The PIETY Study
The PIETY Study is a U.S. longitudinal study of Chinese families derived from the PINE Study. It is the product of a synergistic collaboration between the Chinese Health, Aging, and Policy Program (CHAP) at Rush University, Northwestern University, and many community-based organizations and social service providers. This academic-community partnership is led by XinQi Dong MD, MPH, at Rush University, Melissa A Simon, MD, MPH, at Northwestern University, and Esther Wong, ACSW and Bernarda Wong, ACSW, at Chinese American Service League. The goal of the PIETY Study is to better understand the health and well-being  of Chinese adult children, and understand the factors impacting the health and aging of Chinese older adults from the perspectives and experiences of adult children. Since 2011, more than 4,000 face-to-face interviews were conducted. Each interview was personalized according to languages or dialects the participant preferred, including English, Mandarin, Cantonese, Toishanese, and Teochew. Background. The population of U.S. Chinese adults aged 65 and above has increased four times quicker than the general U.S. older adult population. This rapid growth means there is an increasing demand for elder care within Chinese families. Traditionally, family-oriented values influence the planning  and organization of elder care in Chinese families. Filial piety prescribes that adult children are obligated to provide adequate support to their elderly parents. This demand and cultural precedent calls for a better research understanding of Chinese adult children as family caregivers. Current data collection efforts mostly aggregate Asian as a single category, and therefore social and health data regarding Chinese Americans as specific ethnic group have been scarce. Moreover, conceptual frameworks that have been used in prior research were developed based on Western populations, failing to identify the importance of cultural values within minority populations. In light of those  factors, the knowledge of culture and caregiving within Chinese families was rudimentarily understood. Without a full understanding, public health and policy goals remain under-developed to adequately support the family caregiving practices of Chinese adult children. With this mission in mind, the PIETY Study is built to understand the health and well-being of Chinese families in the Chicago metropolitan area. Methods. The PIETY Study is a community-based participatory population study investigating Chinese adult Children, who lives in the Chicago area. The criteria of participation are: Data collection is through face-to-face interviews using the website-based application . The survey is composed of questionnaires and qualitative questions, which capture adult children's perspectives on the topics regarding filial piety and caregiving. Implications. The data collected from the PIETY Study show that Chinese American adult children confront significant life and health challenges in providing care for their aging parents due to multiple social, structural, cultural and linguistic barriers. Nevertheless, these health challenges also represent tremendous opportunities for family members, community stakeholders, researchers, health professionals, social service agencies, and policy makers to work in concert to improve the health and well-being of all Chinese Americans. Future directions. Longitudinal studies  are needed to better understand changes of biological, behavioral, familial, social, and cultural factors over time. Currently, the PIETY Study is undergoing the second wave of data collection. The third wave is starting in 2017 to examine how the health and intergenerational relationships of Chinese adults change, in order to better understand the causes of certain health outcomes.