distress and health services utilization among five Asian subgroups: Chinese, Korean, Japanese, Filipino, and Vietnamese adults in California. MATERIALS AND METHODS Using a combined dataset using the 2011-2018 cross-sectional cycles of the California Health Interview survey, we assessed moderate and serious distress and four health services utilization indicators in a set of disaggregated analyses among adults 18 years of age and older in five Asian subgroups. We performed bivariate and multivariable analyses. RESULTS The prevalence of and associations between moderate and serious distress and gaps in health services utilization varied among each Asian subgroup. Koreans had the highest prevalence of moderate and serious distress and the most gaps in health services utilization. Compared to those without moderate distress (p < .05), Japanese adults were more likely to delay care. Compared to those without serious distress (p < .05), Chinese adults who experienced serious distress were more likely to delay both medications and care, whereas Filipino and Vietnamese adults were more likely to delay medications. DISCUSSION Disaggregating health data elucidates the impact of mental distress on healthcare-seeking behaviors among specific Asian subgroups. Identifying these influences can facilitate future tailored interventions, yet fully understanding the mechanism linking mental distress and healthcare usage will necessitate a comprehensive assessment of structural influences and Asian American experiences without otherization.
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Affiliation(s)
- Joy J Jiang
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Alexander C Adia
- Philippine Health Initiative for Research, Service, & Training, Brown University School of Public Health, Providence, RI, USA.
| | - Jennifer Nazareno
- Philippine Health Initiative for Research, Service, & Training, Brown University School of Public Health, Providence, RI, USA
| | - Don Operario
- Philippine Health Initiative for Research, Service, & Training, Brown University School of Public Health, Providence, RI, USA
| | - Ninez A Ponce
- UCLA Department of Health Policy and Management, Fielding School of Public Health, Los Angeles, CA, USA
- UCLA Center for Health Policy Research, Los Angeles, CA, USA
| | - Theresa I Shireman
- Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI, 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] [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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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. THE 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] [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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Cullinan J, Walsh S, Flannery D. Socioeconomic Disparities in Unmet Need for Student Mental Health Services in Higher Education. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2020; 18:223-235. [PMID: 31686400 DOI: 10.1007/s40258-019-00529-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Mental health problems are highly prevalent among college students in many countries. However, evidence suggests that many at-risk students do not receive professional help. OBJECTIVE We aimed to understand which students are most likely to have unmet need for mental health services. Given increasing and widening participation in higher education, we focused attention on disparities by socioeconomic background. METHODS We analysed data from a recent survey of over 6000 students enrolled in higher education in Ireland. Using three separate measures of mental health problems, namely stress, anxiety, and depression, we developed and modelled an indicator of unmet need. RESULTS We found that students from the lowest social class and students with the greatest difficulty in making ends meet have higher rates of unmet need overall, but that these disparities disappear once we control for mental ill-health. For those with mental health problems, unmet need is shown to be independently higher for students who are younger, male, heterosexual, and studying for a Ph.D. We also found a strong independent association between unmet need and self-stigma, as well as considerable differences in unmet need across institutions. CONCLUSION Socioeconomic disparities in unmet need are driven by higher rates of mental ill-health among those from lower socioeconomic backgrounds. Our findings have implications for the targeting of services, as well as the provision of information about mental health and associated services.
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Affiliation(s)
- John Cullinan
- Discipline of Economics, J.E. Cairnes School of Business and Economics, National University of Ireland Galway, Galway, Ireland.
| | - Sharon Walsh
- Discipline of Economics, J.E. Cairnes School of Business and Economics, National University of Ireland Galway, Galway, Ireland
| | - Darragh Flannery
- Department of Economics, Kemmy Business School, University of Limerick, Limerick, Ireland
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