Understanding physical function in older African immigrants: the roles of acculturation and racial discrimination

摘要 在老年非洲移民中，身体功能是一个重要的公共卫生问题，因为糟糕的身体功能会导致 导致更糟糕的健康结果，影响生活质量，并使卫生系统付出高昂代价。身体机能困难有 在老年人中普遍存在；33%-40%的社区居住的老年人报告至少有一个困难。非洲移民 是增长最快的移民群体之一，其中近20%的人年龄在55岁以上。为了防止未来 对于残疾和提高生活质量的这一人群来说，有必要了解体能的体验 老年非洲移民的功能障碍。文化适应和种族歧视与较贫穷有关 其他种族/民族移民群体和土生土长的黑人的身体机能。年长的非洲移民经历 文化适应和高种族歧视比率；然而，尚不清楚这些是否影响非洲人的身体机能 移民。在贝瑞的文化适应理论和残疾过程模型的指导下，提出 研究是为了了解老年非洲移民生活在身体功能困难方面的经历；特别是 文化适应和种族歧视的作用。将使用混合方法设计以获得深入的了解 这些概念和关系在这一人群中的重要性。老年非洲移民(≥55岁)将通过以下方式招募 以社区为基础的组织，为巴尔的摩-华盛顿大都市区的非洲移民提供服务。我们会 利用20项患者报告结果测量信息系统的物理功能(PROIS-PF20)来 评估参与者在执行日常任务时的困难，如弯腰、搬杂货和洗澡。使用 PROMIS PF20在这一人群中的测量将使我们能够将参与者的身体功能结果与一般人进行比较 人口，因为使用这个量表的分数被归为一般人口的标准。本研究的具体目的有：1) 研究老年非洲移民的文化适应与身体机能障碍之间的关系。2) 确定种族歧视与老年非洲移民身体机能障碍之间的关系。 3)描述老年非洲移民的身体功能，并探讨文化适应和种族差异 歧视会影响身体机能障碍。这项研究与国家老龄研究所的目标一致 了解老年少数群体所经历的差异和健康不平等。这项研究的发现 有助于根据文化发展量身定制的干预措施，以减少老年人的身体功能困难 非洲移民，朝着减少外国人身体机能困难负担不平等的目标前进 天生的黑人。

Abstract Physical function is an important public health concern in older African immigrants because poor physical function leads to worse health outcomes, affects quality of life and is costly to the health system. Physical function difficulties are prevalent in older adults; 33-40% of community dwelling older adults report at least one difficulty. African immigrants are one of the fastest growing immigrant groups and nearly 20% of them are older than 55 years. To prevent future disability and improve quality of life for this population, there is a need to understand the experience of physical function difficulty in older African immigrants. Acculturation and racial discrimination are associated with poorer physical function in other racial/ethnic immigrant groups and native born Blacks. Older African immigrants experience acculturation and high rates of racial discrimination; however, it is not known if these affect physical function in African immigrants. Guided by Berry’s acculturation theory and the Disablement process model, the purpose of the proposed study is to understand older African immigrants’ experiences of living with physical function difficulties; in particular the roles of acculturation and racial discrimination. A mixed methods design will be used to get an in-depth understanding of these concepts and relationships in this population. Older African immigrants (≥55years) will be recruited through community based organizations that serve African immigrants in the Baltimore- Washington Metropolitan area. We will utilize the 20 item Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF20) to assess participants’ difficulties in performing daily tasks such as bending, carrying groceries and bathing. Use of the PROMIS PF20 measure in this population will enable us to compare participants’ physical function results to the general population, since scores using this scale are normed the general population. The specific aims of this study are 1) Examine the relationship between acculturation and physical function difficulties in older African immigrants. 2) Determine the relationship between racial discrimination and physical function difficulties in older African immigrants. 3) Describe the physical function of older African immigrants and explore whether acculturation and racial discrimination affect physical function difficulties. This study aligns with the National Institute on Aging’s objective to understand the differences and health inequities experienced by older minority populations. Findings from this study can contribute to the development of culturally tailored interventions to decrease physical function difficulties in older African immigrants, towards the goal of decreasing inequities in the burden of physical function difficulties in foreign born Blacks.