Parenting of 1.5 generation Chinese Americans’ parents: A case study

Individuals who arrive in a new country during their childhood and early adolescence are referred to as the 1.5 generation. In this exploratory case study, five Chinese families were interviewed and examined about the effects of their parenting styles on those 1.5 generation Chinese American students. Findings revealed that these parents’ parenting styles—educational values, educational practices, and family dynamics—have exerted a great impact on the students’ academic performance, psychological well-being, and adaptation to their life in the US. Insights about comparisons between American and Chinese education will be inspiring to educators and scholars for culturally comparative analysis and mental health practitioners working with the adolescents of this ethnicity and their families.

Self-Reported Discrimination, Resilience, and Oral Health-Related Quality of Life Among Older Chinese Americans

There is a lack of empirical evidence on self-reported discrimination and oral health-related quality of life (OHRQoL). Further, the mechanism linking the two constructs is not well understood. This study aimed to examine the relationship between self-reported discrimination and OHRQoL and investigate resilience as a mediator in such a relationship among foreign-born older Chinese Americans. Data came from the Population Study of Chinese Elderly in Chicago collected between 2017 and 2019. The working sample included 3,054 foreign-born Chinese Americans (60+ years of age). Mediation analysis was conducted to examine the direct and indirect pathways towards OHRQoL. Self-reported discrimination was directly and indirectly associated with poorer OHRQoL. Resilience mediated the relationship between self-reported discrimination and OHRQoL. Specifically, individuals experienced discrimination reported weaker resilience, and subsequently, reported poorer OHRQoL. Findings illustrate the importance of studying self-reported discrimination in relation to OHRQoL and further identify resilience as an intermediary pathway to promote OHRQoL.

Social Isolation, Resilience, and Psychological Well-Being in Older Chinese Americans

Using data collected in 2018 on 398 older Chinese Americans aged 55+ residing in Hawaii, we examined the associations of social isolation with psychological well-being and the mediating role of resilience. Social isolation was measured by their marital status, living arrangement, contact with children/family/friends, and participation in social activities. Psychological well-being was measured by psychological distress, life satisfaction, and happiness. Results from multivariate linear regressions and ordered logistic regressions showed social isolation was positively associated with psychological distress (β=0.017, p<0.05), and negatively associated with life satisfaction (β=-0.220, p<0.001) and happiness (β=-0.086, p<0.05) . By contrast, resilience was associated with lower psychological distress and higher life satisfaction and happiness. Moreover, mediation analysis showed that resilience contributed to 32% of the association between social isolation and psychological distress, 24.9% of the association between social isolation and life satisfaction, and 16.3% of the association between social isolation and happiness.

Family Conflict and Older Chinese Americans’ Self-Efficacy in End-of-Life Care Planning: The Role of Acculturation

Family involvement in end-of-life (EOL) care is critical to ensure older adults’ health and quality of life. Older adults’ self-efficacy in discussing EOL care plans with family members can facilitate family involvement in EOL care planning. Research shows that family relationships are associated with self-efficacy in discussing EOL care with family members among older Chinese Americans. However, the roles of family conflict and acculturation remain unknown. This study examines the association between family conflict and self-efficacy in discussing EOL care with family members and whether such an association differs by acculturation levels among older Chinese Americans. Data were collected from 207 Chinese Americans aged 65-102 in two metropolitan areas in 2017. Ordinary least squares regression was conducted to examine the association between family conflict, acculturation, and self-efficacy in discussing EOL care with family. Family conflict was negatively associated with older adults’ self-efficacy in discussing EOL care with family. More specifically, the negative association between family conflict and self-efficacy in discussing EOL care with family members was more pronounced for those with higher levels of acculturation. Findings highlighted differential effects of family conflict on self-efficacy of EOL care plan discussion for older adults with different acculturation levels. Those with higher acculturation may be more independent in their EOL care planning and aware of the possible negative effects of family conflict in their EOL care planning discussions. Acculturation needs to be considered by geriatric health providers to develop family-centered interventions in improving end-of-life care planning for this population.

Immigration-Related Factors and Depression Help-Seeking Among Older Chinese Americans

Asian Americans have the lowest mental health service utilization rate among all racial/ethnic groups. One important yet understudied aspect of this group’s mental health service use is its potential associations with immigration-related factors such as migration reasons, years in U.S., acculturation, and ethnic enclave residence. Using data from the Population-based Study of Chinese Elderly in Chicago (collected 2013-2015, N=3,123), this study investigates whether and how immigration-related factors shape mental health service utilization. Four categories of help-seeking behaviors for depressive symptoms were examined, including not seeking help (23.5%), seeking help from informal source(s) only (40%), seeking help from both informal and formal sources (28.7%), and seeking help from formal source(s) only (8.8%). Results of logistic regressions showed that U.S. Chinese older adults who migrated for family reasons were less likely to seek help from informal sources only than those who migrated for other reasons [Odds Ratio (OR)=0.64, 95% Confidence Interval (CI)=0.42-0.99). Less acculturated older immigrants (OR = 0.88, 95% CI = 0.79-0.97) and those who lived in Chinatown (OR = 2.34, 95% CI = 1.21-4.52) were more likely to seek help from formal sources only (relative to not seeking any help). Our findings showed that majority of the older Chinese Americans with depressive symptoms either did not seek help or sought help from informal sources only. Their help-seeking behaviors were shaped by their migration and acculturation experiences. Leveraging informal support networks and ethnicity-specific resources in Chinatown represent a culturally appropriate approach to facilitate mental health help-seeking among U.S. Chinese older adults.

Use of Tangible, Educational, and Psychological Supportive Services Among Chinese American Dementia Caregivers

Background and Objectives Though many studies have examined the service utilization of dementia caregivers, there is limited empirical evidence from Asian Americans and the lack of incorporating community resources and sociocultural factors in this field. Guided by the Andersen's Behavioral Model of Health Services Use (ABM), we aimed to understand whether and how predisposing, enabling and need factors were associated with utilizing multiple types of services among Chinese Americans dementia caregivers. Research Design and Methods We collected survey data from 134 Chinese dementia caregivers in New York City. Logistic regression models were conducted to test the associations between predisposing, enabling and need factors and the likelihoods of using tangible (home health aide, adult daycare, respite care), educational (lectures and workshops), and psychological (peer support groups and psychological counseling) services. Results Consistent with prior literature, caregiver’s knowledge about services, caring tasks, length of care and burden and care recipient’s physical and cognitive deteriorations, were significantly associated with higher possibilities of using multiple types of services among these Chinese American dementia caregivers. Three sociocultural factors, including residing in Chinatowns, availability of alternative family caregivers and diagnosis of cognitive deterioration, were also associated with higher likelihoods of using educational or psychological services. Discussion and Implications: The findings extended the existing literature on service utilization of caregivers by highlighting the importance of distinguishing types of services and the necessity of considering sociocultural factors in future research and practice.

Leveraging a Population-Based Dyadic Data Set to Promote Health Equity Among Chinese Americans

Recognizing the central role of family-oriented values in Chinese culture, developing a family-based understanding of health and wellbeing in Chinese Americans is imperative. By linking two unique population-based datasets (one on Chinese older adults, and another on their corresponding adult children caregivers), the purpose of this symposium is to present interactive analyses of dyad-level data to achieve an interpersonal understanding of health outcomes of Chinese older adults and their adult children within the family context. Data were obtained from 807 Chinese older adults-adult children dyads by merging data from two epidemiological studies, namely the Population Study of ChINese Elderly in Chicago (the PINE study) and the PIETY study of corresponding adult children caregivers of PINE participants. Specifically, this symposium presents findings from five interconnected research projects. Session 1 provides an overview of study design and sample characteristics of the dyadic dataset. Session 2 examines the relationship between adult children’s endorsement of the filial piety value and older parents’ mental health outcomes. Session 3 investigates the level of congruence between older parents’ self-perceived mental health and adult children’s evaluation of their parents’ mental health. Session 4 investigates the extent to which depressive symptoms among older parents were associated with those of their adult children. Session 5 explores the relationship between older parents’ physical function and adult children’s perceived caregiving burden. Taken together, this symposium presents potential contributions of dyad-level analyses in advancing minority population health. Study findings have the potential to inform the development of family-centered intervention strategies targeting Chinese Americans.

The Effects of Stigma on the Caregivers of Elderly Patients With Psychiatric Issues in a Chinese Community

World Health Organization in 2017 indicates the proportion of persons over the age of 60 years will exponentially grow from 12% in 2015 to 22% in 2050. Advanced age is a common risk factor for multiple conditions, including psychosis, depression, and other mental illnesses linked to cognitive and neurologic disorders. The majority of the studies identify ethnicity and socioeconomic status as primary determinants of mental health care access. Recent studies show that up to 12% of elderly Chinese have had a history of mental problems. However, over 50% of Chinese with mental disorders have failed to obtain professional help. Lack of access to health care for mental disorders has been linked to multiple underlying socioeconomic and cultural factors. These Chinese Americans lack an in-depth understanding of their psychosis, and psychiatric conditions are often a minority in nature. This study will systematically review the existing situations relating the factors to the stigma on caregivers. The result shows that the leading cause of psychiatric disorders, physical and emotional components of the elderly population, needs to be incorporated in the care plan in nursing homes and hospitals. In North America, the constant perception of discrimination and the inherent feeling of isolation and stigma among families with elderly members remains challenging. This review could contribute to the policy reform, which can help design effective control strategies to manage gaps of most mental disorders that continue to disproportionately affect different ethnic groups across the U. S. and Canada.