Research Activities
The Center for Aging and Diversity conducts research studies relevant to older minority populations, particularly in the area of health disparities.
Areas of Investigation
Research at the Center is concentrated in four areas:
- Dementia caregiving in diverse populations
- Family caregiving
- Social support and family health outcomes
- Health disparities
Current Research Projects
Closing the Gap on Minority Aging and Health Research
Principal Investigator: Dr. Peggye Dilworth-Anderson
Funder:
National Institute on Aging
Period: 2004-2009
Abstract: Funds from the grant will provide support to: 1) develop a research working group on minority aging and health; 2) expand the research training opportunities for post-doctoral fellows and junior faculty members in minority aging and health; 3) develop a research seminar series on ethnicity, culture, race and aging research; further develop a new course offering for graduate students across the UNC campus, particularly those in health related fields; and, 4) develop and maintain relationships with minority community-based organizations in rural and urban North Carolina to improve subject participation in research.
Train the Trainer: A Dementia Care Program and Caregiver Intervention
Project
Principal Investigator: Dr. Peggye Dilworth-Anderson
Funder: GlaxoSmithKline Global Community Partnership Program of North Carolina
Period: 2003-2010
Abstract: The purpose of this study is to conduct a two-phase dementia caregiving
training and dementia caregiver intervention project: The first phase
of this project will involve a series of interactive half-day sessions
of training to share knowledge about and skills to provide dementia caregiving.
Trainees will receive Alzheimer's trainer certification through the Alzheimer's
Association, Eastern North Carolina Chapter.
The second phase will assist the new trainees in providing an informational intervention for caregivers to elders with Alzheimer's disease and related dementias. A caregiver intervention group (those who receive the information) and a delayed caregiver intervention group (those who will receive the information at a later time) will be included. Caregivers will be assessed on knowledge about normal aging processes, dementia and its symptoms, diagnosis and treatment, caregiving skills, family dynamics and dementia care, managing problem behaviors, and developing help-seeking strategies for caregivers. Most importantly, we expect the caregiver intervention groups to differ from the delayed intervention groups regarding the use of information that leads to seeking a diagnosis and treatment of dementia and improving caregiving skills.
Perceiving and Giving Meaning to Dementia among Caregivers for African American and White Elders: Rural and Urban Differences. Funded by the Alzheimer's Association
Principal Investigator: Dr. Peggye Dilworth-Anderson
Funder: Alzheimer's Association
Period: 2003-2008
Abstract: This will address three major foci (1) it will identify and describe cultural values and beliefs that influence how families perceive and give meaning to dementia; (2) it will examine the influence of culture, geographic location, and other social factors (e.g., socioeconomic status, family cohesion) on the level and type of help caregivers seek when caring for an older relative with dementia; and (3), it will examine the influence of social factors, in particular the role of culture, on physical functioning, general health, and depression of caregivers.
Overall, this study addresses a major gap in the literature that speaks to culture, and not just race. The heuristic logic of the study is to uncover critical, but previously unstudied, cultural and social dimensions of meaning through an intensive qualitative approach. Qualitative information will be used to augment the quantitative assessments of sources of variation in health and functional status, and help-seeking behavior of family members involved in the care of elders with dementia, in a larger sample. This synthesis is expected to yield a more complete model that can be applied in a variety of cultural contexts. Most notably, findings from this study can lead to the development of culturally sensitive interventions that are appropriate and acceptable for elders with dementia and their caregivers.
Current Pilot Research
Stroke Disparities: Conceptualizing Disease Management at the Family Level
Principal Investigator: Sharon Williams, PhD
Co-Principal Investigator: Ana Felix, MD
Purpose:
The central hypothesis of this proposal is that family members function as providers of stroke-related disease management tasks, as well as coordinators and monitors of tasks and other health care services when an older family member has a stroke. The overall purpose of this proposal is to provide pilot data that will identify and classify disease management tasks of caregivers of older African Americans with moderate to severe stroke-related impairment. The specific aims are as follows:
1. Collaborate with UNC's hospital staff to create a list of African Americans over age 50 with an ICD 9 code related to stroke within the last 8 months.
2. Categorize disease management tasks of family caregivers in the caregiving networks of older African Americans with moderate to severe stroke-related impairment.
Both qualitative and quantitative research methods will be utilized in this study. Findings from this study will contribute to empirical evidence regarding needs of the family and identify roles, tasks, or combination of roles and tasks that are facilitators or barriers of better patient and family outcomes.
Stroke Rehabilitation in Two American Indian Tribal Populations.
Principal Investigator: Patricia Gregory, M.D.
Purpose:
The purpose of this study is to conduct exploratory analyses to better understand the rehabilitation experience among American Indians following stroke in North Carolina. Two American Indian Populations, Haliwa-Saponi and Lumbee, are the targeted populations for this study. Although recognized by the State, these two populations are not federally recognized; therefore, they are not eligible for Indian Health Services and will be more likely to encounter access barriers to treatment. In this study, challenges of recruitment among American Indian populations, identified barriers to rehabilitation and stroke outcomes for the Haliwa-Saponi and Lumbee populations are under investigation. Focus groups will provide information on barriers to stroke rehabilitation and details of stroke-related health outcomes. Specific aims of these focus group discussions are as follows:
1. Assess the level of education they receive about rehabilitation treatment options at the time of stroke.
2. Assess the ease at which they were able to access rehabilitation treatment options
3. Assess the level of concordance of specific needs between the patient and the caregiver.
Results of this pilot study will be utilized in development of a survey to be generated for studying patient preferences and experiences following an acute stroke.
A Structured Program of Meal-Related Blood Glucose Self-Monitoring ("Smart Checks")
Principal Investigator: Carmen Samuel-Hodge, PhD
Purpose:
The objective of the "Smart Checks" program is to assist older African Americans with type 2 diabetes in decision-making when blood glucose values (especially those take after meals) are out of range. A randomized controlled design will be used to test the short-term effects of the structured program on metabolic control and other outcome variables. Specific aims of this research are as follows:
1. Assess the program's acceptability and feasibility.
2. Investigate short-term effects of a program with structured pre- and postprandial self-monitoring of blood glucose on glycemic and lipid control,
3. Assess perceptions of general well-being and diabetes self-care competence in older non-insulin-treated African American patients with type 2 diabetes.
This pilot study will provide information on self-management approaches for African Americans with diabetes to reduce the high risk of Coronary Heart Disease.
The Future is Now: North Carolina's Emerging Populations
Principal Investigator: Ellen Roberts, PhD, MPH
Purpose: The purpose of this study is to learn about the health-related experiences and concerns of adults aged 50 and older in selected emerging immigrant populations in North Carolina (Hmong, Mexican and Russian-speaking). The data collected will help to identify the health-care needs of these specific older-immigrant populations.
The project will be conducted using a community-based participatory approach and as such will invest considerable energy in building relationships and engaging participation and securing guidance from community members. We plan to approach the community with the goal of developing a partnership that will potentially be of benefit to the community while also providing data of interest to academia. For recruitment efforts the project has developed community partnerships with the United Hmong Association in Hickory, North Carolina and with the Shamrock Senior Center in Charlotte, North Carolina and within the Hispanic community in North Carolina.
Reducing Barriers and Increasing Utilization of Exercise Programs by Older
African Americans
Principal Investigator: Bernadette R. Williams, PT, DSc, GCS
Purpose: The overall goal of my research agenda is to further increase my knowledge of health disparities and ultimately use this knowledge to develop strategies to reduce poor health outcomes of older African Americans. The initial phase of this project will examine current levels of physical activity/exercise participation among older African Americans attending two senior centers in the Durham/Chapel Hill area. Once a thorough and systematic understanding of the factors that affect participation has been acquired, this information will be used to develop and implement exercise programs that these older African Americans will utilize and adopt. Future studies will measure specific health and functional outcomes of these exercise programs and this information will be disseminated to senior centers, exercise leaders, and others interested in improving exercise participation in this population. For this proposal we use the term exercise to include physical activity as well as structure exercise programs. Specifically, this research project will address the following aims:
1) Determine level of participation of older African Americans in existing exercise programs offered at two local senior centers in North Carolina
2) Identify factors related to participation in these exercise programs, and
3) Increase the participation rate of older African Americans in onsite exercise programs and adherence with home exercise programs.
