Caregiving

Mason researchers develop first social media intervention for Chinese American dementia caregivers

Mary Cunningham — Wed, 02 Nov 2022 14:06:40 +0000

Mason researchers develop first social media intervention for Chinese American dementia caregivers Mary Cunningham Wed, 11/02/2022 - 10:06

In This Story

Y. Alicia Hong, PhD

Led by Alicia Hong, professor of Health Administration and Policy, the interdisciplinary team developed a culturally-tailored WeChat wellness program to improve caregiver skills and reduce their stress.

More than 6 million Americans aged 65 years and older are living with Alzheimer's disease or related dementias (ADRD). More than 11 million family caregivers of ADRD provide an estimated 15.3 billion hours of unpaid care valued at $255.7 billion a year. Family caregivers of ADRD experience high rates of psychosocial distress and negative health outcomes. Minority and immigrant family caregivers face additional barriers; however, few culturally tailored mobile health (mHealth) were designed for these populations.

To address this public health need, ��AV researcher Alicia Hong, professor of Health Administration and Policy, led a multidisciplinary research team to develop Wellness Enhancement for Caregivers (WECARE) program to improve caregiving skills, reduce distress, and improve psychosocial well-being of underserved Chinese American family caregivers of ADRD. The protocol development of WECARE was recently published on JMIR Aging. To the best of the researchers’ knowledge, this is the first culturally tailored social media-based interventions for Chinese American dementia caregivers.

According to Hong, several cultural factors can influence caregivers’ experience. Chinese American family caregivers tend to keep problems within the family and do not seek external help because of the stigma associated with dementia and their cultural value of “saving the face.” The isolation is exacerbated by their minority and immigrant status, and those without English proficiency are further marginalized. Caregivers have limited knowledge and use of formal care and support services; they are also disconnected from “mainstream” dementia support groups due to language and cultural barriers.

“We developed this wellness program for Chinese American caregivers with the specific barriers they face in mind. We wanted them to see themselves in the program and get the most out of it to help them and the family member they care for. We hope more mHealth interventions can be developed for immigrant and minority caregivers,” said Hong.

WECARE is a seven-week mHealth program delivered via WeChat, a social media app popular among Chinese Americans. By subscribing to the WECARE official account, users can receive multiple interactive multimedia articles pushed to their WeChat accounts each week. Users also have the option of joining group chats for peer support.

Other team members of WECARE include Kang Shen, a recent Mason graduate from the Health Informatics master’s program; Kate Lu and Hsiaoyin Chen from Chinese Culture and Community Center, Inc; Yang Gong of University of Texas Health Science Center at Houston School of Biomedical Informatics; Van Ta Park of University of California San Francisco School of Nursing; and Hae-Ra Han of Johns Hopkins University School of Nursing.

The team is currently testing the feasibility and effectiveness of WECARE. The study was funded by Virginia Center for Aging Alzheimer’s and Related Diseases Research Award Fund. The study protocol was approved by the Institutional Review Board of ��AV.

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In sickness and health: the influence of paid leave on employee commitment

Taylor Thomas — Tue, 18 Oct 2022 18:23:45 +0000

In sickness and health: the influence of paid leave on employee commitment Taylor Thomas Tue, 10/18/2022 - 14:23

In This Story

Priyanka Anand, PhD

George Mason Associate Professor of Health Administration and Policy discusses the importance of job-protected paid leave.

Priyanka Anand, PhD

According to surveys conducted by the U.S. Department of Labor in 2018, only 56 percent of Americans have access job-protected leave afforded by the Family and Medical Leave Act (FMLA), leaving 44% of Americans ineligible for this coverage because they haven’t been employed long enough or their workplace is too small.

The FMLA grants employees the ability to take an unpaid leave of absence to care for loved ones in the event of an unforeseen illness or disability. Because many Americans cannot afford to hire professional care providers when a family member falls ill or has a disability, they are often left with the responsibility of providing the care themselves, which is referred to as informal care. For this reason, many people are forced to reduce hours working a paying job to attend to their informal care duties, causing severe loss in income and risking losing their job entirely.

Associate Professor in the Department of Health Administration and Policy at ��AV Dr. Priyanka Anand’s research centers on social safety net programs with a particular focus on disability policy and paid leave. Her most recent research, titled “The role of paid family leave in labor supply responses to a spouse’s disability or health shock,” was featured in the 2022 Economic Report of the President.

Anand’s research provides insight into the influence of paid leave on labor supply decisions and labor force participation. She shares her knowledge of how health shocks affect families and disrupt employment and is available for further comment.

What is difference between FMLA, parental leave, and paid family or caregiving leave?

The Family and Medical Leave Act (FMLA) was established in 1993 to guarantee 12 weeks of job-protected leave for individuals who are away from work due to medical conditions. FMLA is most known for maternity leave, but also covers long and short-term health conditions and caring for a sick or disabled family member. Job-protected leave, like FMLA, means their job will be available when they return from leave; however, employers are not required to compensate employees while on leave.

Parental leave can be paid or unpaid depending on an individual’s place of employment. Parental leave is given on a company-by-company basis and is not guaranteed in the United States. Paid family or caregiving leave, on the other hand, allows employees to take compensated leave to care for a family member experiencing a health condition.

What factors should someone consider when deciding whether to take time off to care for a family member?

When faced with the prospect of caring for a family member, individuals should closely consider their options and understand the potential outcomes of each. My research provides a framework of three pathways people generally take after a family member’s health shock. The first is to continue working and either provide informal care in addition to working or rely on formal care, which can be costly. The second is to take a short period of leave (either paid or unpaid) and eventually return to work. The third pathway is leaving the workforce entirely to provide full-time informal care.

Individuals oftentimes have to choose between the lesser of evils when faced with what to do about a loved one’s care, all of which result in some form of financial consequence both in the household and on the broader economy. The availability of paid leave can play an important role in this decision as well.

What would the addition of state or federal paid leave policies mean for American workers?

In states that have paid leave policies, the length of paid leave ranges from six to 12 weeks, but most states do not have any paid leave policies at all. In April 2021, President Biden proposed the American Families Plan which would have federally ensured all workers in the U.S. are guaranteed 12 weeks of paid family leave. Unfortunately, it did not pass through Congress in the Inflation Reduction Act.

The availability of paid leave and job protection is designed to offset the financial burden of the health shock. Paid family leave allows workers to maintain a steady income while finding a permanent solution for their long-term caregiving needs, rather than choosing between losing earnings or paying for formal care. The ultimate goal of paid family leave is to alleviate the emotional and financial burdens that come hand-in-hand with a family member experiencing an illness or disability, allowing the individual to maintain their participation in the labor force and improve their overall well-being.

In addition to the cost-saving benefits, paid family leave policies have the potential to alleviate gender workforce disparities given that the burden of caregiving often falls onto women.

Priyanka Anand is an associate professor in the Department of Health Administration and Policy at ��AV. She is a renowned researcher whose work includes estimating the effect of the ACA Medicaid expansions on federal disability insurance applications, examining the relationship between rising health insurance costs and employee compensation, and analyzing the time use of people with disabilities. Anand’s novel findings on paid family leave, which are in the 2022 Economic Report of the President and published in the Journal of Health Economics, identify implications for the future of federal paid leave policies.

For more information, contact Michelle Thompson at 703-993-3485 or mthomp7@gmu.edu.

About Mason

��AV, Virginia’s largest public research university, enrolls 39,000 students from 130 countries and all 50 states. Located near Washington, D.C., Mason has grown rapidly over the last half-century and is recognized for its innovation and entrepreneurship, remarkable diversity, and commitment to accessibility. In 2022, Mason celebrates 50 years as an independent institution. Learn more at http://www.gmu.edu.

About the College of Health and Human Services

The College of Health and Human Services prepares students to become leaders and to shape the public's health through academic excellence, research of consequence, community outreach, and interprofessional clinical practice. The College enrolls more than 1,900 undergraduate and 1,300 graduate students in its nationally-recognized offerings, including 6 undergraduate degrees, 13 graduate degrees, and 6 certificate programs. The college is transitioning to a college of public health in the near future. For more information, visit https://chhs.gmu.edu.

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CHHS Research

Department of Health Administration and Policy

Introducing the Innovate for Good Series

John Brandon Cantrell — Fri, 04 Feb 2022 13:52:43 +0000

Introducing the Innovate for Good Series John Brandon C… Fri, 02/04/2022 - 08:52

Innovate for Good is a new ongoing series that examines how faculty in the College of Health and Human Services are improving health outcomes using technology such as artificial intelligence, virtual reality, and personal apps.

Part I: Reducing Caregiver Stress & Improving Recovery Cues

By its very nature, the practice of social work involves people. After all, the definition of social work is, essentially, people helping people. But in an era of artificial intelligence, virtual reality, and machine learning, technology is playing an increasingly central role in how people help people.

In ��AV’s College of Health and Human Services, faculty members from the Department of Social Work are embracing technological innovation in its many forms to advance the practice of social work.

“In the field of social work, our goal has always been to figure out how to help those in our communities, whether through practice, organizational leadership, or policymaking,” said Emily S. Ihara, chair of the Department of Social Work. “What’s new is that we’re looking at fresh ways to gather more data to assess how we can best and most efficiently create social change.”

Innovate for Good begins with two ways researchers are using apps and virtual reality to improve the lives and health of those they work with.

Managing and Minimizing Caregiver Stress with a Phone

Caregiver burnout? There’s an app for that.

Funded by a Virginia Center on Aging, Alzheimer’s & Related Diseases Research Award Fund (ARDRAF) grant of $45,000, Ihara and Cathy Tompkins, professor of Social Work, are working with developers Ram Balasubramanian and Atreya Chaganty to help those who provide care for people living with dementia.

They are evaluating use of an app called Zelar developed by health care company Mantrah. This app will be geared toward caregivers with the intent of helping them manage the care of both the dementia patients they help and themselves.

“Care partners are often overwhelmed,” said Ihara. “The idea is that caregivers will enter information about different aspects of the care plan and they will be given reminders and helpful tips to provide organization.”

The app will have several features, including care plan creation, the ability for collaboration with other caregivers, plus self-care plans, a journaling option, and insights that provide feedback to caregivers on their reported performance.

“We’re trying to see if we can use technology to reduce caregiver stress,” said Ihara.

The project, Managing Mental Health Through Technology: Examining the Effects of Collaborative Care Management Technology Application, is being developed with Mantrah.

“In the field of social work, our goal has always been to figure out how to help those in our communities, whether through practice, organizational leadership, or policymaking. What’s new is that we’re looking at fresh ways to gather more data to assess how we can best and most efficiently create social change.”

Emily S. Ihara, Chair of the Department of Social Work

Harnessing the Power of Recovery Cues with Virtual Reality

A multidisciplinary team of researchers, working across four colleges and centers at Mason, is using technology to develop customized, real-time recovery supports to prevent drug relapse.

The research team is made up of Holly Matto in the Department of Social Work, along with Padmanabhan Seshaiyer in Mason’s College of Science, Stephanie Carmack in Mason’s Center for Adaptive Systems of Brain-Body Interactions, Nathalia Peixoto in Mason’s Volgenau School of Engineering, Siddharth Bhattacharya in Mason’s School of Business, plus graduate students in engineering Vinicius Zanini and Bryce Dunn and in social work Cate Feldkamp, as well as Rudra Nagalia, a Mason intern and student at the Birla Institute of Technology and Science, in Pilani, India.

The team hypothesizes that they can disrupt the drug trigger-craving-relapse cycle by reorienting people to what is personally rewarding in their lives and regulating the brain and body’s response to drug triggers. These are known as recovery cues.

This idea was inspired by Matto’s work in the field of addiction and from the lived experiences of people in recovery. After treatment, individuals often go back to the same environments that trigger a desire to use drugs, resulting in a need for ongoing, consistent support.

“Because craving can still be quite intense even after months of abstinence, real-time interventions to support recovery are essential to preventing relapse long-term,” said Matto. Examples of recovery cues include music, soundscapes, inspirational quotes, and more.

The Mason team and its industry partner, Brightline Interactive, are examining the effects of recovery cues using virtual reality simulations. The work is being supported by a grant from the National Institutes of Health’s National Institute on Drug Abuse through a Small Business Technology Transfer (STTR) Grant.

“Rather than focusing on drug triggers, our team believes that by focusing on the rewarding parts of their lives, their recovery cues and supports, individuals in recovery can strengthen and grow,” said Matto.

Virtual reality is unique among other technological enhancements in that it can recreate some elements of the social situations and physical environments that typically trigger relapse, allowing patients to practice skills they will need when they encounter such situations in real life.

Along with investigating recovery cues using virtual reality, the team is developing their Recovery Engaged Mind (REMind-h) app. In this app, individuals in recovery will be able to upload their customized recovery cues according to their preferred sensory modality (visual, auditory, tactile) and content category (people, places, objects), and be able to access these cues when experiencing intense craving.

Innovate for Good is an ongoing series that examines how Mason faculty in the College of Health and Human Services are harnessing technology to improve health outcomes.

Topics

Healthcare Technology

Addiction

Recovery

In the George