title: Propensity for Japanese-American older adults' use of medical alert services in Hawaii.
abstract: OBJECTIVE
  Hawaii is a fast-aging, multi-ethnic state. At present, ethnic Japanese represent the largest segment of the elderly population (aged ≥65 years). Studies in Western countries have identified an association between ethnicity and the use of homecare services. The present study sought to substantiate this association in relation to the use of a personal emergency response system service by older ethnic Japanese adults in Hawaii.
  
  
  METHODS
  Questionnaires were mailed to 585 elderly subscribers of a company providing personal emergency response system services in Hawaii in 2014. The questionnaire inquired about the subscriber's ethnicity, functional disability, number of medications taken and falls experienced. Additional information on the sex, age and service payer was obtained for each of the responding subscribers from the corporate database. The χ2-test and t-test were carried out to assess the associations between factors.
  
  
  RESULTS
  A total of 244 questionnaires were analyzed (41.7% response rate; mean age of respondents 86.1 + 7.8 years). Compared with non-Japanese older adults, ethnic Japanese older adults had a higher propensity to use the personal emergency response system services, were older, used fewer prescribed medications and were more likely to have these services paid for by family members or to pay themselves.
  
  
  CONCLUSIONS
  Japanese culture might influence the use of personal emergency response system services. Ethnic Japanese older adults might want to receive homecare services focusing on preventing minor accidents from becoming medical crises because of their high level of concern for health, their independence and the availability of family support. Healthcare planners should consider such factors in the provision of care in Hawaii. Geriatr Gerontol Int 2017; 17: 1392-1398.
authors: Department of Medical Education, Tokyo Medical University, Tokyo, Japan.|Department of Public Health, Juntendo University School of Medicine, Tokyo, Japan.
authors: Yuka
authors: Y
authors: Yamazaki
authors: Department of Public Health, University of Hawai'i at Manoa, Honolulu, Hawaii, USA.
authors: Valerie
authors: V
authors: Yontz
authors: St. Francis Healthcare System of Hawaii, Honolulu, Hawaii, USA.|Kupuna Monitoring Systems, Aiea, Hawaii, USA.
authors: Cullen
authors: C
authors: Hayashida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000208:ethnology*; D001213:Asian / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004630:Emergencies / Q000453:epidemiology*; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D057216:Propensity Score; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: Asian American; Hawaii; frail elderly; homecare service; telemedicine