Sociocultural Determinants of Recovery, Health, and Community Participation in Underserved Asian American Rehabilitation Populations - Background: Despite rapidly increasing population growth, Asian Americans with disabilities are highly underserved by rehabilitation care providers and disability services. This is likely due to sociocultural factors (e.g., cultural beliefs about health, language issues, ethnicity of health care providers), although the relationships between these factors and rehabilitation outcomes remains unclear. Research on rehabilitation, health outcomes, and community participation in Asian Americans with the most severe disabilities is critically needed.
Objectives: The study aims to assess and characterize cultural values, beliefs, and subjective experiences which underlie rehabilitation care related decision-making, and to relate these factors to the outcome indictors across different Asian American subgroups.
Methods: The sample will include up to 75 Asian American patients with the most severe disabilities discharged from inpatient rehabilitation and their caregivers. The study will employ a mixed methods design, using a combination of objective ratings of trust, satisfaction, and alliance with rehabilitation providers, as well as community participation, mental and behavioral health, and overall quality of life. Qualitative data collection will involve subjective semi-structured interviews focusing on perception of health and disability, experiences with medical and rehabilitation services, care-related decision-making processes, and perception of recovery and current functioning. Analyses will include between group comparisons, bivariate correlations, hierarchical regressions, and qualitative content analysis.
Results: Results will characterize the sample of Asian Americans with disabilities due to brain and spinal cord injuries. Between group comparisons and bivariate correlations will reveal the associations between these baseline characteristics and outcome variables (i.e., psychological health, quality of life, and community participation). Hierarchical regression models will determine the impact of demographic variables, medical and injury characteristics, and participant experiences (i.e., ratings of trust, alliance, and satisfaction of care) on treatment indicators. Qualitative content analysis will be performed to identify emergent themes from qualitative data. These themes will contextualize the results of quantitative data analysis, such that prominent sociocultural factors which underlie care-related decision-making are elicited.
Conclusions: In order to improve the community outcomes of Asian Americans with disabilities, findings from the study will determine the primary sociocultural factors that influence their decisions regarding treatment engagement, health outcome, and meaningful community participation. These findings will facilitate establishment of guidelines for multicultural training for rehabilitation care providers, as well as guidance for future diversity-related research in disability and rehabilitation psychology.
