Background and Objective: Despite being the fastest-growing U.S. minority group, Asian Americans (AA) remain understudied in mental health research, leading to a significant gap in our comprehension of their well-being. This study utilized data from the 2021 National Survey on Drug Use and Health (NSDUH) to assess the mental health status of AA, identify contributing factors, and explore associations between mental disorders and chronic health conditions.

Methods: Weighted logistic regression modeling and descriptive analyses were conducted on a sample of 1,872 AA adults aged 26 and older, mental disorders were categorized using past-year serious psychological distress (SPD) and major depressive disorder (MDE), assessed by K6 scale scores and DSM-5 criteria. The study also examined chronic health conditions (hypertension, diabetes, cancer, heart conditions), overall health status, and the impact of COVID-19 on mental health, adjusting for sex, age category, and educational levels.

Results: In 2021, 8.3% of AA adults experienced past-year SPD, while 3.5% had past-year MDE. Prevalence rates for chronic health conditions among adults aged 26 or older were 18.1% for hypertension, 12.9% for diabetes, 8.3% for heart conditions, and 2.9% for cancer. However, logistic regression analyses revealed no significant association between mental disorders and chronic health conditions among AA adults, although overall health status and the impact of COVID-19 significantly influenced past-year mental disorders.

Conclusions: This study enhances our understanding of Asian Americans' mental health status, highlighting the factors influencing mental health and identifying barriers to assessing mental health and other health conditions, especially among older individuals.

Background/Significance: Vietnamese Americans are underrepresented in COVID-19 clinical trials. Given the disproportionate impact of COVID-19 on this group, examining trust in information sources relied upon by Vietnamese Americans may reveal facilitators and barriers to participation in COVID-19 clinical trials.

Objective/Purpose: To investigate levels of trust in sources of information and correlation with willingness of Vietnamese Americans to participate in SARS-CoV-2 trials.

Methods: The NIH Community Engagement Alliance (CEAL) Common Survey 2 contained questions about levels of trust in different sources of COVID-19 and COVID-19 clinical trial information and willingness to participate in COVID-19 clinical therapeutic trials. Vietnamese adults in Texas were recruited between December 2022-April 2023 via partnerships with community organizations, health fairs, and clinics. Survey results were analyzed using multivariable logistic regression with high willingness to participate in COVID-19 clinical trials defined as our main outcome variable.

Results: A total of 363 surveys were completed. Out of 250 respondents with complete responses for regression analysis, increasing age (AOR 1.02, 95% CI: 1.00-1.04; p=0.03), and high trust in drug companies (AOR 2.45, 95% CI: 1.02-5.89; p=0.05) and in friends/family (AOR 3.71, 95% CI: 1.34-10.29; p=0.01) significantly increased the odds of high willingness to participate in COVID-19 trials. Language use (Vietnamese vs. English), educational attainment levels, insurance status, and history of COVID-19 infection or completed COVID-19 vaccination were not associated with high willingness to participate in COVID-19 trials.

Discussion/Conclusion: The results provide insight into Vietnamese Americans’ trusted sources of information associated with high willingness to participate in COVID-19 clinical trials.

Background: Asian Americans (AAs) face linguistic barriers to healthcare access which can result in poor health outcomes. Federally qualified health centers (FQHCs) are required by federal law to make language interpretation services (LIS) available to those with limited English proficiency (LEP). However, many AAs are unaware of this requirement and often seek care without utilization of LIS.

Purpose: To understand the relationship between knowledge of federal requirements of LIS and attitudes towards LIS which may impact LIS utilization.

Methods: We conducted a community survey (N=401) among Chinese, South Asian, and Southeast Asian immigrants in Chicago to understand attitudes towards and utilization of LIS. We used bivariate and logistic regression analyses to examine the effect of knowledge of federal LIS requirements on attitudes towards LIS concerning translation privacy and accuracy as well as stigmatizing beliefs towards LIS.

Results: Descriptive bivariate analysis found that individuals who were not aware of the federal requirements for LIS were significantly more likely to agree with statements expressing concerns regarding translation privacy and accuracy and feeling disadvantaged when utilizing LIS. These associations were confirmed by logistic regression models adjusting for sociodemographic characteristics and English proficiency. No relationship was found between knowledge of federal LIS requirements and LIS usage in the previous 12 months.

Conclusions: Results from this study are helpful in informing strategies to reduce patients’ individual-level barriers to utilization of LIS.

Background/Objective

Cancer is the leading cause of death for Asian Americans. Yet, Asian Americans’ experiences with cancer in the Midwest have not been thoroughly explored, which is important for identifying areas of improvement for cancer prevention and control. Therefore, we conducted a study to describe the cancer perceptions or experiences of Asians in St. Louis, Missouri.

Methods

We recruited individuals who 1) self-identified as Asian or Asian American, 2) lived in the St. Louis Metropolitan Area, 3) were at least 15 years old, and 4) were cancer survivors, had a family history of cancer, or were caregivers of someone with cancer. The research team adapted and facilitated an expressive writing activity to provide a culturally sensitive method for discussing cancer perceptions and experiences. Participants wrote continuously in English for 15 minutes about their cancer perceptions or experiences. The participants’ essays were transcribed and coded before generating themes.

Results

Nineteen participants, ages 15 to 62 years, completed the writing activity. Participants’ essays revealed the following major themes: 1) patients with cancer trust family members more than medical interpreters to interpret, 2) cultural stigma prevents open conversations about cancer at the family, community, and population level, and 3) the perception that cancer always results in death despite advances in treatment.

Discussion

We explore the cancer perceptions and experiences of Asian Americans in the Midwest, which provides an important context for understanding how to improve healthcare services for this population. This study could inform additional research that explores cultural influences on cancer care.

The Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion’s Islands Program currently funds a 6-year cooperative agreement (DP19-1901) to prevent and control tobacco use, diabetes, and cardiovascular disease in the US Affiliated Pacific Islands, the US Virgin Islands, and Puerto Rico. The Islands Program conducted an evaluation to identify factors that affected implementation of DP19-1901 and strategies to improve collaboration with these islands. Due to historical trauma, exploitation, and exclusion of these islands, it is critical that the relationship between the funder and recipient is collaborative in nature to be culturally responsive and promote effective implementation.^1-9

Twenty-three telephone interviews with all islands awarded DP19-1901 funds (n=8) and CDC staff that served as part of the Islands Program (n=15) were completed between November 2022-January 2024. Thematic analysis was conducted using in NVivo. Inter-rater agreement reached Kappa ≥ .80.

Program strategies that build on current work and partnerships in the islands, focus on policy approaches, and address root causes of chronic disease yield positive impacts on the islands’ program and health outcomes (n=13). Successfully implemented programs should focus on engaging everyone through regular meetings and peer-learning sessions (n=12); providing clear, frequent communication (n=12); and supporting recipients through in-person technical assistance/training (n=11). Funders that provide creative technical assistance quickly (n=14), are open/approachable (n=8), build close relationships (n=8), relay urgent matters to partners and coordinate a response (n=8), and understand the context and challenges of the islands foster a positive experience for recipients.

Introduction and objectives: The barefoot doctors in China represent a successful precedent with significant implications for public health, particularly in less developed areas. This model not only showcases China's unique approach to integrating traditional and modern medicine but also offers valuable insights for advancing rural healthcare service systems both now and in the future. Despite serving as a reference for the community health worker model worldwide, the existing literature lacks comprehensive information. The purpose of this study was to systematically review the scientific literature concerning barefoot doctors in China.Methods: Keyword and reference searches were conducted in Pubmed, Web of Science, MEDLINE, PsycINFO and CNKI (China Database). Studies related to barefoot doctors were included. Results:Through a comprehensive literature search was conducted in both in English and Chinese on "barefoot doctors in China", resulting in the inclusion of a total of 136 studies that met the inclusion criteria, comprising 96 in English and 40 in Chinese. We organized the findings into four areas.Firstly, the history and development of barefoot doctors. Then, the role and impact of barefoot doctors, focusing on analyzing their contribution to primary health care services.Thirdly, the challenges and difficulties faced by barefoot doctors.And finally, barefoot doctors in a modern perspective.Conclusion: Through this systematic review of the history and impact of the barefoot doctors in China, we underscore the importance of their contributions to preventive medicine, the training and utilization of primary health care personnel, and the integration of traditional and modern medicine in the face of health care challenges.

For over ten years, Chicago's Chinatown Patient Navigation (PN) Research Program has provided cancer screenings to over a thousand participants. Between 2013-2019, the program enrolled almost 800 Chinese women to receive breast and cervical cancer screenings. Since 2021, the program expanded cancer patient navigation services to include men. Our qualitative studies have found that US Chinese men have been less proactive with their health and healthcare decisions compared to women because men tend to defer healthcare decision-making to women. Therefore, we have explored strategies to increase men's health self-efficacy, and we present lessons learned and recommendations.

For over three years, we have conducted multiple surveys with over 400 Chinese adult women and men residing in Chicago’s Chinatown who received navigation services. We analyzed survey logs and patient navigation records.

Most Chinese male participants were recruited through family and friend referrals. Despite support and prompts from patient navigators, most male participants did not seek health information and relied on women in their families for health-related information and decisions. We encouraged female participants to bring their male family members and friends to health educational workshops and seek healthcare services. Social determinants of health also play a crucial role in men's lack of engagement in healthcare.

We recommend health educational workshops and promotional materials to encourage men to be more proactive in seeking healthcare and improve their health literacy. Furthermore, cultural humility among healthcare providers is necessary for developing better rapport with the Chinese male patients, to enhance trust in the healthcare system.

Background

Suicide among youth in Hawaii is a serious public health issue. Native Hawaiian and Micronesian youth have the highest suicide rates among all age groups and ethnicities. The Hawaii’s Caring Systems Initiative for Youth Suicide Prevention (HCSI) is a SAMHSA-funded systems intervention program studying youth suicide prevention and mental wellness through a systems lens across health, education and community sectors. The Sources of Strength (SOS) program was implemented with community partners across the state to strengthen youth resilience by having youth drive mental wellness and awareness activities with guidance from trained adult community members. RCTs have found SOS to be an effective program.

Methods

SOS trainings were conducted across several communities in Hawaii. Trainings ranged in duration from two to four hours. Participants were provided QR codes to complete post-only surveys on their mobile devices. Hard copies were supplied for those who preferred completing with pen and paper. Participation was voluntary. Data analysis consisted of determining percentages of strengths identified after trainings were completed.

Results

Preliminary short-term results demonstrate promising recognition of strengths. Results from 126 surveys high identification with strengths such as community (a finding unique to Hawaii), family support, positive friends, and generosity.

Discussion

This program shows that strengths-based approached work in Hawaii and aligns with results from a previous pilot study. Sources of Strength has been adapted and accepted in Hawaiian communities and is in alignment with cultural and community values, Native Hawaiian concepts of wellness, and strengths related to family, place, spirituality, health, and wellbeing.

Background
There is limited research about how recent US immigrants from China cope with their unmet healthcare needs.

Objective
Elucidate how recent US immigrants from China cope with unmet healthcare needs

Methods
In 2024, we conducted four focus groups with 17 Chinese nationals living in the US for <10 years. Participants were recruited through snowball sampling. Focus groups were conducted in Mandarin on Zoom for 45-65 minutes. Discussions centered on participants’ experiences and challenges accessing healthcare in the US. Transcripts were thematically analyzed using the framework method.

Results
Among the 17 participants, 11 were female, six were male, three were 18-25 years old, 13 were 26-40 years old, and one was over 40 years old.

Overall, challenges revolved around language barriers with healthcare providers, antibiotics accessibility, appointment wait times, and healthcare costs. To cope with language barriers, participants consulted with Chinese-language apps before or instead of meeting healthcare providers. Healthcare providers were perceived as reluctant to prescribe antibiotics, so participants brought their own antibiotics from China and/or purchased them directly from US-based vendors. Appointment waiting times were often perceived as unacceptably long, thus prompting numerous participants to attempt self-medication with over-the-counter drugs. Opaque healthcare costs were a major concern that dissuaded some participants from seeking care, and even considering returning to China for treatment if necessary.

Conclusion
Recent Chinese immigrants in the US are using various strategies to cope with unmet healthcare needs. Further research is needed to understand the prevalence of such strategies and identify promising health service interventions.