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Lee YJ. Work and self-rated memory among native Hawaiian and other Pacific Islander older adults. ETHNICITY & HEALTH 2024:1-10. [PMID: 38591263 DOI: 10.1080/13557858.2024.2337620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES Engagement in work has an important association with cognitive health in later life, yet little is known about this association among Native Hawaiian and other Pacific Islander (NHPI) older adults. This study assesses the associations between various work characteristics and memory problems among this population. DESIGN Using data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS), the research question was explored among those who were aged 50+. RESULTS Engagement in work, certain occupation types (e.g., clerical or professional occupations compared to blue-collar jobs), and the current/most recent job that is also the longest job held were associated with lower odds of having memory problems. CONCLUSION The study's results suggest that work characteristics and opportunities to engage in work are important considerations in preventing memory problems in later life. As the NHPI population experiences cognitive health disparities earlier than other groups, timely interventions that focus on work engagement and a culturally relevant environment require further investigation.
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Affiliation(s)
- Yeonjung Jane Lee
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, HI, USA
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2
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Choi S, Hong S, Gatanaga OS, Yum AJ, Lim S, Neighbors CJ, Yi SS. Substance use and treatment disparities among Asian Americans, Native Hawaiians, and Pacific Islanders: A systematic review. Drug Alcohol Depend 2024; 256:111088. [PMID: 38262197 PMCID: PMC10922506 DOI: 10.1016/j.drugalcdep.2024.111088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/30/2023] [Accepted: 01/05/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND The increasing relevance of substance use disorder (SUD) within the Asian American, Native Hawaiian, and Pacific Islander (AA&NH/PI) communities, particularly amidst rising anti-Asian hate incidents and the disproportionate health and economic challenges faced by the NH/PI community during the COVID-19 pandemic, underscores the urgency of understanding substance use patterns, treatment disparities, and outcomes. METHODS Following PRISMA guidelines, 37 out of 231 studies met the search criteria. Study characteristics, study datasets, substance use rates, SUD rates, treatment disparities, treatment quality, completion rates, and analyses disaggregated by the most specific AA&NH/PI ethnic group reported were examined. RESULTS Despite increased treatment admissions over the past two decades, AA&NH/PI remain underrepresented in treatment facilities and underutilize SUD care services. Treatment quality and completion rates are also lower among AA&NH/PI. Analyses that did not disaggregate AA and NHPI as distinct groups from each other or that presented aggregate data only within AA or NHPI as a whole were common, but available disaggregated analyses reveal variations in substance use and treatment disparities among ethnic groups. There is also a lack of research in exploring within-group disparities, including specific case of older adults and substance use. CONCLUSION To address disparities in access to substance use treatment and improve outcomes for AA&NH/PI populations, targeted interventions and strategic data collection methods that capture diverse ethnic groups and languages are crucial. Acknowledging data bias and expanding data collection to encompass multiple languages are essential for fostering a more inclusive approach to addressing SUD among AA&NH/PI populations.
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Affiliation(s)
- Sugy Choi
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America.
| | - Sueun Hong
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America; New York University Wagner School of Public Policy, New York, NY, United States of America
| | - Ohshue S Gatanaga
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, United States of America
| | - Alexander J Yum
- University of Pennsylvania College of Arts and Sciences, Philadelphia, PA, United States of America
| | - Sahnah Lim
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America
| | - Charles J Neighbors
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America
| | - Stella S Yi
- Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America
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Thomas P, Bishop-Royse J, Lomahan S, Silva A, Murphy AM, Martin MA. Community-Based Organizations Leading Research Efforts: Preliminary Findings from the Chicagoland CEAL Program's COVID-19 Vaccine Uptake and Intention Survey. J Racial Ethn Health Disparities 2024:10.1007/s40615-023-01846-5. [PMID: 38383838 DOI: 10.1007/s40615-023-01846-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND To foster community engaged research in the communities most impacted by COVID-19, the National Institutes of Health (NIH) formed 21 teams of Community Engagement Alliance Against COVID-19 Disparities (CEAL). The national CEAL initiative developed a Common Survey to investigate attitudes and behaviors to the COVID-19 vaccine and clinical trials. This article describes survey implementation at the Chicagoland CEAL Program (CCP). METHODS This community-based participatory research project was the result of a strong collaboration between academic institutions, and a community-based non-profit health equity-focused partner organization. The survey implementation was developed and refined with strong input from CHWs, participants, and staff in the partner organizations and institutions. Survey data were collected with Qualtrics, a web-based survey tool. RESULTS Survey implementation resulted in data collection for 852 participants during the period 12/18/2021-02/18/2023. Excluding participants on the basis of missing data resulted in a sample of 690, 601 of which (87.10%) indicated that they had received at least one dose or intended to get vaccinated. Overall, 54 (7.83%) respondents reported that they had not received the vaccine and were not planning to. CONCLUSION Hard to reach populations present two unique challenges in emerging infectious disease events. Reaching populations vulnerable to poor outcomes with vaccines was essential to addressing the COVID-19 pandemic. Additionally, learning about barriers and hesitancy toward vaccine uptake is difficult in these communities. CCP's partnership of five academic institutions, a community research center, and a community-based non-profit health equity-focused organization shows what is possible when traditional models of research and inquiry are reconsidered for community-based participatory research. Results shown here are drawn from a collaboratively designed and implemented survey, collected in person, with over 90% completion.
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Affiliation(s)
| | - Jessica Bishop-Royse
- Dept. of Adult Health and Gerontological Nursing, College of Nursing, Rush University, Chicago, IL, USA.
| | | | - Abigail Silva
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Chicago, IL, USA
| | - Anne Marie Murphy
- School of Public Health, Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, USA
| | - Molly A Martin
- Department of Pediatrics, University of Illinois Chicago, Chicago, IL, USA
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Weldon EJ, Nakamura RW, Van T, Goo C, Lee AY, Jahansooz JR, Carrazana E, Liow KK. Exercise and Recovery Following Mild-to-Moderate Traumatic Brain Injury in the Community Setting. Cureus 2024; 16:e53459. [PMID: 38435185 PMCID: PMC10909398 DOI: 10.7759/cureus.53459] [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] [Accepted: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction The recommendations on return to exercise post-traumatic brain injury (TBI) remain debatable. As recent as 10 years ago, the conventional recovery modality for a mild TBI was to reduce neurostimulating activity and encourage rest until the symptoms subsided. However, emerging literature has challenged this notion, stating that returning to exercise early in the course of mild TBI recovery may be beneficial to the recovery timeline. This study surveys Hawaii's diverse population to identify trends in exercise and recovery for TBI patients to shape recommendations on return to exercise. Methods A single-center retrospective chart review of the patients with mild-to-moderate TBI was selected from a patient database at an outpatient neurology clinic between January 2020 and January 2022. The variables collected include demographics, the etiology of injury, and symptoms at diagnosis. Self-generated phone surveys were completed to evaluate exercise patterns post-TBI. Results The patients who recovered within two years displayed similar exercise patterns to the patients who took more than two years to recover. Exercise frequency, intensity, and duration did not differ significantly (p=0.75, p=0.51, and p=0.80, respectively; n=100). Hiking and walking were more common in the long recovery (LR) group (p=0.02), likely reflecting advanced age compared to the short recovery (SR) group (50 versus 39 years, p<0.01). Additionally, no correlation exists between exercise intensity and worsening symptoms (p=0.920), suggesting that the patients exhibit exercise patterns suitable for sub-symptomatic recovery. Conclusion Return to exercise does not appear to be a predictor for mild-to-moderate TBI recovery. The patients appear to self-regulate an exercise regimen that will not exacerbate their symptoms or recovery time; thus, it may be suitable to recommend return to exercise as tolerated. These, and other findings in the literature, suggest that patients should be encouraged to return to exercise shortly after a mild TBI so long as the exercise does not exacerbate their symptoms.
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Affiliation(s)
- Edward J Weldon
- Neurology, University of Hawaii John A. Burns School of Medicine, Honolulu, USA
- Neurology, Brain Research, Innovation & Translation Laboratory, Concussion and TBI Center, Concussion Research Lab, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Ryan W Nakamura
- Neurology, University of Hawaii John A. Burns School of Medicine, Honolulu, USA
- Neurology, Brain Research, Innovation & Translation Laboratory, Concussion and TBI Center, Concussion Research Lab, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Tracy Van
- Neurology, Brain Research, Innovation & Translation Laboratory, Concussion and TBI Center, Concussion Research Lab, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Connor Goo
- Neurology, University of Hawaii John A. Burns School of Medicine, Honolulu, USA
- Neurology, Brain Research, Innovation & Translation Laboratory, Concussion and TBI Center, Concussion Research Lab, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Anson Y Lee
- Neurology, University of Hawaii John A. Burns School of Medicine, Honolulu, USA
- Neurology, Brain Research, Innovation & Translation Laboratory, Concussion and TBI Center, Concussion Research Lab, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Julia R Jahansooz
- Neurology, University of Hawaii John A. Burns School of Medicine, Honolulu, USA
- Neurology, Brain Research, Innovation & Translation Laboratory, Concussion and TBI Center, Concussion Research Lab, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Enrique Carrazana
- Neurology, Brain Research, Innovation & Translation Laboratory, Concussion and TBI Center, Concussion Research Lab, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Kore K Liow
- Neurology, University of Hawaii John A. Burns School of Medicine, Honolulu, USA
- Neurology, Brain Research, Innovation & Translation Laboratory, Concussion and TBI Center, Concussion Research Lab, Hawaii Pacific Neuroscience, Honolulu, USA
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Davis J, Taira DA, Lim E, Chen J. Daily Moderate-to-Vigorous Activity of Native Hawaiians and Pacific Islanders and Seven Asian Subgroups by Types of Activities, American Time Use Survey, 2010-2019. Healthcare (Basel) 2024; 12:205. [PMID: 38255093 PMCID: PMC10815051 DOI: 10.3390/healthcare12020205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
The study used the American Time Use Survey data from 2010 to 2019 to compare the daily moderate-to-vigorous activity of Native Hawaiians and Pacific Islanders (NHPI) and seven Asian ethnic subgroups. Adults aged 24 years and older were included. The study analyzed activities from sports and recreation, household activities, and all activities carried out during the day. Outcomes were determined by the completion of 30 min or more of moderate-to-vigorous activity and the type of activity carried out in the day. Significant ethnic differences were observed for sports and recreation but not for household activities and not for all activities carried out during the day. Of the ethnic populations, NHPI were the least active, and Asian Indians and Chinese were the most active. A majority achieved 30 min or more of moderate-to-vigorous activity during the day from all their activities. Physical activity from household activities exceeded physical activity from sports and recreation. The most physically active group was adults over the age of 65 years, perhaps reflecting more time to exercise or greater concerns about their health. For sports and recreation, exercising with someone doubled the minutes of moderate-to-vigorous activity. The results emphasize the importance of activities performed around the household in addition to sports and recreation and the benefit of exercising with someone. Ethnic populations may be receptive to interventions that emphasize activities they are performing in their daily lives.
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Affiliation(s)
- James Davis
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, 651 Ilalo Street Honolulu, Honolulu, HI 96813, USA; (E.L.); (J.C.)
| | - Deborah A. Taira
- Daniel K. Inouye College of Pharmacy, University of Hawai‘i at Hilo, 722 South Aohoku Place, Hilo, HI 96720, USA;
| | - Eunjung Lim
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, 651 Ilalo Street Honolulu, Honolulu, HI 96813, USA; (E.L.); (J.C.)
| | - John Chen
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, 651 Ilalo Street Honolulu, Honolulu, HI 96813, USA; (E.L.); (J.C.)
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Zhang X, Kaholokula JK, Kahn-John M, Walters K, Ma G, Thao C, Lepule JT, Stinson N. Elevating Voice and Visibility: Health Research for American Indian and Alaska Native, Asian American, and Native Hawaiian and Pacific Islander Populations in the United States. Am J Public Health 2024; 114:S25-S28. [PMID: 38207264 PMCID: PMC10785185 DOI: 10.2105/ajph.2023.307494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2023] [Indexed: 01/13/2024]
Affiliation(s)
- Xinzhi Zhang
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Joseph Keaweʻaimoku Kaholokula
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Michelle Kahn-John
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Karina Walters
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Grace Ma
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Chia Thao
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Jonathon Tana Lepule
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
| | - Nathan Stinson
- Xinzhi Zhang is with the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Bethesda, MD. Joseph Keawe'aimoku Kaholokula is with the John A. Burns School of Medicine at the University of Hawai'i at Mānoa. Michelle Kahn-John is with the Johns Hopkins School of Nursing, Baltimore, MD. Karina L. Walters is with the Tribal Health Research Office, NIH, Bethesda. Grace Ma is with the Center for Asian Health, Laura H. Carnell Professor at Lewis Katz School of Medicine, Temple University, Philadelphia, PA. Chia Thao is with the California State University of Bakersfield. Jonathan (Tana) Lepule is with the Pacific Islander Collective San Diego, CA. Nathan Stinson is with the Division of Community Health and Population Science, National Institute on Minority Health and Health Disparities, Bethesda
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Goo C, Morden F, Wong K, Aquino S, Kawamura J, Rubel V, Masca S, Gorenflo R, Carrazana E, Liow K. Familiarity and Perceptions of Aducanumab in Caregivers of Hawaii Alzheimer's Disease Patients: Results of a Telephone Survey. Cureus 2023; 15:e50001. [PMID: 38186481 PMCID: PMC10767469 DOI: 10.7759/cureus.50001] [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: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
AIM To identify current perceptions of aducanumab among patients with Alzheimer's disease (AD) and their caregivers. METHODS A total of 352 caregivers of AD patients seen at Hawaii's largest multidisciplinary neuroscience center between January 01, 2019, and June 21, 2021, were surveyed by telephone to understand patient and caregiver knowledge, familiarity, and hesitancy toward aducanumab. RESULTS Thirty-seven percent of caregivers were familiar with aducanumab. Caregivers who were spouses of their respective patients with AD (p=0.0023) had increased odds of familiarity. Additional predictors of aducanumab familiarity included patients with higher mini-mental state examination scores (p=0.0076) and those who received mental stimulation (p=0.007). Conversely, caregivers who identified as native Hawaiian and other Pacific Islanders (NHPI) (p=0.044) or the patient's child (p=0.010) were predictors of decreased familiarity. Only 33% of caregivers familiar with aducanumab believed it to be safe and 56% reported "side effects" as their top concern. Thirty percent of caregivers were moderately ready or very ready to use aducanumab if given the opportunity. CONCLUSION Most caregivers of Hawaii AD patients were unfamiliar with aducanumab. Furthermore, those familiar were hesitant to trial the medication. Improved education and awareness of AD therapies are important, so families and caregivers of AD patients can make more informed decisions regarding AD treatment.
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Affiliation(s)
- Connor Goo
- Brain Research, Innovation & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
- Neurology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, USA
| | - Frances Morden
- Brain Research, Innovation & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
- Neurology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, USA
| | - Kasen Wong
- Brain Research, Innovation & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
- Neurology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, USA
| | - Sarvia Aquino
- Brain Research, Innovation & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Jaron Kawamura
- Brain Research, Innovation & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Vanessa Rubel
- Brain Research, Innovation & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Samantha Masca
- Brain Research, Innovation & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Rachel Gorenflo
- Brain Research, Innovation & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
| | - Enrique Carrazana
- Brain Research, Innovation & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
- Neurology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, USA
| | - Kore Liow
- Brain Research, Innovation & Translation Laboratory, Hawaii Pacific Neuroscience, Honolulu, USA
- Neurology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, USA
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Quint J, Matagi C, Kaholokula JK. The Hawai'i NHPI Data Disaggregation Imperative: Preventing Data Genocide Through Statewide Race and Ethnicity Standards. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:67-72. [PMID: 37901675 PMCID: PMC10612414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Federal race and ethnicity data standards are commonly applied within the state of Hawai'i. When a multiracial category is used, Native Hawaiians are disproportionately affected since they are more likely than any other group to identify with an additional race or ethnicity group. These data conventions contribute to a phenomenon known as data genocide - the systematic erasure of Indigenous and marginalized peoples from population data. While data aggregation may be unintentional or due to real or perceived barriers, the obstacles to disaggregating data must be overcome to advance health equity. In this call for greater attention to relevant social determinants of health through disaggregation of race and ethnicity data, the history of data standards is reviewed, the implications of aggregation are discussed, and recommended disaggregation strategies are provided.
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Affiliation(s)
| | - Chantelle Matagi
- Center for Pacific Island Studies, University of Hawai‘i at Mānoa, Honolulu, HI (CM)
| | - Joseph Keawe‘aimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (JKK)
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Davis J, Taira DA, Lim E, Chen J. Modeling Poverty and Health for Native Hawaiian and Pacific Islander and Asian Ethnic Populations. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:77-83. [PMID: 37901660 PMCID: PMC10612419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
This study examined differences in poverty and health among Native Hawaiians and Pacific Islanders (NHPI) and 6 disaggregated Asian ethnic subgroups and an aggregated Other Asian category. Participants were followed longitudinally for 2 years using data from 2009 to 2019 from the Current Population Survey, a monthly survey conducted by the Census Bureau. Having 2 years of data enabled the study to assess both prevalence of poverty and fair/poor health in only 1 of the 2 years and in both years. For NHPI, 13.5% were in poverty 1of the 2 years and 7.1% in both years. Asian ethnicities showed high variability ranging from a low of 6.4% for 1 year and 1.9% for 2 years among Asian Indians to 16.0% for 1 year and 6.3% for 2 years among Vietnamese. Fair/poor health also showed ethnic variability, made most apparent after age-sex adjustment in regression models. For poverty, after adjustment, Asian Indians, Filipinos and Japanese had significantly lower odds of being in poverty at least 1 year than NHPI. For having fair/poor health, Asian Indians and Japanese experienced lower odds than NHPI for both 1 and 2 years and Filipinos for 1 year, after age/sex adjustment. The results emphasize the diversity of Asian and Pacific Islander populations, the variability of poverty over time, and the importance of using disaggregated data to understand ethnic differences in poverty and health. These findings can be used to inform future modeling of social determinants on poverty and health among NHPI and Asian subgroups.
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Affiliation(s)
- James Davis
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, HI (JD, EL, JC)
| | - Deborah A. Taira
- Daniel K. Inouye College of Pharmacy, University of Hawai‘i at Hilo, Hilo, HI (DAT)
| | - Eunjung Lim
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, HI (JD, EL, JC)
| | - John Chen
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, HI (JD, EL, JC)
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Pokhrel P, Lipperman-Kreda S, Wills TA, Keaweʻaimoku Kaholokula J, Kawamoto CT, Amin S, Herzog TA. Ethnicity, Coronavirus Disease-Related Stress, and E-cigarette Use and Cigarette Smoking Among Young Adults: A Longitudinal Study. Nicotine Tob Res 2023; 25:1676-1686. [PMID: 37330693 PMCID: PMC10445257 DOI: 10.1093/ntr/ntad095] [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: 01/26/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Research has rarely examined ethnic differences in exposure to coronavirus disease (COVID)-related stress in relation to smoking and e-cigarette use. AIMS AND METHODS Using pre- and post-COVID data from a sample of predominantly Asian American (AA) and Native Hawaiian and Pacific Islander (NHPI) young adults, this study aimed to test the effects of ethnicity on cigarette smoking and e-cigarette use through exposure to COVID-related stress. Young adults from Hawaii who provided pre-COVID data in or before January 2020 were followed up with in March-May 2021. N = 1907 (mean age = 24.9 [SD = 2.9], 56% women) provided complete data relevant to the current analysis at both waves of data collection. Structural equation modeling was used to test the effects of ethnicity (white, Asian [eg, Japanese, Chinese], Filipino, NHPI, and other) on pre- to post-COVID changes in cigarette and e-cigarette use via effects on COVID-related stress. RESULTS Relative to Asian young adults, members of all other ethnic groups (NHPI, Filipino, white, and other) indicated greater exposure to COVID-related stress. Higher levels of COVID-related stress were associated with increased dual-use status and increased current e-cigarette and cigarette use frequencies. Higher COVID-related stress mediated the effects of NHPI, Filipino, and other ethnicity on increased dual-use status. CONCLUSIONS The current data indicate that young adults of vulnerable ethnic groups who experience higher COVID-related stress are at increased risk for dual use of cigarettes and e-cigarettes. IMPLICATIONS The findings imply that tobacco use prevention and treatment efforts may need to pay increased attention to racial or ethnic groups that have experienced greater adverse impact of the COVID-19 pandemic.
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Affiliation(s)
- Pallav Pokhrel
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | - Thomas A Wills
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Joseph Keaweʻaimoku Kaholokula
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Crissy T Kawamoto
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Samia Amin
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Thaddeus A Herzog
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
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Oh EG, Huang AW, Nguyen KH. Inequities in Patient Access to Care Among Asian American, Native Hawaiian, and Pacific Islander Adults in Medicaid. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01719-x. [PMID: 37491628 DOI: 10.1007/s40615-023-01719-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Despite decades of advocacy for disaggregated data collection and reporting for Asian American, Native Hawaiian, and Pacific Islander (AA and NHPI) people, significant gaps remain in our ability to understand AA and NHPI individuals' access to care. We assess inequities in access to care measures between non-Hispanic White and AA and NHPI adult Medicaid enrollees. METHODS We used the 2014-15 Nationwide Adult Medicaid Consumer Assessment of Healthcare Providers and Systems, the first-and-only nationally representative sample of Medicaid enrollees. Our main outcomes were access to needed care, access to a personal doctor, timely access to a checkup, and timely access to specialty care. Using multivariable linear probability models, we assessed the relationship between racial/ethnic group and our outcomes, both in the aggregate and disaggregated into ten racial/ethnic groups, and adjusted for enrollee-level sociodemographic characteristics, health status, and state-level Medicaid expansion status. RESULTS In aggregate, AA and NHPI enrollees reported worse access to care than White enrollees on all four metrics (p < 0.001). The magnitude of disparities varied across the ten AA and NHPI ethnic groups. Disparities relative to White enrollees were particularly large in magnitude, roughly 1.5 to 2 times greater, for Chinese, Korean, and Vietnamese enrollees than for the aggregated AA and NHPI group. CONCLUSIONS Despite comparable insurance coverage, there were inequities in multiple access to care metrics between non-Hispanic White and AA and NHPI Medicaid enrollees. Collection of disaggregated health data on AA and NHPI patients reveals important variation in access to care by ethnic group.
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Affiliation(s)
- Eunhae Grace Oh
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, 02912, USA.
| | - Andrew W Huang
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, 02912, USA
| | - Kevin H Nguyen
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, 02118, USA
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Nguyen-Truong CKY, Waters SF, Richardson M, Barrow N, Seia J, Eti DU, Rodela KF. An Antiracism Community-Based Participatory Research With Organizations Serving Immigrant and Marginalized Communities, Including Asian Americans and Native Hawaiians/Pacific Islanders in the United States Pacific Northwest: Qualitative Description Study With Key Informants. Asian Pac Isl Nurs J 2023; 7:e43150. [PMID: 36648292 PMCID: PMC9976990 DOI: 10.2196/43150] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Asian American (AA) community leaders, Native Hawaiian/Pacific Islander (NH/PI) community leaders, and allies in the United States Pacific Northwest expressed concern that there are families and children from AA communities and NH/PI communities who experience and witness acts of xenophobia and racism. This can cause racial trauma. The long-time practice of aggregating AA and NH/PI data contributes to erasure and makes it challenging to advance health equity, such as allocating resources. According to AAPI Data's long-awaited report in June 2022, there are over 24 million AAs and 1.6 million NHs/PIs in the United States, growing by 40% and 30%, respectively, between 2010 and 2020. Philanthropic investments have not kept up with this substantive increase. The National Academies of Sciences, Engineering, and Medicine emphasized the need for effective partnerships to advance the health and well-being of individuals and communities in antiracism and system-level research. OBJECTIVE The aim of this community-based participatory research qualitative description study was to identify perceptions and experiences regarding racial discrimination, race-based stress, and racial trauma; intergenerational healing and resiliency; and sharing the body with science from key informants of an academic and community partnership to inform antiracism coalition work. This partnership includes academic researchers and community leaders from community-based organizations and a health care organization serving immigrant and marginalized communities, including AAs and NHs/PIs in the United States Pacific Northwest. METHODS In total, 10 key informants joined 1 of 2 participatory group discussions via videoconference for 2 hours in 2022. We used a semistructured and open-ended group interview guide. A qualitative participatory group-level assessment was conducted with the key informants and transcribed. Interpretations and meanings of the main points and the main themes were reflected upon, clarified, and verified with the key informants in real time. The field note-based data transcripts were manually coded using conventional content analysis. Reflexivity was used. RESULTS There were 6 main themes: prejudice plus power in racism definition and working in solidarity to counter lateral oppression/false sense of security, microaggression as multilayers, "not assimilationist by nature" and responding differently to white superiority, intergenerational- and identity-related trauma, what is healing among People of Color and through a lens of resiliency and intergenerational connection and knowledge, and mistrust and fear in the research and health care systems surrounding intentions of the body. CONCLUSIONS The themes highlight the importance of internal and intergenerational healing from racial trauma and the need for solidarity among communities of color to combat white supremacy and colonization. This work was foundational in an ongoing effort to dismantle racism and uplift the community voice through a cross-sector academic and community partnership to inform antiracism coalition work.
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Affiliation(s)
| | - Sara F Waters
- Human Development Department in Vancouver, College of Agricultural, Human, and Natural Resource Sciences, Washington State University, Vancouver, WA, United States
| | - Meenakshi Richardson
- Human Development Department in Vancouver, Washington State University, Vancouver, WA, United States
| | - Natasha Barrow
- College of Nursing, Health Sciences Spokane, Washington State University, Spokane, WA, United States
| | - Joseph Seia
- Lived Experience Coalition, Federal Way, WA, United States
| | - Deborah U Eti
- College of Nursing, Health Sciences Spokane, Washington State University, Spokane, WA, United States
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13
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Chang JS, Saxton K, Bright G, Ryan MS, Lai EF, Jorden MA, Gutierrez A. Invisibility as a structural determinant: Mortality outcomes of Asians and Pacific Islanders experiencing homelessness. Front Public Health 2023; 10:969288. [PMID: 36684879 PMCID: PMC9853290 DOI: 10.3389/fpubh.2022.969288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/23/2022] [Indexed: 01/08/2023] Open
Abstract
Introduction Asians and Pacific Islanders (APIs) who are experiencing homelessness are situated in a social intersection that has rendered them unrecognized and therefore vulnerable. There has been increasing attention to racial disparities in homelessness, but research into API homelessness is exceedingly rare, despite rapidly growing populations. The purpose of this study is to examine the causes of death among APIs who died while homeless in Santa Clara County (SCC) and compare these causes to other racial groups. Materials and methods We report on data obtained from the SCC Medical Examiner-Coroner's Office on unhoused people's deaths that occurred between 2011 and 2021 (n = 1,394), including data on deaths of APIs experiencing homelessness (n = 87). Results APIs comprised 6.2% of total deaths of unhoused people. APIs died less often of causes related to drug/alcohol use than all other racial groups (24.1, compared to 39.3%), and there was a trend toward more API deaths from injuries or illnesses. When APIs were disaggregated into sub-groups (East/Southeast Asian, South Asian, Pacific Islander), there were notable mortality differences in cause of death, age, and sex. Discussion We argue that invisibility is a structural determinant of health that homeless APIs face. Though relatively small in numbers, APIs who are invisible may experience increased social isolation and, subsequently, specific increased mortality risks. To understand the health outcomes of unhoused APIs, it is essential that researchers and policymakers recognize API homelessness and gather and report disaggregated races and ethnicities.
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Affiliation(s)
- Jamie Suki Chang
- Department of Public Health, Santa Clara University, Santa Clara, CA, United States
| | - Katherine Saxton
- Department of Public Health, Santa Clara University, Santa Clara, CA, United States
| | - Georgia Bright
- Department of Public Health, Santa Clara University, Santa Clara, CA, United States
| | - Maya S. Ryan
- Department of Public Health, Santa Clara University, Santa Clara, CA, United States
| | - E. Francis Lai
- Department of Public Health, Santa Clara University, Santa Clara, CA, United States
| | | | - Andy Gutierrez
- Office of the Public Defender Post-Conviction Outreach Unit, San Jose, CA, United States
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14
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Chen Z, Ma GX, Zhang X, McLemore MR. Editorial: Community Engagement Is Key to Promoting Asian American, Native Hawaiian, and Pacific Islander Health. Health Equity 2022; 6:681-683. [PMID: 36225667 PMCID: PMC9536337 DOI: 10.1089/heq.2022.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Zhuo Chen
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Grace X. Ma
- Center for Asian Health, Department of Urban Health and Population Science at Lewis Katz School of Medicine and Fox Chase Cancer Center, Temple University, Philadelphia, Pennsylvania, USA
| | - Xinzhi Zhang
- Center for Translation Research & Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Monica R. McLemore
- Family Health Care Nursing Department, University of California San Francisco, San Francisco, California, USA
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