Improving Vietnamese American Community’s Cognitive Health Literacy through University-Community Partnerships

Background: Waves of Vietnamese refugees/immigrants migrated to the United States (U.S.) following the fall of Saigon in 1975. Currently, 2.3 million Vietnamese live in the U.S., and the number is growing. Many Vietnamese arrived with adverse conditions such as wartime traumas, life-threatening migration journeys, low socioeconomic status, and linguistic barriers, with much of their health data unknown. After 50 years, many are aged and may have unmet health needs. To fill this gap, we developed the Vietnamese Aging and Care Survey and collected their health data in Houston, Texas, the 2^nd largest Vietnamese-populated metropolitan area in the U.S. The data showed a high prevalence of physical (ADL, IADL), mental (depressive symptoms), and cognitive (dementia) disabilities. Using the University (researchers and Vietnamese students) and Vietnamese community partnerships, we developed a linguistically and culturally tailored dementia one-pager to improve the community’s health/dementia literacy in 2022. In 2023, we formed the Cognitive Health Initiative (CHAIN) and offered free memory tests to monolingual Vietnamese refugees/immigrants. This study reports how CHAIN operates, fosters intergenerational relationships between university students and older Vietnamese, and nurtures university-community partnerships in the Houston Vietnamese-American community.

Methods: Using the Cultural Exchange Model as a conceptual framework, we established the CHAIN program and trained bilingual/bicultural Vietnamese students (Cohort 1) in the Vietnamese Montreal Cognitive Assessment (MoCA-V) while building teamwork, accountability to team members, ethics, and responsibility to the community among the CHAIN team. During 2024, when Cohort 2 students joined, we formed a mentor (Cohort 1)-mentee (Cohort 2) relationship, and Cohort 1 demonstrated the MoCA-V and Cohort 2 observed their mentors perform. After several demonstrations, Cohort 2 tried the MoCA-V supervised by Cohort 1. They repeated this sequence until Cohort 2 felt comfortable conducting the MoCA-V independently.

Results: During 2023-2024, we trained 52 students, attended 16 Vietnamese health fairs, and assessed the cognitive health of 406 monolingual Vietnamese older adults. Participants were on average 73±7.1 years old (age range: 53-91) and all were Vietnam-born. The majority were women (67%), married (55%), retired (91%) with primary (32%) or high school education (38%), in good health (44%), and scored 22±4.4 out of 30 MoCA-V on average. Mentors (Cohort 1) successfully trained their mentees (Cohort 2) and provided them with tips for conducting the MoCA-V and how to work with older adults.

Conclusions: We trained bilingual/bicultural Vietnamese university students to conduct a culturally- and linguistically tailored MoCA-V in Vietnamese and assessed the cognitive levels of 406 monolingual older Vietnamese refugees/immigrants. The community’s average score indicated mild cognitive impairment and low health literacy. Improving the community’s health literacy is a big goal and requires long-term commitment from all parties involved. This is the beginning of the university-community partnerships in collaboration with Vietnamese healthcare professionals. The Houston Vietnamese community has a long history of volunteer healthcare professionals, and the university is raising new generations of future healthcare professionals. Thus, the CHAIN program needs to continue this collaboration among researchers, university students, and healthcare professionals to serve a common goal of improving older Vietnamese health literacy.