Introduction:Transgender and gender diverse people often face discrimination and may experience disproportionate emotional distress, leading to suicide attempts. It is, therefore, essential to estimate the frequency and potential determinants of suicide attempts among transgender and gender diverse individuals.Methods: Longitudinal data on 6,327 transgender and gender diverse individuals enrolled in three integrated healthcare systems were analyzed to assess suicide attempt rates.

No abstract

Objectives: Since the novel coronavirus disease (COVID-19) outbreak started in late 2019, the older population has accounted for a large proportion of severe and fatal cases. This study investigated the mental state and attitudes of older Chinese adults during this epidemic. Design: Cross-sectional online surveys on a convenience sample of China's general population at two different time points. Online surveys were disseminated through popular Chinese social media applications. Adults 18 or older living in China during the initial (N ¼ 1148) and second stages (N ¼ 470) were included in the survey. The Worries, Strategies, and Confidence Questionnaire was created to assess worries and awareness of the disease. Results: Combined responses (N ¼ 1618), 76.1% were female and about 7.0% were 60 years or above. In the first wave, older adults were found less likely to worry about being infected by COVID-19 (p < 0.05) and reported less attention paid to protective measures (p ¼ 0.004) than young adults. However, as the disease evolved, older participants in the second wave were more worried than young adults (p ¼ 0.027) and older adults in the first wave (p ¼ 0.001). Conclusions: During the epidemic of COVID-19, watchfulness of the epidemic among older Chinese adults fluctuated over time. Initially, they were slow to respond proactively, but their worries gradually increased. Health care and social service professionals need to address the vulnerabilities of older adults to this public health crisis.

Purposes Dementia-friendly initiatives (DFI) are community-based movements aimed to address stigma, exclusion, and discrimination associated with dementia. This study examined the challenges faced and strategies used by DFI prior to and during the COVID-19 pandemic from the perspectives of stakeholders in the USA and China. Methods Qualitative interviews with 17 stakeholders involved in DFI from the United States and mainland China were conducted via the Zoom platform. Semi-structured interview questions focused on DFI challenges and strategies prior to and during the pandemic. Thematic analysis was used to analyze the data. Results Three major challenges prior to the COVID-19 pandemic included low participation of persons with dementia, difficulties in building community collaborations, and limited funding and resources needed to sustain DFI. During the COVID-19 pandemic, challenges included exacerbated difficulties of involving persons with dementia and reduced policy support for DFI. Strategies implemented prior to COVID-19 included partnerships with community organizations to outreach and engage persons with dementia, and coordination of resources and diversification of funding sources to sustain DFI. Strategies during the COVID-19 pandemic centered on the implementation of person-centered technology to support persons with dementia and family caregivers, and the development of new programs that integrated efforts to address the impact of COVID-19. Implications DFI in the USA and mainland China shared similar challenges for DFI prior to and during COVID-19. During the COVID-19 pandemic, DFI in both countries showed resourcefulness through reliance on technology, community collaboration, and COVID-19–related resources to provide support and services. While it remains critical to advocate to the central government to fund DFI, DFI in both societies need to be open to other funding sources, hire persons with dementia as key staff members of DFI, and demonstrate its effectiveness through rigorous evaluation.

Objectives: This study examined the change in dementia literacy and dementia worry over a 5-year span among older Chinese Americans living in Arizona. Design, setting, participants, and measurement: This study used survey data collected among a purposive sample of 703 community-dwelling Chinese Americans aged 55 years or older living in the metropolitan areas of Phoenix, Arizona, from 2013 to 2017. The average age of participants was 73.1 (SD = 8.7) and 64.2% were female. Dementia literacy was measured by dementia knowledge (knowledge about Alzheimer’s disease and related dementia) and dementia beliefs (biased attitude toward dementia). Dementia worry was measured by assessing participants’ fear toward and concerns of developing dementia. Results: Regression analyses found dementia knowledge decreased (p < 0.05) and dementia beliefs remained unchanged (p > 0.05) from 2013 to 2017 among participants. Dementia worry only increased among those who lived alone. Significant correlates of dementia worry included low formal education level, depressive symptoms, and family conflict. Conclusions: Public health education targeting older Chinese Americans should aim to enhance dementia knowledge and to rectify their biased attitudes toward dementia. Psychosocial education or counseling should be available to older Chinese Americans who present dementia worry, particularly for those who live alone. More studies using diverse study designs, such as a longitudinal design, are needed to examine change in dementia literacy and worry among this population.