Evaluation of Health Literacy and Depression Literacy Among Korean Americans

Low health literacy is closely related to a higher rate of hospitalization and of emergency services usage, leading to billions of dollars in avoidable health care costs and contributing to individuals’ poor physical and mental health. While Korean Americans (KAs) have a high prevalence of general health and mental health problems, relatively little is known about their health and mental health literacy, specifically their depression literacy. This study aims to evaluate KAs’ health literacy and depression literacy, as related to sociodemographic characteristics. An exploratory study was conducted with 681 community-residing adult KAs using the Center for Epidemiologic Studies Depression (CES-D) Scale, the Depression Literacy Questionnaire (D-Lit), and the One-Question Health Literacy Scale. Data analyses were performed using one-way analysis of variance and ordinal logistic regression of health literacy, a multiple linear regression model of depression literacy. Findings indicate a positive correlation between depression literacy and health literacy. Health literacy was also significantly related to religion, English language proficiency, income, education, and perceived physical health. Additionally, depression literacy was significantly related to age, Korean language preference over English, and education. Health literacy and depression literacy education are warranted to address low health literacy and depression literacy among KAs to reduce their health and mental health disparities

A Pilot Randomized Controlled Trial of a Videoconferencing Smoking Cessation Intervention for Korean American Women: Preliminary Findings

Introduction: Korean American women prefer online or telephone smoking cessation interventions that can be remotely accessed from home. However, these interventions have been found ineffective for the group. Methods: This study is a pilot clinical trial testing the feasibility and acceptability of a videoconferencing smoking cessation intervention for Korean American women and compared its preliminary efficacy with a telephone-based smoking cessation intervention. Korean women in the United States were recruited nationwide and randomly assigned at a ratio of 1:1 to either a video arm or a telephone arm. Participants in both arms received eight 30-minute weekly individualized counseling sessions of a culturally adapted smoking cessation intervention and nicotine patches for 8 weeks. They were followed up at post-quit 1, 2, and 3 months. Results: A total of 168 Korean Americans were assessed for eligibility, 77 were determined to eligible and 49 participated in the study. The videoconferencing intervention was acceptable and feasible for women under 50 years, whereas it was not for older women. The videoconferencing intervention produced abstinence rates of 67% at post-quit 1 month and 42% at post-quit 3 months based on self-report. The rate at post-quit 3 months dropped to 33% when those women whose abstinence could not be validated with salivary cotinine tests were treated as smoking. Abstinence rates in the telephone arm did not differ from those in the video arm. Conclusion: Findings suggest that videoconferencing smoking cessation intervention may be feasible and acceptable for Korean American women under 50 years. However, for older Korean American women, the intervention may not be feasible and telephone-based intervention seems to be just as effective if smoking cessation intervention components are adapted at a deep structural level of Korean culture by integrating its core cultural values and addressing psychosocial, social and environmental forces affecting the behavior

Depression, Depression Literacy, and Sociodemographic Characteristics of Korean Americans: A Preliminary Investigation

Despite the rapid growth in the number of Korean Americans (KAs) and the alarmingly high prevalence of depression in this population, relatively little is known about the impact of depression literacy on KAs’ depression. This study investigated the prevalence of depressive symptoms among a community-based sample of KA adults; the associations among socio-demographic characteristics, depression literacy, and depressive symptoms; and predictors related to depressive symptoms. A sample of 600 KAs completed depression and depression literacy scales, as well as socio-demographic questionnaires. Data analyses were conducted to assess the association between depressive symptoms, depression literacy, and the covariates. Forty-five percent of participants showed elevated depressive symptoms. Marital status attained educational level, perceived mental health, and depression literacy were significant predictors of depressive symptoms. Given the high prevalence of depressive symptoms in this population, future research should investigate the causal relationships of various predictors of depression and depression literacy, which will facilitate the development of culturally-appropriate interventions and policies concerning mental health for KAs, and early mental health screening for them

Logo-Autobiography and its Effectiveness on Depressed Korean Immigrant Women: A Replication Study

Objective: This study aimed to examine the longevity of Logo-Autobiography (LA)’s effects and to identify whether different providers and different types of LA intervention have diverse impact on the outcomes for Korean immigrant women with depression. Methods: A pre-experimental research was conducted with pre-, post-, and 4-week follow-up tests using the CES-D depressive symptoms and Purpose in Life scales. LA included a structured weekly session for 6 weeks in either individual or group setting, and autobiography writing with predesigned topics for each session. A total of 47 subjects participated in this study. Repeated measures of ANOVA were conducted to investigate if there were differences between the experimental and control groups. Results: All hypotheses were supported that the experimental group showed 1) significantly lower scores on depressive symptoms, 2) significantly higher scores on purpose in life, and 3) no differences of depressive symptoms and meaning of life scores between medication and non-medication groups, group vs. individual interventions, and among three different providers in the post-test and the 4-week follow-up test. Conclusions: LA may be considered as another alternative therapeutic intervention in treating Korean-American immigrant women who suffer from depression and lost meaning in life. Further studies are needed with a larger sample size using rigorous randomized designs to validate the effectiveness of the LA

Logo-Autobiography and Its Effectiveness on Depressed Korean Immigrant Women

This study aimed to explore the effectiveness of logo-autobiography (LA) as a therapeutic modality for Korean immigrant women suffering from depression and perceiving their lives as meaningless. A nonrandomized quasi-experimental study was conducted with pretest, posttest, and a 4-week follow-up test. Forty subjects—20 with antidepressants and 20 without—were divided quarterly and assigned to the experimental group and the control group. The experimental group reported a significant lower score on depressive symptoms (F = 6.832, p = .013; F = 19.800, p ≤ .001) and a higher score on meaning of life (F = 12.294, p = .001; F = 12.232, p = .001) than did the control group immediately after completing the LA and a 4-week follow-up. The LA was more effective for the subjects in the nonmedication group than in the medication group. In conclusion, LA is effective in reducing depressive symptoms and increasing a sense of meaning in life among Korean immigrant women suffering from depression

Socio-demographic and Health Behavioral Correlates of Depressive Symptoms among Korean Americans

This study identifies the associations between socio-demographic characteristics and help seeking behaviors for depressive symptoms among adult Korean Americans (KAs). Using survey data from 230 residents of the New York City, Teaneck, New Jersey, and Philadelphia areas, simple and multiple logistic regression analyses were performed to assess the association between depressive symptoms and the covariates. Women were at much lower risk of depressive symptoms than were men, even after adjusting other covariates (OR 0.45, 95 % CI 0.21–0.96). Having no health insurance (OR 4.02, 95 % CI 1.28–12.61) and having experience in seeking professional help for mental health problems during the last year were significantly associated with depressive symptoms (OR 2.96, 95 % CI 1.29–6.80). The findings suggest more attention to the risk of depression of KA men and further efforts on understanding the unique contribution of socio-demographic factors and health-related behaviors on depressive symptoms among KAs

Perceived Neighborhood Environment Affecting Physical and Mental Health: a Study With Korean American Older Adults in New York City

This study examined how subjective perceptions of the neighborhood environment (e.g., perceived ethnic density, safety, social cohesion, and satisfaction) influenced the physical and mental health of Korean American older adults. Using data from 420 residents of the New York City metropolitan area (M age = 71.6, SD = 7.59), health perceptions and depressive symptoms were estimated with hierarchical regression models entered in the order of (1) demographics and acculturation, (2) health-related variables, and (3) perceived neighborhood environment. After controlling for the effects of the individual-level variables, perceived neighborhood environment was found to make a significant contribution to both outcomes. Individuals less satisfied with their overall neighborhood environment were more likely to have negative perceptions of health and depressive symptoms. A strong linkage between perceived neighborhood safety and depressive symptoms was also observed. Findings from the study highlight the importance of subjective evaluations of neighborhood environment and provide implications for health promotion

Acculturation, Depression, and Smoking Cessation: a trajectory pattern recognition approach

Introduction Korean Americans are known for a high smoking prevalence within the Asian American population. This study examined the effects of acculturation and depression on Korean Americans’ smoking cessation and abstinence. Material and Methods This is a secondary data analysis of a smoking cessation study that implemented eight weekly individualized counseling sessions of a culturally adapted cessation intervention for the treatment arm and a standard cognitive behavioral therapy for the comparison arm. Both arms also received nicotine patches for 8 weeks. A newly developed non-parametric trajectory pattern recognition model (MI-Fuzzy) was used to identify cognitive and behavioral response patterns to a smoking cessation intervention among 97 Korean American smokers (81 men and 16 women). Results Three distinctive response patterns were revealed: (a) Culturally Adapted (CA), since all identified members received the culturally adapted intervention; (b) More Bicultural (MB), for having higher scores of bicultural acculturation; and (c) Less Bicultural (LB), for having lower scores of bicultural acculturation. The CA smokers were those from the treatment arm, while MB and LB groups were from the comparison arm. The LB group differed in depression from the CA and MB groups and no difference was found between the CA and MB groups. Although depression did not directly affect 12-month prolonged abstinence, the LB group was most depressed and achieved the lowest rate of abstinence (LB: 1.03%; MB: 5.15%; CA: 21.65%). Conclusions A culturally adaptive intervention should target Korean American smokers with a high level of depression and a low level of biculturalism to assist in their smoking cessation

The Role of Self-Rated Mental Health in Seeking Professional Mental Health Services among Older Korean Immigrants

Objectives: The gap between mental health needs and service use in racial/ethnic minorities continues to be a major public health concern. Focusing on older Korean immigrants, the present study examined linkages among mental distress, self-rated mental health (SRMH), and the use of professional mental health services. We hypothesized that SRMH would play a mediating role in the relationship between mental distress and the use of professional mental health services. Method: Using data from the Study of Older Korean Americans (SOKA; N = 2,150, Mean age = 73.4), the direct and indirect effect models were tested. Results: Nearly 30% of the sample fell within the category of experiencing mental distress, but only a small proportion (5.7%) had used professional mental health services. Supporting our hypothesis, the pathway from mental distress to the use of professional mental health services was influenced by an individual’s subjective perception of mental health status: the indirect effect of mental distress on service use through SRMH (.04 [.01]) was significant (bias-corrected 95% confidence interval for the indirect effect = .02, .06). Conclusion: The findings of this study not only contribute to our understanding of help-seeking processes in a group at high mental health risk but also suggest avenues to promote their use of mental health services