Limited English Proficiency, Health, and Healthcare among Older Immigrants

老年移民的英语水平、健康和医疗保健水平有限

• 批准号: 8815489
• 负责人: YURI JANG
• 金额: $ 31.15万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-15 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8815489
• 关键词: Address; American; Area; Behavioral; Binding Sites; Censuses; Characteristics; Code; Communities; Complex; Data; Development; Elderly; Ensure; Environment; Face; Florida; Focus Groups; Geographic Information Systems; Health; Health Planning; Health Service Area; Health Services; Health Status; Healthcare; Healthcare Systems; Immigrant; Indium; Individual; Intervention; Korean American; Koreans; Language; Life; Limited English Proficiency; Linguistics; Link; Maps; Measures; Modeling; Names; Neighborhoods; New York; Outcome; Participant; Pathway Analysis; Persons; Play; Population; Population Density; Population Heterogeneity; Probability Samples; Procedures; Public Health; RHOA gene; Research; Resources; Risk; Role; Services; Site; Social Network; Stress; Subgroup; Surveys; Testing; Texas; Work; aged; base; behavioral health; community based participatory research; density; effective intervention; ethnic minority population; experience; health disparity; indexing; innovation; interest; member; public health relevance; racial and ethnic; response; social

DESCRIPTION (provided by applicant): Limited English proficiency (LEP) is a unique vulnerability of older immigrants that poses a significant risk to health and healthcare. Given tha social and environmental contexts play a critical role in the lives of persons with LEP, this application investigates how social connectedness and neighborhood/community characteristics (e.g., ethnic density, health service environments in the neighborhood) influence the link between LEP and health/healthcare. We used Korean American elders as the target group. Our selection was based on the fact that they are members of a rapidly expanding LEP population (i.e., Korean is ranked 4th in the languages spoken by LEP individuals in the U.S.) and that they manifest marked disparities in health and healthcare. The project aims to explore the direct and interactive roles of social connectedness and neighborhood characteristics (1) in the relation between LEP and health and (2) in the relation between LEP and healthcare. The negative impact of LEP on health/healthcare is expected to be greater when individuals lack social connections and/or when they live in areas lack ethnically oriented resources and services. The project employs an innovative and synergistic mix of Social Network Analysis (SNA) and Geographic Information Systems (GIS). To capture the heterogeneity of the population, we will use 3 sites that combine to represent a continuum of Korean American population density: New York (high), Texas (intermediate) and Florida (low). Following focus groups with Community Advisory Boards, direct assessments of ethnic communities will be conducted. At each site, a master list of ethnically oriented services (including health services) will be generated, and each identified service will be geo-coded. Subsequently, 900 Korean Americans (aged e 65, 300 at each site) will be surveyed using a probability sampling procedure. In addition to the traditional survey measures, name-generator approaches will be used to explore participants' social network members and places for healthcare. Using SNA, information from the name generators (names and addresses of people and places) will be indexed to represent (1) social connectedness and (2) engagement with health services at the community. Using GIS, the survey data will be linked to a file combining the 2010 Census and the area resource map derived from the direct community assessment. The combined file will include variables such as proportions of Koreans in the neighborhood and general as well as ethnically-oriented area health services. Multi-Level Models (MLM) will be used to explore the research questions and hypotheses. The results will not only enhance our understanding of the mechanisms underlying LEP vulnerability but also identify individual- and community-level factors (both in people and places) that could be used in health planning and interventions. The overall approach and findings will inform how to develop effective interventions to reduce language barriers and ensure access to appropriate health services for diverse LEP populations.

描述（由申请人提供）：有限的英语水平（LEP）是老年移民的独特脆弱性，对健康和医疗保健构成了重大风险。鉴于社会和环境环境在LEP患者的生活中起着至关重要的作用，因此该应用程序调查了社会联系和社区/社区特征（例如，族裔密度，社区中的健康服务环境）如何影响LEP与健康/医疗保健之间的联系。我们使用韩裔美国长老作为目标群体。我们的选择是基于这样一个事实，即他们是LEP迅速扩大的成员（即韩国人在美国LEP个人所说的语言中排名第四），并且它们在健康和医疗保健方面表现出明显的差异。该项目旨在探讨社会联系和邻里特征（1）在LEP与健康之间的关系以及（2）LEP与医疗保健之间的关系中的直接和互动作用（1）。当个人缺乏社交联系和/或生活在缺乏以种族为导向的资源和服务的地区时，LEP对健康/医疗保健的负面影响预计会更大。该项目采用了社交网络分析（SNA）和地理信息系统（GIS）的创新和协同组合。为了捕获人口的异质性，我们将使用3个相结合的地点来代表韩裔美国人口密度的连续体：纽约（纽约），德克萨斯州（中级）和佛罗里达州（低）。遵循与社区咨询委员会的焦点小组，将对族裔社区进行直接评估。在每个站点中，将生成以种族为导向服务（包括健康服务）的主列表，每个列表将产生 确定的服务将进行地理编码。随后，将使用概率抽样程序对900名韩裔美国人（每个地点的E 65，300岁）进行调查。除了采取传统的调查措施外，名称生成器方法还将用于探索参与者的社交网络成员和医疗保健地点。使用SNA，将索引来自名称生成器（人和地点的名称和地址）的信息，以表示（1）社交联系和（2）社区中的卫生服务。使用GIS，调查数据将链接到结合2010年人口普查的文件和从直接社区评估中得出的区域资源图。合并后的文件将包括变量，例如附近的韩国人，以及以种族为导向的地区卫生服务。多层模型（MLM）将用于探索研究问题和假设。结果不仅将增强我们对LEP脆弱性机制的理解，而且还可以确定可以在健康计划和干预措施中使用的个人和社区级别的因素（无论是人和地方）。总体方法和发现将告知如何制定有效的干预措施，以减少语言障碍，并确保为不同的LEP人群获得适当的卫生服务。