Janice Crist, UA College of Nursing
Andrea Romero, UA Mexican American and Raza Studies and UA Family Studies & Human Development
Janice Crist, associate professor at The University of Arizona College of Nursing, has focused her academic research on elder care. Her specific niche is looking into the disparities among those seeking the care.
Crist – a registered nurse with a doctorate in nursing who has worked as a home health nurse with expertise in gerentological nursing – has received a $375,000 National Institute of Nursing grant to investigate ways to improve home care for the elderly, particularly those within the Mexican-American Community.
"Elder Mexican-American populations use home care half as much as Anglos and I was curious to find out why," Crist said.
Adding to the mystery is that the Mexican-American disparity in accessing elder care exists even though home care services are covered by most health plans including Medicare.
Crist's interest in elder care disparities created the need to gather research on the Mexican-American population and their lack of use of home care services.
Specifically, she wanted to know whether home health care services were handled differently within the Mexican-American community and, if so, she wanted to know if that system was working.
In 2002, Crist created the ENCASA (Elder and Caregiver Assistance and Support At-home) Community Advisory Council, which is made up of Hispanic community members.
The council has been integral in helping Crist's research efforts. They have helped to identify that there is a need for home care services within the Mexican-American community and have helped to identify barriers to accessing those services.
"We have found that Latino elders receive more care per week from family caregivers compared to other populations. The sense of duty and responsibility for family members can be very beneficial, and does not need to be a barrier to home care services. Interventions need to consider the cultural and family context of elder care," co-investigator and Mexican American and Raza Studies and Family Studies & Human Development associate professor Andrea Romero added.
"Familismo or familism is the notion that family takes care of family," Crist said. "Familism is wonderful but it is a key factor in lack of access to home care along with lack of knowledge of services that could be provided."
Romero, who holds a doctorate in social psychology, said that the use of home care services heightens the elder's ability to function and also decreases the probability of falling ill to other illnesses.
Based upon an idea by journalist John Haradon and upon the council's feedback and suggested modifications, the new grant will fund the creation of a bilingual intervention using a telenovela-style video, a soap opera television format popular among Mexican-Americans.
The video will feature a Mexican-American elder and her family's decision to use home care services to manage her chronic conditions. Crist and her team will test the video's efficacy in persuading Mexican-American families to use elder care services.
The effort includes the need to recruit Mexican-American elders and family members to participate in this project as well as the need to recruit for a half-time director position and data collectors to help with the two-year endeavor.
The video is called "Todo Ha Cambiado" (Everything Has Changed) and keeps the family central to the elder's experience, Romero said.
"What is important to know is that home care doesn't mean the replacement of a family caregiver, but it can provide basic training to help the family caregiver provide more quality care to enhance recovery or provide a higher quality of life," Crist said.
Andrea Romero
520-626-8137