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A targeted culturally-informed approach for caregiver stress among Vietnamese caregivers of family members

A targeted culturally-informed approach for caregiver stress among Vietnamese caregivers of family members [executive summary]

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A targeted culturally-informed approach for caregiver stress among Vietnamese caregivers of family members [executive summary]

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Content 1
A Targeted Culturally-Informed Approach for Caregiver Stress Among
Vietnamese Caregivers of Family Members
Executive Summary
Linda Nguyen, MSW
University of Southern California
Suzanne Dworak-Peck School of Social Work
DSW Program
Renee Smith-Maddox, Ph.D., Chair
July 25, 2024

2
Executive Summary
Family caregiver stress is not only prevalent in the United States where it impacts 71% of
the 41.8 million family caregivers providing services to adults over the age of 50, but also has
significant consequences for the aging system and health care system, and the health and safety
of caregivers and their care recipients (Lynch et al., 2018). The American Academy of Social
Work and Social Welfare has emphasized eradicating social isolation and loneliness (SI/L);
research has found SI/L to be a root cause of family caregiver stress (Grand Challenges of Social
Work, n.d.). Effective evidence-based interventions like the Powerful Tool of Caregivers (PTC)
(PTC; Rosney et al., 2017) and Stress-Busting Program for Family Caregivers (SBP; National
Council on Aging, 2023) have promising outcomes of reduction of caregiver stress. However,
the current research and solution landscape has focused on the general caregiver population,
which has created barriers and gaps in services. For example, Vietnamese family caregivers are
not utilizing these resources, have reported poor comprehension, and are not always aware that
the resources exist (Jang et al., 2022). This Capstone Project developed the Ba Con Café (BCC)
(Translation: grandparent, grandchildren, parent, children, and community Café) in response to
these issues.
Family resilience theory guides the formation and execution of Ba Con Cafe (BCC).
Family resilience theory (Walsh, 2003) posits that strengthening the family unit where family
connectedness is a vital protective factor can help its members and the unit overcome setbacks,
challenges, and future obstacles. The identified solution recognizes that Vietnamese family
caregivers and the older adults living in the home are an interconnected family unit and when the
core unit is strengthened, the family can overcome hardships, such as increasing demands of
caregiving caregiver stress, and SI/L. When the Vietnamese family unit is working

3
collaboratively and effectively, the unit is strengthened and can overcome setbacks and
challenges such as grief, loss, depression, illnesses, and, subsequently, SI/L and family caregiver
stress. The fundamentals of family resilience theory are categorized into two parts to guide BCC
to increase Vietnamese families’ resiliency to overcome future challenges: (a) education on
caregiver stress, and (b) respect for cultural factors and utilization of community resources.
The Capstone Project followed the design thinking principles proposed by the Interaction
Design Foundation (n.d.) and upheld the Design Justice Network’s (2018) principles for design
processes. The design thinking process prioritized the voices, needs, and concerns of the
normally excluded group of Vietnamese family caregivers. Through a nonlinear and interactive
process of stakeholder interviews, stakeholder analysis, design labs, and utilization of a feedback
loop, Vietnamese family caregivers created BCC to eradicate SI/L and caregiver stress. For
example, stakeholder interviews conducted through this Capstone Project revealed that
Vietnamese family caregivers find great difficulty in navigating, understanding, and following
through with current family caregiver interventions.
Stakeholder Questions included the following:
● Do you ever feel overwhelmed with caring for your loved ones?
● Do you find when you are overwhelmed, you are irritable, depressed, lose sleep and
appetite, and have difficulty concentrating?
● Do you know what caregiver stress is?
● What do you do to cope?
● What resources do you use to cope?
Next, low, mid, and high prototypes were created, tested, and iterated. To start
brainstorming the idea of BCC, multiple iterations of a low-fidelity visual storyboard were
created that was inspired by the real-life stories and real-life people in the 15 stakeholder
interviews. The visual storyboard tells the story of Thu, a Vietnamese family caregiver. She
struggles with life balance while taking care of her mother and starts to experience symptoms of

4
caregiver stress. She found difficulties navigating available resources due to language barriers as
well as stigma about reaching out for help. Through the local Vietnamese newspapers and news,
Thu found BCC. Thu found at BCC a community and safe space to overcome challenges in
caregiving and to keep providing quality care to her mother. Design labs were then implemented
to test the effectiveness of the prototype where benchmarks guided by the end users were used to
inform the design process. A virtual class in a design lab was tested using the high-fidelity
prototype (see Appendix A). Five invited participants were all Vietnamese family caregivers of
older adults independently living in the home and who required assisted daily living care. Only
four participants arrived and stayed throughout the entire 60-minute class. Each pair of
participants was invited into a breakout room with each facilitator to record their answers on the
experience in the virtual space. The feedback loop, assessed through a post-module questionnaire
will determine if the project is meeting its desired outcomes and design criteria and will include
six questions. The end users guided and informed the evaluation process (Costanza-Chock,
2020).
Evaluation Questions included the following:
● Were there challenges faced in accessing services?
● Do you feel like you can safely share your voice and learn in a non-judgemental way?
● Has your understanding of caregiver stress increased?
● Do you feel like you have a support network through BCC?
● Have you learned or utilized community resources for family caregivers?
● Are you experiencing a reduction in caregiver stress symptoms or an improvement in
functioning?
The BCC is a culturally-informed approach for Vietnamese family caregivers caring for
family members. BCC seeks to create a community and physically safe space to learn, express,
and address caregiver stress through evidence-based support groups and a culturally responsive
curriculum that respects Vietnamese family caregivers’ traditions, values, and belief systems

5
while breaking down the stigma of seeking help. BCC seeks to provide caregivers with
knowledge, awareness, and a support network through a 5-week program of social support
groups (see Appendix A), stress management techniques (see Appendix B), and a resource tool
kit (see Appendix C) that includes a directory of Vietnamese health care providers, respite care,
and adult day care programs to ultimately empower family caregivers, strengthen family units,
and prevent and treat caregiver stress. Ultimately, BCC provides prevention and self-care options
for caregiver stress through education and community support. BCC recognizes the effectiveness
of current models in addressing caregiver stress while being mindful of the unique challenges
and belief systems that Vietnamese family caregivers face. BCC seeks to bridge the gaps in
support services and knowledge about caregiver stress by creating culturally-informed solutions.
This Capstone Project has the potential to serve as a best practice in the field of inclusive
caregiver stress programs, where other ethnic groups and populations can innovate and create
specialized interventions for specific populations. This Capstone Project also has the potential to
transition to a virtual space and to other physical environments where class sessions are held
face-to-face within the community and continue to promote the best practices for an inclusive
physical environment. In conclusion, this Capstone Project’s mission is to improve the
well-being of Vietnamese family caregivers who are challenged by caregiver stress by reducing
the stigma around getting caregiver stress support and reducing stress through knowledge,
awareness, and skill-building.

6
References
Costanza-Chock, S. (2020). Design values: Hard-coding liberation? In Design justice:
Community-led practices to build the worlds we need (pp. 32–68). MIT Press.
https://doi.org/10.7551/mitpress/122255.003.0005
Design Justice Network. (2018). Design Justice Network principles. Retrieved on July 15, 2024,
from https://designjustice.org/read-the-principles
Jang, Y., Park, J., Choi, E. Y., Cho, Y. J., Park, N. S., & Chiriboga, D. A. (2022). Social
isolation in Asian Americans: Risks associated with socio-demographic, health,
and immigration factors. Ethnicity & Health, 27(6), 1428–1441.
https://doi.org/10.1080/13557858.2021.1881765
Lynch, S., Shuster, G., & Lobo, M. (2018). The family caregiver
experience—Examining the positive and negative aspects of compassion
satisfaction and compassion fatigue as caregiving outcomes. Aging & Mental
Health, 22(11), 1424–1431. https://doi.org/10.1080/13607863.2017.1364344
National Council on Aging. (2023, November 1). Stress-busting program.
https://www.ncoa.org/article/evidence-based-program-stress-busting-program-for
-family-caregivers
Rosney, D. M., F Noe, M., & J Horvath, P. (2017). Powerful Tools for Caregivers, a
group psychoeducational skill-building intervention for family caregivers.
Journal of Caring Sciences, 6(3), 187–198. https://doi.org/10.15171/jcs.2017.019
Walsh, F. (2003). Family resilience: A framework for clinical practice. Family Process, 42(1),
1–18. https://doi.org/10.1111/j.1545-5300.2003.00001.x

7
Appendices
APPENDIX A: HIGH-FIDELITY PROTOTYPE FOR BA CON CAFÉ 8
APPENDIX B: BA CON CAFÉ STRESS MANAGEMENT KIT 14
APPENDIX C: BA CON CAFÉ COMMUNITY RESOURCE KIT 16

8
Appendix A:
High-Fidelity Prototype

9

10

11

12

13

14
Appendix B:
Ba Con Cafe Stress Management Kit with
Guided Zen Meditation Material

15

16
Appendix C:
Ba Con Cafe Community Resource Kit

17

Abstract (if available)

Abstract Family caregiver stress is not only prevalent in the United States where it impacts 71% of the 41.8 million family caregivers providing services to adults over the age of 50, but also has significant consequences for the aging system and health care system, and the health and safety of caregivers and their care recipients. The American Academy of Social Work and Social Welfare has emphasized eradicating social isolation and loneliness (SI/L); research has found SI/L to be a root cause of family caregiver stress. Effective evidenced-based interventions like the Powerful Tool of Caregivers (PTC) and Stress-Busting Program for Family Caregivers have promising outcomes of reduction of caregiver stress. However, the current research and solution landscape have focused on the general caregiver population, which has created barriers and gaps in services. For example, Vietnamese family caregivers are not utilizing these resources, have reported poor comprehension of the resources, and are not always aware that the resources exist. In response to these issues, this Capstone Project developed the Ba Con Café (BCC) (Translation: parent, children, grandparent, grandchildren, and community Café). The BCC is a culturally-informed approach for Vietnamese family caregivers caring for family members who can independently live in the home and who only need assistance with daily living activities. BCC provides prevention and self-care options for caregiver stress through education and community support. BCC recognizes the effectiveness of current models to address caregiver stress while being mindful of the unique challenges and belief systems that Vietnamese family caregivers face. BCC seeks to bridge the gaps in support services and knowledge about caregiver stress by creating culturally-informed solutions.

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Asset Metadata

Creator Nguyen, Linda (author)

Core Title A targeted culturally-informed approach for caregiver stress among Vietnamese caregivers of family members [executive summary]

School Suzanne Dworak-Peck School of Social Work

Degree Doctor of Social Work

Degree Program Social Work

Degree Conferral Date 2024-08

Publication Date 07/26/2024

Defense Date 07/24/2024

Publisher Los Angeles, California (original), University of Southern California (original), University of Southern California. Libraries (digital)

Tag and culturally responsive social supports,caregiver stress,family resiliency,Loneliness,OAI-PMH Harvest,social isolation,Vietnamese caregivers

Format theses (aat)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Smith-Maddox, Renee (committee chair)

Creator Email lindanguyen.thu@gmail.com,lnguyen3@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC1139990GO

Unique identifier UC1139990GO

Identifier etd-NguyenLind-13294-Executive-Summary.pdf (filename)

Legacy Identifier etd-NguyenLind-13294-Executive-Summary

Document Type Capstone project

Format theses (aat)

Rights Nguyen, Linda

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Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA

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