Immigrant Older Adults Research Articles

EXAMINATION OF TRUST IN THE HEALTH CARE SYSTEM AMONG OLDER IMMIGRANTS RESIDING IN THE MIDWEST

Ethnic minority populations, such as immigrants, have demonstrated lower levels of trust in the health care system and their health care providers compared with non-migrant populations (Navaza et al., 2012; Renzaho, Polonsky, McQuilten, & Waters, 2013). This medical mistrust may adversely influence older adult immigrants’ use of and satisfaction with health services (Hong et al., 2018a; Jang, Kim, & Chiriboga, 2005). Thus, the current project aimed to characterize influences of medical mistrust (healthcare system and healthcare providers) in older adult immigrant populations living in the United States of America (U.S.). We interviewed 142 older adult immigrants and refugees (aged 60+ years) who identified as Bosnian, Chinese, Indian, Korean, Latino, and Vietnamese about their perceptions on living in the U.S., of the healthcare system, and healthcare utilization as a part of the Successful Aging among Immigrants in Midlife (SAIM) project. Linear regression models predicting trust in the healthcare system and trust in healthcare providers were tested with healthcare knowledge (measured with a single item about flu shots) , acculturation, length of time in the U.S. , and age as predictors. We found that older age and healthcare knowledge was predictive of higher levels of trust in healthcare providers for Chinese. Although healthcare knowledge was predictive of trust in the health care system for the Chinese participants, greater length of time and higher acculturation were associated with higher trust in the healthcare system among Indian participants. The implications of the different predictive variables in each of the hypothesized models will be discussed.

IMMIGRATION, RESILIENCE, AND ORAL-HEALTH-RELATED QUALITY OF LIFE AMONG CHINESE AMERICAN OLDER ADULTS IN HAWAII

Very few studies have compared oral health status between the US-born and foreign-born immigrant older adults. Using data collected among 430 Chinese older adults age 55+ residing in Hawai’i, we examined the association between immigrant status and oral health related quality of life (OHQoL) and the moderating role of resilience in linking the association. Controlling for some key covariates, our study results show that US-born Chinese immigrant older adults had better OHQoL than their foreign born counterparts. Factors such as higher level of education (graduate degree or higher), better self-reported health status and no significant tooth loss were related to better OHQoL. The association between immigrant status and OHQoL was moderated by resilience. Specially, resilience was positively and significantly associated with OHQoL among U.S.-born older adults but not among the foreign-born ones. Our findings indicate the importance of immigration and resilience in shaping oral health outcomes among older Chinese Americans.

CHALLENGES AND IMPERFECT SOLUTIONS FOR COGNITIVE SCREENING WITH OLDER IMMIGRANTS

Cultural diversity among older adults is increasing and with this comes challenges in health care needs, including the detection of cognitive impairment. Cognitive impairments manifests in many ways, with early symptoms often difficult to detect. Detecting cognitive dysfunction is typically facilitated with brief, portable screening tools. Scores on screening tools may be influenced by culture, education, and verbal abilities; in particular, these are acute issues for screening older immigrants from linguistically and culturally diverse backgrounds. The consequences of improper screening are high and, as such, finding practical, cost-effective solutions is of critical importance. In this project, we qualitatively examined the usability of different cognitive screening tools with the ultimate goal of improving the detection and classification of cognitive dysfunction among older adult immigrants. We extended our previous work by piloting adaptation guidelines for the Saint Louis University Mental Status (SLUMS) exam for use with linguistically and culturally diverse persons. We recruited 23 older immigrants (6 non-English speaking) and 14 U.S. born participants to explore the usability and test-retest reliability of the SLUMS exam administered with and without the adaptation guidelines. Our attempts to improve the flexibility of the SLUMS exam did not achieve the level of success as anticipated. Although this pilot work had low power, when coupled with our past work on developing adaptation guidelines, sheds critical light on the layered complexity that arises at the intersections of education, culture, race, gender, socioeconomic status, and intercultural interactions and the resulting potential directions for future work will be discussed.

OLDER ADULTS’ IMMIGRANT STATUS AND SELF-REPORTED ABILITY TO NAVIGATE THROUGH THE HEALTHCARE SYSTEM

This exploratory study examined the association between older adults’ immigrant status and their self-reported ability to perform each of the 51 self-care behaviors that are needed for them to navigate through the healthcare system. Secondary data analysis was conducted based on a 2018 telephone survey of community-dwelling adults 65 y/o or older, living in a western Canada province (N = 1,000). A previously validated survey tool, Patient Involvement Behaviors in Health Care (e.g., indicating Yes=1 or No=0 regarding their ability to perform each self-care behavior), and a demographic data form (e.g., are you an immigrant? Yes=1 or No=0) were used. Descriptive analyses and chi-square tests for independence (alpha= 0.05) were conducted. Among the 993 adults who indicated their immigrant status, 51 (5.1%) self-declared as immigrants. 32 (62.7%) of the immigrant participants and 457 (48.5%) of the non-immigrant participants resided in the urban areas. 88.2% of these immigrant participants was white, 7.8% was Asian, and 2% was black; 72.5% indicated that English is their first language. Immigrant participants were less likely to report being able to perform 5 self-care behaviors than non-immigrant participants. These 5 behaviors were: bringing someone to help you move around when needed; asking your providers to share your medical record with each other; finding insurance that best matches your needs; changing health insurance coverage as needed; and knowing of any interactions with old and new treatments. Clinicians should co-create approaches with older adult immigrants to improve their self-care capacity (e.g., connecting with relevant peer support networks).

PREMIGRATION, DISPLACEMENT, AND POSTMIGRATION EXPERIENCES OF LONELINESS AMONG HMONG OLDER ADULTS

Available evidence highlights the detrimental impact of loneliness on the mental and physiological health of older adults. While immigrant older adults report higher prevalence for experiencing loneliness compared to native born older adults, minimal research has simultaneously explored the premigration, displacement, and postmigration experiences of loneliness among older adults with a refugee history. This study aimed to explore loneliness in these three phases among Hmong older adults, an ethnic minority group resettled in the United States as refugees over 40 years ago. Drawing on data from a constructivist grounded theory study guided by an intersectionality framework, the first author interviewed 17 community-dwelling Hmong older adults age 65 and older residing in Fresno and Sacramento, California. Two coders coded and analyzed the transcribed interviews. Findings revealed negative, disruptive, and discriminatory experiences underscored by systems of oppression grounded on the social, political, psychological, and cultural context of each phase. Influencing factors that contributed to loneliness were identified as: trust, loss, aging-related issues, isolation, sense of community, access to cultural community, instability, violence, and cultural adjustments. In specific phases, particular influencing factors were more evident and persistent in producing loneliness. Some influencing factors remained a problem for participants across all phases. With the unprecedented growth of refugees all over the world, this study highlights the need for more research, practice, and policy focused on the context of the refugee experience to gain greater insight into their loneliness experiences and expand the notion of loneliness as an individual experience.

EXPERIENCES OF DISCRIMINATION ARE ASSOCIATED WITH DECREASED FUNCTIONAL ABILITY IN AFRICAN IMMIGRANT OLDER ADULTS

Discrimination impacts functional health outcomes of African Americans and other racial/ethnic minorities in the United States; yet this is understudied in African immigrants whose population has risen by 137% since 2000. We examined the relationship between discrimination and physical function with a convenience sample of first-generation African immigrants age 50+ recruited through community-based organizations (N=124). Discrimination was measured with the Everyday Discrimination scale with higher scores indicating more experiences of discrimination (range=0-23). High versus low levels of discrimination were categorized at the mean. Physical function was measured using the PROMIS Physical Function measure with high scores indicating greater functional ability (range=11-50). Raw function scores were converted to standardized T-scores with a population mean of 50 and standard deviation (SD) of 10. Linear regression was used for analyses. Mean age of the sample was 61.4(SD=7.9) years. About two-thirds (63%) were female, more than half (52.4%) immigrated in search of better opportunities and half of the sample had high levels of discrimination. The mean function score was 44.2(SD=8.3) indicating that this sample had functional ability 6 points less than the population average. After adjusting for demographic and migration factors, the mean physical function score was 2.5 points lower (b=-2.53, 95% CI= -5.04, -0.01) for participants with more experiences compared to those with fewer experiences of discrimination. In conclusion, discrimination was associated with poor physical function in African immigrant older adults after adjusting for covariates. Longitudinal studies of discrimination and physical functioning should be pursued in more diverse, larger samples of African immigrants.

RESILIENCE AND HEALTH AMONG CHINESE OLDER ADULTS: FINDINGS FROM THE U.S. AND CHINA

The new framework of resilient aging has gained its importance in recent years. This symposium provides new findings on resilience and health among the Chinese population. Using data collected among 430 Chinese older adults in Honolulu, the first presentation examines resilience as an explanatory mechanism linking neighborhood social environment and well-being. Results showed that neighborhood cohesion was positively related to psychological well-being and life satisfaction. Resilience contributed to a substantial portion of the associations. Using the same data, the second presentation examines the association between immigrant status and oral health related quality of life (OHQoL) and the moderating role of resilience. Findings showed that U.S.-born Chinese immigrant older adults had better OHQoL than their foreign-born Chinese American counterparts. Resilience was positively associated with OHQoL for the former but not for the latter. The third paper presents findings from the same dataset along with a survey of 800 older adults in Wuhan, China. The positive relationship between attitudes towards aging and self-rated health (SRH) was found to be moderated by resilience such that higher levels of resilience weakened this association substantially. Both the positive focal relationship and the moderating effect appeared to be stronger among participants in Honolulu. Using both datasets, the fourth paper investigates patterns of intergenerational transfer and their relationships with SRH as well as the meditating effect of resilience. Findings highlighted the beneficial health effects of receiving emotional support from adult children as well as the mediating role of resilience for older females in both study sites.

Situating the life story narratives of aging immigrants within a structural context: the intersectional life course perspective as research praxis

Research on racialized older immigrants does not fully acknowledge the interplay between the life course experiences of diverse populations and the structural conditions that shape these experiences. Our research team has developed the intersectional life course perspective to enhance researchers’ capacity to take account of the cumulative effects of structural discrimination as people experience it throughout the life course, the meanings that people attribute to those experiences, and the implications these have on later life. Here we propose an innovative methodological approach that combines life story narrative and photovoice methods in order to operationalize the intersectional life course. We piloted this approach in a study of the everyday stories of aging among diverse immigrant older adults in two distinct Canadian provinces with the goals of enhancing capacity to account for both context and story and engaging with participants and stakeholders from multiple sectors in order to influence change.

Fostering trust and sharing responsibility to increase access to dementia care for immigrant older adults

ABSTRACT Objectives: This paper explores the role of immigrant-serving agencies in facilitating access to dementia services and supports provided by dementia service agencies (particularly the health authority and local chapters of the Alzheimer Society) through their propensity to develop trusting relationships between staff and clients. Design: Our research is a qualitative case study of Punjabi and Korean speakers living in the Lower Mainland of BC, Canada. Data are drawn from interviews with 15 dyads of persons with dementia and their family caregivers (10 Punjabi, 5 Korean), six focus groups (one focus group with each of 8–10 older men, older women, and mixed gender working age adults in each community). We also interviewed 20 managerial and frontline staff of dementia service agencies, i.e. the health authority and the local Alzheimer Society (n = 11) and two immigrant-serving agencies (n = 9), each dedicated to either Punjabi or Korean-speaking clients. We adopted the Candidacy framework for understanding access to dementia services and supports and the concept of trust as guiding precepts in this study. Results: Families of persons with dementia are pivotal to identification of a problem requiring professional help, navigation to appropriate services and acceptance of services offered. However, trust in family members should not be taken for granted, since family dynamics are complex. Alternative sources of trusted support are therefore needed. Immigrant-serving agencies are more often instrumental in establishing trusted relationships between their staff and clients, but they often lack detailed knowledge about heath conditions, their treatment and management, and they lack power to implement statutory care. Conclusions: Partnerships between mainstream mental health/dementia services and the community sector have proven successful in increasing the accessibility of specialized resources, while maximizing their combined trustworthiness, accessibility and effectiveness. Such partnerships should become fundamental components of health service strategy and provision for vulnerable and underserved immigrant older adults.

Korean immigrant older adults residing in Non-Korean ethnic enclaves: Acculturation strategies and psychosocial adaptation

ABSTRACTBased on Berry’s bi-dimensional model of acculturation, this study examined acculturation strategies among first-generation Korean immigrant older adults residing in areas without a well-established Korean ethnic enclave and how their acculturation strategies are associated with psychosocial adaptation and acculturative stressors. Cluster analysis (N = 108) identified three acculturation strategies such as separated, moderately bicultural, and fully bicultural, indicating that the sample did not exhibit all four acculturation strategies of Berry’s model. The moderately bicultural group of the sample was the most dominant in size, which indicated strong adherence to Korean culture. The fully bicultural group reported less acculturative stress and depressive symptoms than the separated group, which indicated that biculturalism is strongly associated with a better psychosocial adaptation. A factor analysis showed that the separated group perceived stressors such as limited English proficiency and social isolation as more stressful than the other groups. The findings suggest that even though a strong adherence to ethnic culture might be a first-generation Korean immigrant older adults’ dominant acculturation strategy, it may make them more vulnerable to lingual and cultural barriers in a mono-cultural community without Korean ethnic enclaves. Implications for social work practice are explored.

Does Acculturation Matter? End-of-Life Care Planning and Preference of Foreign-born Older Immigrants in the United States.

Background and ObjectivesAdvance care planning (ACP) is a critical component of health care affecting the quality of later life. Responding to the increase in the older immigrant population in the United States, this empirical study explored the racial/ethnic gaps in ACP behaviors among older immigrants and examined the end-of-life (EOL) care planning and preferences of foreign-born immigrant older adults focusing on race/ethnicity, acculturation, health need factors, and enabling social factors (financial capability, public assistance, and informal supports) after controlling predisposing factors (sociodemographic characteristics).Research Design and MethodsUsing a subsample from the National Health and Aging Trends Study 2011 and 2012, hierarchical logistic regression models of the EOL plan and preferences were examined with 50 multiple imputation data sets (n = 232).ResultsDescriptive statistics reveal lower ACP engagement of immigrants from racial/ethnic minority groups. In logistic models, however, only Black immigrants were less likely than Whites to have EOL conversations. Among acculturation factors, age at immigration was only negatively associated with having a durable power of attorney for health, but not significantly associated with other ACP behaviors. Instead, health and social factors, primarily need in health and informal support (i.e., number of coresidents and receiving financial help from family members), were associated with different types of ACP components. Receiving public assistance (i.e., receiving Medicaid and SSI) were positively associated with EOL treatment preferences.Discussion and ImplicationsOlder foreign-born immigrants, in general, showed lower ACP engagement than the overall older population. Moreover, minority immigrants were lower on ACP engagement than both White immigrants. This study highlights the need for formal and informal assistance for enhancing EOL planning for older immigrants. Adding to the culturally competent approach, policy efforts should address social and health factors that accrued throughout individuals’ life spans and affect older immigrants’ EOL preparation and care.

Acculturative Stress as Experienced by Filipino Grandparents in America: A Qualitative Study

The aim of this qualitative study was to describe the factors that contribute to acculturative stress among recent older adult immigrants (N = 40) who co-reside with their children in the USA. Results of the qualitative analysis yielded three main themes with corresponding subthemes. The main themes were (a) aging in America, (b) losing sense of agency, and (c) feeling alienated/Being needed. Nurses and practitioners who interact with grandparents who are recent immigrants need to explore issues related to isolation and emotional distress. Assisting these individuals in the development of supportive environments may help moderate their acculturative stress.

Sensor-Based Passive Remote Monitoring and Discordant Values: Qualitative Study of the Experiences of Low-Income Immigrant Elders in the United States.

BackgroundRemote monitoring technologies are positioned to mitigate the problem of a dwindling care workforce and disparities in access to care for the growing older immigrant population in the United States. To achieve these ends, designers and providers need to understand how these supports can be best provided in the context of various sociocultural environments that shape older adults’ expectations and care relationships, yet few studies have examined how the same remote monitoring technologies may produce different effects and uses depending on what population is using them in a particular context.ObjectiveThis study aimed to examine the experiences and insights of low-income, immigrant senior residents, family contacts, and staff of housing that offered a sensor-based passive monitoring system designed to track changes in movement around the home and trigger alerts for caregivers. The senior housing organization had been offering the QuietCare sensor system to its residents for 6 years at the time of the study. We are interested in adoption and discontinuation decisions and use over time, rather than projected acceptance. Our research question is how do cultural differences influence use and experiences with this remote monitoring technology? The study does not draw generalizable conclusions about how cultural groups interact with a given technology, but rather, it examines how values are made visible in elder care technology interactions.MethodsA total of 41 participants (residents, family, and staff) from 6 large senior housing independent living apartment buildings were interviewed. Interviews were conducted in English and Korean with these participants who collectively had immigrated to the United States from 10 countries.ResultsThe reactions of immigrant older adults to the passive monitoring system reveal that this tool offered to them was often mismatched with their values, needs, and expectations. Asian elders accepted the intervention social workers offered largely to appease them, but unlike their US-born counterparts, they adopted reluctantly without hope that it would ameliorate their situation. Asian immigrants discontinued use at the highest rate of all residents, and intergenerational family cultural conflict contributed to this termination. Social workers reported that none of the large population of Russian-speaking residents agreed to use QuietCare. Bilingual and bicultural social workers played significant roles as cultural navigators in the promotion of QuietCare to residents.ConclusionsThis research into the interactions of culturally diverse people with the same monitoring technology reveals the significant role that social values and context play in shaping how people and families interact with and experience elder care interventions. If technology-based care services are to reach their full potential, it will be important to identify the ways in which cultural values produce different uses and responses to technologies intended to help older adults live independently.

Disparities in the Prevalence and Correlates of Disability in Older Immigrants in the USA: a Systematic Review of the Literature.

Disability in older adults leads to poor quality of life, is costly for the health system, and is a risk for mortality. Little is known about disability in older immigrants to the USA. To synthesize the evidence on the prevalence and factors associated with disability in older adult immigrants. We conducted searches in PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus. Disability was defined as difficulty in performing basic or instrumental activities of daily living. Older adult was defined as 65years and older. Immigrant status was defined as someone born outside of the USA. Eighteen articles met the inclusion criteria. Seven studied Hispanic/Latino immigrants, six studied Asian immigrants, four studied diverse older immigrant samples, and one studied European immigrants. Prevalence of disability ranged from 2 to 49% in Asians and 3 to 58.1% in Hispanic/Latinos. In a diverse sample of immigrants, the prevalence of disability was 19.3%. Correlates of disability included female gender, low income, limited education, single status, migration in late adulthood, obesity, arthritis, and diabetes. Factors protective against disability in older adult immigrants were acculturation, migrating at a younger age, exercise, alcohol intake, and church attendance. Disability prevalence was generally lower in Asian immigrants compared to Hispanic/Latino immigrants. Identification of the precise rates and factors associated with disability in older immigrants can inform health interventions for this population.

Importance of Health and Relative Importance of Satisfaction with One’s Own Health: A Case of Frail Immigrant Older Adults

The purpose of the current study is to investigate (1) the relative or perceived importance of health, and (2) the relative importance of health-related quality of life (HRQOL, in relation to satisfactions with other non-health-related life domains) in a longitudinal context. Based on longitudinal survey data of a group of frail immigrant older adults, this study found that (1) the perception of health being most important among major life domains did not vary with time, and (2) the fact that in comparison with satisfactions with other major life domains, satisfaction with one’s own health was not the strongest predictor of overall life satisfaction, did not vary with time either. These findings continue to support the main points suggested by Hsieh (Soc Indic Res 87:127–137, 2008): the importance of health as a major domain of life must not be overlooked; but the association between HRQOL and quality of life must not be overestimated.

Service Use, Participation, Experiences, and Outcomes Among Older Adult Immigrants in American Adult Day Service Centers: An Integrative Review of the Literature.

Older adult immigrants are often socially isolated and vulnerable to poor health. Adult day service (ADS) centers could potentially facilitate social integration and address their long-term health care needs. The current review (a) identifies barriers to and facilitators of ADS use among immigrants, (b) explores how ADS programs impact older adult immigrants' health and well-being, and (c) isolates the most effective culturally based components of ADS programs. An integrative review was conducted using Whittemore and Knafl's methodology. Four databases were searched. Articles were critically appraised and data were organized within an ADS-specific framework. Functional impairment, race, gender, and degree of loneliness were all predictors of ADS use. ADS enhanced immigrants' quality of life and provided fulfillment. Transportation, bilingual nurses, peer support, and cultural activities were deemed essential by participants. ADS can provide support to older adult immigrants by adding cultural elements to existing services and using nurses as cultural liaisons. More research is needed to assess the impact of ADS on disease outcomes, including dementia, and on immigrants in multi-ethnic settings. [Res Gerontol Nurs. 2018; 11(6):317-328.].

'It's Like Chicken Talking to Ducks' and Other Challenges to Families of Chinese Immigrant Older Adults in Long-Term Residential Care.

Immigrant older adults are increasingly moving into long term residential care (LTRC) homes; however, most were designed and continue to be run in accordance with Anglocentric norms and values. Participation and interest in Family Councils-through which they might collectively voice concerns-was low within our purposive sample of nine Chinese-origin residents living in LTRC homes and 11 family carers. Our study, conducted in two LTRC homes in British Columbia, Canada between January and March 2016, further explored participants' perceptions of quality of care by staff and quality of life of residents. Our findings negate participants' rationale that they do not attend because they have no issues to raise. Solutions must recognize that carers' time is precious and care-work is gendered; language incongruity and failure to address it marginalizes residents and their family members. A culturally informed reticence to speak out is reinforced when attempts to do so are silenced.

Age and Gender Variations in Healthy Immigrant Effect: a Population Study of Immigrant Well-Being in Canada

The healthy immigrant effect (HIE) is the phenomenon in which immigrants show better health than their native-born counterparts but this healthier condition declines with length of residence. This study investigated whether (1) immigrants also show better adaptation than non-immigrants as well as better health, (2) length of residence affects their health and adaptation differently, and (3) differential outcomes are found for different age and gender groups. Utilizing the Canadian Community Health Survey (2011–2012) data, immigrants (N = 17,555) and non-immigrants (N = 103,579) were divided into adolescents (15–19 years old), adults (20–49), older adults (50–64), and seniors (65–74) to examine their subjective general and mental health, diagnosed chronic and psychological illnesses, and self-reported daily stress, life satisfaction and sense of belonging. After controlling for key demographics, HIE was found to be more robust in health than adaptation. In general, recent immigrants reported better health conditions than long-term immigrants; however, the two did not differ with daily stress or life satisfaction. The older adult immigrants were the only segment of the immigrant population who did not display HIE; within the immigrant population, working-aged long-term adult immigrants were those experiencing negative well-being in both health and adaptation compared to the same-aged recent immigrants. Regarding diagnosed psychological illnesses, immigrants yielded no difference by age, gender, or length of residence, indicating ‘reluctant’ views on seeking professional help for mental health were persistently held by both recent and long-immigrants. The findings suggest that health policy needs to take into consideration age-related life stages, and enhancement of mental health awareness for immigrant well-being.

Meanings and experiences associated with computer use of older immigrant adults of lower socioeconomic status

Immigrant older adults are a substantial demographic composing 12% to 30% of older adults in the United States and Canada, yet no research has addressed the meanings associated with computer use for low-socioeconomic-status and immigrant older adults. The study explored the meanings, occupational engagement, and experiences associated with computer use. A mixed-methods approach, qualitative participatory action research (photovoice) and survey (Computer Proficiency Questionnaire), was used. Data collection consisted of narratives, focus groups, and Likert scale responses for nine participants. The participants expressed the meanings they associated with computer use as freedom, personal growth, and engagement. Computers promote occupational engagement in social participation, education, and leisure. The findings of personal growth may inform occupational therapy interventions using computers to enable adjustment to changes related to aging and wellness. Social participation and education were motivators for computer use, which may inform computer engagement strategies for this population.

Health-Assistive Smart Homes for Aging in Place: Leading the Way for Integration of the Asian Immigrant Minority Voice.

Caring for America’s aging population is a complex humanitarian issue. The number of older adults is expected to increase to 98.5 million by 2060 with a 295% growth in foreign-born older adults, including Asian immigrants. Most older adults will have one or more chronic conditions and 95% of healthcare costs will be attributed to caring for these conditions. Among Asian Americans, common chronic conditions include respiratory disease, cancer, cardiovascular disease, and pain. The National Institutes of Health, Institute on Aging, and National Science Foundation call for innovative technologies to be developed by multidisciplinary teams to address these concerns. Asian community leaders at Asian Health & Service Center and community members in Oregon identified the use of health-assistive technologies as a priority for potentially reducing stress and improving quality of life for both older adults and their caregivers. The purpose of this article is to introduce nurses and healthcare workers, advocating for the interests of Asian/Pacific Island community members, to the innovative health-assistive smart home. The health-assistive smart home uses artificial intelligence to identify and predict health events. Inclusion of minority persons’ data in the development of artificial intelligence has been generally overlooked. This may result in continued health inequities and is incompatible with the goals of global health. Integration of minority voices while exploring the efficacious use of the health-assistive smart home is of significant value to minority populations. Asian immigrant older adults engaging in smart home research and development will enhance the cultural and technical safety of future devices. Asian families may be particularly interested in smart homes for extending independence because they place an emphasis on collective culture and family-based care. Community engagement of stakeholders and steadfast leadership are needed so that future technologies used in healthcare delivery are both technically and culturally sound. A community-engaged research approach promotes community empowerment that is responsive to community identified priorities and is a good fit for studying adoption of smart home monitoring for health-assistance.