IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v75y2012i10p1769-1777.html
   My bibliography  Save this article

“Community ambassadors” for South Asian elder immigrants: Late-life acculturation and the roles of community health workers

Author

Listed:
  • Blair, Thomas R.W.

Abstract

Elder immigrants face multiple barriers to accessing health care and other basic services. The Community Ambassador Program for Seniors (CAPS), based in Fremont, California, trains volunteer “ambassadors” from several ethnic and faith communities to perform information and referral services for elders, particularly immigrants. The purpose of this study is to examine the roles of ambassadors in ecologic context as community health workers (CHWs) for clients undergoing late-life acculturation. Ambassadors from three different communities, all of South Asian heritage, were interviewed using a semi-structured guide. 20 out of 23 ambassadors from these communities participated, from December 2008 to December 2009. Data collection and analysis followed grounded theory methodology. Results are presented as an integrated explanatory model, with three major components: (1) acculturative stress, particularly within elders' families; (2) polygonal relationships, a construct that includes elders, their caregivers, CHWs, and service providers, and builds on the notion of a “geriatric triad” (Adelman, Greene, & Charon, 1987); and (3) role hybridity, a novel explanation for CHWs' social niche. Ambassadors mediated elder clients' acculturation both inside and outside elders' families. As such, ambassadors worked in polygonal relationships with elder clients and elders' children, rather than simply working in dyads with elder clients themselves. In the CAPS context, this polygonal framework integrates intra-familial and extra-familial acculturative dynamics into a single relational model. Within these relationships, CHWs exhibited hybridity of social roles, integrating familial and professional attributes, but fully achieving neither familial nor professional status. Practical implications, including importance of outreach to elders' children, accessibility of social programs, and the consequences of role hybridity as a property of CHW identity and function, are discussed.

Suggested Citation

  • Blair, Thomas R.W., 2012. "“Community ambassadors” for South Asian elder immigrants: Late-life acculturation and the roles of community health workers," Social Science & Medicine, Elsevier, vol. 75(10), pages 1769-1777.
    • Handle: RePEc:eee:socmed:v:75:y:2012:i:10:p:1769-1777
    DOI: 10.1016/j.socscimed.2012.07.018
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S027795361200559X
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2012.07.018?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Sadhna Diwan, 2008. "Limited English Proficiency, Social Network Characteristics, and Depressive Symptoms Among Older Immigrants," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 63(3), pages 184-191.
    2. Ghosh, C., 2003. "Healthy People 2010 and Asian Americans/Pacific Islanders: Defining a Baseline of Information," American Journal of Public Health, American Public Health Association, vol. 93(12), pages 2093-2098.
    3. Ishikawa, Hirono & Roter, Debra L. & Yamazaki, Yoshihiko & Takayama, Tomoko, 2005. "Physician-elderly patient-companion communication and roles of companions in Japanese geriatric encounters," Social Science & Medicine, Elsevier, vol. 60(10), pages 2307-2320, May.
    4. Ramirez-Valles, Jesus, 1998. "Promoting health, promoting women: the construction of female and professional identities in the discourse of community health workers," Social Science & Medicine, Elsevier, vol. 47(11), pages 1749-1762, December.
    5. Miltiades, Helen B. & Wu, Bei, 2008. "Factors affecting physician visits in Chinese and Chinese immigrant samples," Social Science & Medicine, Elsevier, vol. 66(3), pages 704-714, February.
    6. Gay Becker & Yewoubdar Beyene & Edwina Newsom & Nury Mayen, 2003. "Creating Continuity Through Mutual Assistance: Intergenerational Reciprocity in Four Ethnic Groups," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 58(3), pages 151-159.
    7. Getrich, Christina & Heying, Shirley & Willging, Cathleen & Waitzkin, Howard, 2007. "An ethnography of clinic "noise" in a community-based, promotora-centered mental health intervention," Social Science & Medicine, Elsevier, vol. 65(2), pages 319-330, July.
    8. Glenton, Claire & Scheel, Inger B. & Pradhan, Sabina & Lewin, Simon & Hodgins, Stephen & Shrestha, Vijaya, 2010. "The female community health volunteer programme in Nepal: Decision makers' perceptions of volunteerism, payment and other incentives," Social Science & Medicine, Elsevier, vol. 70(12), pages 1920-1927, June.
    9. May, Marlynn L. & Contreras, Ricardo B., 2007. "Promotor(a)s, the organizations in which they work, and an emerging paradox: How organizational structure and scope impact promotor(a)s' work," Health Policy, Elsevier, vol. 82(2), pages 153-166, July.
    10. Wolff, Jennifer L. & Roter, Debra L., 2011. "Family presence in routine medical visits: A meta-analytical review," Social Science & Medicine, Elsevier, vol. 72(6), pages 823-831, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Zhang, Shuai & Cheng, Meili & Ma, Wen & Liu, Huashui & Zhao, Chunjuan, 2023. "Companion responses to diagnosis in Chinese outpatient clinical interaction," Social Science & Medicine, Elsevier, vol. 338(C).
    2. Mosa Moshabela & Shira Gitomer & Bongiwe Qhibi & Helen Schneider, 2013. "Development of Non-Profit Organisations Providing Health and Social Services in Rural South Africa: A Three-Year Longitudinal Study," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-1, December.
    3. Steven Yen & Hung-Hao Chang & Tsui-Fang Lin, 2013. "Out-of-pocket expenditures on traditional and Western medicine in Taiwan," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(4), pages 583-592, August.
    4. Huang, Nicole & Chou, Yiing-Jenq & Hu, Hsiao-Yun & Lee, Cheng-Hua, 2013. "Gender disparities in AMI management and outcomes among health professionals, their relatives, and non-health professionals in Taiwan from 1997 to 2007," Social Science & Medicine, Elsevier, vol. 77(C), pages 70-74.
    5. Zoya Gubernskaya & Zequn Tang, 2017. "Just Like in Their Home Country? A Multinational Perspective on Living Arrangements of Older Immigrants in the United States," Demography, Springer;Population Association of America (PAA), vol. 54(5), pages 1973-1998, October.
    6. Nichols, Carly, 2024. "Equity and empowerment effects: Multiple styles of ‘voluntarism’ in community-based health projects," World Development, Elsevier, vol. 174(C).
    7. Valeria Bordone & Helga A. G. Valk, 2016. "Intergenerational support among migrant families in Europe," European Journal of Ageing, Springer, vol. 13(3), pages 259-270, September.
    8. Wallace, Carolyn & Farmer, Jane & McCosker, Anthony, 2019. "Boundary spanning practices of community connectors for engaging ‘hardly reached’ people in health services," Social Science & Medicine, Elsevier, vol. 232(C), pages 366-373.
    9. Araviinthansai Subramaniam & Kalyani Kirtikar Mehta, 2024. "Exploring the Lived Experiences of Caregiving for Older Family Members by Young Caregivers in Singapore: Transition, Trials, and Tribulations," IJERPH, MDPI, vol. 21(2), pages 1-27, February.
    10. Olaniran, Abimbola & Madaj, Barbara & Bar Zeev, Sarah & Banke-Thomas, Aduragbemi & van den Broek, Nynke, 2022. "Factors influencing motivation and job satisfaction of community health workers in Africa and Asia - a multi-country study," LSE Research Online Documents on Economics 111837, London School of Economics and Political Science, LSE Library.
    11. Sheabo Dessalegn, S., 2017. "Social capital and maternal health care use in rural Ethiopia," Other publications TiSEM bb0ec225-4ec3-4028-90d6-1, Tilburg University, School of Economics and Management.
    12. Annie George & Kim M Blankenship, 2015. "Peer Outreach Work as Economic Activity: Implications for HIV Prevention Interventions among Female Sex Workers," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-14, March.
    13. Bataineh, Hana & Devlin, Rose Anne & Barham, Vicky, 2019. "Social capital and having a regular family doctor: Evidence from longitudinal data," Social Science & Medicine, Elsevier, vol. 220(C), pages 421-429.
    14. Edward, Anbrasi & Branchini, Casey & Aitken, Iain & Roach, Melissa & Osei-Bonsu, Kojo & Arwal, Said Habib, 2015. "Toward universal coverage in Afghanistan: A multi-stakeholder assessment of capacity investments in the community health worker system," Social Science & Medicine, Elsevier, vol. 145(C), pages 173-183.
    15. Closser, Svea & Mendenhall, Emily & Brown, Peter & Neill, Rachel & Justice, Judith, 2022. "The anthropology of health systems: A history and review," Social Science & Medicine, Elsevier, vol. 300(C).
    16. Wolff, Jennifer L. & Roter, Debra L., 2011. "Family presence in routine medical visits: A meta-analytical review," Social Science & Medicine, Elsevier, vol. 72(6), pages 823-831, March.
    17. Chun, Kevin M. & Chesla, Catherine A. & Kwan, Christine M.L., 2011. ""So We Adapt Step by Step": Acculturation experiences affecting diabetes management and perceived health for Chinese American immigrants," Social Science & Medicine, Elsevier, vol. 72(2), pages 256-264, January.
    18. Jianyun Wang & Yaolin Pei & Renyao Zhong & Bei Wu, 2020. "Outpatient Visits among Older Adults Living Alone in China: Does Health Insurance and City of Residence Matter?," IJERPH, MDPI, vol. 17(12), pages 1-12, June.
    19. Marla L. Clayman & Carma L. Bylund & Betty Chewning & Gregory Makoul, 2016. "The Impact of Patient Participation in Health Decisions Within Medical Encounters," Medical Decision Making, , vol. 36(4), pages 427-452, May.
    20. South, Jane & Purcell, Martin E. & Branney, Peter & Gamsu, Mark & White, Judy, 2014. "Rewarding altruism: Addressing the issue of payments for volunteers in public health initiatives," Social Science & Medicine, Elsevier, vol. 104(C), pages 80-87.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:75:y:2012:i:10:p:1769-1777. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.