Yu-Ping Chang

Background: While both older adults receiving assistance with daily living tasks for health or functioning reasons and the family members or kin-like friends who help them are affected by the context of caregiving, little is known about how their interactions might simultaneously affect each other’s well-being. Objective: This study aimed to determine the influence of intrapersonal factors on health outcomes for dyads of older adults and their family caregivers and examine the moderating effect of dementia status on these associations. Methods: Cross-sectional dyadic data were obtained from the National Health and Aging Trends Study (NHATS; Round 12, 2022) linked to the National Study of Caregiving (NSOC; IV, 2022), yielding a sample of 1,560 older adults paired with their respective primary family caregiver, defined as the person providing the greatest number of hours of care. A series of actor–partner interdependence models (APIMs), which statistically account for nonindependent observations, examined associations between older adults’ and caregivers’ positive affect, negative affect, and self-realization on both their own and each other’s mental health (depression and anxiety) and perceived general health. A second series of APIMs explored interactions between predictors and dementia status of the care recipient. All models controlled for dyad members’ own age, gender, race/ethnicity, and dementia status. Results: Dyad members’ positive affect, negative affect, and self-realization were significantly associated with their own depression, anxiety, and perceived general health. Additionally, caregivers’ negative mood was associated with their care recipients’ symptoms of depression, and older adults’ self-realization was associated with their caregivers’ perceived general health. Dementia status of the older adult was also found to moderate the relationship between older adults’ positive affect and their own depression. Probing revealed that this relationship was stronger for older adults with dementia than for those without dementia. Discussion: Considering caregiving dyads together provides a more holistic perspective. Intrapersonal factors are potentially modifiable aspects of caregiving contexts, and addressing older adults and their family caregivers simultaneously could be synergistically beneficial.

Background: Older immigrant adults are at an increased risk of depression due to factors such as low acculturation, language barriers, and social isolation. In Chinese communities, a strong cultural stigma surrounding mental health further exacerbates these challenges. However, limited knowledge exists about how Chinese immigrants self‐manage their depression. This study aimed to increase the understanding of strategies and challenges of self‐management practices among older Chinese immigrants who are living with major depressive disorder (MDD). Methods: A qualitative study design was employed, with participants recruited from a psychiatric clinic in New York City. Participants first completed a demographic survey to capture their characteristics, followed by semistructured individual interviews to explore their experience of self‐management of depressive symptoms. Data were analyzed using descriptive statistics and grounded theory approach. Findings: Seventeen older Chinese immigrants with MDD were recruited. Their average age was 60.53 (SD: 6.47; range: 51–75) years, 52.9% were male, and 70.6% were married. Strategies of self‐management included seeking help and adhering to treatment, finding comfort in supportive relationships and social engagement, engaging in enjoyable activities, and practicing acceptance and letting go. Challenges to self‐management included failing to recognize underlying emotional problems, fighting cultural stigmas and misconceptions, encountering help‐seeking barriers as immigrants, and ongoing struggles with medication reliance and concerns about side effects. Conclusions/Implications: Our findings revealed that participants developed individualized strategies to manage depressive symptoms and maintain balance in their daily lives. Healthcare providers should assess older adults’ perception of depression, understand the challenges they face in self‐management, and provide tailored interventions for those struggling to manage depressive symptoms. Furthermore, efforts to deliver culturally sensitive, collaborative care should include enhancing mental health literacy, increasing public awareness, and implementing antistigma interventions for this population.

Despite efforts to promote inclusivity in behavioral health research, Black communities remain significantly underrepresented. There is a critical gap in research examining their own perspectives regarding research participation, which fails to capture their unique health disparities or responses to treatment, reducing the generalizability and effectiveness of medical interventions. The purpose of this study was to explore perceptions of research participation among Black adults residing in Western New York and identify factors that influence their willingness for research engagement. This qualitative study used semi-structured interviews with 95 Black participants in Western New York who were enrolled in a randomized controlled trial of a behavioral health intervention. Thematic analysis identified key themes related to motivations, barriers, and recommendations for improving engagement in research. Two main areas of focus emerged: (1) participants' perceived benefits of research participation and (2) their recommendations for increasing representation in research. Within these areas, six key themes were identified. Participants emphasized the importance of well-being, advocating for racial representation in research, and mental health promotion. They also revealed that community involvement, accountability, and dynamic recruitment by researchers are essential strategies to increase Black engagement. Research participation among Black communities is influenced by historical context, perceived personal and communal benefits, and the behavior of researchers themselves. Future studies should prioritize community-based participatory research (CBPR) to improve relationship-building, inclusion, and culturally attuned behavioral health research.

Elder mistreatment (EM) is an important public health issue. Guided by the Andersen’s Behavioral Model of Health Services Use, this study aimed to examine factors that impede or facilitate help-seeking behaviors among U.S. Chinese older adults who reported EM. Data were from the Population Study of Chinese Elderly in Chicago (PINE). Different types of mistreatments and help-seeking behaviors were assessed. Descriptive statistics and multinominal logistic regression were used to examine the factors associated with help-seeking. Among 450 participants who reported EM, 46.55% experienced psychological mistreatment, 29.91% had financial exploitation, 14.92% had caregiver neglect, 4.68% had physical mistreatment, and 1.11% had sexual mistreatment. Compared to those who did not seek help, EM victims who were female, married, perceived more social support, experienced financial exploitation, and experienced caregiver neglect were more likely to seek help from informal resources. EM victims who had higher income and perceived more social support were more likely to seek formal resources. EM victims who were female, experienced financial exploitation, and experienced caregiver neglect were more likely to seek help from both resources. Our findings reported the predisposing factors, enabling resources, and need factors that impacted seeking help from informal or/and formal resources among mistreated older Chinese Americans. Immigrants may be exceptionally socially isolated, and culturally specific barriers may substantially impact their motivations to seek help. Our findings suggested that greater attention to the provision of informal and formal social support can increase the effectiveness of prevention and intervention strategies in this vulnerable population.

This study investigates the mediating effect of intraminority gay community stress on the relationships between sexual minority stress and mental health problems-including loneliness, depression, anxiety, and suicidality-among gay and bisexual men (GBM) in Taiwan. A total of 736 GBM were recruited from August 2021 to May 2022. Intraminority gay community stress was assessed using the Traditional Chinese Version of the Gay Community Stress Scale. The Homosexuality-Related Stigma Scale measured perceived familial sexual stigma. The Measure of Internalized Sexual Stigma for Lesbians and Gay Men quantified internalized sexual stigma. Scores from the latter two scales were combined to form an overall sexual minority stress score. Intraminority gay community stress significantly mediated the effects of sexual minority stress on loneliness (regression coefficient = 0.34, 95% confidence interval [CI]: 0.21, 0.50), depression (regression coefficient = 1.43, 95% CI: 1.03, 1.93), anxiety (regression coefficient = 1.21, 95% CI: 0.85, 1.69), and suicidality (regression coefficient = 0.09, 95% CI: 0.05, 0.14). The findings confirm that intraminority gay community stress acts as a mediator between sexual minority stress and mental health outcomes in GBM. Addressing both forms of stress is crucial for improving mental health interventions targeted at this population.

Purpose: To determine the mediating effects of the quality of family caregivers' relationships with their older adult care recipients on the association between care-giver burden and caregivers' mental health and perceived general health. Method: Participants included 2,431 family/informal caregivers from the 2022 National Study of Caregiving. Mediator path analysis models adjusting for caregivers' age, sex, and race/ethnicity were used to test the direct and indirect effects of caregiver burden on mental health and perceived general health via the caregiving relationship. Results: Quality of the caregiving relationship partially mediated the association between caregiver burden and mental health, and also partially mediated the association between caregiver burden and perceived general health. Conclusion: Caregiver burden and quality of the caregiving relationship are influential factors in caregiver health. Strategies addressing caregiver burden and the caregiving relationship simultaneously could yield potential benefits. [ Journal of Gerontological Nursing, 51 (5), 27–34.]