Arab Americans represent a rapidly growing subpopulation in the United States, with an estimated 3 million individuals. However, they face unique challenges in understanding and engaging in dementia and mental health research. Despite increasing recognition of these issues, there remains a scarcity of research focused on dementia and mental health within this community. Many Arab Americans hesitate to participate in research in general and in dementia and mental health research in particular, which hinders the efforts to understand and address their healthcare needs. Therefore, the aim of this study is to explore the perceptions and knowledge of foreign-born Arab Americans about research on dementia and mental health. Three in-person focus group discussions ( n = 12, n = 10, and n = 6 participants) were conducted in Arabic and English, guided by semi-structured interviews. A total of 28 participants (18 women) aged 30 years and older took part. The discussions were audio-recorded, transcribed, translated, and analyzed using Atlas.ti software. Inductive thematic analysis identified the commonly recurring themes. A concluding formal educational session was held to raise participants’ awareness about the topic and answer their questions. A preliminary analysis of the focus groups revealed five major themes: a varied understanding of research and its purpose, a lack of awareness about early dementia symptoms, prevalent fears and stigma surrounding dementia and mental health, barriers to research participation, including lack of knowledge and apprehension, mistrust, and competing life priorities, and strategies to enhance participation, including community education, increased outreach programs, and incentives. Cultural factors play a critical role in Arabs’ perceptions of research, dementia, and mental health. Participants valued the concluding educational session, which provided an opportunity to ask questions and engage in discussions. Addressing stigma through culturally tailored education, promoting research literacy, and increasing community engagement efforts are essential strategies for improving participation in dementia and mental health research. Future initiatives should prioritize trust-building, community-led interventions, and multilingual resources to ensure accessibility and inclusivity in healthcare research.
Alzheimer's disease and related dementias (ADRD) affect approximately 202,800 residents in Michigan. Older Asian Americans often face limited knowledge, culturally biased beliefs, and elevated worries regarding ADRD, yet few culturally appropriate programs exist to address these needs in Michigan. This study evaluated a newly developed intervention aimed to enhance ADRD knowledge and reduce stigma and worry among three older Asian Americans (i.e., Chinese, Indian, Korean). The intervention consisted of an educational session and one chosen culturally appropriate activity, with input from ethnic community stakeholders. Culturally tailored activities included ethnic meals for the Chinese group, mindfulness yoga for the Indian group, and Tai Chi for the Korean group. Participants were recruited through senior centers, senior housing facilities, religious congregations, ethnic organizations, and self-referrals. Each ethnic group received pre and posttest evaluations. Outcome measures consisted of ADRD knowledge, stigma, and dementia worry. The intervention was provided to 15 Korean participants (Mage = 76.4/ SD = 10.0, 80% female), 82 Chinese participants (Mage = 82.2/SD = 6.6, 60% female), and 32 Indian participants (Mage = 74.4/SD = 7.3, 56.3% female). Korean participants showed significant increases in ADRD knowledge (Hedges’ g = 0.60, p < .05) and reductions in stigma (Hedges’ g = -1.00, p < .01), though changes in worry were not significant. Chinese participants experienced similar improvements in knowledge (Hedges’ g = 0.32, p < .01) and stigma (Hedges’ g = -0.45, p < .01). Indian participants had significant gains in knowledge (Hedges’ g = 0.50, p < .01), but changes in stigma and worry were not statistically significant. Figures 1 and 2 illustrate changes in ADRD knowledge and stigma across the groups. This study underscores the value of culturally tailored, community-based interventions for improving ADRD literacy among older Asian Americans. Knowledge improved across all groups, while stigma reduction was observed in Korean and Chinese participants. Addressing dementia-related worry remains challenging, calling for innovative strategies to manage emotional responses, such as anxiety and fear, related to ADRD awareness. Further research is needed to understand subgroup differences in dementia stigma reduction.
Alzheimer's disease and related dementias (ADRD) affect approximately 202,800 residents in Michigan, with many living in rural areas. These conditions impose significant financial, physical, and psychological burdens on family caregivers, who play a critical role in supporting this population. Providing access to resources and support is crucial to dementia care, as there is currently no medical cure for ADRD. However, rural caregivers face persistent challenges, including limited availability of services, transportation barriers, insufficient knowledge of ADRD and care, and a lack of culturally appropriate services. This project seeks to address disparities in access to dementia support and services for underserved rural communities by providing a technology-based platform. A particular focus is placed on rural communities, with an emphasis caregivers. The project employs a two-tiered, technology-assisted service model developed through partnerships between the MSU School of Social Work and the Region 9 Area Agency on Aging. Tier 1 – Self-Paced Support: Delivered through the Trualta online platform, this level provides users with information, training, and tailored dementia-related resources. Tier 2 – Staff-facilitated Support: Offered by MSW staff and interns, this includes both in-person and online dementia education and caregiver support services. This tier also enhances the workforce capacity of staff and interns to assist families affected by dementia, particularly in rural and minority communities. About 40% of caregivers registered on the Trualta platform are over 60, with slightly less than 40% aged 46–60. Approximately 14% of users are male. The overall use level is moderate. The most frequently accessed resources include caregiver wellness, balancing work and caregiving, and practical tips for toileting and transferring. Other popular features include monthly seminars and community forums. Personalized training was well received among rural participants and showed improve knowledge of ADRD and reduction of caregiver stress. Implications in terms of improving access to dementia services in rural communities reflect on the sustainability of the community collaboration model, highlighting its potential to enhance the quality of life for families affected by dementia across rural populations in Michigan.
Providing care for relatives with dementia poses additional challenges for families in rural communities where access to information, education, and supportive services is often limited. This case study examines the implementation of a technology-based platform, Trualta, to support dementia caregivers in 12 selected rural counties in Michigan by providing education, skills training, peer connection, and local resources (e.g., adult day centers, county specific resource guides). Once logged in, caregivers have on demand access to the platform based upon their needs. Data from 172 caregivers enrolled between July 2023 to July 2025 were analyzed to assess usage patterns, impact, and lessons learned. On average, caregivers completed 13.5 learning modules (SD = 32.37), which are dementia care education and skills training; 41 participants attended at least one synchronous seminar. Participants viewed local resources an average of 4.2 times (SD = 5.0). Trualta’s peer support forum provides caregivers with space to share questions, reflections, and experiences. On average, participants contributed 2.74 entries to the forum (SD = 10.40), reflecting meaningful engagement. A thematic analysis of posts revealed that the two most prominent categories were daily care techniques and emotional support, which accounted for 33.0% and 17.4% of all entries, respectively. Interaction analysis found posts were notably detailed and insightful, with an average length of 633 characters and 58.0% using structured titles. Findings indicate technology-based interventions can empower rural dementia caregivers by addressing their needs for education, emotional support, and community resources. However, future research needs to evaluate the program’s long-term impact on caregiver stress and well-being.
ObjectivesLatinos are about twice as likely to develop cognitive impairment. Culturally, filial support and familismo are expected within Latino families. Yet approximately twenty percent of Latinos live alone in the United States. The purpose of this study is to explore the concerns and priorities of older Latinos living alone with cognitive impairment, using a precarity framework.MethodWe conducted 22 in-home interviews with older Latinos living alone with cognitive impairment, and we supplemented the interviews with interviews with members of the older adults' social circle and providers. Themes influencing the precarity of Latino older adults living alone were organized through the major areas of the precarity lens; 1) Limited awareness of cognitive impairment; 2) Self-management of cognitive impairment; and 3) Lacking tailored services for cognitive impairment.ResultsLatino culture permeated and intersected across the lived experiences of participants living alone with cognitive impairment. Precarity was prevalent in all participants' lives and was exacerbated by familismo combined with cognitive impairment.ConclusionFindings showed precarity in the experiences the participants shared. Participant narratives reveal how the Latino culture intersects with the experience of precarity while living alone with cognitive impairment, especially in reference to the role that family plays through the expectation of familismo. However, given the difficult demands of employment and raising their own families, familismo can become more like a goal than a practice. Further research is needed to better understand how to bridge the gap between the needs of these older Latino adults living alone with cognitive impairment, their families, and formal services.
Abstract This study evaluates a community-based participatory intervention designed to enhance ADRD knowledge and reduce ADRD stigma and worry among older Asian Americans in Michigan. Participants were recruited from senior centers and housing, religious congregations, and community Asian service agencies. They engaged in a 2.5-hour program comprising an educational session and a selected culturally tailored activity (e.g., group meals, mindfulness yoga. Pre- and post-intervention surveys focused on ADRD knowledge, worry, and stigma. The intervention was administered to 15 Korean participants (76.4±10.0 years old, 80% female), 82 Chinese participants (82.2±6.6 years old, 60% female), and 32 Indian participants (74.4±7.27 years old, 56% female) delivered in the participants’ native language; the images and examples were also culturally relevant to participants. For the Korean group, ADRD knowledge significantly increased (Hedges’ g =.60, p <.05), and stigma significantly decreased (Hedges’ g =-1.0, p<.01), though changes in worry were not statistically significant. The Chinese participants showed a similar pattern, with an increase in knowledge (Hedges’ g=.32, p<.01) and a decrease in stigma (Hedges’ g=-0.45, p<.01). The Indian community experienced an improvement in ADRD knowledge (Hedges’ g=.50, p<.01) but no significant changes in stigma or worry. Findings underscore the importance of culturally sensitive community-based interventions to address ADRD literacy gaps among older Asian Americans. While knowledge levels increased across all Asian groups, reducing stigma was only effective in the Korean and Chinese communities. Addressing dementia-related worry remains challenging, suggesting the need for more innovative strategies.
Introduction Health behaviours during a public health crisis for families with vulnerable ageing relatives are worth studying. After the Chinese government’s zero-tolerance policy on COVID-19 ended at the close of 2022, a significant surge in COVID-19 cases was observed among the Chinese population. This surge exposed a notable disparity in medical resources between urban and rural areas in China, with rural regions experiencing a pronounced lag in healthcare infrastructure. Amidst this backdrop, the health-seeking behaviour for rural older adults during the COVID-19 epidemic emerged as a critical subject for investigation. Chinese society heavily relies on interpersonal relationships. As such, access to medical resources for the older adults depends on their family members. How family members access higher-quality medical resources is a subject worthy of research. This study will explore the health-seeking behaviour for rural older Chinese from the perspective of migration and social support network in COVID-19 epidemic.Methods This study used qualitative methods and conducted interviews with 20 rural Chinese families where older relatives resided. The interviewees primarily consisted of adult children of older adults, alongside two grandchildren and two older adults themselves. After interviews, thematic analysis method was used to analyse the collected data and extracted three themes based on the questions raised.Results The study found that older adults had to leverage their extended family network to access urban medical facilities and resources to prevent and manage COVID-19 infections. The study also highlighted the significant influence of structural and cultural factors on the social support networks within rural families.Conclusion Families with older adults used their social support network to access better medical resources. The social support networks of families with older adults are also influenced by other structural and cultural factors. The health-seeking behaviour of families with older adults relies on private relationship resources, which make necessary task to build public health resources in rural China.
Hurricane Maria devastated Puerto Rico in September 2017. The destruction displaced and uprooted families. Combining the Person-Process-Place Attachment Framework and Walsh's Family Resilience Framework, we examined how families in migration negotiated cultural and geographical separation as a family resilience process. This study piloted an art-based inquiry method. Families co-created art postcards and posters prompted by themes. We conducted focus groups to discuss art pieces. Nine different Latino family units in central FL participated in the intervention and focus groups. Families expressed conflicted attachments through feelings about displacement in migration and those left behind due to opportunities in the new migration context. Through visual and verbal representations, they expressed a liminal tension in the process of relocation (detachment) with a family-driven resolve on resiliency (reattachment). Understanding the process of family separation and displacement has on resilience through attachment can lead to future development of family interventions and better understanding of how to foster resilience. Attachment theory and resiliency played key roles in the participating families' process of adaptation to new migration settings.
In a period of growing support as well as hostility toward, diversity, equity and inclusion (DEI) in the United States, we developed two college-level DEI minors. We grounded each minor in critical pedagogy, a broad theoretical and philosophical perspective on the purpose and process of education that encapsulates a variety of practices and methods. The goal was to move beyond performative DEI by collaborating with students to develop the necessary tools to become engaged and self-managed citizens both nationally and globally. As such, we embedded dialogue, self-reflection, diverse knowledge networks and sources, and critical frameworks into the minors, as we sought to balance developing critical awareness with working toward change. In the following paper, we describe these basic elements of critical pedagogy to transformative DEI and link them to the processes of constructing and ultimately delivering the minors. Key examples are provided to demonstrate the implementation of these elements in our work. We conclude with our reflections on how this experience may inform similar efforts.
Abstract While community-based support and services are increasingly available to family caregivers (FCGs) of a person with dementia (PWD), those from ethnic minority groups tend to be underserved. This study aimed to identify unaddressed challenges to dementia care and uncover strategies to better assist FCGs within Asian and Latino communities in Michigan. Focus group and individual interviews were conducted with service professionals (SPs) and FCGs. Specifically, we ran two focus groups with SPs (n=11), and one with Asian FCGs (n=8). Four individual telephone interviews were conducted with Latino FCGs. Sessions were audiotaped and conducted in the participants’ preferred language, then transcribed and translated into English for analysis. Shared challenges to dementia care included: transportation to services; lack of translation services and language-concordant specialists, daycare/respite workers, and in-home care staff; and feelings of shame in needing support. Latino FCGs reported the emotional burden of witnessing the cognitive decline of their PWD, whereas Asian FCGs focused on challenges related to the behaviors of PWD. SPs and FCGs expressed the desire for more education for FCGs on dementia and self-management of stress. Limited technology literacy impacted their access to digital education. Culturally informed outreach and intervention strategies were recommended, such as partnering with community leaders and adapting cultural practices (e.g., providing family-oriented events, and using social media popular among specific ethnic groups). This study highlights the sociocultural challenges and practical outreach approaches for FCGs in Asian and Latino communities by integrating the perspectives of FCGs and SPs involved in dementia care.
Abstract Objectives This study examines the relationship between post-traumatic stress and loneliness and whether this relationship varies by perceived everyday discrimination among older Puerto Ricans. Methods A total of 304 Puerto Ricans aged 60 and above from Wave 3 of the Boston Puerto Rican Health Study were included. Ordinary least squares regression examined the association between post-traumatic stress, perceived everyday discrimination, and loneliness. Results Post-traumatic stress was significantly associated with a higher level of loneliness (β = 0.282; p < 0.001; 95% CI: 0.142, 0.423). The interaction effect between post-traumatic stress and perceived everyday discrimination on loneliness was statistically significant (β = 0.083; p < 0.05; 95% CI: 0.062, 0.230). More specifically, the positive association between post-traumatic stress and loneliness becomes more robust with the increase in perceived everyday discrimination. Conclusion Given an increase in population size on the U.S. mainland and migration from Puerto Rico due to natural disasters and declining economic conditions, it is essential to better understand the effect of perceived discrimination against older Puerto Ricans on the mainland United States as well as those who immigrated and stayed through older age. Outreach strategies and interventions that address perceived discrimination can help mitigate loneliness among older Puerto Ricans who experienced trauma.
Hurricane Maria hit Puerto Rico on September 20, 2017. The devastation displaced many families and led to negative mental health outcomes. We use the intersection of Oyserman's possible selves' theory and Walsh's family resilience theory, to aid in elucidating the process of positive familial coping within resilience among Latinx families. Nine different family units participated in an art-based intervention and subsequent focus groups in Florida in November 2018. Grounded theory guided analysis, and themes emerged using intersecting aspects of the above-mentioned theories. Understanding the impact that positive familial selves have on resilience can lead to future development of family interventions and a better understanding of how to foster resilience.
Loneliness is associated with worse mental health conditions, more functional limitations, and higher mortality among older adults. Almost one third older Puerto Ricans have experienced loneliness. Research has shown that post-traumatic stress has been associated with higher risk of loneliness among older adults; however, such an association has not been examined among Puerto Ricans despite their high prevalence of post-traumatic stress disorder. In addition, perceived discrimination, a critical risk factor of social isolation, is likely to reduce help-seeking behaviors and aggregate loneliness among individuals who have experienced trauma. Nonetheless, few studies have focused on the moderating role of perceived discrimination on the association between post-traumatic stress and loneliness. This study examines the association between post-traumatic stress and loneliness and whether that association differs by everyday perceived discrimination among older Puerto Ricans. Data were collected from 304 Puerto Ricans aged 60 and above living in the Greater Boston area who responded to questionnaires. We used ordinary least squares regression to examine the association between post-traumatic stress, perceived everyday discrimination, and loneliness. We found that post-traumatic stress was significantly associated with higher levels of loneliness; however, the association differed by perceived everyday discrimination. The association between post-traumatic stress and loneliness was stronger for those that perceived a higher level of everyday discrimination. Findings underscored the role that perceived discrimination plays in exacerbating loneliness among older Puerto Ricans experiencing post-traumatic stress and have clinical and public health implications for service delivery and mental health promotion among older Puerto Ricans.
Natural disasters continue to devastate families and communities across the United States. An important aspect of family resiliency within a disaster context is the role spirituality plays in how families make sense of their experience. Using an arts-based visual research approach, this study explored the role of spirituality in the psychosocial adaptation of displaced Puerto Rican families who resettled in Orlando, Florida post-Hurricane Maria. Three main themes emerged: spirituality through 1) the relinquishment of control, 2) sense of empowerment, and 3) stabilization and security. The data suggest that spirituality plays a critical role in how Puerto Rican families make sense of their displacement experience and find the strength and motivation to adapt and move forward. The findings provide important insights for community-based organizations and religious leaders regarding how Latino families spiritually cope and navigate resettlement after a natural disaster.
OBJECTIVES:Older adults with diabetes have double the normal average risk for depression. While women also report higher rates of depression, men are less likely than women to recognize symptoms and seek assistance for mental health treatment. Racial disparities in mental health care use among men have also been identified. While age and gender differences in mental health care use have been accounted for in adults with comorbid diabetes and depression little is known about within group differences among men. The purpose of this study was to examine the influence of age and race on mental health service use in a sample of men with comorbid diabetes and depression.METHODS:This study utilized secondary data from a large health care delivery system serving in a Midwestern urban city and included 335 Black, and non-Latino White men with comorbid type 2 diabetes and depression.RESULTS AND DISCUSSION:Findings indicate that men under the age of 55 were less likely to experience a 6-month or more delay in receiving a psychiatric medication prescription after their initial depression diagnosis. Black men over 55 years of age were significantly more likely to experience a delay of over six months to receiving psychiatric medication. More research is needed to explore preferred depression treatment methods for older Black men with type 2 diabetes, in addition to any issues with access to pharmacological medications to treat depression.
Domestic violence shelter advocates closely guard the confidentiality of survivors in their shelter programs, yet they are simultaneously mandated reporters of child abuse and neglect. The mandate to report child abuse and neglect may include a child’s exposure to domestic violence, which may be disclosed when assessing danger for program entry. The purpose of this study is to understand what decision making factors influence domestic violence shelter advocates’ decision to override survivor’s confidentiality and report child abuse and neglect. A survey of 142 domestic violence shelter advocates found that advocates that holistically consider the impact of reporting are less inclined to report child abuse and neglect. At the same time, advocates who perceive that their agency has a better relationship with child protective services are more inclined to report child abuse and neglect. Implications of these findings are discussed in relation to research, policy and practice.
Abstract Background: Puerto Ricans have the highest likelihood of psychiatric disorders among Latinos. This study developed and evaluated a prototype depression literacy curriculum; culturally grounded with perspectives and narratives of Puerto Rican older adults. The way a person determines need for services and decides to seek help has been found to be influenced by their perceptions of services and providers. McGuire (1989) presents the Communication Persuasion Model (CPM) that takes into account how persuasive communication changes attitudes and behaviors of consumers. Using the CPM as a theoretical foundation, this study presented a culturally grounded story through a Virtual Reality (VR) platform. Methods: A script was developed based on narratives of Puerto Rican older adults about depression. Filmed in 360° format and enhanced with supporting imagery, participants were presented two versions of the video, one with a VR headset and the other with a smartphone. Two focus group interviews were conducted with community-dwelling Puerto Rican older adults (n=14) in Orlando, FL. Results: Participants preferred the VR headset and found it was beneficial to educate about depression because it felt more immersive and encouraged an environment conducive to identifying their own experiences about depression. They noted that presenting the material with a case narrative was more culturally sensitive for the population. All participants needed minor assistance with operating technology. Conclusions and Implications: A narrative approach to depression literacy may be effective in personalizing messages. Assisted VR technology with supporting imagery may be efficacious and standardize positive messages to underrepresented and low resource populations.
This study examined the experiences of Latino caregivers of family members with dementia in Michigan. Latinos are now the largest racial/ethnic group in the United States, representing 16.7 percent of the total population. In Michigan, the Latino population represents 4.5 percent of the total population. In fact, between 2000 and 2010, the Latino population increased by 33.8 percent even as the total population in Michigan decreased. Older adults (65 years and older) comprise 6.1 percent of the total Latino population in the United States (United States Bureau of the Census, 2004). Census Bureau projections show that between 2008 and 2030 the Latino population aged 65 years and older will increase by 224% compared to a 65% increase for the white population aged 65 and older. Yet, there is a large disparity in dementia detection, care, and outcomes for Latinos (Lines, Sherif, & Wiener, 2014). Culture plays an important role to factor in the effectiveness of health communication to influence health literacy and behaviors (Kreuter & McClure, 2004). Making programs more culturally accessible and near Latino communities must be a part of improving access and outcomes. The project consisted of focus group interviews (3 groups, n=21) with community-dwelling older Latino adults across Michigan. Preliminary results show that there are many unmet needs for Latino dementia caregivers in Michigan. Further, a disconnection with formal services aggravates outcomes for Latino caregivers. There is a need for new formal service models that are sensitive to the cultural needs of Latino populations.
Alzheimer's disease (AD) is the most common type of dementia among individuals 65 or older. There are more than 5 million diagnosed cases in the US alone and this number is expected to triple by 2050. Therefore, AD has reached epidemic proportions with significant socioeconomic implications. While aging in general is the greatest risk factor for AD, several additional demographic factors that have contributed to the rise in AD in the US are under study. One such factor is associated with the relatively fast growth of the Latino population. Several reports indicate that AD is more prevalent among blacks and Latinos. However, the reason for AD disparity among different ethnic groups is still poorly understood and highly controversial. The Latino population is composed of different groups based on nationality, namely South and Central America, Mexico, and Caribbean Hispanics. This diversity among the Latino population represents an additional challenge since there are distinct characteristics associated with AD and comorbidities. In this review, we aim to bring attention to the intersection between social determinants of health and genetic factors associated with AD within the Latino community. We argue that understanding the interplay between identified social determinants of health, co-morbidities, and genetic factors could lead to community empowerment and inclusiveness in research and healthcare services, contributing to improved diagnosis and treatment of AD patients. Lastly, we propose that inserting a neuroethics perspective could help understand key challenges that influence healthcare disparities and contribute to increased risk of AD among Latinos.