This article is based on ethnographic research that explored experiences of suffering in late life. From a group of 60 oldest-old (age 80 and above) male participants, four were primary, at-home caregivers for wives with dementia. Men's narratives showed the inter-relation between masculinities, a sense of personal control, and experiences of suffering within caregiving. Three thematic “tools” of control emerged as strategies men used to mediate their suffering: 1) the power of the little; 2) preserving self-identity and marriage-identity and, 3) finding purpose in the role of caregiver. We offer insight into the world of the oldest-old male caregiver through men's accounts of suffering, their daily tasks, thoughts about themselves as caregivers, and the manner in which they embody their masculinity in caregiving.

After a decade of changes in federal law, regulation, and policy designed to promote the growth of publicly funded participant-directed long-term services and supports (PD-LTSS) programs, the number of these programs has grown considerably. The National Resource Center for Participant-Directed Services (NRCPDS) at Boston College started developing an inventory of these programs in 2010–2011 to determine the number and characteristics of publicly funded PD-LTSS programs in the United States. The 2010–2011 NRCPDS inventory provides baseline data for future research efforts in gauging the growth and expansion of this service delivery model. This article details the process for developing this data resource, describes some of the major characteristics of PD-LTSS programs in the United States, and discusses possible implications and areas for future research.

Introduction: To develop more culturally appropriate and effective intervention strategies, this qualitative study explored Korean American women’s barriers to mammography and their coping strategies within their sociocultural context. Methodology: Semistructured individual interviews were conducted with 30 Korean American women in 2016. Thematic analysis was used to analyze the data and identify themes. Results: Four themes and their associated subthemes emerged from the data: (1) barriers to accessing mammography (cost, time consuming and complicated procedure, and language barriers), (2) psychosocial concerns related to mammography (pain, discomfort and embarrassment, and exposure to radiation), (3) strategies to access mammography (identifying ways to get a cost-free mammogram and having procedure done in home country), and (4) ways to deal with psychosocial concerns (being positive and avoiding or postponing the procedures). Discussion: Health professionals should account for cultural differences including, but not limited to, patients’ concerns, access to care, and beliefs surrounding screening processes.

Introduction: In the United States, vaccine hesitancy is higher among rural and racially and ethnically diverse communities, and messaging from trusted individuals may increase vaccine acceptance. The purpose of this study is to understand vaccine hesitancy, messaging from trusted individuals, and vaccine acceptance strategies among racially and ethnically diverse, medically underserved rural populations. Methods: The researchers conducted 12 in-person focus groups, each consisting of 5 to 12 participants, with community members and trusted leaders from three rural counties in Eastern North Carolina (n = 119). Thematic analysis was used to synthesize insights from the discussions, allowing for the identification of recurring patterns and community-specific considerations regarding vaccine perceptions and messaging. Results: The researchers identified seven key themes within the primary focus areas of the study: factors influencing vaccine hesitancy, messaging from trusted individuals, and strategies to improve vaccine acceptance. Participants reported differences in trust based on how long a vaccine has been available, concerns about becoming sick after a vaccine, seeing the symptoms of vaccine-preventable diseases, and misinformation on social media. Overall, participants reported trust in messages from medical providers. Trusted leaders advised people to conduct their own research on vaccines when determining whether to receive vaccinations. Lastly, social determinants such as cost, education, and transportation were identified as key barriers to vaccination. Conclusions: Our findings indicate that medical providers are trusted messengers for vaccine information and the promotion of vaccine uptake. However, distrust linked to fear, misinformation, and structural barriers persist. Public health efforts to increase vaccination confidence among rural, racially and ethnically diverse populations in the United States Southeast should address these factors in future vaccine interventions and educational efforts.