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Objectives: Mental health remains an unmet need among Chinese Americans. This study aims to identify specific needs and strategies that may address the needs. Design: A total of 55 Chinese Americans consented and participated in online focus groups conducted in either Chinese or English using nominal group technique. Participants discussed the following questions, achieved themes, and provided ranking of themes in importance for each: (1) In general, what do people in the Chinese American community think about mental health or emotional well-being? (2) What have you found to be helpful for accessing mental health or emotional well-being services or care in the Chinese American population? And (3) What actions would you suggest to improve mental health and emotional well-being in the Chinese American population? Results: Across the focus groups, we observed high consistency of top ranked themes including lack of knowledge and awareness, negative impression, lack of Chinese-speaking providers, and that the most helpful factor toward access to care was education and increased awareness. Seminars and trainings was the top actionable suggestion. Conclusion: The findings are consistent with previous findings and continue to show that Chinese Americans need more education and training and that providers who can speak the language and understand the culture would be very helpful to increase access to care. This study emphasizes addressing mental health disparities in the Chinese American community through awareness, tailored interventions, and barrier removal. Promoting equal access also underscores the need for ongoing assessment and responsive strategies. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has devastated the restaurant industry, with Asian restaurants having perhaps suffered the most, as many reported business losses well before shelter-in-place orders were announced. Media outlets argue that this decline in business reflects biases that are linked to the China- and food-related origin of COVID-19. However, discrimination against Asian Americans and their cuisine is not new, as it is rooted in a long and history of assimilation and racism. Overlooked in this body of literature, as well as in conversations on the impacts of COVID-19 on Asian restaurants, is the role of how government institutions shape these biases against a cuisine that has hundreds of years of history in the US yet remains distinctly 'foreign'. In this study, we use 3-years of New York City restaurant health inspection data to examine trends in citation scores before and after the onset of the news of the COVID-19 pandemic. Using a synthetic control approach, we find that Asian restaurants uniquely received more citations after news of the pandemic became pervasive in the US. We end by discussing the implications of this finding for the history of Asian cuisine in the US, theoretical frameworks to understand assimilation, and the restaurant industry. [ABSTRACT FROM AUTHOR]

Context: Depression is prevalent among Asian Americans (AsA) during the COVID-19 pandemic, and depression often leads to sleep disturbance in this population. The gut microbiota (GM) plays a critical role in mental health and sleep quality, and the composition of the GM is largely unknown among AsA. Objectives: Examine associations of the GM with depressive symptoms and sleep disturbance among Chinese and Korean American immigrants. Methods: Depressive symptoms (PROMIS Short Form-Depression) and sleep quality (Pittsburgh Sleep Quality Index [PSQI]) were collected via surveys. PROMIS measure T-score > 55 indicates positive depressive symptoms, and a total PSQI score > 5 indicates sleep disturbance. 16S rRNA V3-V4 gene regions were sequenced from fecal specimens to measure GM. Permutational multivariate analysis of variance and linear discriminant analysis effect size were applied to examine associations of the GM with symptoms. Results: Among 20 participants, 55% (n = 11) reported depressive symptoms and 35% (n = 7) reported sleep disturbance. A higher α-diversity was marginally associated with lower depressive symptoms: Chao1 (r = −0.39, p = 0.09) and Shannon index (r = −0.41, p = 0.08); β-diversity distinguished participants between categories of depressive symptoms (weighted UniFrac, p =0.04) or sleep disturbance (Jaccard, p =0.05). Those with depressive symptoms showed a higher abundance of Actinobacteria, while those without depressive symptoms had a higher abundance of Bacteroidetes. No significant taxa were identified for sleep disturbance. Conclusions: Gut microbial diversity showed promising associations with depressive symptoms and sleep disturbance among Chinese and Korean immigrants. Specific taxa were identified as associated with depressive symptoms. Future studies with a larger sample size are warranted to confirm our findings. [ABSTRACT FROM AUTHOR]

Trump and his administration brought with them an inflammatory rhetoric that reduced complex issues into the simplified polarity of "us" and "them." With this as the dominant paradigm, racism was encouraged and spread like a virus throughout the nation, appearing in heightened jingoism against other nations, anger towards fellow citizens and violence towards neighbors. When the pandemic Covid-19 spread throughout the nation and the world, it became politicized, used by Trump as a novel corona vehicle help inflame intolerance. He repeatedly associated China and Chinese people with the virus to forward his political agenda regarding US trade with China and he used the resulting demonization of China as a foil for his complicity with Russian crimes. In response to increased and wellpublicized acts of violence against Black Americans, systemic racism against Black people is finally being noticed. However, anti-Asian violence has largely been disregarded. This paper discusses both the increased violence against Asian Americans and the lack of attention to it. Dividing the paper into three sections, I correlate an artwork to the main issue in each section: the state-of-affairs provide a context in which to understand the artworks. Reciprocally, because artworks evoke an embodied understanding, involving our senses as well cognition, artworks change our relationship with issues from topical to personal. The artworks recontextualize what we thought we already knew and present possibilities for constructing the world differently. [ABSTRACT FROM AUTHOR]

Background: Asian Americans with metastatic cancer are an understudied population. The Describing Asian American Well-Being and Needs in Cancer (DAWN) Study was designed to understand the supportive care needs of Chinese-, Vietnamese-, and Korean-descent (CVK) patients with metastatic cancer., Objective: This study aims to present the DAWN Study protocol involving a primarily qualitative, convergent, mixed methods study from multiple perspectives (patients or survivors, caregivers, and health care professionals)., Methods: CVK Americans diagnosed with solid-tumor metastatic cancer and their caregivers were recruited nationwide through various means (registries, community outreach newsletters, newspapers, radio advertisements, etc). Potentially eligible individuals were screened and consented on the web or through a phone interview. The study survey and interview for patients or survivors and caregivers were provided in English, traditional/simplified Chinese and Cantonese/Mandarin, Vietnamese, and Korean, and examined factors related to facing metastatic cancer, including quality of life, cultural values, coping, and cancer-related symptoms. Community-based organizations assisted in recruiting participants, developing and translating study materials, and connecting the team to individuals for conducting interviews in Asian languages. Health care professionals who have experience working with CVK patients or survivors with metastatic solid cancer were recruited through referrals from the DAWN Study community advisory board and were interviewed to understand unmet supportive care needs., Results: Recruitment began in November 2020; data collection was completed in October 2022. A total of 66 patients or survivors, 13 caregivers, and 15 health care professionals completed all portions of the study. We completed data management in December 2023 and will submit results for patients or survivors and caregivers to publication outlets in 2024., Conclusions: Future findings related to this protocol will describe and understand the supportive care needs of CVK patients or survivors with metastatic cancer and will help develop culturally appropriate psychosocial interventions that target known predictors of unmet supportive care needs in Chinese, Vietnamese, and Korean Americans with metastatic cancer., International Registered Report Identifier (irrid): DERR1-10.2196/50032., (©Jacqueline H J Kim, Marjorie Kagawa Singer, Lisa Bang, Amy Ko, Becky Nguyen, Sandy Chen Stokes, Qian Lu, Annette L Stanton. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 22.04.2024.)

In this essay, we review how the COVID-19 (coronavirus) pandemic that began in the United States in early 2020 has elevated the risks of Asian Americans to hate crimes and Asian American businesses to vandalism. During the COVID-19 pandemic, the incidents of negative bias and microaggressions against Asian Americans have also increased. COVID-19 is directly linked to China, not just in terms of the origins of the disease, but also in the coverage of it. Because Asian Americans have historically been viewed as perpetually foreign no matter how long they have lived in the United States, we posit that it has been relatively easy for people to treat Chinese or Asian Americans as the physical embodiment of foreignness and disease. We examine the historical antecedents that link Asian Americans to infectious diseases. Finally, we contemplate the possibility that these experiences will lead to a reinvigoration of a panethnic Asian American identity and social movement. [ABSTRACT FROM AUTHOR]

The American Heart Association's ideal cardiovascular health score is based on 7 cardiovascular health metrics to measure progress toward their Impact Goal of reducing cardiovascular disease by 20 % before 2020. This study applied this construct to assess cardiovascular health in a sample of Asian Americans. Convenience sampling methods were used to enroll self-identified Asian American's over the age of 18 years who were attending community health fairs across the greater Philadelphia and urban areas of New Jersey. The heart health metrics of tobacco use, body mass index, physical activity, diet, blood pressure, and glucose were measured. In the greater sample (N = 541), 82 % were female, the mean age was 65.1 (SD = 15.5) years, 45 % were Vietnamese, 38 % were Chinese and 17 % were Korean. Prevalence of ideal heart health for the metrics of tobacco use (95 %) was high. Only 19.4 % achieved ideal levels of physical activity, 35.1 % for BMI, 28.9 % for glucose and 66 % for blood pressure. Dietary intake was ideal for 20.7 % of the sample. More years since migration and Korean race trended toward having a higher prevalence of poor health in some metrics. Most Asian Americans are not achieving ideal cardiovascular health for several of the metrics evaluated, with those residing in the United States for more than 13 years and Korean Americans being higher-risk groups. Targeted community based intervention approaches to improving and monitoring heart health in Asian American, and Asian American subgroups, are needed. [ABSTRACT FROM AUTHOR]

This study examined the impact of acculturative stress and social support (family and friend) on psychological distress among Asian American immigrants and three Asian sub-groups (Vietnamese, Filipino and Chinese) immigrants. The National Latino and Asian American Study 2002-2003 dataset was used. The study findings were: (1) among all Asian American immigrants high language barrier and discrimination stress were associated with increased level of psychological distress, but similar association was not present for legal stress; (2) among all Asian American immigrants high family social support decreased the levels of psychological distress, and in addition, friend social support buffered the relationship of discrimination and psychological distress; and (3) among Vietnamese, Filipino, and Chinese, differential association of social support and acculturative stress to psychological distress were observed. These findings highlight the importance of social support among Asian American immigrants, while also paying attention to the variation that may exist between different sub-groups. [ABSTRACT FROM AUTHOR]

Understanding how knowledge and attitudes about colorectal cancer (CRC) screening differs among Asian immigrants is important for informing targeted health interventions aimed at preventing and treating CRC in this diverse population. This study examines how Asian subgroup and acculturation are associated with CRC knowledge and attitudes among Chinese and Korean immigrants in the United States (U.S.). Data come from the baseline survey of a randomized controlled trial to increase CRC screening among Chinese and Korean American immigrants living in the Baltimore-Washington DC Metropolitan Area (n = 400). We use linear regression to examine how Asian subgroup, time in the U.S., English-speaking proficiency, and ethnic identity are associated with CRC knowledge and screening attitudes, accounting for demographic variables, socioeconomic status, and health insurance status. Results show that greater socioeconomic status was associated with higher CRC knowledge, and socioeconomic status explained more of the variance in CRC knowledge than acculturation factors. Additionally, attitudes varied by Asian subgroup, with Chinese reporting lower CRC screening salience, worry, response efficacy, and social influence compared to Koreans. Findings suggest that in-language interventions aimed at increasing CRC knowledge and capitalizing on attitudes about screening can help to bridge disparities in CRC screening by socioeconomic status and country of origin. We discuss implications for future interventions to increase CRC screening uptake among Chinese and Korean immigrants in the U.S., (© 2021. American Association for Cancer Education.)

The last two decades have seen a rapid increase of Fuzhounese immigrants (from Fujian Province, China) to the USA. This group spurred the interest of researchers because of their new immigrant status and their demographic and sociocultural background that places them at a significant disadvantage compared with the majority of already established Chinese immigrants. This paper synthesizes existing research on the Fuzhounese's historical/cultural and migration experiences and examines ways in which sociocultural forces interact with postmigration stressors to impact the onset, manifestation, diagnosis, and treatment of symptoms in this group. From prior ethnographic work, we suggest that the pursuit of four core social goals plays a key role in interfering with psychiatric treatment adherence: (1) To payoff their smuggling debt (often >$80,000); (2) To send money to their natal families to improve social standing; (3) To save money for a dowry to perpetuate the familial lineage by marrying and producing offspring; and (4) To attain legal status. To offer more insight on how these core social motivations impact psychiatric disability, we present a case vignette of a Fuzhounese man diagnosed with schizophrenia. We relate his treatment issues to specific fundamental values that infuse both the lived experience of mental illness and inform clinical and community treatment strategies for this group. We also extend relevant treatment recommendations to migratory workers from other ethnic groups. [ABSTRACT FROM AUTHOR]

This article elaborates a Chinese/Cuban cultural critique that operates through the notion of unsettling in light of recent work in Asian American studies and Chinese diaspora studies. Examining three case studies--Carlos Felipe's play The Chinaman (El Chino), Rigoberto López's documentary The Longest Journey (El Viaje Más Largo), and Michael Mann's feature film Miami Vice--the author suggests that these examples of expressive culture function as memory projects, which construct Chinese/Cuban figures and reconfigure attachments to place through often immaterial, but not insignificant, investments. Chinese/ Cuban cultural critique finally provokes a series of productive questions for the study of human migration. [ABSTRACT FROM AUTHOR]

Through Our Eyes, Hear Our Voices is a virtual photovoice project that documents the impact of COVID-19 on Asian American and Pacific Islander (AAPI) communities. Quantitative studies on the disproportionate impact of COVID-19 are still emerging, but they do not reveal qualitative experiences of a racialized pandemic exacerbated by political leaders labeling it "China virus." As a qualitative participatory action research approach, photovoice is an ideal archival and pedagogical tool to capture the lived experience of AAPI communities. However, we had to adapt photovoice to a virtual research environment. We did so by adopting a variety of digital learning and information sharing platforms. In addition, we enlisted community-based organizations who are providing essential services for underrepresented communities to serve as research mentors for university student researchers. Finally, given the historic nature of the pandemic and the underrepresentation of AAPI experiences in mainstream archives, we emphasized the importance of students as co-producers of archival knowledge.

Introduction: A growing body of literature has indicated that disaggregated analyses using distinct Asian subgroups allow for identification of varying mental health challenges and health services utilization. In this study, we examined the associations between distress and health services utilization among five Asian subgroups: Chinese, Korean, Japanese, Filipino, and Vietnamese adults in California., Materials and Methods: Using a combined dataset using the 2011-2018 cross-sectional cycles of the California Health Interview survey, we assessed moderate and serious distress and four health services utilization indicators in a set of disaggregated analyses among adults 18 years of age and older in five Asian subgroups. We performed bivariate and multivariable analyses., Results: The prevalence of and associations between moderate and serious distress and gaps in health services utilization varied among each Asian subgroup. Koreans had the highest prevalence of moderate and serious distress and the most gaps in health services utilization. Compared to those without moderate distress (p < .05), Japanese adults were more likely to delay care. Compared to those without serious distress (p < .05), Chinese adults who experienced serious distress were more likely to delay both medications and care, whereas Filipino and Vietnamese adults were more likely to delay medications., Discussion: Disaggregating health data elucidates the impact of mental distress on healthcare-seeking behaviors among specific Asian subgroups. Identifying these influences can facilitate future tailored interventions, yet fully understanding the mechanism linking mental distress and healthcare usage will necessitate a comprehensive assessment of structural influences and Asian American experiences without otherization., (© 2021. W. Montague Cobb-NMA Health Institute.)

Immigrants tend to live in areas with higher co-ethnic density, and the effect of neighborhood ethnic composition could be particularly salient for health. This study explored associations between neighborhood ethnic composition and self-rated health among Asian immigrants. We analyzed data collected at baseline from 670 Chinese and Vietnamese immigrants enrolled in a lifestyle intervention trial. Residential addresses were geocoded and combined with neighborhood socio-demographic profiles based on census data. We used generalized estimating equations to examine neighborhood ethnic composition and self-rated health. Independent of individual-level factors, living in neighborhoods more densely populated by whites was associated with poor/fair self-rated health. Neighborhood household income and density of participants' own ethnic group were not associated with poor/fair self-rated health. More research is warranted to disentangle reasons why Chinese and Vietnamese immigrants living in white-concentrated neighborhoods reported poorer self-rated health, including investigating effects of discrimination, relative deprivation, and availability of social resources.

Objective: Like the barrio advantage theory related to Mexican Americans, a theory about the protective effects of Chinese American enclaves is developing. Such protections were examined among socioeconomically vulnerable people with colon cancer. Design: A colon cancer cohort established in California between 1995 and 2000, and followed until the enactment of the Affordable Care Act was utilized in this study. Secondary analysis was conducted on the 5-year survival among 127 Chinese Americans and 4524 other Americans (3810 non-Hispanic white and 714 Hispanic people). A third of the original cohort was selected from high poverty neighborhoods. Chinese American enclaves were neighborhoods where typically 25% or more of the residents were Chinese Americans. Effects were tested with Cox regressions and group differences described with age and stage-standardized survival rate ratios (RR). Results: Though they were less adequately insured, Chinese American women residing in Chinese American enclaves (63%) were more likely to survive than were other Americans (50%, RR = 1.26). The protective effect of being married was also larger for Chinese Americans (RR = 1.31) than for others (RR = 1.17). Chinese American women (61%) were more likely than men (46%) to live in such enclaves and a large enclave survival advantage was observed among Chinese American women only (RR = 1.59). Conclusions: There is consistent evidence of the relatively protected status of Chinese American women, particularly those who were married and resided in Chinese American enclaves. Mechanisms that explain their apparent advantages are not yet well understood, though relatively large, kin-based social networks seem instrumental. Research on the influence of social networks as well as the possible effects of acculturation is needed. This study also exposed structural inequities related to the institutions of marriage, health care and communities that disadvantage others. Policy makers ought to be aware of them as future reforms of American health care are considered.

We report the results from cognitive interviews with Asian American patients and their caregivers. We interviewed seven caregivers and six patients who were all bilingual Asian Americans. The main goal of the cognitive interviews was to test a survey instrument developed for a study about perspectives of Asian American patients with advanced cancer who are facing decisions around end-of-life care. We were particularly interested to see whether items commonly used in White and Black populations are culturally meaningful and equivalent in Asian populations, primarily those of Chinese and Vietnamese ethnicity. Our exploration shows that understanding respondents' language proficiency, degree of acculturation, and cultural context of receiving, processing, and communicating information about medical care can help design questions that are appropriate for Asian American patients and caregivers, and therefore can help researchers obtain quality data about the care Asian American cancer patients receive., (© The Author(s) 2016.)

Mental illness stigma has adverse effects on both the caregivers' psychological well-being and the effectiveness of care that consumers receive. While anti-stigma interventions for family caregivers from Western settings have recently shown efficacy, these interventions may not be equally applicable across culturally diverse groups. Specifically, Chinese immigrant caregivers experience heightened internalized stigma, which predisposes the adoption of harmful coping strategies and reduced quality of social networks. We present an anti-stigma intervention based on a peer-family group format, co-led by a clinician and a trained family caregiver, to counter stigma among Chinese immigrants. Data are presented from a brief intervention administered to a pilot sample of 11 Chinese immigrant caregivers that provides: psychoeducation, strategies to counter experienced discrimination, and techniques to resist internalized stigma. Case vignettes illustrate implementation of this intervention, and how the peer-family format via interactive contact counteracts internalized stereotypes, encourages adaptive coping strategies, and reinvigorates social networks. Quantitative results further suggest preliminary efficacy in reducing internalized stigma for caregivers who evidenced at least some prior internalized stigma. This study constitutes an initial but important step towards reducing mental illness stigma among Asian Americans, for whom stigma has played a powerful role in the delay and underuse of treatment.