Nan Sook Park

Social Engagement in Assisted Living and Implications for Practice

While it is known that social engagement is important for the well-being of older people, its role among residents in assisted living (AL) residences has not been well explored. The purposes of this study were to explore the experiences of social engagement among AL residents and explain its components and processes as unique to this setting. Qualitative data were collected via semistructured, in-depth interviews with 29 residents in four AL residences in a Southern state. Salient themes were derived using the grounded theory approach. Findings revealed the complexity of social engagement and were organized around five themes related to characteristics of desired social relationships, the perspective of time and loss, barriers to and resources for social engagement, and strategies to develop or modify relationships. AL providers could make concerted efforts to develop practices to provide residents with more social and emotional resources and help them engage in meaningful social interactions.

Religiousness and Longitudinal Trajectories in Elders' Functional Status

The purpose of this study was to examine the effects of religiousness on the trajectories of difficulties with activities of daily living (ADLs) and instrumental ADLs (IADLs) in community-dwelling older adults over a three-year period. Seven waves of data from the University of Alabama at Birmingham Study of Aging were analyzed using a hierarchical linear modeling method. The study was based on the 784 participants who completed interviews every six months between December 1999 and February 2004. Frequent religious service attendance was associated with fewer ADL difficulties and IADL difficulties at baseline. Furthermore, religious service attendance predicted slower increases for frequent churchgoers and steeper increases for less frequent churchgoers in IADL difficulties, controlling for variables related to demographics and resources. Religious service attendance was independently associated with ADL and IADL difficulties cross-sectionally. However, significant protective effects of religious service attendance were identified longitudinally only for the IADL trajectory.

The Mediating Role of Loneliness in the Relation Between Social Engagement and Depressive Symptoms Among Older Korean Americans: Do Men and Women Differ?

OBJECTIVES This study conceptualized loneliness as a mediator in the relation between social engagement and depressive symptoms and explored gender differences in the mediation model. Various indices of social engagement were considered including living arrangement, social network, and activity participation. METHOD Using data from 674 community-dwelling Korean American older adults, we first examined the mediation effect of loneliness in the relation between each of 3 indices of social engagement (not living alone, social network, and activity participation) and depressive symptoms. Subsequently, gender differences in the mediation model were examined. RESULTS As hypothesized, loneliness was found to mediate the relation between each of the indices of social engagement and depressive symptoms in both men and women. We also observed gender differences in the strength of mediating effects; the effect of living alone was more likely to be mediated by loneliness among men, whereas women showed greater levels of mediation in the models with social network and activity participation. DISCUSSION Our findings suggest that loneliness may explain the mechanism by which deficits in social engagement exerts its effect on depressive symptoms and that gender differences should be considered in interventions targeting social engagement for mental health promotion.

An Empirical Typology of Social Networks and Its Association With Physical and Mental Health: A Study With Older Korean Immigrants

OBJECTIVES In the context of social convoy theory, the purposes of the study were (a) to identify an empirical typology of the social networks evident in older Korean immigrants and (b) to examine its association with self-rated health and depressive symptoms. METHOD The sample consisted of 1,092 community-dwelling older Korean immigrants in Florida and New York. Latent class analyses were conducted to identify the optimal social network typology based on 8 indicators of interpersonal relationships and activities. Bivariate and multivariate analyses were conducted to examine how the identified social network typology was associated with self-rating of health and depressive symptoms. RESULTS Results from the latent class analysis identified 6 clusters as being most optimal, and they were named diverse, unmarried/diverse, married/coresidence, family focused, unmarried/restricted, and restricted. Memberships in the clusters of diverse and married/coresidence were significantly associated with more favorable ratings of health and lower levels of depressive symptoms. DISCUSSION Notably, no distinct network solely composed of friends was identified in the present sample of older immigrants; this may reflect the disruptions in social convoys caused by immigration. The findings of this study promote our understanding of the unique patterns of social connectedness in older immigrants.

Predicting the trajectories of depressive symptoms among southern community-dwelling older adults: The role of religiosity

Background: This study examined the effects of religiosity on the trajectories of depressive symptoms in a sample of community-dwelling older adults over a four-year period in a Southern state in the US. Methods: Data from the University of Alabama at Birmingham (UAB) Study of Aging were analyzed using a hierarchical linear modeling (HLM) method. This study involved 1000 participants aged 65 and above (M age = 75 at baseline, SD = 5.97) and data were collected annually from 1999 to 2003. The Geriatric Depression Scale measured depressive symptoms; the Duke University Religion Index measured religious service attendance, prayer, and intrinsic religiosity; and control variables included sociodemographics, health, and social and economic factors. Results: The HLM analysis indicated a curvilinear trajectory of depressive symptoms over time. At baseline, participants who attended religious services more frequently tended to report fewer depressive symptoms. Participants with the highest levels of intrinsic religiosity at baseline experienced a steady decline in the number of depressive symptoms over the four-year period, while those with lower levels of intrinsic religiosity experienced a short-term decline followed by an increase in the number of depressive symptoms. Implications: In addition to facilitating access to health, social support and financial resources for older adults, service professionals might consider culturally appropriate, patient-centered interventions that boost the salutary effects of intrinsic religiosity on depressive symptoms.

Early Adolescent Pathways of Antisocial Behaviors in Poor, Inner-City Neighborhoods

The change and stability of antisocial behavior during adolescence has triggered interest in a number of social scientific disciplines. This article longitudinally examines pathways of antisocial behavior among predominantly African American adolescents residing in inner-city, poor neighborhoods. Data were collected from 354 youth (ages 12 through 15) in an ongoing longitudinal study designed to identify the life-course trajectories of behaviors and associated developmental outcomes in inner-city youth. Growth mixture modeling was used to classify antisocial behavior trajectories, which identified three distinct developmental trajectories of antisocial behavior: high starter, incremental, and steady. Understanding developmental trajectories of antisocial behaviors is important in that it informs prevention and intervention efforts, particularly for high-risk youth populations.

Hospice Use Among African Americans, Asians, Hispanics, and Whites: Implications for Practice

Objective: This study examined the characteristics of individuals in hospice care by racial/ethnic groups. Methods: A total of 22,936 patients served by a hospice in Central Florida during a four-year period, from 2002 to 2006, were included. Of these, 80.6% were White, 9.6% were Black/African-American, 9.3% were Hispanic and 0.5% were Asian American/Pacific Islander. We examined the associations between the characteristics of hospice users and race/ethnicity, and change of hospice user characteristics over time using chi-square and ANOVA tests. Results: More females than males were represented. Spouse caregivers were most common for Whites (35%) and Asian/Pacific Islanders (36%). However, “other” (41%) caregivers were most frequent for African Americans and daughters (33%) were most often caregivers for Hispanics. Cancer was the primary diagnosis across the four groups. Racial/ethnic minorities were more likely to rely on Medicaid than Whites (10-70% vs. 4%) and African Americans were most likely to be transferred from hospital (57%), whereas Whites were referred from assisted living/nursing homes more frequently than others(16% vs. 7-10%). Conclusion: As the hospice settings become more racially/ethnically diverse, it is essential to attend to the different circumstances and needs of the various groups in providing optimal care.

Transportation Difficulty of Black and White Rural Older Adults

This study explores self-reported transportation difficulty among rural older adults, using data from the University of Alabama at Birmingham Study of Aging for community-dwelling participants (255 Black and 259 White) residing in rural areas. The authors examine the relationship of predisposing characteristics, enabling resources, and measures of need for care with self-reports of transportation difficulty. Blacks report having more transportation difficulty than Whites (24.7% vs. 11.6%; p < .05). When the authors introduce other variables, race differences disappear, but there is a race-by-income interaction with transportation difficulty. Whites with lower incomes are more likely to have transportation difficulty than Whites with higher incomes. When data from Blacks and Whites are analyzed separately, income is the only variable associated with transportation difficulty among Whites. Among Blacks, income is not related to transportation difficulty but several variables other than income (age, gender, marital status, Mini Mental State Exam scores, and depression) are.

Social Capital in Ethnic Communities and Mental Health: A Study of Older Korean Immigrants

This study examined how social capital in ethnic communities (e.g., social cohesion, community support, community participation, and negative interaction) influences depressive symptoms of older Korean immigrants. Using survey data from 209 participants in Central Texas (Mage = 69.6, SD = 7.50), hierarchical regression models of depressive symptoms were examined with the following sets of predictors: (1) demographics, (2) physical health, (3) sociocultural factors, and (4) ethnic community factors. After controlling for the multiple sets of individual-level variables previously known to be important predictors of mental health, ethnic community factors made a substantial contribution. Higher levels of depressive symptoms were observed among individuals who received lower levels of community support (β = −0.14, p < 0.05), had limited participation in ethnic community events and activities (β = −0.15, p < 0.05), and reported more frequent negative interactions with ethnic community members (β = 0.12, p < 0.05). Findings highlight the importance of social capital in ethnic communities and hold implications for improving older ethnic immigrants’ mental well-being.

The association between self-rated mental health and symptoms of depression in Korean American older adults

Objective: The study examined the association of self-rated mental health (SRMH) with three measures of depressive symptoms (the short form CES-D, GDS-SF, and PHQ-9) in Korean American older adults. Method: The sample consisted of 420 community-dwelling Korean American older adults (M age = 71.6, SD = 7.59) in the New York City metropolitan area. Hierarchical regression models of SRMH were estimated with an array of predictors: (a) sociodemographic characteristics, (b) physical health-related variables, and (c) each of the three depressive symptom measures. Results: The three measures of depressive symptoms were interrelated, and each of them made a significant contribution to the multivariate models of SRMH. The amount of variance explained by the short-form CES-D, GDS-SF, and PHQ-9 was 11%, 10%, and 16%, respectively. Conclusion: Findings show a moderately strong linkage between the measures of depressive symptoms and SRMH and invite further research on SRMH in diverse populations.