Journal of Social Service Research最新文献

Geographical differences in Alzheimer's disease and related dementias (ADRD) prevalence may be driven by under-diagnosis due to insufficient healthcare access. Telehealth may improve ADRD detection in remote regions but relies on broadband service availability. We evaluated the influence of county-level broadband availability on Appalachian and rural variation of ADRD prevalence in six US Central Appalachian states and hypothesized that accounting for broadband access may accentuate Appalachian/non-Appalachian and rural/urban differences. An ecologic analysis evaluated county-level ADRD prevalence among the Medicare fee-for-service population across 591 Central Appalachian counties from 2015 to 2018. ADRD prevalence by Appalachian/non-Appalachian and rural/urban county-designation was estimated using negative binomial regression sequentially adjusting for age/education, diagnostic access, broadband presence/usage, poverty, and internet access/device ownership. Appalachian counties had lower ADRD prevalence than non-Appalachian counties in rural compared to urban counties (β_AppXRural = -0.028; 95% Confidence Interval (CI): -0.052, -0.005). This variation attenuated with adjustment for broadband access (β_AppXRural = -0.014; 95% CI: -0.038, 0.009). Broadband presence (β= -0.020; 95% CI: -0.032, -0.008) and a higher proportion of households with broadband in a county (β= -0.405; 95% CI: -0.534, -0.277) were negatively associated with ADRD prevalence after adjustment for poverty. Future research should implement alternative study designs to investigate mechanisms linking broadband access to ADRD prevalence.

Parenting program research demonstrates positive impact on children yet are primarily designed for White families, which limits generalizability. Parenting interventions tailored for Black and Latiné families are crucial to ensure culturally appropriate programs. This study aimed to understand Black and Latiné parent and provider perspectives on program preferences to inform adaptations. Qualitative interviews were conducted with 33 parents (82% women, 64% Black, 36% Latiné) and six providers who work with Black and Latiné families (83% women, 50% Black, 33% Latiné). Shared parent-provider themes included: Preferences and Recommendations for Program Content, Preferences and Recommendations for Program Delivery, Barriers to Attending and Implementing a Parenting Program. Parent interviews yielded one additional theme: Facilitators to Attending a Parenting Program. Preferred program content included discussions of race, culture, and ethnic-racial socialization, child and parent wellbeing, and parenting practices. Parents and providers highlighted the importance of interventionist relatability. Provider-identified barriers included limited family resources, while parent-identified barriers included competing responsibilities and inconvenience. Parents offered solutions, including easing the burden of competing responsibilities, increasing convenience, and facilitating feeling supported by a program. Findings have implications on culturally-relevant adaptations to programs for Black and Latiné parents. Future research should investigate acceptability and efficacy of resulting parenting programs.

This study, with research questions guided by the socio-ecological model, examined how ethnic minority older adults with limited English proficiency navigate cultural and language barriers in their daily lives, relationships, and healthcare interactions, and what challenges and strategies emerge in their efforts while living in the U.S. Individual in-depth interviews with Korean American older adults with limited English proficiency and chronic medical conditions (N=12) were conducted over a 90-day period between November 2023 and January 2024. Using the thematic analysis technique of constant comparative method, data analysis identified 9 coping strategies, which were organized into four levels: (1) individual-level strategies (resilience in self-management); (2) family-level strategies (prioritizing family in health decisions, mitigating acculturative hurdles, and avoiding burdening family); (3) co-ethnic peer-level strategies (reciprocal information sharing and expectations of cohesion); and (4) community-level strategies (reliance on Korean-speaking healthcare providers, community services, and religious groups). The findings highlight the importance of culturally tailored services and balanced support from family, peers, and community organizations to ensure equitable healthcare access among older ethnic immigrants. Future research should explore in what ways these findings may apply to other ethnic immigrant groups in the U.S. in efforts to develop interventions toward improving health and social outcomes.