Search Results (14)

Background: Vast spatial mobility changes happened globally during the COVID-19 pandemic, profoundly affecting older adults’ well-being and active aging experience. This study aims to examine how the virtual environment and cyberspace, in conjunction with the physical and social neighbourhood environments, influence outdoor activities and spatial mobility for older immigrants. Methods: Four online focus groups were conducted with 25 older Chinese immigrants aged 65 and over in the Greater Toronto Area, Canada. The focus groups explored coping strategies during the pandemic and spatial mobility patterns related to different activity types such as grocery shopping, leisure activities and physical exercises, social and familial activities, and healthcare. Qualitative thematic analysis was conducted guided by the neighbourhood and health theoretical framework. Results: The overall engagement of older Chinese immigrants in various types of outdoor activities declined drastically and the spatial mobility pattern was complex. This change was shaped largely by the intersecting physical/built (e.g., residential conditions, access to public spaces), social (e.g., social support, interpersonal cohesion) and virtual (e.g., online communities and internet-based resources) environmental factors, as well as individual risk perceptions towards COVID-19 and public health interventions during the pandemic. Conclusions: Virtual environment emerged as an important domain that compensates for the heavily reduced spatial mobility of the group during the pandemic. It functioned as a vital channel for older Chinese immigrants to sustain the necessary leisure, social, and healthcare-related activities and maintain well-being during the pandemic. The study provides implications for addressing neighbourhood-level factors in policymaking and implementing initiatives to enhance active ageing experience of older Chinese immigrants. Full article

Objectives: This study compared the psychological wellbeing, life satisfaction, and perceived social support in Chinese older immigrants living in Canada between the early (i.e., Wave 1: September–November 2020) and late (i.e., Wave 2: January–February 2023) stages of the COVID-19 pandemic. Additionally, it assessed perceived social support from family, friends, or others as predictors for psychological wellbeing and life satisfaction in this population. Methods: These questions were addressed with a cross-sectional survey design with two independent samples at Wave 1 (n = 171) and Wave 2 (n = 191), respectively. Results: The results revealed lower levels of psychological wellbeing, life satisfaction, and perceived social support in Wave 2 compared to Wave 1. The hierarchical regression models identified social support from friends (but not from family or others) as a significant predictor for psychological wellbeing and life satisfaction. Additionally, a higher level of income and being a male predicted better psychological wellbeing. A higher level of income and a lower level of education predicted greater life satisfaction. Conclusions: The findings suggest a deterioration in psychological wellbeing and life satisfaction from the early to late stages of the pandemic and highlight the protective effect of social support from friends among Chinese older immigrants. Full article

Multilingual and multicultural worship can take on many models and expressions. Initially, Chinese immigration to the UK in the 1950s and 1960s led to an increased population of churches. Many Chinese church services were conducted in Cantonese, catering to the needs of first-generation immigrants, mainly from Hong Kong. Yet, the children of these older generations grew up with a bicultural hybridized identity expressed first in small English-speaking youth groups that led to English-speaking worship services within Chinese churches. Contributing to the field of worship studies through music repertoire studies over four weeks in June and July 2017 at Birmingham Chinese Evangelical Church, we raised the following questions: (1) what do the chosen worship songs represent with regards to the liturgical theology and cultural expressions of this community and (2) how is self-perception and perception of the divine expressed in the lyrical themes of these songs? Our study revealed that singing English songs from the West dominated the corporate liturgical identity of these services. Yet, through a British-born Chinese evangelical cultural reading, some lyrical themes were particularly resonant within Chinese culture, such as honor, shame, reverence, and bowing. Full article

The psychological impact of medical care accessibility during the pandemic has been widely studied, but little attention has been given to Asian immigrants in Canada. This study aimed to fill this literature gap by using a cross-sectional survey, which aimed to evaluate the impact of the COVID-19 pandemic on Chinese immigrants in North America during the second wave of the pandemic. The study focused on Chinese immigrants aged 16 or older in Canada. Covariates included sociodemographic variables, delayed access to medical care (i.e., treatment or health assessment), and other COVID-19 related variables. We used logistic LASSO regression for model selection and multivariate logistic regression models to evaluate the association between delayed access to treatment/health assessment and psychological distress outcome, as measured by the COVID-19 Peritraumatic Distress Index (CPDI). Missing data were handled using multiple imputation. Our study included 746 respondents, with 47.18% in the normal CPDI group and 36.82% in the mild-to-severe CPDI group. Most respondents were originally from Mainland China and residing in Ontario. Over half have stayed in Canada for at least 15 years. The multivariate logistic regression models identified significant risk predictors of psychological distress status: delayed access to medical care (OR = 1.362, 95% CI: 1.078–1.720, p = 0.0095), fear of COVID-19 (OR = 1.604, 95% CI: 1.293–1.989, p < 0.0001), and social loneliness (OR = 1.408, 95%CI: 1.314–1.508, p < 0.0001). Sociodemographic variables and other COVID-19-related variates did not significantly impact the study’s outcome. Our findings shed light on the importance of timely medical care access to psychological well-being among Chinese Canadians. Reliable health information, mental health support, and virtual care tailored to immigrants should be considered to mitigate this impact and promote their overall health and well-being. Full article

Chinese patients face higher risks of gastrointestinal (GI) cancers and greater cancer-related deaths than Canadian-born patients. The older population encounters barriers to quality healthcare, impacting their well-being and survival. Previous studies highlighted Chinese immigrant perceptions of not requiring healthcare support. During the COVID-19 pandemic, their underutilization of healthcare services garnered attention. The present study explores the experiences of older Chinese cancer patients to improve culturally sensitive cancer care. A total of twenty interviews carried out in Cantonese and Mandarin were conducted with Chinese immigrants, aged 60 or above, diagnosed with Stage 3 or 4 GI cancer. These interviews were transcribed verbatim, translated, and subjected to qualitative descriptive analysis. Among older Chinese immigrant patients, a phenomenon termed “Premature Acceptance: Normalizing Death and Dying” was observed. This involved four key themes: 1. acceptance and letting go, 2. family first, 3. self-sufficiency, and 4. barriers to supportive care. Participants displayed an early acceptance of their own mortality, prioritizing family prosperity over their own quality of life. Older Chinese patients normalize the reality of facing death amidst cancer. They adopt a pragmatic outlook, acknowledging life-saving treatments while willingly sacrificing their own support needs to ease family burdens. Efforts to enhance health literacy require culturally sensitive programs tailored to address language barriers and differing values among this population. A strengths-based approach emphasizing family support and practical aspects of care may help build resilience and improve symptom management, thereby enhancing their engagement with healthcare services. Full article

Due to linguistic and cultural barriers, immigrants often have limited access to health information. Online health information is popular and accessible, but quality is questionable and its benefits dependent on an individual’s eHealth literacy. This study examined online health information-seeking behaviours, eHealth literacy and its predictors among first-generation Chinese immigrants. A sample of 356 Chinese immigrants living in Australia completed an anonymous paper-based survey, including sociodemographic, clinical data, English proficiency, health literacy, online health information-seeking behaviours, and eHealth literacy. Linear regression models analyzed predictive factors of eHealth literacy. Participants were aged mean 59.3 years, female (68.3%), 53.1% completed university, and their English proficiency was rated fair/poor by 75.1%. Participants perceived online health information as useful (61.6%) and important (56.2%) to their health. Health information accessed was often related to lifestyle (61.2%), health resources (44.9%), diseases (36.0%), and medications (30.9%). Inadequate health literacy and eHealth literacy occurred in 48.3% and 44.9%, respectively. Age, number of technological devices used, education, and health status were independently associated with eHealth literacy. While most Chinese immigrants used online health information, many had inadequate eHealth literacy. Healthcare authorities and providers should support older immigrants, those with lower education and poorer health, and those less engaged with technology in online health information use by providing culturally and linguistically appropriate information, directing immigrants to credible websites, and involving them in health material development processes. Full article

Background: Older adults are vulnerable to social exclusion and its detrimental health outcomes. However, few existing studies focus on the social exclusion of older adults as immigrants and ethnic-minority individuals. To fill the gap, drawing on the conceptual framework of old-age vulnerability, this study explored the multi-dimensional experience of social exclusion for older Chinese immigrants in the U.S. and investigated how old age and immigration exacerbated older adults’ experiences of social exclusion. Method: The study included 24 in-depth face-to-face individual interviews in Los Angeles and employed thematic analysis on the qualitative data. Themes were identified until consensus was reached among the research-team members. Triangulation of multiple analysts was used to avoid analytic bias. Findings: Findings showed that older Chinese immigrants experienced social exclusion in the following dimensions: basic services; material and financial resources; social relations and activities; socio-cultural aspects; and neighborhood/territory/community. In addition to age-related factors, immigration-related factors, including changes in physical and socio-cultural environments and legal status, also contributed to older immigrants’ extra vulnerabilities to social exclusion. Conclusions: This study provides useful information and strategies for human and healthcare service providers to find ways to overcome social exclusion and enhance older Chinese immigrants’ social inclusion in the U.S. Full article

This study examined the effects of loneliness, social support, and acculturation on psychological well-being, as indexed by general emotional well-being and life satisfaction, of older Chinese adults living in Canada during the COVID-19 pandemic. A total of 168 older Chinese adults, recruited via WeChat and the internet, completed an online study through a facilitated Zoom or phone meeting, or through a website link, individually or in a group. The testing package included demographic information, The UCLA Loneliness Scale, The Multidimensional Perceived Social Support Scale, Vancouver Index of Acculturation, The Satisfaction with Life Scale, and The World Health Organization’s Five Well-Being Index. The results showed that the psychological well-being (both general emotional well-being and cognitively perceived life satisfaction) was positively predicted by perceived social support but negatively predicted by loneliness. Acculturation was not predictive of both outcomes, and it did not moderate the predictive relationships of social support or loneliness. The results shed light on the importance of community services that target enhancing social support and reducing loneliness in promoting psychological well-being of older Chinese immigrants in Canada amidst and post the pandemic. Full article

This study examined the relationship between intercultural social efficacy (ISE), coping strategies, Mandarin Chinese and English language proficiency, and depression. In total, 1870 foreign students in Taiwan participated in the study. Study results indicated that aspects of background demographics may influence depression levels. Participants with an immigrant background and those who are older are more likely to suffer from depression; however, gender and length of stay do not seem to affect depression. The moderating effects of Mandarin Chinese and English language proficiency and ISE on the relationship between coping strategies and depression were examined. Based on the results, the moderating role of Mandarin Chinese and English language proficiency was not supported, suggesting that coping strategies are independent of linguistic proficiency. However, knowing both languages is an important factor in reducing the stress of studying abroad. Additionally, the results confirmed the moderating effects of ISE, suggesting that a higher level of social effectiveness reinforces the negative association between coping strategies and depression. Students who are better able to interact with other cultures may be able to develop effective coping strategies. Moreover, this study found that although most of the study abroad students were not depressed, early intervention and prevention measures could help alleviate possible mental health crises. Full article

The majority of studies on stressful life events focus on posttraumatic stress disorder and depression, while less is known about whether the cumulative exposure to stressful life events over the life course will deteriorate cognitive function. This study aims to investigate the association between lifetime stressful life events and cognitive function in an immigrant population. The data were drawn from the Population Study of Chinese Elderly in Chicago (PINE). Face-to-face interviews were conducted with a sample of 3125 U.S. Chinese older adults in 2017–2019. Twelve types of stressful life events were assessed: physical assault, residential fires, sexual assault, miscarriage, abortion, imprisonment, being falsely accused, divorce, death of a loved one, being robbed, experiencing cancer, and being homeless. Cognitive function was measured through global cognition, episodic memory, working memory, processing speed, and Mini-Mental State Examination (MMSE). Linear regression was performed. Older adults who experienced a higher number of life events were associated with higher global cognition (b = 0.11, SE = 0.01, p < 0.001), episodic memory (b = 0.14, SE = 0.02, p < 0.001), working memory (b = 0.17, SE = 0.03, p < 0.001), processing speed (b = 1.92, SE = 0.18, p < 0.001), and MMSE (b = 0.29, SE = 0.07, p < 0.001), while controlling for age, gender, income, education, medical comorbidities, ADL, and depressive symptoms. In contrast with earlier studies, we identified the positive relationships between aggregate and individual life events and cognition. Older adults who had prior experience with stressful life events could demonstrate an advantage over those without such experiences. In addition, older adults who experienced life event(s) during adulthood and old age are associated with higher cognitive function. Further studies could investigate how individuals respond to stressful life events and how the underlying resilience mechanism would promote cognitive function. Full article

Environmental correlates, barriers, and facilitators of physical activity, healthy eating, and socializing are understudied in older immigrants to developed countries. This study developed/adapted and validated measures of perceived barriers and neighborhood environmental characteristics related to these health-enhancing behaviors appropriate for older Chinese immigrants to Australia and similar Western countries. Older Chinese immigrants living in Melbourne (Australia) were recruited from neighborhoods varying in walkability and percentage of Chinese residents. Versions of the Neighborhood Environment for Healthy Aging–Chinese Immigrants to Australia (NEHA-CIA) questionnaire (20 subscales) and the Perceived Barriers to Health-Enhancing Behaviors questionnaire (four subscales) were developed from extant validated scales and information collected in formative qualitative research. Thirty-one participants took part in cognitive interviews aimed to pilot-test and refine the questionnaires. The modified questionnaires were administered to 52 participants twice, two weeks apart. Test-retest reliability (intraclass correlation coefficients), internal consistency (Cronbach’s α), and construct validity (associations with theoretically-relevant constructs) were examined. Most items and subscales of both questionnaires had good test-retest reliability and internal consistency, while the NEHA-CIA also showed good construct validity. Future studies need to further examine the construct validity of the questionnaire of perceived barriers and determine the factorial validity of both measures on large representative samples. Full article

This study examines the influence of self-rated health and subjective economic status on the life satisfaction of older Chinese immigrants in the United States. Data were obtained from a cross-sectional survey of 205 older Chinese immigrants aged 66 to 90 years living in Los Angeles and Honolulu. Ordinary Least Squares (OLS) regression analysis was employed to explore the independent effects of self-rated health and subjective economic status. The results demonstrated that self-rated health and subjective economic status were positively associated with life satisfaction. This cross-sectional study provides empirical evidence that self-rated health and subjective economic status are directly associated with subjective life satisfaction among older Chinese immigrants. Full article

Nepali people are one of the ethnic minority immigrants of Hong Kong. This epidemiological investigation aims to determine and compare the knowledge level and hand hygiene (HH) behaviour of the Nepali people and the population of their host country (i.e., native Chinese population of Hong Kong). A total of 1008 questionnaires were collected via an online platform. The overall knowledge level of the native population towards HH was considerably higher than that of the Nepali respondents. Lower levels of knowledge in young and older people were noted. Reduced HH knowledge was also observed in people with low educational level or with comorbid illness(es). Significant differences between groups were noted in the self-reported hand washing behaviours. Regarding hand drying, more Nepalese than native Chinese respondents always/sometimes dried their hands on their clothing irrespective whether after performing handwashing in public washrooms or at home. Misconceptions and suboptimal practices on HH were prevalent in the two populations. The findings of this comparative study offer valuable information for the development of culturally sensitive health educational programs to enhance HH practices for the ethnic minorities and native Chinese population. Full article

Background. The purpose of this study was to identify factors associated with the national cervical cancer screening behaviors of married female immigrants living in South Korea. Methods. The present study dataset was collected by the National Health Insurance Services in 2014–2015. A final study population of 15,935 was considered eligible for inclusion in this study if they met the criteria for participation in the national cervical cancer screening program in 2014–2015. Results. Of the 15,935 subjects, 7837 (49%) participated in cervical cancer screening. Based on the results of the logistic regression analysis of the association between cervical cancer screening behaviors and related factors, the odds ratio (OR) for participation in cervical cancer screening among individuals older than 50 years was the highest (OR: 2.13; 95% confidence interval (CI): 1.82–2.51), and the OR increased as their duration of stay in South Korea decreased. The OR of Chinese women for cervical cancer screening participation was higher than that of non-Chinese women (OR: 1.83; 95% CI: 1.69–1.99). The OR value was 29.4 (95% CI: 25.9–33.3) among those who participated in the general health screening compared with those who did not participate. Conclusions. To improve awareness about cervical cancer screening and reduce disparities in access to healthcare, appropriate programs should be developed to promote cervical cancer screening participation to socially vulnerable classes. Continuous social attention is needed to address these issues and encourage participation in general health screening to improve the rate of cervical cancer screening. Full article