Older Chinese and Filipino American Immigrants with Type 2 Diabetes and their Adult Child: A Qualitative Dyadic Exploration of Family Support.

Type 2 Diabetes (T2D) among older Asian American immigrants (AA) is a growing concern. Asian Americans represent 9% of diagnosed diabetes. Very little is known on how older Asian American immigrants with T2D navigate diabetes management, in particular the role of family support. This qualitative study examines Chinese and Filipino Americans, the two largest Asian subgroups in the US (4.2 million, and 3.6 million, respectively), and family support dynamics among adult children and their parents diagnosed with T2D. Ten dyads (n = 20) made up of adult children and aging parents participated in in-depth and dyadic interviews. Results indicate that family support occurs in a trajectory of stages. The following thematic patterns emerged in these dyads around support: independence, transitions, partnership, and stepping in. The findings point to various supportive stages that Asian American adult children and aging parents with T2D experience and the importance of developing supportive interventions for both adult children and aging parents at these various stages.

Adult Children of the Prison Boom: Family Troubles and the Intergenerational Transmission of Criminal Justice Contact.

Intergenerational transmission processes have long been of interest to demographers, but prior research on the intergenerational transmission of criminal justice contact is relatively sparse and limited by its lack of attention to the correlated "family troubles" and familial incarceration that predate criminal justice contact. In this article, we provide a test of the intergenerational transmission of criminal justice contact after adjusting extensively for these factors that predate such contact by linking longitudinal data from the Project on Human Development in Chicago Neighborhoods with official arrest histories from 1995 to 2020. The results provide support for three conclusions. First, parental criminal justice contact is associated with a shorter time to first arrest and a larger number of arrests even after rigorously accounting for selection. Second, robustness checks demonstrate that neither the magnitude nor the significance of the findings is sensitive to model choices. Third, associations are strongest among White individuals and inconsistently significant for African American and Hispanic individuals. Despite large recent crime declines, the results indicate that parental criminal justice contact elevates the criminal justice contact of the adult children of the prison boom, independent of the often-overlooked troubles that predate criminal justice contact, and that these associations are strongest among the White population.

Age at Immigration and Depression: The Mediating Role of Contemporary Relationships With Adult Children Among Older Immigrants.

OBJECTIVES: For the growing population of older immigrants in the United States, both age at immigration and familial relationships are important factors affecting psychological well-being. This study explores how age at immigration and contemporary relationships with adult children combine to explain older immigrants' depressive symptoms. METHOD: This study uses 2014 Health and Retirement Study data from a sample of 759 immigrants aged 65 and older who have at least one adult child aged 21 or older. A series of ordinary least squares regressions and mediational analyses were conducted. RESULTS: Findings indicate that structural solidarity significantly mediates the association between age at immigration and depressive symptoms. Specifically, immigrating in later life was associated with a lower level of depressive symptoms through its relationship with structural solidarity. In addition, giving monetary support to children and providing care for grandchildren may alleviate depressive symptoms for older immigrants. DISCUSSION: This study suggests that relationships with adult children may differ with age at immigration. The types of support that older immigrants provide to their adult children may be crucial because such support may instill a sense of obligation and reciprocity that may be beneficial to the psychological well-being of older immigrants.

Elevated Anthropometric and Metabolic Indicators among Young Adult Offspring of Mothers with Pregestational Diabetes: Early Results from the Transgenerational Effect on Adult Morbidity Study (the TEAM Study).

Exposure to maternal diabetes in utero increases the risk in the offspring for a range of metabolic disturbances. However, the timing and variability of in utero hyperglycemic exposure necessary to cause impairment have not been elucidated. The TEAM Study was initiated to evaluate young adult offspring of mothers with pregestational diabetes mellitus. This paper outlines the unique enrollment challenges of the TEAM Study and preliminary analysis of the association between exposure to diabetes in pregnancy and adverse metabolic outcomes. The TEAM Study enrolls offspring of women who participated in a Diabetes in Pregnancy (DiP) Program Project Grant between 1978 and 1995. The DiP Study collected medical and obstetric data across pregnancy. The first 96 eligible offspring of women with pregestational diabetes were age-, sex-, and race-matched to adults from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 with an OGTT. Descriptive and regression analyses were employed to compare TEAM participants to NHANES participants. Among a subset of TEAM participants, we compared the metabolic outcomes across maternal glucose profiles using a longitudinal data clustering technique that characterizes level and variability, in maternal glucose across pregnancy. By comparing categories of BMI, TEAM Study participants had over 2.0 times the odds of being obese compared to matched NHANES participants (for class III obesity, OR = 2.81; 95% confidence interval (CI): 1.15, 6.87). Increasing levels of two-hour glucose were also associated with in utero exposure to pregestational diabetes in matched analyses. Exposure to pregestational diabetes in utero may be associated with an increased risk of metabolic impairment in the offspring with clinical implications.

Filial Piety and Parental Depressive Symptoms: All Children Matter - Evidence from Rural Northern China.

Little research has considered all children while investigating adult children's role in their older parents' health and well-being. In this study, we examine the effect of filial piety across all children on parental depressive symptoms. A sample of 432 older parents with 1,223 adult children in a rural county in northern China rated the filial piety level for each child individually. Ratings were then combined across multiple children and organized into an ordinal variable of filial piety including three levels: all children being filial, some of the children being filial, and none of the children being filial. Ordinary least squares linear regression analyses were performed. The results reveal a significant and negative relationship between adult children's filial piety levels and older parents' depressive symptoms after controlling for age, gender, marital status, financial strain, chronic conditions, and social support from family and friends, respectively. That is, one level lower in the adult children's filial piety corresponds to increase in level of older parents' depressive symptoms. Filial piety seems to benefit older Chinese parents' mental health net of social support from family and friends in this sample. Including information from all children in the analyses is informative for better understanding the psychological significance of filial piety for healthy aging in China.

Racial Differences in Early Parental Death, Midlife Life Problems, and Relationship Strain With Adult Children.

OBJECTIVES: Black Americans typically experience the death of a parent earlier in the life course than do non-Hispanic Whites, and early parental death is known to hinder subsequent relationship outcomes. Whether early parental death may contribute to racial differences in midlife family relationships and the role midlife adults' current life problems play remain unexplored. METHOD: Using multilevel modeling, we examined how timing of parental death is associated with relationship strain with adult children and whether the association differs by midlife adults' life problems in Black (n = 166) and non-Hispanic White (n = 467) families from the Family Exchanges Study. RESULTS: Losing a parent in childhood was associated with more relationship strain with adult children for Black midlife adults, but not for their non-Hispanic White counterparts. Among the bereaved, earlier timing of parental death was associated with more relationship strain with adult children only for Black midlife adults. In both bereaved and nonbereaved sample, participants' recent physical-emotional problems exacerbated the link between timing of parental death and relationship strain with adult children for Black midlife adults. DISCUSSION: Experiencing the death of a parent in the early life course can be an added structural disadvantage that imposes unique challenges for Black Americans in midlife. Policies and programs aimed at supporting bereaved children may benefit relationships with their own children later in life, and addressing physical-emotional problems in midlife may be a viable intervention point for those midlife adults who experienced the death of a parent in the early life course.

Counting on Potential Grandparents? Adult Children's Entry Into Parenthood Across European Countries.

As populations age and longevity rises, the structure of the extended family is changing. Parents of young children are increasingly turning to the children's grandparents to provide childcare and help them reconcile work and family. This study is the first to investigate whether would-be grandparents' propensity to care for their grandchildren influences the adult children's transition to parenthood. Because grandparental childcare provision is not observable at the time of the transition to the first birth, I built a measure based on the characteristics of both actual grandparents and adult children to act as a proxy for the childcare that prospective grandparents are expected to provide in the future. Using data from the first two waves of the Survey of Health, Aging, and Retirement in Europe, I examine changes in the likelihood of having a first birth by different levels of expected future childcare provision. Given that the role grandparents play varies depending on the national context, I estimate distinct models for different groups of countries. Furthermore, I analyze different intensities of grandparental childcare: regular, occasional, and any other type of positive childcare. The comparison across 11 countries reveals that grandparental propensity to provide occasional childcare has a positive effect on the transition to parenthood in all country clusters and that grandparental propensity to provide regular childcare has a positive and significant association with having a first child in both pro-natalist (Belgium and France) and pro-traditional countries (Austria, Germany, Greece, Italy, Spain, and Switzerland).

Perspectives of elders and their adult children of Black and minority ethnic heritage on end-of-life conversations: A meta-ethnography.

BACKGROUND: People of Black and minority ethnic heritage are more likely to die receiving life supporting measures and less likely to die at home. End-of-life care decision making often involves adult children as advance care planning is uncommon in these communities. Physicians report family distress as being a major factor in continuing with futile care. AIM: To develop a deeper understanding of the perspectives of elders of Black and minority ethnic heritage and their children, about end-of-life conversations that take place within the family, using a meta-ethnographic approach. DESIGN: Systematic interpretive exploration using the process of meta-ethnography was utilised. DATA SOURCES: CINAHL, MEDLINE, PubMed and PsycINFO databases were searched. Inclusion criteria included studies published between 2005 and 2019 and studies of conversations between ethnic minority elders and family about end-of-life care. Citation snowballing was used to ensure all appropriate references were identified. A total of 13 studies met the inclusion criteria and required quality level using Critical Appraisal Skills Programme. RESULTS: The following four storylines were constructed: 'My family will carry out everything for me; it is trust'; 'No Mum, don't talk like that'; 'I leave it in God's hands'; and 'Who's going to look after us?' The synthesis reflected the dichotomous balance of trust and burden avoidance that characterises the perspectives of Black and minority ethnic elders to end-of-life care planning with their children.

Lessons from filial piety: A social-life-span approach to building the connection that survives death.

The purpose of this article is to unpack concepts surrounding "the connection that survives death" between living people and the deceased. The study was designed as the qualitative arm of an integrated project on filial piety in contemporary times, and data were collected from 17 interviews with Korean human service professionals from Australia, New Zealand and Korea. The findings from the study indicate that the connectedness with the dead is an important part of the participants' mental and social lives, and this postmortem relationship can be embodied through practising "memorial piety" and "memorial work".

The Impact of Living Alone and Intergenerational Support on Depressive Symptoms Among Older Mexican Americans: Does Gender Matter?

The study examined gender differences in the impact of living alone and intergenerational support on depressive symptoms among Mexican American older adults. The sample included 335 parent-adult child pairs which are nested within 92 Mexican American respondents, because each respondent reported their specific relationships with each child. Clustered regression analysis showed gender differences in the impact of living alone and intergenerational support on depressive symptoms among Mexican American older adults. In general, older men provided and received less intergenerational support than older women, but their depressive symptoms were more susceptible to living alone and different types of intergenerational support. Factors such as living alone, receiving instrumental support were associated with more depressive symptoms in older men than inolder women, whereas older men benefited more from the emotional closeness with children than older women. The findings highlight the need for a gender-specific approach to future research on this topic.

Emotional regulation as a mediator between the filial behaviour of the oldest son and subjective well-being of older parents in Pakistan.

BACKGROUND: The link between the filial behaviour of an adult child and older parents' well-being is well entrenched, and theoretical evidence has indicated that it may be mediated by emotional regulation. Therefore, the current study aimed to examine whether emotional regulation (i.e. cognitive reappraisal and suppression) mediates the association between filial behaviour of the oldest son (i.e. the filial behaviour of respect and filial behaviour of daily maintenance) and subjective well-being in older parents. METHODS: This correlational study recruited 400 community-dwelling older parents in Rawalpindi Pakistan through a multistage cluster random sampling technique. Subjective well-being was measured by Concise Measure of Subjective Well-being; filial behaviour was examined through receipt of 12 domains; emotional regulation was assessed by using the Emotional Regulation Questionnaire. The structural equation modelling was employed to test the mediation effects. RESULTS: Cognitive reappraisal was found to partially mediate the relationship between filial behaviour of respect and subjective well-being (ß in direct model = 0.661, P < 0.000; ß in full mediational model = 0.327, P < 0.000), but it failed to mediate between filial behaviour of daily maintenance and subjective well-being (ß in direct model = 0.080, P = 0.149; ß in full mediational model = 0.030, P = 0.362). Moreover, suppression did not exert mediation effects in the associations between the filial behaviour of respect and subjective well-being (ß = 0.003, P = 0.338); and filial behaviour of daily maintenance and subjective well-being (ß = -0.004, P = 0.221). CONCLUSIONS: Taken together, the results suggest that different dimensions of the filial behaviour of the oldest son exert differential effects on emotional regulation and subjective well-being in older parents. Based on the current findings, there is a need to develop adaptive emotional regulatory capacity intervention programs for the development and enhancement of subjective well-being in older parents within their familial context.

Older Filipino immigrants' reconfiguration of traditional filial expectations: a focus ethnographic study.

BACKGROUND: One of the many socio-cultural issues impacting older immigrants in host countries is the cultural expectations of filial piety from their adult children. OBJECTIVE: To understand older Filipino immigrants' beliefs and values towards filial expectations. DESIGN: Focused ethnography. RESULTS: Two major themes were identified. The first theme 'moving away from filial expectations' drew out older Filipino's changing views of cultural expectations from their adult children. The second theme 'maintaining cultural values through good family relationships' highlighted the importance of acknowledging the cultural values considered to be most important by older Filipinos, which was having harmonious relationships and avoiding family conflict. CONCLUSION: The reconfigured expectation was salient with participants' who identified 'not being a burden' to their adult children and the ardent desire to maintain positive family relationships. Impact Statement: Nurses need to be aware of changes to our current understanding of filial piety when providing care to older Filipinos.

Time and Personhood across Early and Late-Stage Dementia.

How do time and personhood become related when dementia sets in? This article brings together ethnographies from a memory clinic and a dementia nursing home in Copenhagen, Denmark, pursuing how personhood and time become intertwined across early and late-stage dementia. In the memory clinic, the dementia diagnosis is enacted and experienced simultaneously as an indispensable prophecy of discontinuity of personhood and life for the patients, and as a prognosis that renders the future indeterminate and open to intervention. In the nursing home, institutionalized care marks the fulfillment of the prophecy of decline, yet nursing home staff insist on practicing prognoses for the residents. Across our empirical sites, we enquire what the tension between prophecy and prognosis mean for personhood and the possibilities of the present, arguing that people with dementia are made and unmade through different understandings and enactments of future-oriented temporalities.

Influence of socio-cultural factors on the emotional problems among college going young-adult children of parents with alcoholism: A study from South India.

Young-adult children of parents with alcoholism are vulnerable to anxiety and depression. We studied the prevalence of emotional psychopathology and examined the mediating role of environmental factors (family support, community support and participation in religious rituals) in relation to psychopathology. College students (N = 1555), aged 18-24 years, from urban and rural domicile were screened on Children of Alcoholics Screening Test (CAST) and those who were positive were assessed for emotional psychopathology on Depression, Anxiety and Stress Scale (DASS-21). Young-adult children of alcoholics with emotional psychopathology were compared with those without emotional psychopathology on demographic characteristics, quality of life, and a questionnaire which measured the role of socio-cultural factors. 33% (N = 512) of 1555 participants screened were found to be Young-adult children of alcoholics. Among them, 35% (N = 181) reported experiencing emotional psychopathology. Participants with high emotional psychopathology reported receiving less support from the family (8.44 ± 1.19 vs 9.57 ± 1.26, p = 0.003), community (6.97 ± 1.08 vs 8.88 ± 1.19, p = 0.001); they participated less in religious rituals (5 ± 0.18 vs 6.56 ± 0.41, p = 0.008) compared to those without psychopathology. Quality of life was significantly lower among Young-adult children of alcoholics with emotional psychopathology. A considerable proportion of Young-adult children of alcoholics reported emotional psychopathology and their quality of life was poor. The modifiable socio-cultural factors such as family, community support and participation in religious rituals were associated with emotional psychopathology. A better utilization of these factors may mitigate the burden of emotional psychopathology and improve quality of life in this vulnerable group.

Family and community in the lives of UK Bangladeshi parents with intellectual disabilities.

BACKGROUND: Little is known about the lives of parents with intellectual disabilities from minority ethnic communities. Previous research suggests that what it means to live with intellectual disabilities varies across cultural contexts. The current research aimed to explore how cultural values and practices impact upon the experiences of parents with intellectual disabilities within the Bangladeshi community in London, England. METHOD: Six members of the Bangladeshi community, four Bangladeshi parents with intellectual disabilities and four of their family members were interviewed. Thematic analysis was used to identify key themes. RESULTS: Both parenting and intellectual disability are thought about in this community in ways that make parenting more accessible for people with learning disabilities, but also create tensions to be negotiated. CONCLUSIONS: Bangladeshi family carers face dilemmas balancing the benefits and risks of promoting parenting for sons and daughters with intellectual disabilities, particularly in the context of service principles of autonomy and informed consent.

Parental Smoking and Adult Offspring's Smoking Behaviors in Ethnic Minority Groups: An Intergenerational Analysis in the HELIUS Study.

Introduction: To understand smoking behaviors among ethnic minority groups, studies have largely focused on societal factors, with little attention to family influences. Yet studies among majority groups have identified parental smoking as an important risk factor. It is unknown whether this applies to ethnic minority groups. We investigated the association between parental smoking and adult offspring's smoking behaviors among ethnic minority groups with an immigrant background. Methods: We used data from the Healthy Life in an Urban Setting study from Amsterdam (the Netherlands) from January 2011 to December 2015. The sample consisted of 2184 parent-offspring pairs from South-Asian Surinamese, African Surinamese, Turkish, Moroccan, and Ghanaian origin. We collected self-reported smoking data: current status, duration of exposure to parental smoking, number of daily cigarettes, heavy smoking ( > 10 cigarettes/day), and nicotine dependency (using the Fagerström Test). Analyses were stratified by offspring's age, cohabitation with parent, education (parent/offspring), offspring's cultural orientation, and gender concordance within pairs. Logistic regression was used. Results: Overall, parental smoking was associated with offspring's smoking behaviors (eg, current smoking: odds ratio 2.33; 95% confidence interval 1.79-3.03), with little ethnic variation. We found dose-response associations between exposure to parental smoking and offspring's smoking. The associations were similar across different strata but stronger in gender-concordant pairs (3.16; 2.12-4.51 vs. 1.73; 1.15-2.59 in gender-discordant pairs; p-value for interaction .017). Conclusions: Parental smoking is associated with offspring's smoking behaviors in ethnic minority groups across different strata but particularly in gender-concordant pairs. Similar to majority groups, family influences matter to smoking behaviors in ethnic minority groups. Implications: Our findings have deepened our understanding of smoking behaviors among ethnic minority groups. Future studies should simultaneously consider societal factors and parental influences, to comprehensively understand their impact on smoking among ethnic minority groups. Also, smoking patterns among family members should be addressed in individual counselling, irrespective of ethnicity.

Cultural Beliefs, Perceptions, and Practices of Young Adult Offspring of African Immigrants Regarding Healthy Eating and Activity.

INTRODUCTION: African immigrants and their offspring are increasing in the United States. Yet little is known about the beliefs, perceptions, and practices of second-generation African immigrants regarding healthy eating and physical activities within the context of culture and environment. METHOD: Five small group interviews using a focused ethnography qualitative method were conducted with 20 college-age students who were offspring of African immigrants. Data were analyzed using Leininger's four phases of analysis. RESULTS: Four themes emerged: (1) family, community, and religious ties to traditional African foods; (2) traditional African cuisine as healthy and american foods as nonhealthy; (3) eating patterns vary according to availability and resources; and (4) exercise patterns have familial, peer-driven, and generational influences. DISCUSSION: African food was a connection to family and the African community. Food choices and activities were strongly influenced by accessibility, social structures, and the environment. Dietary and activity-based interventions should include both American and African influences.

Parental history of moderate to severe infantile malnutrition is associated with cognitive deficits in their adult offspring.

OBJECTIVES: We compared the IQ and academic achievement of the young adult offspring of parents malnourished in infancy and those of a healthy control group in order to test the hypothesis that the offspring of previously malnourished individuals would show IQ and academic deficits that could be related to reduced parental socioeconomic status. METHODS: We conducted a group comparison study based on a community sample in Barbados (Barbados Nutrition Study). Participants were adult children ≥16 years of age whose parents had been malnourished during the first year of life (n = 64; Mean age 19.3 years; 42% male) or whose parents were healthy community controls (n = 50; Mean age 19.7 years; 48% male). The primary outcome was estimated IQ (Wechsler Abbreviated Scale of Intelligence); a secondary outcome was academic achievement (Wide Range Achievement Test - Third Edition). Data were analyzed using PROC MIXED with and without adjusting for parental socioeconomic status (Hollingshead Index of Social Position). RESULTS: IQ was reduced in the offspring of previously malnourished parents relative to the offspring of controls (9.8 point deficit; P < 0.01), but this difference was not explained by parental socioeconomic status or parental IQ. The magnitude of the group difference was smaller for basic academic skills and did not meet criteria for statistical significance. DISCUSSION: The deleterious impact of infant malnutrition on cognitive function may be transmitted to the next generation; however, this intergenerational effect does not appear to be explained by the reduced socioeconomic status or IQ of the parent generation.