Older Immigrant African Women in Metro West Massachusetts Capstone Project

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Running head: DEPRESSION AMONG OLDER IMMIGRANTS DEPRESSION AMONG OLDER IMMIGRANTS 30Depression among Older Immigrant African Women in Metro West MassachusettsTable of ContentsAbstract 4Section 1: Foundation of the Study and Literature Review 5Problem Statement 7Purpose of the Study 9Research Questions 9Definition of Key Terms 10Significance of the Study 12Theoretical Framework 13Review of Professional and Academic Literature 14Cultural Competence 15Mental Health of Immigrants 17Depression Among Older African Immigrant Women 18Stressors faced by Older African Immigrant Women 19Summary 22Section 2: Research Design and Data Collection 23Research Design 23Methodology 25Data Analysis 29Ethical Procedures 31Limitations, Challenges, and/or Barriers 33Summary 35References 37AbstractThis study titled ‘Depression among Older Immigrant African Women in Metro West Massachusetts’ set out to understand the causes and prevalence of depression among older women coming from Africa to live in the United States of America. The study situated older women to be women above the age of 55 and focused on exploring the views of social workers in relation to issues of depression among these women. The present study is guided by the following questions: a) from the social work perspective, what factors influence older immigrant African women’s adaptive capacity in Metro West Massachusetts? (b) from a social work perspective, what mental health service do social works offer to older women from Africa living in the USA? (c) How do social workers assess the need for mental health services for their clients and (d) what service modifications can social workers introduce to enhance mental health service delivery for older women coming from Africa? These questions led to the investigations in this study that was guided by the structural-functional theory. Data was collected using the quota sampling. Interviews and questionnaires were most appropriately used to collect date and the SPSS software was used to analyze data. The study respected ethical issues strictly.Section 1: Foundation of the Study and Literature ReviewIn West Massachusetts United States, the most common health disorders are anxiety and depression, which are prevalent in elderly immigrant women aged between 50 and 79 years (Agbemenu, 2016). Despite a variety of efficacious interventions for depression and anxiety, it is clear elderly immigrant women experience mental health care disparities in their access to mental health services and the quality of treatment they receive. Research indicated African American heterogeneity prevents access to depression and anxiety treatment. In addition, African Americans are becoming an increasingly visible minority within the United States especially in West Massachusetts and are often depicted as Blacks. The current study sought to understand the causes and prevalence of depression among older immigrant African American women in Metro West Massachusetts as well as how the older immigrants cope with depression. A total of 12 self-identified social workers were interviewed about their patient’s mental health problem symptoms and treatment experience, what they thought was the cause of their patient’s anxiety, stressors facing their patient’s life in West Massachusetts, their patient access to mental health services, and how patients coped with depression. Results indicated considerable variability across the two groups, with African American elderly immigrant women endorsing higher rates of depression and anxiety, as well as higher rates of treatment seeking, than the Whites. Individual\'s gender, age, marital status, and origin played a major role in the endorsement of anxiety and depression for the immigrants. Finally, although the two groups differed in the extent to which they experienced stigma about mental health issues, stigma did not predict symptom endorsement or treatment-seeking behavior for any of the two groups. These findings underscored the importance of attending to both between-groups and within-group differences in the mental health and mental health treatment experiences of different ethnic groups.Overview of…

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…Runninghead:DEPRESSIONAMONGOLDERIMMIGRANTSDEPRESSIONAMONGOLDERIMMIGRANTS30DepressionamongOlderImmigrantAfricanWomeninMetroWestMassachusettsTableofContentsAbstract4Section1:FoundationoftheStudyandLiteratureReview5ProblemStatement7PurposeoftheStudy9ResearchQuestions9DefinitionofKeyTerms10SignificanceoftheStudy12TheoreticalFramework13ReviewofProfessionalandAcademicLiterature14CulturalCompetence15MentalHealthofImmigrants17DepressionAmongOlderAfricanImmigrantWomen18StressorsfacedbyOlderAfricanImmigrantWomen19Summary22Section2:ResearchDesignandDataCollection23ResearchDesign23Methodology25DataAnalysis29EthicalProcedures31Limitations,Challenges,and/orBarriers33Summary35References37AbstractThisstudytitled‘DepressionamongOlderImmigrantAfricanWomeninMetroWestMassachusetts’setouttounderstandthecausesandprevalenceofdepressionamongolderwomencomingfromAfricatoliveintheUnitedStatesofAmerica.Thestudysituatedolderwomentobewomenabovetheageof55andfocusedonexploringtheviewsofsocialworkersinrelationtoissuesofdepressionamongthesewomen.Thepresentstudyisguidedbythefollowingquestions:a)fromthesocialworkperspective,whatfactorsinfluenceolderimmigrantAfricanwomen’sadaptivecapacityinMetroWestMassachusetts?(b)fromasocialworkperspective,whatmentalhealthservicedosocialworksoffertoolderwomenfromAfricalivingintheUSA?(c)Howdosocialworkersassesstheneedformentalhealthservicesfortheirclientsand(d)whatservicemodificationscansocialworkersintroducetoenhancementalhealthservicedeliveryforolderwomencomingfromAfrica?Thesequestionsledtotheinvestigationsinthisstudythatwasguidedbythestructural-functionaltheory.Datawascollectedusingthequotasampling.InterviewsandquestionnairesweremostappropriatelyusedtocollectdateandtheSPSSsoftwarewasusedtoanalyzedata.Thestudyrespectedethicalissuesstrictly.Section1:FoundationoftheStudyandLiteratureReviewInWestMassachusettsUnitedStates,themostcommonhealthdisordersareanxietyanddepression,whichareprevalentinelderlyimmigrantwomenagedbetween50and79years(Agbemenu,2016).Despiteavarietyofefficaciousinterventionsfordepressionandanxiety,itisclearelderlyimmigrantwomenexperiencementalhealthcaredisparitiesintheiraccesstomentalhealthservicesandthequalityoftreatmenttheyreceive.ResearchindicatedAfricanAmericanheterogeneitypreventsaccesstodepressionandanxietytreatment.Inaddition,AfricanAmericansarebecominganincreasinglyvisibleminoritywithintheUnitedStatesespeciallyinWestMassachusettsandareoftendepictedasBlacks.ThecurrentstudysoughttounderstandthecausesandprevalenceofdepressionamongolderimmigrantAfricanAmericanwomeninMetroWestMassachusettsaswellashowtheolderimmigrantscopewithdepression.Atotalof12self-identifiedsocialworkerswereinterviewedabouttheirpatient’smentalhealthproblemsymptomsandtreatmentexperience,whattheythoughtwasthecauseoftheirpatient’sanxiety,stressorsfacingtheirpatient’slifeinWestMassachusetts,theirpatientaccesstomentalhealthservices,andhowpatientscopedwithdepression.Resultsindicatedconsiderablevariabilityacrossthetwogroups,withAfricanAmericanelderlyimmigrantwomenendorsinghigherratesofdepressionandanxiety,aswellashigherratesoftreatmentseeking,thantheWhites.Individual\'sgender,age,maritalstatus,andoriginplayedamajorroleintheendorsementofanxietyanddepressionfortheimmigrants.Finally,althoughthetwogroupsdifferedintheextenttowhichtheyexperiencedstigmaaboutmentalhealthissues,stigmadidnotpredictsymptomendorsementortreatment-seekingbehaviorforanyofthetwogroups.Thesefindingsunderscoredtheimportanceofattendingtobothbetween-groupsandwithin-groupdifferencesinthementalhealthandmentalhealthtreatmentexperiencesofdifferentethnicgroups.OverviewoftheProblem,ItsHistoryandSignificanceRelatedToTheStudyInrecentyears,therehasbeenagrowingneedforsocialworkforimmigrants,particularlytheoldimmigrantsaged65yearsandabove(SocialWorkToday,n.a.).Theyaretheoneswhoexperiencetherelocationinanentirelynewgeographicalregionwherepeoplearestrangerstothem.Thesociety’sacceptabilityislowtowardsthemthatcreatenegativeimpactsontheirphysicalandcognitivehealth.Theimpactscouldbeobservedinsocialisolation,lossofindependence,cognitivedeclinesandhealthprobleminoldage.Oldageisthecriticaltimeoflifewhentheelderlypeopleneedspecialcareandattention.Theirsocializationpatternsarechanged,especiallywhentheyhavetomigrate.Thenegativeeffectsmayemergeineconomic,social,psychological,politicalandculturalterms(Lotfi,2020).Immigrationhasadverseeffectsonageingpeopleastheyarementallyweakenedtotakethepressuresenforcedonthembyvariouschanges.Theirfamilyandsocialrelationsareaffected,resultinginmorecomplexproblemslikephysical,psychologicalandsociologicaldifficulties.Socialworkinterventionsareinnovativestrategiestouplifttheemotionalandphysicalwellbeingofelderlymigratingpeople.Socialworkershelptheelderlyindividualstowardstheadaptationprocesssothatsocialexclusionshouldbemitigatedandsocialjusticecouldbeserved(Haidar,n.a.).Sincetheyworkwith‘mixedstatus’families,theyhavetotakecareoftheirrights,especiallytargetingtheirethnicbackgrounds.AnincreaseinAfricanAmericanoldermigrantsisexpectedtoincreasebytheyear2050withracialethnicneedsarisingandthosewhohaveloweducationallevels(Gilmore,2013).Theirsocialandemotionalneedsmustbeaddressedbyculturallycompetentsocialworkerssothatmedicalandtherapeutichealthcareservicesshouldbeappropriatelyprovidedtotheneedy.However,ithasbeenobservedthattherearehealthcareaccessbarrierstotheracialandethnicallydiverseolderimmigrants(Koehn,2009).Thereisavastdisparityofhealthcareprovisiontothenativepopulationsandthoseagingmigrantswhoaretransferredtootherregions,adverselyaffectingthesepopulations\'morbidityandmortalityrates(Kristiansenetal.,2016).ProblemStatementTheintentinthisstudyistoexploretheviewsofsocialworkersinrelationtodepressionamongolderimmigrantAfricanwomencurrentlylivinginwestMassachusetts.OlderimmigrantAfricanwomenreferstowomenwhoareover55yearsofageandtheyrelocatedfromanyAfricancountryafteracquiringpermanentresidencyintheUnitedStates.Depressionamongelderlyimmigrantwomenstandsoutasanimportantphenomenonforstudyinthecontextofsocialworktakingintoconsiderationtheextenttowhichtheconditionaffectsvulnerablepopulations.Derr(2017)pointedoutimmigrantstypicallyfacestressorsrelatingtomigrationexperiencewhichmaycauseorintensifymentalhealthproblems.Moreover,Derr(2017)alsodiscussedthatimmigrantstendtoaccessmentalhealthservicesatalowerrateascomparedtonon-immigrants.Subsequently,thissituationleavesimmigrantsatriskofuntreatedhealthconditionsleadingtoincreaseddiseaseburden(Lynch,Berg,Manna,&Schade,2016).Assuch,thisnegativehealthpredispositioncreatedgreaterneedformentalhealthservicesamongimmigrantswhoseemmoresusceptibletodevelopdepression.Thissituationmakesitimperativetoestablishtheviewsofsocialworkersaddressingthementalhealthneeds,especiallydepression,amongolderimmigrantAfricanwomeninMetroWestMassachusetts.ItisduetoaninferencethatMetroWestMassachusettshasaclusterofcitiesandtownswhereoneofthefastestgrowingcommunitiesinAfricanAmericans,havingarateof95%growthsince2000(ImpactMetroWest,n.a.).However,disparitiesineducationalandsocialgainsarestillseenforthepeopleof‘color’,asareevidentinotherpartsoftheUnitedStates(Rosenberg,2020).Inturn,insightsgainedshouldplayacriticalroleinthedevelopmentofcomprehensivementalhealthprogramsaimedatimprovingtheimmigrants’healthoutcomes.Asnoted,migrationcanbechallenging,andmanyimmigrantwomenexperiencechallengesthataffecttheirmentalhealth(Fooetal.,2018).Forexample,thechangesinpractices,values,socialfactorsandculturalidentificationareconsideredasfactorscontributingtothepotentialriskofdevelopingmentalhealthissues(Alegría,Álvarez,&DiMarzio,2017).Similarly,Fooetal.(2018)assertedmigrationintoanewcountryleadstodrasticchangesinessentialaspectsofnormaldaylife.Here,theprocessofassimilatingtonewenvironmentsandculturescausesconsiderablelevelsofacculturativestress,whichresearchershavelinkedtotheoccurrenceofpsychiatricdisorders(Fooetal.,2018).Therefore,examiningstressorssurroundingthemigrantexperiencesfromthesocialworkperspectiveshouldofferinsightsintotheissuesfacedbythisvulnerablepopulation,especiallyforwomenaged50yearsandabove.Basedonthehighlightedproblem,itisimperativetodeterminetheviewsofsocialworkersfromWestMassachusettswhoworkwitholderimmigrantAfricanwomeninMetroWestMassachusettsaffectedbydepression(O’Donnelletal.,2016).Suchanundertakingmayrevealservicemodificationssuchasgivingpatientswithlanguagebarriersmoretimeneededtoenhanceaccesstoqualitymentalhealthservices(O’Donnelletal.,2016).Assuggestedbyresearchers,immigrationcancreateworry,whichmayincreasetherisksofexperiencingdepression,andthiscanbeexacerbatedbyculturalfactors,suchaslanguagebarrierswhichmaycausedifficultyindiagnosingandtreatingthisdisorderamongimmigrantpopulations(Landa,Skritskaya,Nicasio,Humensky,&Lewis-Fernández,2015).Failuretodetermineappropriatelytheviewsofsocialworkersondepressionwithinacertaincommunitytranslatestoneglectingsocialhealthandwelfare(Baldwin-Clark,OfahengaueVakalahi,&Anderson,2016).Inresponse,theintentofthisstudyistoobtaintheperspectiveofsocialworkersregardingdepressionwithintheselectedmigrantpopulationaswellasinsightsintothewaysinwhichprofessionalsinthehealthcaresectorcanhelpmeetemergingneeds.PurposeoftheStudyInthisstudy,theviewsofsocialworkersregardingdepressioninolderimmigrantAfricanwomeninMetroWestMassachusettswillbeobtained.Throughanalyzingtheseperspectives,insightscanbeprovidedintowaysthesocialworkerssectorcanassisttomeettheemergingneedsofthepopulation.ExpectedintheresultsofthisstudywillbeanyservicemodificationneededtomeettheneedsoftheimmigrantAfricanwomenlocatedinMetroWestMassachusetts(Takeuchi,2016).Thesefindingscanenhanceaccesstoqualitymentalhealthservicesandensurethewomenunderstandtheimplicationsofnotseekingmentalhealthservices.Havingexaminedthestressorsfacedbythemigrantwomen,insightswillbegainedintotheissuesthewomenfacewithinthepopulationandsolutionsdirectlytargetedtothepopulationcanbedeveloped(Agbemenu,2016).Socialworkerswillalsobenefitastheywillusethefindingsofthisstudytodeterminemethodstheycanusetoreachouttothepopulationunderstudy.ResearchQuestionsThisstudywouldfocusonansweringthefollowingresearchquestions:1.Fromtheperspectiveandbenefitsofsocialworkers,whatfactorsinfluenceolderimmigrantAfricanwomen’sadaptivecapacityinMetroWestMassachusetts?2.Fromthesocialworkperspective,whatmentalhealthservicesdosocialworkersoffertoolderimmigrantAfricanwomeninMetroWestMassachusetts?3.HowdosocialworkersassesstheneedformentalhealthservicesforolderimmigrantAfricanwomeninMetroWestMassachusetts?4.WhatservicemodificationscansocialworkersintroduceinpracticetoenhancementalhealthservicedeliveryforolderimmigrantAfricanwomeninMetroWestMassachusetts?DefinitionofKeyTerms1.Culturallyinformed-Culturallyinformedisdefinedastheofferingofcarebyhealthcareprofessionalsthatrespects,acknowledges,andintegratesthepatient\'sculturalvalues,practices,andbeliefs(HealthPolicyInstitute,n.a.).Inourstudy,cultureextendsbeyondidentifyingthepatientandfamilybyraceandethnicitytoincludevariableslikefaith,countryoforigin,educationlevel,socioeconomicstatus,andlevelofacculturation.Inthisstudyculturallyinformedreferstotheabilityofthesocialworkerstoofferservicesthatrecognize,affirm,andvaluetheworthoftheclients,theirfamilies,communities,andpreservesandprotectstheirdignity.1.OlderimmigrantAfricanwomen-OlderimmigrantAfricanwomenreferstowomenwhoareover65yearsofage(Noubicier&Charpentier,2013),andtheyrelocatedfromanyAfricancountrytotheUnitedStates.ThewomencouldhavecometotheUSlegallyorillegally.ThephrasealsoreferstowomenwhocametotheUSasrefugeesandtheyhaveremainedtheretilltheiradvancedage.Forthisstudy,thefocuswillbeonolderimmigrantAfricanwomenwholiveinWestMassachusettsandsufferfromdepression.1.Immigrant-AccordingtotheGimeno-Feliu,Calderón-Larrañaga,Díaz,etal(2019),animmigrantisdefinedasapersonwhocomestopermanentlyliveinaforeigncountry.Therearefourtypesofimmigrationstatusnamelycitizens,residents,undocumented,andnon-immigrants.Inthispaperthefocuswillnotbeonthestatusoftheimmigrant,butweexpectthestatusoftheimmigranttocontributetohowtheimmigrantaccessmentalhealthservices.Therefore,thestudywillconsiderallimmigrantsprovidedtheyimmigratedfromAfricaandtheyhavebeenlivingintheselectedcommunity.1.Africanwomen-AfricanwomenreferstoanativeorinhabitantwomanofAfricaorawomanwhohasAfricanancestry(Ythera,2017).Inthisstudy,AfricanwomenreferstotheolderimmigrantAfricanwomenwhowerebornoutsideofUSinAfricaandtheyhadtomigratetotheUSeitherlegallyorillegallyandtheycurrentlyresideinWestMassachusetts.ThewomenwillhavelivedalmosthalftheirlifeinAfricabeforetheyimmigratedtotheUS.1.Copingmechanisms-Copingmechanismisthecollectionofstrategiesusedtocopewithstressfuleventsinone’slifeandthetraumaalongwithitspainfulmemories(GoodTherapy,2018).Inthestudy,copingmechanismreferstothedifferentculturalstrategiesusedbythewomenandtodealwiththestressfulsituationstheyencounter.Themethodsthewomenwillusetoadjusttothestresstheyfaceandassistthemtomaintaintheiremotionalwell-being.1.Migration-Migrationistemporaryorpermanentmovementofhumansoranimalsfromonegeographicregiontoanother(Sinha,2005).Inthestudy,migrationreferstothemovementofpeoplefromanyAfricancountrytotheUnitedStates.ThefocuswillonlybeonthewomenwhohavemigratedfromAfricatotheUSeitheralone,withtheirfamily,orwitharelativeandtheyarecurrentlylivinginWestMassachusetts.Theprocessofthewomenmigratingwillnotbeamajorfocus,butitcanbereliedupontodetermineifitcontributestothewomenfailingtoaccessmentalhealthservices.1.Hostcountry-AccordingtoYamlaksira,Getachew,Paul,andBeamish(2021),ahostcountryisacountrythatholdsaculturaleventorsportingeventtowhichothersareinvited.Inthisstudy,hostcountryreferstothecountrythatisaccommodatingtheAfricanimmigrantsorwheretheimmigrantsareliving,whichistheUS.SignificanceoftheStudyThesignificanceofthisresearchcouldbeassessedfromthefactthatAfricanAmericancommunityhasbeenfacingracialdisparitysincethetimesoftheirslaveryandhasstillnotneeded,whichcouldbeseeninmoderntimes(Watkins,Hawkins&Mitchell,2019).Thistypeofmodernslaveryaffectstheirlivingsocialconditionsanddirectlyaffectstheirhealth.Amongthemarethosewhoareoldandhaveamoreserioustendencyofgettinghealthconditionduetothenegativeracialexperiences.SocialworkershavecometohelptheAfricanAmericancommunitywithanethnic-centeredandholisticapproachwhileworkingwiththissegmentofthepopulation.Therefore,itisforthisreasonthatsocialworkerswouldgainsupportfromthisresearchtospecificallyaddresstheconcernsoftheolderimmigrantsfromtheAfricanAmericancommunity.Theincrementinsocialworkforthisparticularcommunityhasbeenrisingforthepastfewdecadesanduseoftheoreticalandpracticalstrategieshavebeendevelopedwithcontinuousresearch,design,implementation,andevaluationofseveralsocialworkpracticesinthisverypopulationsegment.TheAfrocentricorAfricentricparadigmshavebeenestablishedtodiscusstheseriousnessoftheoppressionandtheprolongedcultureofslaverystillfacedbythiscommunity(Watkins,Hawkins&Mitchell,2019).Ittravelsalongthelinesofphysicalandmentalhealthduetolossofidentitieswhentheytraveltoanewregionandchangedlivingconditionsareexperienced,itisforthispurposethatthecurrentstudywouldaddressthesocialworkinterventionsfortheelderlycommunityamongtheAfricanAmericanimmigrants.ThefindingsofthisstudywillcontributenewknowledgetoaddressthegapinresearchregardingdepressioninolderimmigrantAfricanwomenresidinginMetroWestMassachusetts.Findingswillofferinsightsintowayssocialworkerscanmeettheemergingneedsofthispopulation.ThestudyresultswillassistthecommunitysocialworkerstobetteraddresstheemergingneedsandchallengesolderimmigrantAfricanwomenfacewhenaccessingmentalhealthservices.Morespecifically,thestudywillfocusonhowthetargetpopulationisaffectedbydepressionwhentherearebarrierstothemreceivingsupport.FindingsinthestudywillequipsocialworkerswiththeknowledgetodevelopstrategiestheycanusetotreatdepressionandbringawarenesstotheuniqueneedsoftheolderimmigrantAfricanwomen.TheoreticalFrameworkThetheoreticalframeworkthatcanbeusedtoframethisprojectisthestructural-functionaltheory.SometheoristssuchasCassel(1995)andCobb(1976)expressedsocialsupportservesasaresistancefactor,andplaysanimportantroleinreducingadverseimpactofexposuretonegativelifeevents(Thoits,1985).ThistheoryshouldplayakeyroleinunderstandingtheonsetofdepressionamongolderimmigrantAfricanwomen,giventhevarioussocialdemandsassociatedwithbeingamigrant.Further,KinserandLyon(2014)emphasizedthatdepressingexperiencesmayincreaseaperson’spossibilitytosufferfromstressfulepisodes.Stressandvulnerabilityadduptothepossibilityofdevelopingdepression,wherechangesintheenvironment,lackofcopingmechanismsandlackofsupporthaveanadverseimpactonthementalhealthoutcomeofthisgroup(Alegríaetal.,2017).Culturalinfluencescanberevealedthatwillbevitalindeterminingthemethodsthatcanbeusedtotreatthispopulation.Tobecomeculturallycompetentwhendealingwiththispopulation,socialworkerswouldneedtobefamiliarwiththeStructural-FunctionalTheory.Explainedinthistheoryiswhysocietyfunctionsthewayitdoes,anditemphasizesontherelationshipsbetweenthedifferentsocialinstitutionsthatmakeupsociety(Emadpoor,Lavasani,&Shahcheraghi,2016).Someofthesesocialinstitutionsareeducation,law,government,religion,andculture.Thesocialworkersaretrainedtounderstandthatthesocietyislikeasystemwhereallthepartswillworktogethertocreateawhole.Emadpooretal.(2016)positsocietieswillneedcultureforthemtofunction.Therefore,beingculturallyinformedisbeneficialtothesocialworkeranditwillallowthemtoreachouttothecommunitymembersandapproachtheminanacceptablemanner(Sabbionietal.,2018).ReviewofProfessionalandAcademicLiteratureFromthereviewconducted,alackofliteratureexistsinwhichtheprimaryfocuswasplacedonolderAfricanimmigrantwomen(Okudo&Ross,2016).ThisshortageisduetonumerousfactorsthatmostlyinvolvewiththeperceptionthatAfricanimmigrantshaveregardingdepression(Thomson,Chaze,George,&Guruge,2015).Mosttimes,depressedindividualsarestigmatized,andmostAfricancommunitiesbelievedepressioniscausedbybadspirits.Withthisnotionitbecomesdifficultforthewomentoseekprofessionalhealthservicesastheywouldbelabelledandjudgedbyothercommunitymembersharshly(Sánchezetal.,2014).Acomprehensivesearchfrompeer-reviewedpublicationswasconductedforthisstudyfocusingonmentalhealthamongolderAfricanimmigrantwomen,fromthefollowingsources,MEDLINE,PsycINFO,CINAHL,EBSCO,ResearchGate,ProQuest,SAGEJournals,andEMBASE.Thekeyword(s)usedtosearchfortheappropriateliteratureforthisstudywasdepressioninolderwomen,depressioninolderimmigrantwomen,olderAfricanAmericanwomen,olderimmigrantAfricanwomen,depressioninimmigrantAfricanwomen,depression,andolderimmigrantwomen.Tospecificallytargettheresearchtowards‘AfricanAmericanwomen’,thiskeywordisincludedforkeepingtheliteratureconcise.CulturalCompetenceOkudoandRoss(2016)offeredinformationonthevarioushealthchallengesthatAfricanImmigrantsfromdifferentpartsofAfricafacewhentheyrelocatetotheUSovertimeandtheexplorationofthehealthyimmigranteffect(HIE)WhenAfricanimmigrantsrelocatetotheUS,theyarehealthierthantheirAmericancounterpartsduetoHIE.However,astheimmigrantsacclimatizeintotheUSsystem,theywilladopttheunhealthylifestylesandbehaviorsoftheUS,whichleadstothemdevelopinglifestylediseasestheywouldnothavedevelopedhadtheynotrelocatedtotheUS.Thisarticleissignificantasitsupportsourstudybyofferinginsightsintothechangeimmigrantsundergoregardingtheirhealthandhowthispopulationisneglectedbyphysicians.WithoutunderstandingthepeculiaritiespertainingtotheAfricanimmigrantpopulation,physicianscannotofferculturallyusefulcaretotheimmigrants.ThesignificanceofthisarticleisthatwecanusetheinformationtodetermineifsocialworkersmakeuseofculturallyacceptablepracticeswhentreatingolderimmigrantAfricanwomen.Sánchezetal.(2014)identifiedthemostcommonlyoccurringmentalhealthdisordersaredepressionandanxiety.Theauthorsalsonotethereisdisparityinthequalityofcaregivenandintheiraccesstomentalhealthservices.Theroleofcultureandstigmatizationwasexploredinthestudy.Thisarticleindicatestherearementalhealthcaredisparitiesexperiencedbyimmigrantsduetoinsufficientmentalhealthservicesintheircommunities,lackofculturalcompetency,andmentalhealthstigmatization.WiththisinformationisbecomesclearastowhymanyAfricanimmigrantsdonotreceiveorseekmentalhealthservices.UnderstandinghowtoovercomesomeofthesebarrierswillassistinreducingthecasesofdepressionamongolderAfricanimmigrantwomeninthecommunity.AsnotedbyDelara(2016)thementalhealthofAfricanimmigrantwomenisaffectedbysocial,cultural,andthehealthcaresystemandthereisaneedtoembracedifferentmethodologiesforpromotingmentalhealthamongthewomen.AccordingtoDelara(2016)themerefactawomanisamigrantmakeshermorevulnerabletonegativeandpositivementaleffectsofmigration.Theeffectsfeltbythewomanwillbedependentontheirlegalstatus,stageofmigrationcycle,andmodeoftravel.TheauthorsnotetheimmigrationprocesscouldbetraumatizingformostwomenespeciallyifthewomenhadtoseekclandestinemeanstoarriveintheUS.Askingthesewomenrepetitivequestionsregardingtheirimmigrantvictimizationcouldbringaboutmentaldisorderslikedepression.Thewomencouldalsoavoidseekingmentalhealthservicesastheyfearbeingaskedquestionsabouttheirimmigrationexperience.OlderimmigrantAfricanwomenhavebeenfoundtoexperienceproblemsofisolation,language,abuse,culture,andmobility.Theseproblemshindertheiraccesstomentalhealthservices.Therelevanceofthisarticleisthatisshowstheproblemsolderimmigrantwomenfaceandthereasonswhytheyfailtoseekprofessionalmentalhealthservices.MentalHealthofImmigrantsRashidandGregory(2014)focusedontheexperiencesofAfricanImmigrantwomenwithafocusontheirlifebeforeandaftertheirrelocation.RashidandGregory(2014)havedemonstratedAfricanimmigrantwomenfacenumerouschallengeswhentheyrelocatetotheUS.However,therearewomenwhohavemanagedtoovercomethechallengesandwithstandtheadversitytheyfaced.ItisvitaltoknowwhysomeolderimmigrantAfricanwomenwillsufferfromdepressionwhileotherswillnot.Thisarticleoffersvitalinformationonhowsomeofthewomenmanagedtheirrelocationandavoideddevelopingdepression,whichcouldbeusedbyotherAfricanimmigrantwomenwhentheyrelocatetotheUS.Thomsonetal.(2015)therelocationprocesscanimpactthementalhealthofimmigrantsandwithoutinformationonmentalhealthandhelpfulservicesmanyimmigrantsaredeniedaccesstomentalhealthservices.Theauthorsnotedimmigrantsareunderrepresentedinthementalhealthcaresystemandtheyunderutilizementalhealthservices.BarrierstoserviceutilizationplayakeyroleinolderimmigrantAfricanwomen.Thisarticlenoteseconomichardshipsfacedbytheimmigrantsaffecttheirmentalhealthandaccesstomentalhealthservices.Forthisstudy,thisarticleisrelevantasitallowsustounderstandwhymostimmigrantsdonotaccessmentalhealthservicesandwhytheysufferfromdepression.Thethreemajorbarriersnotedbytheauthorsarebarriersintheuptakeofhealthinformationandservices,inadequacyoflinguisticallyandculturallyappropriateservices,andbarriersrelatedtothesettlementexperience.TheresearcherwantstodetermineifthesearethesamebarriersfacedbytheolderimmigrantAfricanwomeninWestMassachusetts.DepressionAmongOlderAfricanImmigrantWomenBaldwin-Clarketal.(2016)noteddepressionisamajorproblemamongolderAfricanimmigrantwomenandsincetheyareunderstudied,theirdepressionisrarelydiscussedorresearched.ThelackofrelevantresearchfocusingonolderimmigrantAfricanwomenisanindicationtheprevalenceratesofdepressionmightbehigherthanwhatisthought.ThefocusofmostdepressionstudieshasbeenWhiteolderadults.ItisraretofindAfricanimmigrantsmakinguseofhealthcare,socialservices,andlong-termcareandthereasonistheylackawarenessoftheresources,limitedfinancialresources,differencesintheinterpretationofmentalhealthissues,andmistrustofthesystems.ThisstudyisbeneficialtoourcurrentstudyasitfocusesonolderimmigrantAfricanwomen.Theauthorshavedemonstratedthereasonwhymentalhealthservicesarenotaccessedbythewomenandstrategiestousetoencouragethewomentoaccesstheservices.Understandingwhytheyfailtoaccesstheservicesisbeneficialtoourstudyasitwillassisttheresearchertoformulatequestionstothesocialworkersaimedatestablishingifthesearethesameissuesfacedbythepopulationunderstudy.Lazar-Neto,Louzada,deMoura,Calixto,andCastro(2018)assessedthefrequencyofdepressionamongimmigrantslivinginMassachusettstodeterminecorrelatesofdepression.Theauthorsdemonstratethatmostimmigrantsdosufferfromdepression.ByanalyzingBrazilianimmigrantswhohaverelocatedtoMassachusetts,theauthorsindicatethemigrantsencounterthesamebarriersasthosefacedbyolderimmigrantAfricanwomen.Therefore,theproblemofaccesstomentalhealthservicescouldbeduetosystemicissuesandnotthemigrantsthemselves.Understandingwhathindersmigrantsfromaccessingorseekingmentalhealthserviceswillbebeneficialtothecommunitiesasthoseproblemscanbeeliminated.Thisarticleenablestheresearchertodeterminetheaccessofmentalhealthservicesbydifferentmigrantswithinthesamestate.Whileitmightbeeasytostatethefailuretoaccessisduetoalackofknowledgebythemigrants,thereareotherissueslikeculturalpreferencesandlackofservices.ImmigrantsfromAfricaandBrazilfacethesamelanguagebarrierswheretheyarenotcompetentinEnglish,whichresultsinthemfailingtounderstandwhatphysiciansormentalhealthprofessionalsarerecommendingoradvising.Cultureplaysakeyroleinthetreatmentofmigrants.Therefore,culturalcompetencyshouldbeanalyzedtoestablishifthesocialworkersareculturallyawareoriftheyunderstandtheroleofculturewhenitcomestotreatingordealingwithimmigrants.ThesignificanceofthisarticleisthatimmigrantsseemtosharethesameexperienceswhenitcomestodepressiononcetheyrelocatetotheUS.Therefore,thereisaneedtoinvestigatetheissuessurroundingmentalhealthservicesinthecommunitiesandestablishthereasonsbehindthediscriminatoryaccesstotheservices.StressorsfacedbyOlderAfricanImmigrantWomenStressorsfacedbyAfricanimmigrantsandrefugeeswhentheyrelocatetotheUnitedStateswereanalyzedbyLi,Liddell,andNickerson(2016).Theauthorslinkthestressorstothedevelopmentofdepression.Manyimmigrantsfacesocialandinterpersonalchallengeswhentheymigratetoanewcountry.Someofthesocialandinterpersonaldifficultiesincludeseparationfromfamily,socialisolation,anddiscriminationinthehostcountry.AnotherdifficultypositedbyLietal.(2016)islossofsocialidentitytiedwiththeirformerculturalandcommunitygroups.ThesedifficultieswillleadtodepressionsymptomsintheolderimmigrantAfricanwomen.ThearticlebyLietal.(2016)increasestheknowledgeonthedevelopmentofdepressionamongimmigrantwomenandtheunderlyingcausesofthesymptoms.Theauthorshavegonefurthertodemonstratethestrategiesemployedbymostoftheimmigrantstoreducethesymptomsofdepression,whichwouldbesignificantforourstudyaswecanquestionifthesamestrategiescouldbeappliedtothepopulationunderstudy.Thepost-migrationfactorsaffectingmentalhealthinmigrantsshouldbecloselyanalyzed.Addingtothecurrentinformationwehaveregardingthestressorsandissuesfacedbyimmigrants,theauthorshavedemonstratedthereisneedtonotonlyconsiderthepre-migrationfactors,butthepost-migrationfactorsaswell.Post-migrationfactorshavebeenfoundtobehighcontributorstotheimmigrantsdevelopingdepressivesymptomsandfailingtoseekmentalhealthservices.Fooetal.(2018)wasanalyzingtheextentofdepressionamongimmigrantsandexploredthevariationsonprevalencebasedondemographicandeducationalfactors.WhenolderimmigrantAfricanwomenhavetoassimilatetonewculturalpracticesandsurroundings,theydevelopacculturativestress,whichleadstothedevelopmentofdepression.Theauthorswantedtoexaminethelinkbetweenmigrationanddevelopmentofdepression.Thearticlehasnotedthattheearlypost-migrationphaseishighlyattributedwithincreasedlevelsofacculturativestress,whichtendtoreduceastheimmigrantsettlesdowninthehostcountry.Theincreasedlevelsofacculturativestresscouldleadtoincreasementaldistressandifnotproperlytreatedcouldresultindepressionlateroninlife.However,theauthorshavenotedthereisnorelationbetweenmigrationanddevelopmentofdepressionsinceoncetheimmigrantiswellacclimatizedwiththenewenvironmenttheywilladaptandsettledowntothenewculture.Theadjustmentperiodinvolvesadjustmentofculturalvaluesandsocialnetworks,whichleadstoconfusionanddevelopmentofdepression.Thelackofsocialsupportisshownasahugecontributortowardsthedevelopmentofdepressionlaterinlifeastheolderimmigrantwillbelonely,andshewillnothavethesocialsupportshewouldhaveinherhomecountry.EkwemalorandEzeobele(2020)exploredtheportrayalofdepressionamongNigerian-bornimmigrantwomenwhowerelivingintheUnitedStates.Whenmovingfromapatriarchalculturetoamoredemocraticonecanbechallengingforimmigrants.Withlimitedknowledgeofwhatservicesareavailabletotheimmigrantsandthecultureofbeingsecretivedeniesmostmigrantstheopportunitytoreceiveassistancewithmentalhealthproblems.DisruptionofthetraditionalfamilystructureisoneoftheeffectsofmigratingtotheUS.FamilystructureasitisknownbackinAfricanisnotthesameandthiscausesdistresstothewomenwhoareusedtosocializationbetweentheextendedfamilymembers.WhenNigerianmigrantsarefacedwithstressfulsituationstheycanbeguardedintheirinteractionsandtheywillnotdivulgeinformation.Therefore,thereisneedforculturalcompetenceonthepartofthesocialworkers.Withoutculturalcompetence,thesocialworkerswillnotgetthroughtotheimmigrantsandtheywillcontinuesufferinginsilence.Culturalexpectationsplayakeyrolewhenitcomestomentalhealthproblemslikedepression.Thebeliefstheyhadbackhomewillbeharboredinthehostcountryandthewomenwillnotwanttoheartheyhavebeendiagnosedwithdepression.Inthestudyconductedby EkwemalorandEzeobele(2020),theresearchersestablishedthatmostNigerianWomenwhohaveimmigratedtotheU.S.labeldepressionascrazinessormadness.Oneparticipantstatedthat‘YoupeopleintheU.S.callitdepression;wecallitmadnessinNigeria.’ThisshowsthelevelofstigmathatonewouldhaveiftheyweretobediagnosedwithdepressionandtheyhappentocomefromNigeria.TheauthorshaveproposedtheuseofconversationalstyleofinterviewtoassistinrelaxingtheNigerianimmigrantswhentheyareundergoingtheirhealthassessment.Usingconversationalstyleinterviewswillbreaktheculturalshieldanallowthewomentodisclosetheirhealthconditions.SummaryTheprofessionalandacademicliteratureindicateolderimmigrantAfricanwomendonotreceiveadequatementalhealthservices.Therearesystemicandculturalbarrierspromotingthelackofaccesstomentalhealthservices,whichshouldbeinvestigatedfurther.Identifyingthemissinglinksonlyisnotenoughandthereshouldbeinvestigationonhowtoovercomethebarriersandmakeiteasierforthewomentoaccessmentalhealthservices.Thestudiesunderreviewhaveallconfirmedthereisadiscrepancywhenitcomestoaccessandusageofmentalhealthservicesamongtheelderlywomen.MostimmigrantswillcometotheUSAhealthyandtheywillonlybegindevelopingtheselifestylediseasesduetothechallengestheyfaceafterrelocation.Socialworkersinteractcloselywiththeimmigrantsandtheycanoffervitalinsightstohowtheimmigrantsmakeuseoftheavailablementalhealthservices.Thelackofservicescanalsobeconfirmedbythesocialworkersastheyarechargedwithofferingtheavailableservicestothepopulation.MostresearchershavepointedouttheimpactofimmigrationandhowAfricanimmigrantsbegindevelopingdepressionandothermentalhealthissues.Thesynthesisofthesestudiesindicatesthatsocialworkersshouldtargettheolderwomeninimmigrantpopulationandmustrethinktheirstrategiesforaddressingtherelocationchallengesofthissegment.Thearticleswereselectedtoenforcethisnotionthatolderimmigrantwomenareunderseriousthreatofdepression.Thesocialworkorganizationsmustdirecttheirenergiestospecificallyworkforthisstratumofpopulation.Section2:ResearchDesignandDataCollectionResearchDesignThiswillbeanexploratorystudytouncovertheviewsofsocialworkerswhoworkwithimmigrantAfricanwomenlocatedinMetroWestMassachusetts.Thereasonforselectingexploratorystudyforcurrentresearchisthatitwouldgiveflexibilityintheentireresearchprocesses.Thebetterunderstandingoftheestablishedresearchquestionisthemajorobjectiveofsuchastudy,whichsuitsbestforthisresearch(QuestionPro,n.a).Whenthenecessaryinformationisgatheredabouttheselectedissuethroughliteratureanalysis,theresearchercontemplateswhytheissueneedstobeaddressedandthatexploratoryinsightisneeded.Theinterpretationisdonebasedonthegaineddatasothattheresearchquestionanditsrelevantquerieslike‘what’,‘how’and‘why’areanswered.Inadditiontothat,ithasseveralbenefitssuchasbeinglowcost,layingdownthefoundationofresearchforfurtherimplicationsinthefuture,identificationofthecorrecttopicintheinitialsstagessothattimeandresourcesarenotwasted,andprovidingassistanceforotherresearchersonthesametopic(QuestionPro,n.a.).ThefocusofthestudyistogaininsightsintothebarriersolderimmigrantAfricanwomenfaceinaccessingmentalhealthresources,whichwillalsoincludeananalysisoftheavailabilityofthoseresources.Duetotheirunderstandingofandinteractionwiththispopulation,theviewsofthesocialworkerswillbeexaminedtoensuretheinformationbeingpresentedisreliable.Socialworkersareresponsibleforaddressingthehealthchallengesthatthiscommunityfaces.Withthisinmind,vitalinsightscanberevealedbyinterviewingandgainingtheirperspectiveregardingthecurrentsituation.TheviewsexpressedbythesocialworkersshouldbeanalyzedtodeterminetheeffectofdepressionamongolderimmigrantAfricanwomen.Thesourceofinformationforthisstudywillcomefromtheresponsesobtainedfromtheindividualinterviewswitheachsocialworker.TheepistemologyofthisstudywillfocusonexploringtheexperiencesofsocialworkersworkingwitholderAfricanimmigrantwomenlivinginMetroWestMassachusetts.Socialworkersworkinginthecommunityforthreeormoreyears,aregraduatelevelsocialworkersorhigher,willbeusedforthisstudy.ExclusionswillincludesocialworkerswhomeettheabovecriteriabuthavenotworkedwitholderAfricanimmigrants.Thisinclusionprocesswillensureexperiencedsocialworkersareprovidinginformationrelevanttothestudy.Allparticipantswillneedtocompleteconsentformspriortoparticipatinginthestudy.InthecontemporarytimesofCovid-19,therecruitsforsocialworksmustbevaccinatedastheirvaccinationformswouldbechecked.Theywouldberequiredtowearfacemasksatalltimes.Also,theymustpossessahandsanitizereitherinthepocketsoftheirwhiterobesorattachedwithhangingchainsalongwiththeirnametagsaroundtheirnecks.Theinterviewswillbeaudiorecordedandtheresearcherwillbetakingnotesastheinterviewprogressesaftertakingconsentfromtheparticipantsinwrittenform.Theaudiorecordingswouldbeusedastheavailabletranscriptionsoftheinterview,deemingittobethefirststepofdataanalysis.Theresearcherwouldusethesetranscriptionstodevelopcodesbeforeenteringthedataintothesystem.Forthisstudy,theresearcherwillmakeuseofSPSSStatisticssoftwaretoanalyzethedata.Theselectionofthissoftwarefortheanalysisistodeterminethefactors,ormorespecifically,thebarrierstohealthservicesthatolderimmigrantwomenface.Theresearcherwouldanalyzethedatahimselfashewouldbeclosertotheobtaineddataandknowthedimensionsuponwhichtheresponsescouldbeverified.Thedatacouldbeverifiedbyinvitingtheparticipantstoreviewthoserecordingandascertainthatthoseweretheactualwordsintheirvoiceutteredbythem.Anymanipulationsshouldbenegatedbytheparticipantssothatdataisconsideredvalid.Ethicalconsiderationmustalsobetakenintoaccountbytakingthepermissionfromtheparticipantsforrepeatedfutureuseofthoserecordingforresearchpurposes.MethodologyThedatatypesofthestudywillbequalitativeastheresearcherswillrelyoninterviewswiththesocialworkers.Thereasonforselectingthistypeofstudyisthatqualitativeresearchprovidesinsightintothefeelings(Rahman,2017),emotionsandopinionsoftheparticipantswhichiscrucial.However,extremecareneedstobetakentointerpretlanguageandmeaningsassignedtothewordsthattheparticipantsutter.Thevalidityandreliabilityoftheresearchresultsdependsonthisphasesinceanethicalresearchmustbefreeofbias.Thesocialworkers’feelingsandthoughtsrelevanttotheparticularsettinginwhichtheyworkandtheculturetheydealwith,whichisAfricanAmerican,wouldhelpshapetheircomments.Hence,whentheanalystswouldgivemarksandgradestotheresponses,themeaningoftheirevaluationswouldbebetterunderstood.Asqualitativeresearchisflexible,theparticipantscanopenupabouttheirfeelingsandemotionsindetailwhichcannotbedonethroughasurvey.Thedetailedinformationhelpstheresearcherdeterminewhatisconstantfortheparticipantsandwhatisomitted.TheinterviewswouldbeconductedusinginternetserviceslikeGoToMeeting,skype,Zoom,oranyotherweb-basedservice,suggestedbythesocialworkers.TheonlineformofinterviewswouldbeconductedbykeepingCoronasocialdistancinginmind.Therearecertainbenefitsofconductinginterviewsforthecurrentresearchsuchasflexibility,interpretationsofthenon-verbalresponsessuchassighs,laughter,lowandhightonesinbetweenthesentences,etc.,thedecidedplacebytherespondentwouldgivethemacomfortzonewheretheycouldrespondtotheinterviewsquestionsthatwoulddirectlyimpactuponthequalityofresponsesandthevalidityofanalysis.Theresearcher\'scontrolovertheorderofthequestionssothatoneresponsemightleadtotheanswerofanotherandthesimilarityordifferencesinresponsescouldbeevaluated(SociologyGroup,n.a.).Experiencedsocialworkershavetheabilitytounderstandtheirclientsandtheycaneducateusontheimpactculturehasonwomen\'sdepression(UniversityofSouthernCalifornia,2020).Toconducttheresearch,sampleswillbeselectedfromsocialworkerswhoarecurrentlyservingtheMetroWestMAregion,whichisapriorplaceofemploymentfortheresearcher.Thisresearcherwillpostflyersaroundmentalhealthoffices,retirementhomes,andhospitalsinvitingsocialworkerstoparticipateinthestudy.Additionalmethodwillbehandingoutflyerstosocialworkersattendingconventions,trainings,andprogramswithinthearea.Theresearchquestionsendeavortohelpdeterminetherolesocialworkersplayininsuringtheavailabilityofmentalhealthservicesaswellasmodificationsthatcanhelpimproveservicedelivery.Forexample,whatroledoyouplayinensuringelderlyAfricanimmigrantwomenareabletoaccessmentalhealthservices?ThedatacollectionprocesswillrelyoninternetserviceslikeGoToMeeting,skype,Zoom,oranyotherweb-basedservicetoconducttheinterviews,where10questionsareadministeredtoprobeforrelevantinformationfrom10-12socialworkersworkingwithelderlyimmigrantsparticipatinginvariousinstitutionsthroughoutWestMassachusetts.Someofthemwereexcludedduetonoconsent,leavingthestudyearlyornointerviewduetotimeconstraints,limitingthenumberofrespondentsto10-12socialworkers.Anacceptablesamplesizeisconsideredas10%ofthetotalpopulation(ToolsforDev,n.a.)..TheGoToMeeting,skype,orZoominterviewwilllastapproximately45minutestoonehour.Toensuretheintervieweeswillbecomfortableduringtheinterviewprocess,thisresearcherwillproposeconductingtheinterviewsontheiragreeduponspaceandtimewhereallinformationobtainedcouldbekeptconfidential,offworkhourswillalsobeanoption.ParticipantsSocialworkersoperatebyinteractingwithdifferentpeopleinthecommunity.Theyhandlenumerouscases,andtheyareattheforefrontofthecommunityinitiativesregardinghealthcare.Thismakesthemthebestcandidatesforourstudyastheydealwithdifferentclientsandtheyhandlecasesofdepression.Interviewingthesocialworkerswilloffertheresearcherinformationontheprevalenceofdepressionandunderstandwhyitisnothighlyreported.Theywilloffervitalinsightsrelatedtodepression,particularlyassociatedwiththiscommunity.Socialworkersareinastrategicpositiontointeractevenwithpeoplewhohadnotcometotheirfacilityfordepression.Beingabletospotanissuegivesthemtheedgetoinitiateconversationwithawomanwhopresentswithdepressivesymptoms.Socialworkersarechargedwithvisitingthemembersofthecommunityintheirhouseholds,whichgivesthemanadvantageastheycancheckupontheolderwomenandhavediscussionswiththemabouthowtheyarefeeling.Bymakingthesevisits,itisexpectedthatthesocialworkercandiscoverundiagnosedcasesofdepression.Theprojectednumberofstudyparticipantsis10-12socialworkerswhohavebeenworkingintheMetroWestMassachusettsareaforaminimumofthreeyears.Theresearcherhasdeterminedthatworkingwiththisnumberofsocialworkerswouldberepresentativeofthepopulationunderstudyastherearearound120socialworkersinthearea.Accordingtothecriteriamentionedaboveofaccuratelyrepresentingsamplesize,whichis10%ofthetotalpopulation,12participantsistherightchoice.Withalargesamplesize,theresearcherwillspendtoomuchtimeconductingtheinterviewsandperformingdataanalysis(Okudo&Ross,2016).Itwouldbeunethicaltoselectalargesamplesizebecausetheresearchermightendupbeingunabletointerviewalltheparticipants.Also,thereisapossibilitythatthisresearcherwillbepressedfortimeandopttoshortentheinterviewtimeline.Thiswillresultinunclearanswersandtheresearchstudywouldbeaffected.InstrumentationThisstudywillmakeuseofquotasampling,duetotheinclusionarycriteriawhichidentifiesthecharacteristicsforparticipantstobeincludedinthisstudy.Quotasamplingissimilartopurposivesampling(FamilyHealthInternational,n.a.);theonlydifferenceisthattheresearcherdecidesonthenumberofparticipantsandthecharacteristicstheyarelookingforintheparticipants.Inpurposivesampling,theparticipantsaregroupedtoapreselectedcriterion(Glen,n.a.).Thesamplesizesarenotfixedonpurposivesamplingastheyareinquotasampling.Thecharacteristicsusedinquotasamplingareage,gender,class,residence,profession,experience,ormaritalstatus(Iliyasu&Etikan,2021).Byusingthequotasamplingstrategy,thisresearcherwillfocusonthesocialworkerswhowouldbemostlikelytohaveexperienceworkingwitholderAfricanimmigrants,knowaboutdepressioninthecommunity,andhavevitalinsightsintotheresearchtopic.Thereasonresearcherchosequotasamplingisthattheresearcherhasaspecificcriterionoftheparticipantshewouldliketohaveforthestudy.Someotherreasonsforselectingquotasamplingforthisresearchincludegainingofthebestrepresentationofpotentialparticipantsintheclosingsample,quotashavingthetendencyofrepresentingthepopulationasclosertorealityaspossible,theresultsandanalysisareclosertothepopulationcharacteristicsmakingtheresultsmorereliable,timesavingindatacollectionsincethepre-determinedcriteriainselectingthequotawouldbebeneficial,andsavingextracostsofconductingextensivedatacollectionandsampleoncethecriteriaareknownaboutthetypeofquotatobeselected(QuestionPro,n.a.).DataAnalysisAlltheinterviewswillbeaudiorecordedandtranscribedverbatim.Thiswillprotectagainstbiasandwillprovideapermanentrecordofthedatacollectedfromtheinterviewer.Theresearcherwillmakefieldnotesduringtheinterviewindicatingtheobservationsnoted,thoughts,andopinionabouttheinterview.Duringfacetofaceinterviews,observationslikebodylanguageandgeneralcomposureoftheintervieweeisvitalasitgivesapictureofhowtheinterviewprocesswillbeconducted;howeverthisinformationcouldbelimitedwhenusinginternet-basedtechnology.Towhateverextentitisavailable,itwillbehelpfulinthedataanalysisprocess.Thedataanalysiswillcomeafteralltheinterviewshavebeenconducted.Thereisalsoaneedtodoaproperanalysistoensurethereisvalidityoftheresults.Theresearchermighthavepreconceivedassumptionsofwhattheyexpecttouncoverfromtheinterviewees.Withathoroughandobjectiveanalysis,thesebiaseswillbeeliminatedinordertoconductasystematicanalysis(Pannucci&Wilkins,2011).Dataanalysisgivesothersawayofunderstandingexactlyhowtheresearcherreachedvariousconclusionsandmakestheresultsmuchmoretrustworthy.Sincetheresearcherwillbeconductingsemi-structuredinterviews,Iwillmakeuseofthematicanalysisofthedata.Thematicanalysisisflexibleandcanbeusedforexplorativestudieswheretherearenoclearpatternsbeingsearchedfor(Nowelletal.,2017).Thestepsforathematicanalysisarefamiliarizationwiththedata,assigningpreliminarycodesfordescribingthecontent,searchingforpatternsinthecodes,reviewingthemes,defining,andnamingthemes,andproducingthereport(Mortensen,2020).Selectingthematicanalysisfortheinterviewsistodeterminetheamalgamationoffactorsthatserveasthemesandemergeascommonfeatureswithintheinterviews(Nowelletal.,2017).Ithasbecomeanincreasinglymeaningfulwaytoconductqualitativestudiessinceitisflexible,asareexploratoryandqualitativeresearch.Itmatchesthepurposeofthequalitativeresearchifarigorousthematicanalysisisconducted,whichwouldclosetoreality.Thecoreskillsthatathematicanalysisinheritsareimperativeforthecurrentresearchsincethecommunicationofviewpointsandtheirinterpretationistheessenceofthisresearch.Asdiscussedinpreviouschapters,itisvitaltoensurethatthestudyisreliableandvalid.Towardsthisend,theresearcherwillmakesureduringthedataanalysisprocessthattheanalysisisdonewithhighlevelofobjectivity.Theresearchermighthavehis/herpreconceivedassumptionsregardingthestudyandthesehaveawayofcreepinguponthemastheyperformthedataanalysis(Bengtsson,2016).Byadheringtothestepslaiddownforthematicanalysis,theresearcherwilleliminatethepreconceivedassumptionstheymightbeharboring,whichwillgivethestudythevalidityitneeds.Also,bydocumentingtheresearcher\'sprocessesfordataanalysisandcollection,theycanmanagetodemonstratetothereaderthattheyremainedobjectiveinthedatacollectionandanalysis(Austin&Sutton,2014).Givingastep-by-steprepresentationofwhatwillbedoneensuresthereadercanfollowtheresearcherthroughthejourneyandtheywillfeelconfidenttheresearcherhasconductedthestudywiththeutmostcredibility.Theresearcherintendstoofferalltheinformationregardingthestudyincludingthenumberofsocialworkers,theselectioncriteria,andquestionsaskedduringtheinterview.Thisinformationwillgivethestudythereliabilityandvalidityneeded(Taherdoost,2016).Inthefinalreporttheresearcherwillprovideinformationonhowtheanalysiswascarriedout,whichwillallowfutureresearcherstoreplicatethestudyandconfirmitsvalidity.EthicalProceduresAnyresearchthatinvolveshumansubjects,hasinteractionorinterventionthatinvolveshumansubjects,orinvolvestheaccesstoidentifiableprivateinformationshouldundergoanInstitutionalReviewBoard(IRB)reviewandapproval(Wolf,Clayton,&Lawrenz,2018).Forthisstudy,theresearcherplansoninterviewingsocialworkers,whichindicatesthattheresearcherwillbeinvolvinghumansubjectsinthestudy.Therefore,theresearcherisrequiredtoundertakeanIRBreviewandcannotbeginthestudybeforereceivingtheIRBapprovalnumber.TheIRBApprovalisafederalrequirementputinplacetosafeguardhumansubjectswhoareinvolvedinanyresearchstudy.TheTuskegeeSyphilisstudywasoneoftheunderlyingreasonswhytherewasrequirementthatbeforehumansubjectsareinvolvedinanyresearchstudy,theresearchersmustseekapprovalfromtheboardtoensurethattheyhaveputinplacemeasuresforsafeguardingtheinterestsoftheparticipants.TheTuskegeeSyphilisstudyhadnumerousethicalviolationsthatnecessitatedfortheinvolvementofanindependentboardtooverseeresearchstudiesthatinvolvehumansubjects(Barrett,2019).Anyresearchstudythatinvolveshumansubjectsmustseekinformedconsentfromthestudyparticipantsbeforethestudybegins(Wolfetal.,2018).Thereshouldbebothawrittenandverbalconsentforparticipationintheresearch.Asresearchers,wearechargedwitheducatingandinformingthepotentialstudyparticipantsabouttheresearchstudyandtheroletheywillplayinthestudy.Weunderstandthattheinformationwewillsharewiththeparticipantsmightbecomplexordistressfulandtheparticipantsmightneedsometimetoabsorballtheinformation(Biros,2018).Towardsthistheresearcherwillgivetheparticipantsatleast48hourstoreviewtheinformationprovidedbeforetheycansignoffonparticipation.Theresearcherwillbeavailabletothepotentialresearchparticipantstoansweranyquestionstheymighthave.Ensuringthestudyparticipantsreceivealltheassistanceandsupporttheyneedbeforetheyappendtheirsignaturesontheconsentform.VerbalconsentcanonlybeallowedwiththeapprovaloftheIRB(UniveristyofCaliforniaSanFrancisco,2021).Theconsentisthewrittendocumentthattheparticipantsgivetotakepartintheresearch.AccordingtoWaldenUniversityIRB,thereisadifferencebetweenconsentandassentastheconsentisawrittendocumentation.Incontrast,assentisjustago-aheadforresearch(WaldenUniversity,n.a.).ItimpliesthatWaldenconsideredassentas‘verbalagreement’;however,anethicalresearchwrittenconsent.InthelightofCovid19,therearenospecificrequirementsthatneedtobefollowedregardingIRBWaldenresources.Theresearcherwouldadheretoanylocalsocialdistancingregulationstobeusedasaprocessbeingconsistentwiththeoverallstudy.WaldenUniversityIRBhasgivensomespecificationsforgainingconsentfromtheparticipants(CenterforResearchQualityWalden,n.a.).Thesampleconsentformtemplateforparticipantsaging18yearsandaboveindicatesfeaturestobeincluded,suchasstatingpurposeofthestudy,theinvolvedprocedures,thevoluntarynatureoftheresearch,risksandbenefitsassociated,payment(ifthereistobepaidtotherespondentsforconsentingtoparticipate),privacyissues,contactsandquestions,andfinallyaboxinwhichthefinalconsentwouldbeclarifiedbyfillinguptheboxwithparticipant’sinformationforhisname,dateofconsent,participant’sandresearcher’ssignatures.Theresearcherisrequiredtogivethepotentialsubjectsampletimetoprocesstheinformationandaskquestion(UCIOfficeofResearch,n.a.).Thepotentialsubjectsshouldbeencouragedtoaskquestionstoensurethattheyhaveunderstoodwhatthestudyentails.AlthoughWaldensampleconsentformincludes‘contactsandquestions’sectioninwhichtheresearchergiveshiscontactnumbersothattheparticipantscouldcontacthimforfurtherclarifications,thesamenotionhasbeenkeptinmindinthisresearchaswell,knowingthatanyresearchinvolvinghumansshouldbebasedonethics.Theinformedconsentprocessinvolvesgivingthesubjectadequatetimetoreviewtheinformationgivenandthepotentialsubjectisgivenadequatetimetoconsideralloptions.Theresearcherisrequiredtoanswerallthequestionsposedbythepotentialsubjecttoclarifyanythingthatisnotclear.Itisvitalthattheresearcherensuresthepotentialsubjectcomprehendsalltheinformation.Thereshouldbeampletimegivenfortheresearcherandthesubjecttoexchangeinformationandaskquestions.Oncethepotentialsubjectiscertainabouttheinformation,theymightbegivenfurthertimetoreviewtheinformationandaskanyquestionsbeforesigningtheconsentform(UCIOfficeofResearch,n.a.).Ethicalconsiderationsofconductingaresearchimplythatjustforthesakeofconductingone’sstudyandfulfillingitspurposes,theresearcherdoesnothaveanyrighttoinfringethefundamentalrightsofotherhumansbyconsideringthemparticipantswithouttheirconsent(Nihjhawanetal.,2013).Theinformedconsenthasagoalofgivingsufficientinformationtotheparticipantsinaneasytounderstandlanguagesothatcomprehensionofinformationcouldbecomeeasier.Also,theirdecisionshouldbevoluntaryandnotcoercedforwhichthewrittendocumentationservesasproofoftheirsignatures.Inrealterms,informedconsentistheentireprocessforgainingpermissionoftheparticipantssothatresearchcouldbeconductedonthem.Itincludestheresearcher\'sobligationtowardshispotentialsubjectssothatnoharmorprivacybreachisobserved.Limitations,Challenges,and/orBarriersRecruitingsocialworkerswillbeahugechallengeforthisresearchmainlyduetohavingnopriorrelationshipwithprospectiveparticipants.Trustwillneedtobeestablishedbetweentheresearcherandtheparticipantstoobtaintherequiredinformationconcerningtheirrulesassocialworkers.Theroleoftrustisconsideredcrucialforaresearchinwhichhumanparticipantsareinvolved(Guilleminetal.,2018).Theresearch\'ssuccessdependsonthetrustrelationshipbetweentherespondentsandtheresearchersothatthefactorsthataretobeexploredandforwhichhonestresponsesfromtheparticipantsarerequiredshouldbeobtainable.Eventhefirststageofconductingaresearch,whichisgaininginformedconsent,wouldnotbepossibleunlessthepotentialsubjectscannottrusttheresearcher.Forthisreason,researchethicsshouldbefollowedwithakeeninterestingainingreliableresultsastheparticipanthastorelyonlyonthegoodwilloftheresearcher.Anotherchallengeistimelimitation,asthesocialworkersmightbeunavailablefortheinterviews.Thereshouldbeenoughtimefortheresearchertoobtainfullinformationtomakeanin-depthanalysisnotremainaproblem.Whentheresearcherhasenoughtimeotinteractwithhisrespondents,hewouldbeabletobettergaugetherespondents\'expressions,opinions,andemotionsthataremandatoryforthisresearchtobesuccessful.Therefore,thetimeconstraintwouldserveasalimitationifanyoftheparticipantshadtoleavetheinterview,whichwoulddirectlyimpacttheauthenticityoftheresults.Anotherchallengethatmightoccurissomesocialworkersmighthaveanemergencyand,asaresult,mighthavetocanceltheirinterview.Face-to-faceinterviewsmaynotbefeasibleduetoCOVID19.AccordingtotherenewedguidanceforfollowingtheprotocolsofhumanresearchissuesbyIRB,ifface-to-facecontactisnotinvolved,thenthecollectionofdatacouldbecontinuedbasedontheapprovedprotocolorotherwiseonlineplatformslikeZoomandSkypeshouldbeused(Davidson.Edu,n.a.).ToovercomethischallengetheresearcherproposesusinginternetserviceslikeGoToMeeting,skype,Zoom,oranyotherweb-basedservice.SummaryThedatacollectionwillbedoneusingonlineinterviewsthroughinternetserviceslikeGoToMeeting,skype,Zoom,oranyotherweb-basedservice.Thestudyparticipantswillcomprise10-12socialworkersworkinginMetroWestMassachusetts.Alltheinterviewswillberecordedtoaidintranscriptionduringthedataanalysisprocess.Theresearcheraimstouncoverpatternsandmakecodesforuseinthethemestobediscovered.Thestudymethodologywouldincorporatesemi-structuredinterviewsthatwouldusecloseandopen-endedquestions,contactingtherespondentsviavirtualmeetings,collectingfeedbackfromtherespondentsabouttheconsent,asdoneinthepriorstudies(Mannan,2020).Duringthedataanalysisprocess,theresearcherwillbefamiliarwiththedata,assignpreliminarycodesfordescribingthecontent,searchforpatternsinthecodes,reviewthethemes,defineandnamethemes,andproducethereport.Thesestepswillflowsystemicallyensuringtheresearcherdoesnotmissanythingvital.Forsampling,thequotasamplingmethodisutilizedtoadheretotheidentifiedinclusioncriteriaforthesocialworkers.Thedataisanalyzedthroughathematicanalysis,aflexiblebutsystematicapproachtotheevaluationprocessforkeepingtheresultsobjective.Afterwards,anappropriatepresentationofresultsismandatory,whichisdonebydescribingthefindingsuncoveredandreportingthethemesdiscoveredfromtheobtaineddata.Ethicalconsiderationshavebeentoppriorityintheentireprocessforthevalidationandreliabilityoftheresults.AComprehensiveSummaryThecurrentstudyfocusesonexploringtheviewsofsocialworkersconcerningdepressionamongolderimmigrantAfricanwomencurrentlylivinginwestMassachusetts.Forthispurpose,aqualitativestudyisundertakentoprobetheemotions,feelingsandopinionsofthesocialworkersworkingwiththiscommunity.Basedontheliteraturereviewfindings,ithasbeenknownthatOlderAfricanwomenhadbeenundermentalstresswhentheymigratedtodifferentregionsotherthantheirresidingareas.Toaddressthisissue,theviewpointsfromthesocialworkerswouldbegatheredfromtelephonicinterviews,keepinginmindCovid-19socialdistancingprecautions.Thedatawouldbeanalyzedthroughthematicanalysisthatisconsideredflexibleandsuitableforthequalitativeandexploratoryapproachofthisresearch.Thethemeswouldbeuncoveredintheresultsandanalysissection.Anin-depthunderstandingofthesocialworkersandtherelatedfactorsthatolderAfricanimmigrantwomenfacecouldbeevaluated.Ethicalconsiderationsaretakenintoaccountforkeepingtheresearchasmuchasethicalaspossible.Itisalsoforthereasonthatauthenticityisbasedontheresearchbeingethical.WaldenUniversityIRBguidelineshavebeenscrutinizedfortakingconsentfromtheparticipants.Indicationoflimitationsandchallengeshasalsobeenincludedtodisplaythedifficultiesthatcameinwayofthisresearch.Theseincluderelationshipoftrustbetweentheresearcherandtheparticipants,timelimitationsandtheemergencyleavingoftheparticipantsbasedontheirjobcalls.AlthoughCoronaprecautionshavebeentakentoconducttheinterviewsonline,therespondentsmighthavetoleavethecallduetosomeemergencycalls.Also,ifthestettingwheretheywouldbepresentfortheinterviewwouldnotbecomfortable,theywouldnotbeabletogiveatrustworthyreply,whichisalsoconsidered.

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