Chenjuan Ma, PhD

Despite being the fastest-growing racial/ethnic group in the US including over 20 subgroups, US Asians are among the least studied minority groups in health research. Align with a growing Asian population and strong negative views of nursing home replacement is an increasing need for home health care (HHC)from Asians. HHC is the fastest growing healthcare sector and the most commonly used home and community-based services for older adults, particularly among persons with dementia. However, little is known of what quality of HHC is provided to Asians and how factors with strong cultural relevance influence HHC. Build on our previous research, the specific aims of this proposed study are to (Aim 1)identify the extent to which timely initiation of care varies by dementia status, living arrangement and caregiving availability among Asian Americans when considering other individual characteristics, and organizational and neighborhood factors; and(Aim 2a) identify the role of dementia, living arrangement and caregiving availability in timely initiation of care among two Asian subgroups, Chinese and Korean Americans; and (Aim 2b) compare timely initiation of care and influence of dementia, living arrangement and caregiving availability between Chinese and Korean Americans. To achieve the aims, we will use population-based national CMS claims data and HHC assessment data(Aim 1) and HHC datasets from a local HHC agency (Aim 2a and 2b). Various statistical approaches will be used in data analysis, from descriptive statistics to multi-level hierarchical logistic regressions. This study will inform future HHC improvement for optimal outcomes of Asians.