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Liu J, Lou Y, Cheung ESL. Beyond Dichotomy and Stability: ICT Use Among Asian American Older Adults During the COVID-19 Pandemic. J Appl Gerontol 2024; 43:170-181. [PMID: 37807902 DOI: 10.1177/07334648231204781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
This study examined the effect of the COVID-19 pandemic on information and communications technology (ICT) use and the typology of ICT users among older Chinese and Korean Americans. Survey data were collected from 513 Chinese and Korean older adults in New York City. We measured ICT use for social contact, grocery shopping, health care, and COVID-19 information seeking. In the study sample, ICT use for online shopping with others, contact with doctors, and telehealth significantly increased during the pandemic. Three groups of ICT users were identified: limited, users, expanding users, and active users. Older Chinese Americans and those with better English proficiency were more likely to be expanding and active ICT users. The patterns and heterogeneity of ICT use among older Asian Americans are multifaceted and dynamic beyond dichotomy and stability. The findings of this study offer helpful guidance for future development of ICT-based interventions for older Asian Americans.
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Affiliation(s)
- Jinyu Liu
- Diana R. Garland School of Social Work, Baylor University, Waco, TX, USA
| | - Yifan Lou
- Department of Internal Medicine, Section of Geriatrics, Yale School of Medicine, New Haven, CT, USA
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Oh H, Morey BN, Shi Y, Lee S. Distress, multimorbidity, and complex multimorbidity among Chinese and Korean American older adults. PLoS One 2024; 19:e0297035. [PMID: 38295036 PMCID: PMC10830023 DOI: 10.1371/journal.pone.0297035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/27/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Studies suggest that distress is associated with various health conditions such as hypertension, asthma, diabetes, and coronary heart disease. However, only few studies focused on Asian Americans and little is known about the association with multiple comorbidity. METHODS We conducted a cross-sectional analysis among 400 Chinese and Korean American participants (aged 50-75 years) of the STOP CRC randomized controlled trial. Perceived distress was assessed using the distress thermometer scale (range 0-10). Disease diagnosis was self-reported by the participants. Multimorbidity (MM) was defined as having ≥2 chronic conditions. Complex multimorbidity (CMM) was defined as having ≥3 of the following body system disorders: circulation disorder, endocrine-metabolic disorder, cancer, anxiety or depression, breathing problem, and other health problems. We performed logistic regression for CMM and Poisson regression with robust error variance for MM to estimate associations with distress, adjusting for potential confounders. RESULTS The mean age was 58.4 years and mean distress score was 3.65. One-unit increase in distress score was associated with a 1.22-fold increase in the odds of having CMM (95% CI: 1.04-1.42). The magnitude of association slightly increased after additional adjustment for socioeconomic factors and health insurance status (OR: 1.29; 95% CI: 1.10-1.52). Higher distress score was positively associated with MM but the association was only marginally significant (PR: 1.04; 95% CI: 0.99-1.10), adjusting for socioeconomic factors and health insurance status. CONCLUSION Our data suggest that higher perceived distress may be associated with simultaneous dysfunction of multiple distinct body systems among Chinese and Korean American older adults.
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Affiliation(s)
- Hannah Oh
- Department of Public Health Sciences, Interdisciplinary Program in Precision Public Health, Graduate School of Korea University, Seoul, Republic of Korea
- Department of Health Policy and Management, College of Health Sciences, Korea University, Seoul, Republic of Korea
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, California, United States of America
| | - Brittany N. Morey
- Department of Health, Society and Behavior, Program in Public Health, University of California, Irvine, Irvine, California, United States of America
| | - Yuxi Shi
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, California, United States of America
| | - Sunmin Lee
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, California, United States of America
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Park T, Pierre-Louis J, Jean T, Barua P, Ilma TT, Pinanez MA, Ravenell J, Castor C, Gousse Y. COVID-19 knowledge and mental health impact assessment in Haiti. Glob Ment Health (Camb) 2024; 11:e19. [PMID: 38414724 PMCID: PMC10897491 DOI: 10.1017/gmh.2024.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 01/04/2024] [Accepted: 01/11/2024] [Indexed: 02/29/2024] Open
Abstract
Mental health is a significant public health challenge globally, and one anticipated to increase following the COVID-19 pandemic. In many rural regions of developing nations, little is known about the prevalence of mental health conditions and factors that may help mitigate poor outcomes. This study assessed the impact of the COVID-19 pandemic on mental health and social support for residents of rural Haiti. Data were collected from March to May 2020. The Patient Health Questionnaire subscales for anxiety and depression, and the Perceived Stress Scale were utilized in addition to tailored questions specific to COVID-19 knowledge. Half (51.8%) of the 500 survey respondents reported COVID-19-related anxiety and worrying either daily or across a few days. Half (50.2%) also reported experiencing depression daily or across several days. Most (70.4%) did not have any social support, and 28.0% experienced some stress, with 13.4% indicating high perceived stress. Furthermore, 4.6% had suitable plumbing systems in their homes. The results were immediately actionable, informing the implementation of a mental health counseling program for youth following a loss of social support through school closures. Long-term investments must be made as part of public health responses in rural communities in developing nations, which remain under-studied.
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Affiliation(s)
- Taehwan Park
- Department of Pharmacy Administration and Public Health, St. John's University, Queens, NY, USA
| | | | - Tachel Jean
- Biomedical Program, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Prachurjya Barua
- Biomedical Program, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Taheera T Ilma
- Biomedical Program, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Mariana A Pinanez
- Biomedical Program, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Joseph Ravenell
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Chimene Castor
- Department of Nutritional Sciences, Howard University, Washington, DC, USA
| | - Yolene Gousse
- Department of Pharmacy Administration and Public Health, St. John's University, Queens, NY, USA
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Lozano P, Peters A, Southworth A, Mo Y, Lam H, Randal FT, Kim KE. Smoking behavior among Asian Americans during the initial phase of the COVID-19 pandemic: The influence of pandemic stressors and depression. Tob Induc Dis 2024; 22:TID-22-28. [PMID: 38274001 PMCID: PMC10809060 DOI: 10.18332/tid/176923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/13/2023] [Accepted: 12/16/2023] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION Heightened levels of distress among Asian Americans during the initial phases of the pandemic may be associated with current smoking behavior. In this study, we examine differences in current smoking among Asian Americans from two different ethnic backgrounds before and during the COVID-19 pandemic. METHODS We analyzed cross-sectional survey data (n=202) from Chinese and South Asian adults in Chicago, collected between February and May 2020. We conducted logistic regression models to estimate the relationship between exposure to the COVID-19 pandemic and current smoking. We tested whether the association varied by Asian American ethnic group, unemployment, racial discrimination, and depression symptoms. RESULTS We found that current smoking increased from 28% to 48% among Asian Americans (i.e. Chinese and South Asians) during the pandemic. We found a statistically significant interaction between the COVID-19 period indicator variable and current smoking by Asian American ethnic groups (p=0.014), such that current smoking was lower for Chinese compared to South Asians before COVID-19, but was comparable for both groups during the pandemic. We also found a statistically significant interaction between the period indicator variable and current smoking by racial discrimination (p=0.047) and depression symptoms (p=0.02). Results from these interactions suggest that Asian Americans who experienced racial discrimination and depression during the pandemic may be more likely to be current smokers compared to their pre-pandemic counterparts. CONCLUSIONS The findings of the study highlight the need for culturally tailored smoking cessation interventions for Asian American communities that address pandemic-related stressors such as discrimination that may trigger cigarette use.
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Affiliation(s)
- Paula Lozano
- Department of Biomedical Sciences, Center for Asian Health Equity - University of Chicago Medicine, Chicago, United States
| | - Aven Peters
- Department of Biomedical Sciences, Center for Asian Health Equity - University of Chicago Medicine, Chicago, United States
| | | | - Yicklun Mo
- Asian Health Coalition, Chicago, United States
| | - Helen Lam
- Department of Biomedical Sciences, Center for Asian Health Equity - University of Chicago Medicine, Chicago, United States
| | | | - Karen E. Kim
- Department of Biomedical Sciences, Center for Asian Health Equity - University of Chicago Medicine, Chicago, United States
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Lee J, Howard JT. Increased Self-Reported Mental Health Problems Among Asian-Americans During the COVID-19 Pandemic in the United States: Evidence from a Nationally Representative Database. J Racial Ethn Health Disparities 2023; 10:2344-2353. [PMID: 36129608 PMCID: PMC9491255 DOI: 10.1007/s40615-022-01414-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND To investigate changes in mental health outcomes among racial groups between 2019 and 2020. METHODS A retrospective cohort study was conducted using the third through fourth quarters of 2019-2020 longitudinal data from the National Health Interview Survey. Self-reports of diagnosed depression and anxiety disorder were key outcomes. We calculated the percentage of depression and anxiety disorder across baseline sample characteristics. Discrete-time hazard models stratified by race/ethnicity were conducted, with hazard ratios (HRs), 95% confidence intervals (CIs), and p-values reported. RESULTS Of a total 10,415 individuals, 16.3 and 14.1% reported that they were diagnosed with depression and anxiety disorder in 2019, respectively. In the multivariable model, only Asian-Americans experienced a significant increase in the probability of receiving a diagnosis of depression by 104% between 2019 and 2020 (HR 2.04, 95%CI 1.19-3.52; p = 0.010). Also, Asian-Americans had a 97% (HR 1.97, 95%CI 1.23-3.15; p = 0.005) greater probability of being diagnosed with anxiety disorder in 2020 than in the previous year, while Hispanics and Whites had a relatively moderate increase of 40% (HR 1.40, 95%CI 1.01-1.76; p = 0.040) and 11% (HR 1.11, 95%CI 1.03-1.20; p = 0.007), respectively. CONCLUSIONS Asian-Americans experienced a disproportionate increase in mental health conditions during the COVID-19 pandemic. Discriminatory behaviors against Asian-Americans may be important contributors. The study findings suggest the need for serious actions to address this issue.
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Affiliation(s)
- Jusung Lee
- Department of Public Health, College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, USA.
| | - Jeffrey T Howard
- Department of Public Health, College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, USA
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Chen S, Luo Y, Dong KR, Yau Y, Hires B, Liang S, Tang AM. HEAR US: a qualitative study of racial discrimination in Boston's Chinatown and empowering change from within the community. Front Public Health 2023; 11:1212141. [PMID: 37732089 PMCID: PMC10507619 DOI: 10.3389/fpubh.2023.1212141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/07/2023] [Indexed: 09/22/2023] Open
Abstract
Objective To qualitatively explore the impact of anti-Asian racism in a Chinese community in the greater Boston area. Methods Individual semi-structured interviews (n = 27) were conducted between June and September 2021. Eligible participants were ethnic Chinese immigrants living in the Boston area, who were recruited through a community-based organization and by word-of-mouth. Interviews were conducted in Mandarin and Cantonese and translated into English. Data were coded and analyzed using a directed approach to content analysis. Results The majority of participants reported personal experiences of anti-Asian racism, ranging from microaggressions to violent attacks. Although lockdown and isolation during COVID-19 affected all communities, the Chinese community suffered unique and prolonged trauma stemming from the fear of violent attacks against Asians. The older person/people, in particular, were severely isolated due to fear of exposure to anti-Asian hate crimes. Participants reported a variety of emotional, mental, and physical health effects associated with feelings of fear, anxiety, isolation, and powerlessness. Many preferred to engage in self-protective behavior changes rather than relying on external resources. Conclusion Participants advocated for more education, community, and governmental support, and increased allyship between communities of color. These findings provide cultural context on the trauma this population faces and can inform further actions to address the wide range of reported health effects.
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Affiliation(s)
- Siyu Chen
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States
| | - Yajing Luo
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Kimberly R. Dong
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States
| | - Yoyo Yau
- Boston Chinatown Neighborhood Center (BCNC), Boston, MA, United States
| | - Ben Hires
- Boston Chinatown Neighborhood Center (BCNC), Boston, MA, United States
| | - Shiwei Liang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Alice M. Tang
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States
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Liu T, Phan L, Chen-Sankey J, Ajith A, Hacker K, Jewett B, Choi K. Race, Concern About COVID-19 Discrimination, and Cigarette Smoking Behavior: Comparison Between US Asian and White Adults Who Use Commercial Tobacco. J Racial Ethn Health Disparities 2023; 10:1955-1961. [PMID: 35994174 PMCID: PMC9395842 DOI: 10.1007/s40615-022-01377-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/16/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022]
Abstract
Anti-Asian discrimination incidents in the USA have resurged during the COVID-19 pandemic. It is unclear how concern about being discriminatorily treated due to the COVID-19 pandemic varies between Asian and Asian American (A&AsA) and White adults. We examined A&AsA vs. White differences in concern about COVID-19 discrimination and associations of this concern with changes in cigarette smoking behaviors before and during the pandemic. Data were from a US representative sample of A&AsA and White adults (≥ 21 years) who currently and formerly used commercial tobacco (n = 1052), collected through an online panel oversampling A&AsA adults in January-February 2021. Participants reported their concern, worry, and stress about COVID-19 discrimination and past-30-day cigarette consumption before and during the pandemic. We examined the association between race and overall concern about COVID-19 discrimination, and this concern's associations with changes in past-30-day cigarette smoking consumption, smoking continuation, and return to smoking using weighted multivariable logistic and linear regression models. Overall concern about COVID-19 discrimination was higher (adjusted mean = 1.7, standard error = 0.16) among A&AsA adults who currently and formerly used commercial tobacco than their White counterparts (adjusted mean = 0.60, standard error = 0.04; p < 0.01). Overall concern about COVID-19 discrimination was associated with increased past-30-day cigarette consumption by 26.5 cigarettes (95% confidence interval [CI] = 1.2-51.9) and 4.4 times (95% CI = 2.3-8.5) greater odds of return to smoking among adults who smoke cigarettes. A&AsA adults who currently and formerly used commercial tobacco disproportionately bore higher concern about COVID-19 discrimination, and in turn could lead to increased smoking behavior and related morbidity and mortality among A&AsA adults.
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Affiliation(s)
- Tina Liu
- Department of Stem Cell and Regenerative Biology, Harvard College, Cambridge, MA, USA
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA
| | - Lilianna Phan
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA.
| | - Julia Chen-Sankey
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Aniruddh Ajith
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kiana Hacker
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA
| | - Bambi Jewett
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA
| | - Kelvin Choi
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA
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Richardson BN, Noh HI, Webster CI, Zhang W, Kim S, Yang I, Bai J. Oral Microbiome, Mental Health, and Sleep Outcomes During the COVID-19 Pandemic: An Observational Study in Chinese and Korean American Immigrants. OMICS : A JOURNAL OF INTEGRATIVE BIOLOGY 2023; 27:180-190. [PMID: 36946910 PMCID: PMC10122216 DOI: 10.1089/omi.2022.0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
COVID-19 is a systemic disease whose effects are not limited to the respiratory system. The oral microbiome (OM)-brain axis is of growing interest in understanding the broader, neuropsychiatric, impacts of the COVID-19 pandemic through a systems biology lens. In this context, mental health and sleep disturbance are often reported by Asian Americans. In a cross-sectional observational study design, we examined the associations of the oral microbiome with mental health among Asian Americans during the COVID-19 pandemic (between November 2020 and April 2021). Participants (n = 20) were adult Chinese and Korean American immigrants in Atlanta, Georgia, and primarily born outside the United States (60%) with a mean age of 34.8 years ±14 (standard deviation). Participants reported depressive symptoms, anxiety, and sleep disturbance, as measured by standard questionnaires. The OM was characterized by 16S rRNA V3-V4 gene using saliva. Depressive symptoms and anxiety were reported by 60% (n = 12) of participants, whereas 35% (n = 7) reported sleep disturbance. The α-diversity was significantly associated with depressive symptoms, and marginally with anxiety. Participants with depressive symptoms and anxiety had enriched Rothia and Scardovia, respectively, whereas those without symptoms had enriched Fusobacterium. Individuals with sleep disturbance had enriched Kingella. In conclusion, this study suggests significant associations of the OM diversity with certain mental health dimensions such as depressive symptoms and anxiety. Specific taxa were associated with these symptoms. The present observations in a modest sample size suggest the possible relevance of the OM-brain axis in studies of mental health during COVID-19.
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Affiliation(s)
- Brianna N. Richardson
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Hye In Noh
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Caitlin I. Webster
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Wenhui Zhang
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Sangmi Kim
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Irene Yang
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
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Intimate Partner Violence Among South Asian Women During the COVID-19 Pandemic: A Cross-Sectional Survey of Prevalence and Risk Factors. J Immigr Minor Health 2023:10.1007/s10903-023-01454-9. [PMID: 36745278 PMCID: PMC9901397 DOI: 10.1007/s10903-023-01454-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 02/07/2023]
Abstract
The goal of this study was to understand the prevalence of intimate partner violence (IPV) among South Asian women during COVID-19, and to identify predictors of IPV presence and severity. We recruited South Asian women (n = 132) to complete an online survey about their mood, experiences with COVID-19, and IPV. 47% of South Asian women (n = 132) reported experiencing any IPV, most commonly economic abuse. Women experiencing IPV had higher rates of COVID-19 related worry (t=-1.3, p = .001) and anxiety (t=-2.2, p = .027). The following variables were associated with greater odds of experiencing IPV: COVID-19 related worry (OR: 1.44 [1.11, 1.87]) and full-time employment status (OR: 0.13 [0.02, 0.99]). Depressive symptoms were a significant positive predictor of economic abuse severity (b = 0.80, p = .002). Future research should examine cultural and environmental factors that interact with the experience of IPV among South Asian women to better inform interventions for survivors.
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Hope C, Shen N, Zhang W, Noh HI, Hertzberg VS, Kim S, Bai J. A Pilot Study of the Gut Microbiota Associated With Depressive Symptoms and Sleep Disturbance Among Chinese and Korean Immigrants in the United States. Biol Res Nurs 2023; 25:150-160. [PMID: 36056574 PMCID: PMC10068504 DOI: 10.1177/10998004221124273] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
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.
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Affiliation(s)
- Chloe Hope
- Nell Hodgson Woodruff School of
Nursing, Emory University, Atlanta, GA, USA
| | - Natalie Shen
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Wenhui Zhang
- Nell Hodgson Woodruff School of
Nursing, Emory University, Atlanta, GA, USA
| | - Hye In Noh
- Nell Hodgson Woodruff School of
Nursing, Emory University, Atlanta, GA, USA
| | - Vicki S. Hertzberg
- Nell Hodgson Woodruff School of
Nursing, Emory University, Atlanta, GA, USA
| | - Sangmi Kim
- Nell Hodgson Woodruff School of
Nursing, Emory University, Atlanta, GA, USA
| | - Jinbing Bai
- Nell Hodgson Woodruff School of
Nursing, Emory University, Atlanta, GA, USA
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
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11
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Ikram M, Shaikh NF, Vishwanatha JK, Sambamoorthi U. Leading Predictors of COVID-19-Related Poor Mental Health in Adult Asian Indians: An Application of Extreme Gradient Boosting and Shapley Additive Explanations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:775. [PMID: 36613095 PMCID: PMC9819341 DOI: 10.3390/ijerph20010775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
During the COVID-19 pandemic, an increase in poor mental health among Asian Indians was observed in the United States. However, the leading predictors of poor mental health during the COVID-19 pandemic in Asian Indians remained unknown. A cross-sectional online survey was administered to self-identified Asian Indians aged 18 and older (N = 289). Survey collected information on demographic and socio-economic characteristics and the COVID-19 burden. Two novel machine learning techniques-eXtreme Gradient Boosting and Shapley Additive exPlanations (SHAP) were used to identify the leading predictors and explain their associations with poor mental health. A majority of the study participants were female (65.1%), below 50 years of age (73.3%), and had income ≥ $75,000 (81.0%). The six leading predictors of poor mental health among Asian Indians were sleep disturbance, age, general health, income, wearing a mask, and self-reported discrimination. SHAP plots indicated that higher age, wearing a mask, and maintaining social distancing all the time were negatively associated with poor mental health while having sleep disturbance and imputed income levels were positively associated with poor mental health. The model performance metrics indicated high accuracy (0.77), precision (0.78), F1 score (0.77), recall (0.77), and AUROC (0.87). Nearly one in two adults reported poor mental health, and one in five reported sleep disturbance. Findings from our study suggest a paradoxical relationship between income and poor mental health; further studies are needed to confirm our study findings. Sleep disturbance and perceived discrimination can be targeted through tailored intervention to reduce the risk of poor mental health in Asian Indians.
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Affiliation(s)
- Mohammad Ikram
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Robert C. Byrd Health Sciences Center [North], P.O. Box 9510, Morgantown, WV 26506-9510, USA
| | - Nazneen Fatima Shaikh
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Robert C. Byrd Health Sciences Center [North], P.O. Box 9510, Morgantown, WV 26506-9510, USA
| | - Jamboor K. Vishwanatha
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Usha Sambamoorthi
- Department of Pharmacotherapy, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
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Okazaki S, Lee CS, Prasai A, Chang DF, Yoo N. Disaggregating the data: Diversity of COVID-19 stressors, discrimination, and mental health among Asian American communities. Front Public Health 2022; 10:956076. [PMID: 36339147 PMCID: PMC9627279 DOI: 10.3389/fpubh.2022.956076] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 09/28/2022] [Indexed: 01/24/2023] Open
Abstract
Much of the public discourse as well as research regarding the negative impact of COVID-19-related anti-Asian discrimination has been conducted at the broad racial group level, yet data aggregation masks critical points of diversity among Asian Americans. We conducted an online survey of 620 Asian American adults in December 2020 and examined whether there were any demographic differences-including by ethnic subgroup and Chinese street race (being Chinese or being mistaken as Chinese)-in their experiences of COVID-19-related stress, direct and vicarious discrimination, and psychological outcomes. Our analyses found that younger age was correlated with higher reports of pandemic stress, discrimination, distress, and worry. Female and U.S.-born participants reported higher levels of pandemic stress and vicarious discrimination, but there were no gender or nativity differences in levels of direct discrimination. Being uninsured was also related to higher levels of pandemic stress, discrimination, and distress. East Asian Americans reported significantly lower frequencies of direct anti-Asian discrimination than did South Asian or Southeast Asian Americans, but the ethnic subgroups did not differ in their reports of vicarious discrimination. Of note, Chinese street race was not associated with either direct or vicarious discrimination. Separate hierarchical regression analyses for East Asian, South Asian, and Southeast Asian participants revealed that, regardless of ethnicity, racial discrimination significantly contributed to psychological distress and worry beyond the effects of pandemic stress. However, the three groups varied in the demographic indicators and COVID-19 stressors that were associated with psychological outcomes. Pandemic stress was more strongly associated with negative outcomes among South Asian Americans than East Asian and Southeast Asian Americans, and neither direct nor vicarious discrimination were associated with mental health among South Asian Americans. Direct discrimination, compared to vicarious discrimination, was a particularly robust predictor of both distress and worry among East Asian Americans. For Southeast Asian Americans, direct discrimination significantly predicted higher levels of distress, whereas vicarious discrimination predicted higher levels of worry. Vicarious discrimination was not significantly related to distress across ethnic subgroups. Results suggest that practitioners and policy makers would benefit from attending to these within-group differences in Asian Americans' experiences during the pandemic.
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Affiliation(s)
- Sumie Okazaki
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, United States
| | - Christina Seowoo Lee
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, United States
| | - Aakriti Prasai
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, United States
| | - Doris F. Chang
- Silver School of Social Work, New York University, New York, NY, United States
| | - Nari Yoo
- Silver School of Social Work, New York University, New York, NY, United States
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Tiwari BB, Zhang D“S. Differences in Mental Health Status Among Asian Americans During the COVID-19 Pandemic: Findings from the Health, Ethnicity, and Pandemic Study. Health Equity 2022; 6:448-453. [PMID: 35801151 PMCID: PMC9257548 DOI: 10.1089/heq.2022.0029] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose: This study aims to explore the differences in mental health status among Asian Americans during the COVID-19 pandemic. Methods: Data from the 2020 Health, Ethnicity, and Pandemic (HEAP) Study were used to explore the psychological distress of 2672 adults, using the Standard Kessler Psychological Distress Scale. Results: We observed that among Asian American subgroups, South Asian Americans had significantly higher odds of experiencing psychological distress than non-Hispanic White Americans (odds ratio = 1.82, 95% confidence interval = 1.00–3.31), after controlling for covariates. Conclusion: The study identified differences in mental health status among Asian American subgroups. We recommend the implementation of culturally appropriate interventions to help Asian Americans cope with mental health challenges.
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Affiliation(s)
- Biplav Babu Tiwari
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Donglan “Stacy” Zhang
- Division of Health Services Research, New York University Long Island School of Medicine, Mineola, New York, USA
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