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BACKGROUND: Physical inactivity is associated with adverse health outcomes among Asian Americans, who exhibit the least adherence to physical activity guidelines compared with other racial and ethnic groups. Mobile app-based interventions are a promising approach to promote healthy behaviors. However, there is a lack of app-based interventions focused on improving physical activity among Asian Americans whose primary language is not English. OBJECTIVE: This pilot study aimed to assess the feasibility and acceptability of a 5-week intervention using a culturally and linguistically adapted, evidence-based mobile phone app with an accelerometer program, to promote physical activity among Chinese-, Tagalog-, or Vietnamese-speaking Americans. METHODS: Participants were recruited through collaborations with community-based organizations. The intervention was adapted from a 12-month physical activity randomized controlled trial involving the app and accelerometer for English-speaking adults. Sociodemographic characteristics, lifestyle factors, and physical measurements were collected at the baseline visit. A 7-day run-in period was conducted to screen for the participants who could wear a Fitbit One (Fitbit LLC) accelerometer and complete the apps daily step diary. During the 4-week intervention period, participants wore the accelerometer and reported their daily steps in the app. Participants also received daily messages to reinforce key contents taught during an in-person educational session, remind them to input steps, and provide tailored feedback. Feasibility measures were the percentage of eligible participants completing the run-in period and the percentage of participants who used the app diary for at least 5 out of 7 days during the intervention period. We conducted poststudy participant interviews to explore overall intervention acceptability. RESULTS: A total of 19 participants were enrolled at the beginning of the study with a mean age of 47 (SD 13.3; range 29-70) years, and 58% (n=11) of them were female. Of the participants, 26% (n=5) were Chinese, 32% (n=6) were Vietnamese, and 42% (n=8) were Filipino. All participants met the run-in criteria to proceed with the intervention. Adherence to the app diary ranged from 74% (n=14) in week 2 to 95% (n=18) in week 4. The daily average steps per week from accelerometers increased each week from 8451 (SD 3378) steps during the run-in period to 10,930 (SD 4213) steps in week 4. Participants reported positive experiences including an increased motivation to walk and the enjoyment of being able to monitor their physical activity. CONCLUSIONS: This is the first pilot study of a multicomponent intervention and evidence-based mobile phone app to promote physical activity among Asian Americans who use apps in traditional Chinese, Tagalog, or Vietnamese, which demonstrated high feasibility and acceptability. Future work focused on multilingual mobile apps to address disparities in physical inactivity among Asian Americans should be considered.

Background: Thirdhand smoke (THS) contains toxic residues, including carcinogens, which persist on surfaces and clothes even after cigarette smoke dissipates. The public awareness of THS and its health effects remain low. Objective: This study examined beliefs about THS among Chinese-speaking former smokers and their non-smoking family members, before and after participating in a family-based THS education program. Methods: We implemented a 2-week THS education intervention delivered by lay health workers with 30 Chinese American dyads (N=60) residing in Northern California, consisting of former smokers who quit within the past 2 years and their family members. THS beliefs were assessed using the Beliefs About Thirdhand Smoke (BATHS) questionnaire administered at pre- and postintervention. Focus groups with 8 former smokers and 7 family participants were conducted. We used multivariable regression with Generalized Estimating Equations to account for time points and household correlations to assess changes in BATHS scores (Overall, Persistence and Health subscales). Focus group transcripts underwent independent coding by two researchers and thematic analysis. Results: The study sample included 30 male former smokers (37% with slight to mild craving for smoking), and 30 family members (97% female) who never smoked. A majority (82%) spoke English less than well, 83% were married, 58% lived with children and 27% with current smokers. All multivariable models showed a significant time x role (former smokers vs family) interaction (p < 0.05). Former smokers had lower BATHS scores than their family at preintervention (p < 0.01), but their scores became similar at post-intervention. Former smokers’ BATHS scores increased from pre- to post-intervention (Overall: p=0.02; Persistence: p=0.03; Health: p=0.04) while family had no significant change. Prominent themes from focus groups supported gaining new knowledge for both persistence and health effects of THS. Both former smokers and family members appreciated learning about cleaning methods and both shared increased family discussions and collaboration in household cleaning post intervention. Conclusion: THS education impacts former smokers and their non-smoking family members differently. Family-based interventions are promising to align beliefs and promote collaboration within households in addressing THS. Future randomized controlled trials should investigate broader impacts of the program on enhancing support for motivating quitting for current smokers, maintaining smoking abstinence, and in reducing THS exposure.

Significance: Thirdhand smoke (THS), which includes secondhand smoke contami- nants, can be re-emitted and re-suspended into the air and are embedded into carpets, floors, and clothing. The awareness of THS and the health impacts from exposure to its harmful residues is low in the general population of the United States, especially in immigrant communities where smoking remains prevalent. Our study implemented a THS family-based intervention to promote THS awareness among Chinese American immigrants. Methods: The THS intervention included an education and home cleaning component delivered by lay health workers to 30 Chinese American dyads (N=60). Dyads consisted of former smokers who quit within the last two years and their non-smoking family member living in the same household. Participants completed pre- and post-in- tervention survey interviews and a sub-sample (N=15; 8 former smokers and 7 family members) participated in a post-intervention focus group. Multivariable regression adjusted for dyadic data was conducted to compare pre- and post-intervention changes in the Beliefs About Thirdhand Smoke (BATHS) overall and subscale (Persistence and Health) scores. Transcriptions from focus group interviews, conducted in Cantonese, were transcribed and translated, coded by two independent researchers and themati- cally analyzed using Dedoose. Results: All participants were born outside the US and 59% immigrated at age 30 or older (range: 7 to 63 years old). A majority (82%) spoke English less than “well” and 87% were married. BATHS scores analyses suggested that former smokers increased their THS awareness from pre- to post-intervention: BATHS Overall (M=3.95 [SD=0.50], p=0.021); Persistence (M=3.95 [SD=0.48], p=0.031) and Health (M=3.94 [SD=0.58], p=0.038), and their post-intervention THS scores became similar to the BATH scores of non-smoking family members which did not change at post-intervention. Thematic analyses of focus group interviews revealed emerging themes highlighting impacts on former smokers in increasing THS knowledge and strengthening desires to create dialogue about tobacco use with friends; for example, a former smoker shared “I will share my [THS] knowledge with others. I think it will help [my friends] as well.” Conclusion: A family-based THS education intervention has promising impacts to advance tobacco control in Chinese American immigrant communities by providing new THS knowledge and encouraging former smokers to become agents of change. Future research on empowering former smokers to become effective agents of change to promote tobacco-free communities is warranted.

BackgroundCancer is the leading cause of death among Asian Americans, who often face barriers to cancer care. Cancer supportive care needs among Asian Americans remain understudied.AimsWe examined cancer supportive care needs and participant factors correlated with these needs, identified profiles of supportive care needs, and examined whether needs profiles are associated with quality of life among Asian American adults.Methods and resultsWe recruited 47 Asian American adults with colorectal, liver, or lung cancer who spoke Chinese, English, or Vietnamese, and were starting or undergoing cancer treatment. We assessed cancer supportive care needs in four domains: cancer information, daily living, behavioral health, and language assistance. Hierarchical cluster analysis was used to identify clusters of participants based on their supportive need profiles to further examine the association between need profiles and quality of life (QoL) assessed by the Functional Assessment of Cancer Therapy. Participants (mean age = 57.6) included 72% males and 62% spoke English less than very well. Older participants (age ≥ 65) and those with annual income

Bond line thickness (BLT) is an essential parameter of thermal conductive composite gels as the thermal interface material (TIM). Extensive research has been performed on designing next-generation TIMs with high thermal conductivity; however, it remains elusive how to link laboratory measurements and the theoretically predicted BLT. Here, we propose a new model to estimate BLT based on a rheological property, in which the TIM is assumed to be a simple power law fluid. To avoid the unrealistic situation of the BLT tending to zero, we introduce a decaying exponential function to describe the influence from fillers during the lid attach process and rebuild the force balance equation. Compared with previously reported models, the theoretical prediction BLT based on the proposed model is in good agreement with the experimental data. Our model has a guiding significance in predicting the BLT, which may help to optimize the thermal performance of TIMs. [ABSTRACT FROM AUTHOR]

BackgroundHepatitis C virus (HCV) screening remains suboptimal. We assessed the efficacy of a mobile application and provider alert in enhancing HCV screening among Asian Americans.MethodsA secondary analysis of a cluster-randomized clinical trial was performed during the birth cohort screening era to assess the efficacy of a Hepatitis App (intervention), a multilingual mobile application delivering interactive video education on viral hepatitis and creating a Provider Alert printout, at primary care clinics within 2 healthcare systems in San Francisco from 2015 to 2017. A comparison group received usual care and a similar intervention on nutrition and physical activity. The outcome was electronic health record (EHR) documentation of HCV screening along with patient-provider communication about testing and test ordering.ResultsFour hundred fifty-two participants (mean age 57 years, 36% male, 80% foreign-born) were randomized by provider clusters to the intervention (n = 270) or comparison groups (n = 182). At 3-month follow up, the intervention group was more likely than the comparison group to be aware of HCV (75% vs 59%, P = .006), to discuss HCV testing with their providers (63% vs 13%, P < .001), to have HCV testing ordered (39% vs 10%, P < .001), and to have EHR-verified HCV testing (30% vs 6%, P < .001). Within the intervention group, being born between 1945 and 1965 (odds ratio, 3.15; 95% confidence interval, 1.35-7.32) was associated with increased HCV testing.ConclusionsThe Hepatitis App delivered in primary care settings was effective in increasing HCV screening in a socioeconomically diverse Asian American cohort. This highlights the importance of mobile technology as a patient-centered strategy to address gaps in HCV care.

The Early Start Denver Model is an evidence-based, comprehensive naturalistic developmental behavioral intervention for young and very young children with autism spectrum disorder. This interdisciplinary model is suitable for the Taiwanese public health system. In this study, we evaluated the effectiveness of an Early Start Denver Model program with adaptation, including a lower intensity, shorter duration, and delivery in general hospitals by multidisciplinary professionals. A quasi-experimental study with pre-, post-intervention, and 6-month follow-up was conducted. Forty-five young children with autism spectrum disorder, aged 2-4 years, were grouped into the Early Start Denver Model and control (the usual community treatment) groups. The Early Start Denver Model group received 6 months of one-on-one intervention for approximately 8-9 h per week. Compared with the control group, the Early Start Denver Model group showed greater improvements in overall development quotient and nonverbal development quotient from pre- to post-intervention, but these differences (a Group-by-Time interaction) did not sustain at the 6-month follow-up. Being mindful of some potential threats to internal validity associated with clinical trial designs and implementation, this study provides preliminary evidence to support the effectiveness of the Early Start Denver Model intervention in regional general hospital settings in the context of Han-Chinese-mainly culture.

PurposeCancer is the leading cause of death for Asian Americans. However, few studies have documented supportive care needs from the perspective of Asian American cancer patients. This study describes the needs reported by Asian American patients with colorectal, liver, or lung cancer over a 6-month period during their treatment.MethodsParticipants were recruited through the Greater Bay Area Cancer Registry and from cancer care providers in San Francisco. Participants self-identified as Asian or Asian American; were age 21 or older; spoke English, Chinese, or Vietnamese; and had stage I-III colon, rectum, liver, or lung cancer. Participants were matched with a language concordant patient navigator who provided support during a 6-month period. Needs were assessed by surveys at baseline, 3, and 6 months.ResultsAmong 24 participants, 58% were 65 years or older, 42% did not complete high school, and 75% had limited English proficiency (LEP). At baseline, the most prevalent needs were cancer information (79%), nutrition and physical activity (67%), language assistance (54%), and daily living (50%). At the 3- and 6-month follow-up surveys, there was a higher reported need for mental health resources and healthcare access among participants.ConclusionIn this pilot study of Asian American cancer patients who predominantly had LEP, participants reported many needs, with cancer information and language assistance as the most prominent. The findings highlight the importance of culturally and linguistically appropriate patient navigators in addressing supportive care needs among cancer patients with LEP.Trial registrationClinicalTrials.gov identifier: NCT03867916.

BACKGROUND: There are few studies to date of interventions to increase viral hepatitis screening among Asian Americans, who have high rates of chronic hepatitis B (HBV) infection. OBJECTIVE: To develop, implement, and test the efficacy of a mobile application (Hepatitis App) delivered in four languages to increase HBV screening among Asian Americans. DESIGN: Cluster-randomized clinical trial. PARTICIPANTS: Four hundred fifty-two Asian American patients ≥ 18 years of age, who had no prior HBV testing, and received primary care within two healthcare systems in San Francisco, CA. INTERVENTIONS: The intervention group received the Hepatitis App, delivering interactive video education on viral hepatitis in English, Cantonese, Mandarin, or Vietnamese and a provider printout (Provider Alert) and Provider Panel Notification. The comparison group received a mobile application delivering nutrition and physical activity education and Provider Panel Notification. MAIN MEASURES: Primary outcomes were patient-provider discussion about HBV and documentation of a HBV screening test within 3 months post-intervention. Secondary outcome was documentation of an order for a HBV screening test. KEY RESULTS: Participants had a mean age of 57 years and were 64% female, 80% foreign-born, and 44% with limited English fluency. At post-visit, over 80% of intervention participants reported they liked using the Hepatitis App. At 3-month follow-up, the intervention group was more likely than the comparison group (all P

This study examined the use of first language in English reading lessons and the perceptions of teachers and students towards it in three Hong Kong Chinese-medium secondary schools. The data comprised three teachers and sixty-three Form 2 students' participation and responses in (i) 3 classroom observations about how L1 was used in actual teaching and learning settings, (ii) survey forms gathering the frequency of participants using L1 teaching and learning strategies (based on the three teachers and nineteen selected students from the pool), and (iii) subsequent in-depth interviews concerning their perceptions about using L1 in English reading lessons. The findings revealed that (i) the use of L1 bottom-up language focused teaching strategies and condition-oriented teaching and learning strategies were effective for teaching and learning in English reading lessons and (ii) there was a negative relationship between students' proficiency in English and the use of L1. The study concluded that the use of first language in English reading lessons brought positive effects on the second language learning in English reading, especially when students' English proficiency and teaching contexts were taken into consideration.

Background: Cerebral small vessel disease (SVD) is a common neurological disorder contributing to stroke, dementia, and disability. No treatment options exist although clinical trials are ongoing. We aimed to understand what matters to people and families affected by SVD to inform future research. Methods: We thematically analysed unsolicited correspondences from members of the public addressed to members of the Edinburgh SVD Research Group on a variety of subjects related to SVD. We used inductive thematic codes, categorised under concerns, requests, emotions, and contributions, to form a grounded theory that categorised and ranked concerns raised. Results: 101 correspondents expressed 346 concerns between August 2015 and February 2021, mostly via email. 60 correspondents (59.4 %) disclosed a SVD diagnosis, 39 (38.6 %) disclosed a previous stroke or TIA, and 40 (39.6 %) were family of people living with SVD. Primary concerns related to cognitive problems (number of correspondents (n)=43 (42.6 %)), lack of support or information from healthcare services (n = 41 (40.6 %)), prognosis (n = 37 (36.6 %)), sensory disturbances (n = 27 (26.7 %)), functional problems (n = 24, (23.8 %)), impact on daily life (n = 24 (23.8 %)), and causes of SVD (n = 19 (18.8 %)). 57 correspondents (56.4 %) expressed support for research, 43 (42.6 %) expressed an eagerness to understand SVD, 35 (34.7 %) expressed helplessness, and 19 (18.8 %) expressed frustration. Conclusions: Cognitive decline was the main concern for people and families living with SVD who corresponded with the Edinburgh SVD research group. These findings also indicate a need for more accessible services and better information about SVD for patients and families.

Objective: There is a lack of controlled studies of community-wide interventions to increase screening for hepatitis B (HBV) among Asian Americans, particularly Vietnamese Americans, who disproportionately suffer from HBV-related illnesses. The objective of our study was to develop, implement, and evaluate the effectiveness of a media campaign to promote HBV screening among Vietnamese Americans.Design: We designed and implemented a three-year media campaign promoting HBV screening among Vietnamese Americans. Evaluation consisted of cross-sectional pre- and post-intervention population-based telephone surveys of Vietnamese Americans adults age 18-64 who spoke English or Vietnamese and lived in the Northern California (intervention) or Greater Washington, D.C. (comparison) communities in 2007 or 2011. Statistical analysis was completed in 2012. The main outcome was self-report of HBV testing, defined as participants answering 'Yes' to the question: 'Have you ever had a blood test to check for hepatitis B?'Results: The sample sizes at pre- and post-intervention were 1,704 and 1,666, respectively. Both communities reported increased exposure to HBV-related booklets, radio and television advertisements, and websites. Only the intervention community reported increased exposure to newspaper elements. HBV screening increased in both communities (intervention: 65.3% to 73.1%, p