Community Connectedness and Depression Among Southeast Asian Immigrants in Late Life

1
Community Connectedness and Depression Among
Southeast Asian Immigrants in Late Life
Giang T. Nguyen MD MPH MSCE, Ethan Nguyen
Department of Family Medicine and Community
Health

• SPECIFIC AIMS
• To assess levels of depressive symptoms,
  community connectedness, and isolation in a
  community-based sample of adult Vietnamese and
  Laotian immigrants in late life.
• To explore correlations among depressive
  symptoms, community connectedness, and isolation
  in a community-based sample of adult Vietnamese
  and Laotian immigrants in late life.

1. Obtain/create a translated Laotian version of
the Geriatric Depression Scale (GDS). A validated
Vietnamese version has been obtained. 2. Assess
community connectedness and isolation with a
Vietnamese and Laotian versions of the Lubben
Social Network Scale which looks at social
connectedness to family, friends, and neighbors.
3. Create a general data collection form in
Vietnamese and Laotian for demographic
information (age, sex, ethnicity, immigration
date, self-reported English proficiency, etc),
self-reported quality of health, and the presence
of recent stressful life events (death of spouse,
death of other family members, death of close
friends, serious illness or injury, discord with
spouse, discord with in-laws, changes in
financial situation, stay in hospital, stay in
nursing home, and moving from their house),
degree of participation in Asian elder activities
known to be available in the Philadelphia
community (e.g., intergenerational projects,
health outreach projects, etc).
Vietnamese per capita income 16,590v. 22,402
city-wide and 18,416 for Asians. 42 percent o\f
NYCs Vietnamese adults had not graduated from
high school surpassing 28 percent of all adults
and 31 percent of Asian adults in the city. More
than 6 in 10 Vietnamese residents (61 percent)
spoke limited English compared with 24 percent
of all residents and 49 percent of Asians
throughout the city Among senior citizens, 89
percent of Vietnamese had limited English ability
exceeding 27 percent of all elderly New Yorkers
and 73 percent for Asian city residents. Vietnames
e households averaged 3.39 people more than
2.59 city-wide and 3.13 for Asian New Yorkers.
More than three-quarters (77 percent) of
Vietnamese in the city were foreign-born, and 45
percent of those immigrants had come to the
United States since 1990.
Part 1

• GERIATRIC DEPRESSION IN THE ASIAN AMERICAN
  POPULATION
• Intense isolation.
• Language and cultural barriers.
• Distanced them from families.
• Hindered integration into community settings.
• Few acculturating experiences such as work or
  school.
• Limited financial resources.
• Reliance on children to provide assistance.
• Shifts in the filial relationship Older parents
  are relegated into a powerless role in the family
  setting, which is culturally contrary to the
  order inside Asian families.
• Role limited to the home cleaning, cooking,
  child care
• Limits their social network.
• We are bored because we are staying home always.
  
• Nothing to go, thats my problem

1. Post pilot testing/refinement, data collection
material will be used in interviewer administered
sessions by multilingual SEAMAAC outreach staff
to obtain cross-sectional data from Vietnamese
and Laotian immigrants in late life (age 60). We
will aim for a goal of n80-100. The primary
site for data collection will be a weekly Elders
Breakfast hosted by SEAMAAC. This breakfast is
held in South Philadelphia, where large numbers
of Southeast Asian immigrants live. GDS scores
will be computed immediately after each
interview, and participants with scores beyond a
5/6 cutoff will be offered referral to a
behavioral health programs.
Part 2
1.Data will be double-entered into an electronic
spreadsheet with automated comparisons to
identify errors in data entry. We will use Stata
or an equivalent statistical software package for
analysis. Basic univariate analyses will be
performed to identify and address outliers and
data that are not normally distributed.
Correlations will be calculated among depressive
symptoms, social connectedness, physical health,
demographic characteristics, and the presence of
stressful life events. Using positive Geriatric
Depression Scale as the primary outcome, we will
perform multivariable logistic regression to
identify independent predictors of depression, as
well as any first-order interactions between
independent variables. Relative risks/odds ratios
will be reported as appropriate.
Part 3