This proposal refers to Racial/Ethnic Differences and Health Disparities; Research to disentangle the effects of socioeconomic status, social and environment factors, health behaviors and race and ethnicity on health. In order to meet the health needs of our growing ethnic minority elderly population, on of NIA's strategic goals for the next decade is to improve interventions and services for minority elderly with dementia and their caregivers. Interventions and services must be accessible to be effective. Surprisingly little research has examined help-seeking processes in dementia as a way to improve service access and thereby reduce health care disparities for minorities and women. This proposal seek funding for an in-depth, comparative qualitative study of help-seeking and barriers to care for dementia-related neuropsychiatric symptoms and behavioral problems. This study focuses on dementia neuropsychiatric symptoms because they are among the most difficult problems caregivers face in providing care to a loved one with dementia and are associated with a range of adverse outcomes. Spousal caregivers and primary care clinicians of Mexican-American (n=32) and White non-Hispanic (n=32) elderly with dementia will be recruited from the UC Davis Alzheimer's Disease Center and from an on- going epidemiological study.
Specific aims of the proposed study are: 1) to examine the impact of ethnicity and gender on explanatory models, help-seeking behaviors, and treatment preferences for dementia-related neuropsychiatric symptoms, 2) to systematically compare spousal caregiver perspectives with those of the primary care clinician who is caring for the dementia-affected elderly, and 3) to develop hypotheses about factors that influence help-seeking patterns and barriers to care for dementia mental and behavioral disturbances. In addition, this research aims to advance basic behavioral science theory and methods for help- seeking processes that may be applied to other conditions. The hypotheses generated by pilot study will be investigated in a larger, multi- site, longitudinal quantitative and/or qualitative study funded through the R01 funding mechanism.
