{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:51:41Z","timestamp":1760143901745,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:00:00Z","timestamp":1709683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences, University of California, Los Angeles Clinical and Translational Science Institute Grant","doi-asserted-by":"publisher","award":["UL1TR001881"],"award-info":[{"award-number":["UL1TR001881"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>The Centers of Medicare and Medicaid Services recently announced a new voluntary nationwide model. This model aims to provide comprehensive, standard care for people living with dementia and their unpaid caregivers and to enhance health equity in dementia care. However, little is known about the needs of older adults with dementia and their caregivers in a multiethnic and multicultural patient population of a safety net health system. The aim of this study is to include their voices. We conducted four focus groups in English and Spanish to investigate the common needs and barriers unique to the care of patients within the Los Angeles County healthcare system. Using qualitative, iterative analyses of the transcripts, we identified four domains of concern from the dyads (persons with dementia and their caregivers): need for education for dyad-centered care, barriers to resources, dyad safety, and caregiver burden and insight. These domains are interconnected, and the way this patient population experiences these domains may differ compared to those in well-resourced or predominantly English-speaking healthcare settings. Therefore, the identified domains serve as potential building blocks for dementia support programs inclusive of underserved, multicultural populations.<\/jats:p>","DOI":"10.3390\/geriatrics9020033","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T04:03:50Z","timestamp":1709697830000},"page":"33","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Informing Dementia Support Programs That Serve Low-Income, Multilingual Communities in a Safety Net Health System: Use of Focus Groups to Identify Specific Needs"],"prefix":"10.3390","volume":"9","author":[{"given":"Andrew","family":"Pak","sequence":"first","affiliation":[{"name":"Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abriella","family":"Demanes","sequence":"additional","affiliation":[{"name":"Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USA"},{"name":"Section of Geriatrics, Division of General Internal Medicine, Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USA"},{"name":"Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA 90024, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8908-2513","authenticated-orcid":false,"given":"Shirley","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USA"},{"name":"Section of Geriatrics, Division of General Internal Medicine, Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USA"},{"name":"Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA 90024, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Ward","sequence":"additional","affiliation":[{"name":"Geriatrics Section in the Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mailee","family":"Hess","sequence":"additional","affiliation":[{"name":"Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USA"},{"name":"Section of Geriatrics, Division of General Internal Medicine, Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USA"},{"name":"Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA 90024, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,6]]},"reference":[{"key":"ref_1","unstructured":"Alzheimer\u2019s Association (2023). 2023 Alzheimer\u2019s Disease Facts and Figures. Alzheimer\u2019s Dement., 19, 21\u201333. Available online: https:\/\/www.alz.org\/media\/Documents\/alzheimers-facts-and-figures.pdf."},{"key":"ref_2","unstructured":"Alzheimer\u2019s Los Angeles (2023, June 12). Alzheimer\u2019s Disease in Los Angeles. Available online: https:\/\/www.alzheimersla.org\/wp-content\/uploads\/2018\/08\/Alzheimers-Los-Angeles-Fact-Sheet-2018.pdf."},{"key":"ref_3","unstructured":"Los Angeles County Department of Health Services (2023, June 12). Department of Health Services (DHS) Fact Sheet, Available online: http:\/\/file.lacounty.gov\/SDSInter\/dhs\/1060051_DHSFactSheetFY19-20-FINAL.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"217","DOI":"10.31887\/DCNS.2009.11.2\/hbrodaty","article-title":"Family caregivers of people with dementia","volume":"11","author":"Brodaty","year":"2009","journal-title":"Dialog-Clin. Neurosci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1007\/s11136-016-1471-7","article-title":"Patient and caregiver goals for dementia care","volume":"26","author":"Jennings","year":"2017","journal-title":"Qual. Life Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1002\/gps.1322","article-title":"Why caregivers of people with dementia and memory loss don\u2019t use services","volume":"20","author":"Brodaty","year":"2005","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.1017\/S1041610212000737","article-title":"The problem with \u201cproblem behaviors\u201d: A systematic review of the association between individual patient behavioral and psychological symptoms and caregiver depression and burden within the dementia patient\u2013caregiver dyad","volume":"24","author":"Ornstein","year":"2012","journal-title":"Int. Psychogeriatr."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Zwingmann, I., Dreier-Wolfgramm, A., Esser, A., Wucherer, D., Thyrian, J.R., Eichler, T., Kaczynski, A., Monsees, J., Keller, A., and Hertel, J. (2020). Why do family dementia caregivers reject caregiver support services? Analyzing types of rejection and associated health-impairments in a cluster-randomized controlled intervention trial. BMC Health Serv. Res., 20.","DOI":"10.1186\/s12913-020-4970-8"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1097\/JGP.0b013e3181bf9caf","article-title":"A Systematic Review and Meta-Analysis of Ethnic Differences in Use of Dementia Treatment, Care, and Research","volume":"18","author":"Cooper","year":"2010","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1002\/gps.2484","article-title":"A systematic review of ethnicity and pathways to care in dementia","volume":"26","author":"Mukadam","year":"2011","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kenning, C., Daker-White, G., Blakemore, A., Panagioti, M., and Waheed, W. (2017). Barriers and facilitators in accessing dementia care by ethnic minority groups: A meta-synthesis of qualitative studies. BMC Psychiatry, 17.","DOI":"10.1186\/s12888-017-1474-0"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s10823-019-09378-4","article-title":"Characteristics and Consequences of Family Support in Latino Dementia Care","volume":"34","author":"Rote","year":"2019","journal-title":"J. Cross-Cult. Gerontol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1111\/j.1532-5415.2004.52356.x","article-title":"Ethnic Differences in the Prevalence and Pattern of Dementia-Related Behaviors","volume":"52","author":"Sink","year":"2004","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1093\/geront\/41.3.334","article-title":"Racial, Ethnic, and Cultural Differences in the Dementia Caregiving Experience: Recent findings","volume":"41","author":"Janevic","year":"2001","journal-title":"Gerontologist"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1093\/geront\/45.6.783","article-title":"African American, Chinese, and Latino Family Caregivers\u2019 Impressions of the Onset and Diagnosis of Dementia: Cross-Cultural Similarities and Differences","volume":"45","author":"Mahoney","year":"2005","journal-title":"Gerontologist"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1111\/jgs.17091","article-title":"\u201cMy backpack is so heavy\u201d: Experiences of Latino caregivers of family with early-onset Alzheimer\u2019s","volume":"69","author":"Withers","year":"2021","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_17","unstructured":"Centers for Medicare and Medicaid Services (2023, June 12). Guiding an Improved Dementia Experience (GUIDE) Model, Available online: https:\/\/www.cms.gov\/priorities\/innovation\/innovation-models\/guide."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Demanes, A., Ward, K.T., Wang, A.T., and Hess, M. (2022). Systematic Review of Dementia Support Programs with Multicultural and Multilingual Populations. Geriatrics, 7.","DOI":"10.3390\/geriatrics7010008"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1177\/1533317515578256","article-title":"The Effect of a Personalized Dementia Care Intervention for Caregivers From Australian Minority Groups","volume":"31","author":"Xiao","year":"2016","journal-title":"Am. J. Alzheimer\u2019s Dis. Other Dement."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.trci.2015.03.003","article-title":"Impact of the care coordination program \u201cPartners in Dementia Care\u201d on veterans\u2019 hospital admissions and emergency department visits","volume":"1","author":"Bass","year":"2015","journal-title":"Alzheimer\u2019s Dement. Transl. Res. Clin. Interv."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1111\/1475-6773.12647","article-title":"Health Services Utilization in Older Adults with Dementia Receiving Care Coordination: The MIND at Home Trial","volume":"53","author":"Amjad","year":"2018","journal-title":"Health Serv. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1001\/jamainternmed.2019.4101","article-title":"Effect of Collaborative Dementia Care via Telephone and Internet on Quality of Life, Caregiver Well-being, and Health Care Use: The Care Ecosystem Randomized Clinical Trial","volume":"179","author":"Possin","year":"2019","journal-title":"JAMA Intern. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1080\/01634372.2014.901998","article-title":"Use of an Online Community to Provide Support to Caregivers of People With Dementia","volume":"57","author":"Rudloff","year":"2014","journal-title":"J. Gerontol. Soc. Work."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.1001\/jama.295.18.2148","article-title":"Effectiveness of Collaborative Care for Older Adults With Alzheimer Disease in Primary Care","volume":"295","author":"Callahan","year":"2006","journal-title":"JAMA"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1016\/j.jagp.2013.02.019","article-title":"A videophone psychosocial intervention for dementia caregivers","volume":"21","author":"Czaja","year":"2013","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/s10823-021-09432-0","article-title":"Knowledge and Attitudes of two Latino Groups about Alzheimer Disease: A Qualitative Study","volume":"36","author":"Cabrera","year":"2021","journal-title":"J. Cross-Cult. Gerontol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1177\/07334648211001190","article-title":"Role of Community Health Workers in Addressing Dementia: A Scoping Review and Global Perspective","volume":"40","author":"Alam","year":"2021","journal-title":"J. Appl. Gerontol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1370\/afm.2208","article-title":"Roles and Functions of Community Health Workers in Primary Care","volume":"16","author":"Hartzler","year":"2018","journal-title":"Ann. Fam. Med."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Verhagen, I., Steunenberg, B., De Wit, N.J., and Ros, W.J. (2014). Community health worker interventions to improve access to health care services for older adults from ethnic minorities: A systematic review. BMC Health Serv. Res., 14.","DOI":"10.1186\/s12913-014-0497-1"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1080\/08952841.2016.1222758","article-title":"Beliefs and expectations of family and nursing home care among Mexican-origin caregivers","volume":"29","author":"Amorim","year":"2017","journal-title":"J. Women Aging"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Ward, K.T., Hess, M., and Wu, S. (2019). Geriatric Assessment in Multicultural Immigrant Populations. Geriatrics, 4.","DOI":"10.3390\/geriatrics4030040"},{"key":"ref_32","unstructured":"California Department of Health Care Services (2023, June 12). Older Adult Full Scope Expansion Eligibility and Enrollment Plan, Available online: https:\/\/www.dhcs.ca.gov\/services\/medi-cal\/eligibility\/Documents\/OAE\/Eligibility-and-Enrollment-Plan-OAE.pdf."},{"key":"ref_33","first-page":"100040","article-title":"Care for dementia patients and caregivers amid COVID-19 pandemic","volume":"3","author":"Paplikar","year":"2022","journal-title":"Cereb. Circ.-Cogn. Behav."}],"container-title":["Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3417\/9\/2\/33\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:09:46Z","timestamp":1760105386000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3417\/9\/2\/33"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,6]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["geriatrics9020033"],"URL":"https:\/\/doi.org\/10.3390\/geriatrics9020033","relation":{},"ISSN":["2308-3417"],"issn-type":[{"type":"electronic","value":"2308-3417"}],"subject":[],"published":{"date-parts":[[2024,3,6]]}}}