We are grateful for the constructive comments and suggestions from the prior review to improve this application. The overall objective of this resubmission study (R01NR014846) is to conduct a population-level 3-waves longitudinal investigation of 300 adult children caregivers in order to quantify the relations between intergenerational solidarity and needs for caregivers of Chinese older adults with significant cognitive impairment. More specifically, we will conduct three waves of data collection and employ mixed effects models to examine three primary objectives: 1) Quantify the relations between intergenerational solidarity to the trajectory of caregivers' psychological distress; 2) Quantify the relations between intergenerational solidarity and caregivers' preparedness; 3) Quantify the relations between intergenerational solidarity and caregiver's help seeking behaviors in providing care for Chinese older adults with significant cognitive impairment. Our secondary objectives are to: 4) examine the gender differences in the above aims 1-3; and 5) explore the barriers, challenges, and cultural variations in adult children's expectation and adherence of intergenerational solidarity in providing care for Chinese older adults with cognitive impairment. Despite the rapid growth of Chinese populations, there is great paucity in our current understanding of caregivers' needs for Chinese older adults with significant cognitive impairment. Due to cultural beliefs, many families believe dementia is a form of mental illness. The word dementia (F) literally translates into two characters: Crazy and Catatonic. The stigma, shame and negative responses experienced by patients and families interfere with their willingness to seek appropriate medical care. This marked gap in our knowledge is further exacerbated by the linguistic and cultural complexities and nuances when studying these issues. Moreover, there has been inadequate community support necessary to empower the Chinese community to be fully engaged as equal partners in research on culturally sensitive issues. Accordingly, we will leverage principles of community-based participatory research (CBPR) to quantify the relationship between important cultural factors and caregiving needs for Chinese older adults with cognitive impairment. In this application, a bilingual and bicultural principal investigator and an experienced multi-institutional interdisciplinary team will build on our prior NIH funded CBPR projects to collaborate with Chicago Chinese community groups. The findings from this proposal will inform clinician, investigator, community, social services and policy makers to: a) identify risk/protective factors; b) better understand pathways for addressing caregiver needs; c) inform future prevention and intervention studies; and d) inform the practice and policy to improve health and wellbeing in caregiver populations.
This proposal will conduct a population-level investigation to quantify the relationship between intergenerational solidarity and trajectory of caregiver's psychological distress, caregiver preparedness and help seeking behaviors in providing care for Chinese older adults with cognitive impairment. This has implication for investigator, clinicians, community, social services and policy makers to reduce caregiver's psychological distress, to improve caregiving preparedness, and to increase help seeking behaviors in providing care for Chinese older adults with cognitive impairment.
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