Background There is growing concern of mental health issues among South Asian immigrant populations, although limited disaggregated data on determinants of these issues exists. The aim of this study was to examine factors associated with mental health outcomes among South Asian older adult immigrants living in New York City (NYC). Methods Data were sourced from a needs assessment among self‐identified South Asians aged 60+ conducted by an NYC‐based frontline agency and nonprofit organization. Variables assessed included the 9‐item Patient Health Questionnaire, degree of difficulty experienced due to depression, loneliness, emotional distress, as well as sociodemographic, living situation, acculturation, general health, and financial related indicators. Results Among the 682 responses, 9.4% of participants displayed symptoms of mild or moderate depression (16% of Caribbean‐origin, 10% of Pakistani, 9% of Bangladeshi, and 8% of Indian participants). About a third of participants (29.9%) reported feeling lonely sometimes and 39.1% experienced any type of emotional distress. When compared to those with excellent or very good self‐rated health, having fair, poor, or terrible self‐rated health was associated with a greater adjusted odds ratio (AOR) of having mild or moderate depression (AOR: 8.42, 95% confidence interval [CI]: 22.09) and experiencing emotional distress (AOR: 3.03, 95% CI: 1.88–4.94). Those experiencing emotional distress were more likely to be younger (AOR: 0.97, 95% CI: 0.95–1.00) and live alone (AOR: 2.06, 95% CI: 1.21–3.53). Discussion Findings support the need for tailored mental health interventions targeting concerns, such as poor self‐rated health, among South Asian older adult immigrants, as well as specific subpopulations such as Indo‐Caribbeans who may be experiencing a disproportionate burden.
Community-clinical linkage models (CCLM) have the potential to reduce health disparities, especially in underserved communities; however, the COVID-19 pandemic drastically impacted their implementation. This paper explores the impact of the pandemic on the implementation of CCLM intervention led by community health workers (CHWs) to address diabetes disparities among South Asian patients in New York City. Guided by the Consolidated Framework for Implementation Research (CFIR), 22 stakeholders were interviewed: 7 primary care providers, 7 CHWs, 5 community-based organization (CBO) representatives, and 3 research staff. Semi-structured interviews were conducted; interviews were audio-recorded and transcribed. CFIR constructs guided the identification of barriers and adaptations made across several dimensions of the study’s implementation context. We also explored stakeholder-identified adaptations used to mitigate the challenges in the intervention delivery using the Model for Adaptation Design and Impact (MADI) framework. (1) Communication and engagement refers to how stakeholders communicated with participants during the intervention period, including difficulties experienced staying connected with intervention activities during the lockdown. The study team and CHWs developed simple, plain-language guides designed to enhance digital literacy. (2) Intervention/research process describes intervention characteristics and challenges stakeholders faced in implementing components of the intervention during the lockdown. CHWs modified the health curriculum materials delivered remotely to support engagement in the intervention and health promotion. (3) community and implementation context pertains to the social and economic consequences of the lockdown and their effect on intervention implementation. CHWs and CBOs enhanced efforts to provide emotional/mental health support and connected community members to resources to address social needs. Study findings articulate a repository of recommendations for the adaptation of community-delivered programs in under-served communities during a time of public health crises.
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