What contributes to older Korean American immigrants becoming frail? A qualitative study

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Abstract
Background: Frailty is prevalent in older adults and represents a dynamic condition that can improve with early detection and interventions focused on influencing factors. Older immigrant populations, marked by diverse cultural backgrounds, distinct health beliefs and behaviors, language barriers, and low health literacy, require a focused exploration of factors influencing frailty. This study examines the perceived factors affecting frailty among older Korean American immigrants (OKAIs). Methods: A focus group interview was conducted with nine OKAIs (five frail/prefrail and four robust) in Alabama, supplemented by demographic and health-related surveys. Semi-structured questions addressed health literacy, physical activity, nutrition, and mental health. Data analysis included both descriptive and content analysis methods. Results: Participants displayed notable differences in health literacy scores between Korean and English assessments. Content analysis highlighted that social activities, health behaviors, and healthcare utilization for OKAIs were shaped by distinct environmental and healthcare contexts compared to those in Korea. Limited English proficiency and access to healthcare resources further influenced their experiences. Participants expressed a preference for Korean healthcare providers, interpreters, and traditional food options to maintain well-being. Conclusion: Interventions aimed at preventing and managing frailty among OKAIs should consider their unique characteristics and challenges to improve effectiveness.

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