Date of Award
Doctor of Philosophy (PhD)
Yin-Ling Irene Wong
Older Asian Americans (OAAs) represent one of the largest and the fastest growing older minority populations nationwide. The striking growth and intra-group diversity of OAA underline the urgency for an improved understanding of ethnic Asian groups' health care access and service utilization patterns. This dissertation therefore examines health seeking and utilization behaviors among OAAs. It consists of two studies. The first study used secondary data from the 2011-2012 California Health Interview Survey (CHIS) to explore health service utilization (HSU) patterns among OAAs. Bivariate and multivariate regression analyses were conducted to examine the significant factors associated with physician visits, emergency department (ED) visits, and hospitalization, focusing on psychological distress as the key independent variable. The study findings suggest that psychological distress was associated with the utilization of ED services among older Korean and Chinese Americans. Other significant factors associated with HSU included self-reported health, length of residence in the U.S., and English proficiency. ED encounters may therefore represent opportunities to identify older Korean and Chinese Americans with psychological distress and initiate appropriate treatment.
The second study is a qualitative study that examined culturally-informed perceptions of dementia and barriers/facilitators in accessing/providing dementia-related services from the perspectives of older Korean and Chinese immigrants, their family caregivers, and home care providers. In-depth face-to-face interviewers were conducted with 12 older Asian immigrants and 12 family caregivers. Three semi-structured focus group sessions were conducted with home care professionals and ethnic home health aides. Data were analyzed using the conventional content analysis approach. Six themes emerged: perceptions and attributions of dementia, delayed help-seeking, perceived barriers in accessing care, caregiving burdens, barriers in providing care, and service needs. The findings underscore the importance of culture in shaping perceptions of dementia and related help-seeking behaviors. Culturally and linguistically appropriate training and educational programs should be developed to enhance awareness and knowledge of dementia in the Asian community to facilitate timely help-seeking. Culturally and linguistically appropriate social services are imperative to address the emotional and social needs of older Asian immigrants and their family caregivers.
Kong, Dexia, "Health Services Utilization Among Older Asian Americans" (2018). Publicly Accessible Penn Dissertations. 2836.