Abstract: Limited English proficiency (LEP) is a unique vulnerability of older immigrants that poses a significant risk to health and healthcare. The newly funded project “Limited English Proficiency, Health, and Healthcare among Older Immigrants” (R01AG047106) was designed to investigate how social connectedness and neighborhood/community characteristics (e.g., ethnic density and health service environments in the neighborhood) influence the link between LEP and health/healthcare. Using an innovative and synergistic mix of Social Network Analysis (SNA) and Geographic Information Systems (GIS), the project explores the direct and interactive roles of social connectedness and neighborhood characteristics in the relation between LEP and health/healthcare. The target group is older Korean immigrants because they are members of a rapidly expanding LEP population (i.e., Korean is ranked 4th in the languages spoken by LEP individuals in the US), and they manifest marked disparities in health and healthcare. As originally designed, the project included three sites that represent a continuum of Korean American population density: New York and California (high), Texas (intermediate) and Florida (low). This application proposes to include an additional site in Hawaii, which will not only enhance the generalizability of the findings but also provide a unique opportunity to address the emerging issues on aging for current and future immigrant groups. With integration of the additional site, the overall aim of the project will continue, and test the direct and interactive effect of social connectedness and neighborhood characteristics in the relation between LEP and health/healthcare.
Funding from this EP-EG Grant will provide support for data collection in a new site, and the dataset will serve as a foundation for publications (e.g., American Journal of Geriatric Society) and future grant applications (e.g. NIMHD R01) on chronic disease management among LEP populations.
Investigator: Gayle Acton, PhD, RN, CS
Co-Investigators: Patricia Carter, PhD, RN, CNS, and Lyda Fleches Arevalo, RN, PhD
Title: Translation and Cultural Validity of Intervention Materials and Research Instruments for Hispanic Family Caregivers
Abstract: Family caregivers of persons with dementia are at significant risk for poor self-management as a result of providing near round-the-clock care to a loved one with dementia. This poor self-management is often manifested in symptoms of insomnia, hypertension, pain, and/or depression. When a family caregiver suffers from chronic physical and emotional distress as a result of their caregiving duties, not only does the individual caregiver suffer, but the person with dementia is at increased health risks as well. In response to this negative cascade of health and illness that often results in the family caregiver, a number of interventions have been developed. However, the primary focus of these interventions is on skills building to teach the family caregiver how to provide effective and efficient care to the individual with dementia. While these programs are essential, they do not meet the need for interventions to improve self-management in family caregivers.
In response to this gap in the caregiving science, we have developed and tested a multi-component health promotion intervention for family caregivers of persons with dementia. This intervention focuses on building the caregivers’ skills to self-manage their own health and wellbeing alongside of the work they do to manage the person with dementia. This intervention has been found to be effective in English speaking family caregivers and was translated and pilot tested in Spanish speaking family caregivers. The next step is to validate the translations of the program materials and the instruments for a larger clinical trial with Hispanic family caregivers of persons with dementia.
This EP-EG grant will convene a panel of bilingual-bicultural healthcare professionals with expertise in family caregiving and health literacy, and community members (family caregivers) who are bilingual (English-Spanish) or monolingual native Spanish speakers. This panel will review and modify (if needed) the health promotion program materials and instruments. This work is necessary to ensure the quality of the translations, congruence between the meaning of the English and Spanish versions, and the cultural competence of the program to be delivered to Hispanics living in Central Texas. We will use rigorous translation methodology to ensure validity of the translations for both the intervention modules and the instruments. We believe with improved methods related to translation science, that we can submit a successful R01.