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Snow KSR, Merrill K, Macintosh J, Thomas M, Miles L. Mental health literacy in Polynesian Native Hawaiian and Other Pacific Islanders. Int J Ment Health Nurs 2024; 33:683-692. [PMID: 38071505 DOI: 10.1111/inm.13275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 05/19/2024]
Abstract
The high prevalence of mental health problems and underutilization of mental health treatment are more severe among the Native Hawaiian and Other Pacific Islander (NHPI) populations and remain misunderstood and understudied. Examining mental health literacy (MHL) - the knowledge and beliefs about mental disorders - aids their recognition, management, or prevention - has been shown to identify barriers to seeking and receiving care. This study aimed to assess the level of MHL in NHPIs and identify associated demographic variables. Data for this cross-sectional study were collected from 298 US NHPIs via an online questionnaire of the Mental Health Literacy Scale (MHLS). The overall mean MHLS score was 121 (SD = 17.3), with statistically significant higher scores in female participants, >31 years old, Tongan, more educated, and with higher income. This study demonstrated that overall MHL is comparable among NHPI compared to the current literature. However, NHPI men ≤30 years old and with lower income had lower MHL, which may be linked to the mental health disparities specific to this population. Current interventions should focus on increasing knowledge of risk factors, causes, self-treatments, and available professional help regarding mental disorders. Efforts to improve the MHL of NHPI should target men ≤30 years with lower income (<$50 000).
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Affiliation(s)
| | | | | | - Michael Thomas
- Brigham Young University College of Nursing, Provo, UT, USA
| | - Leslie Miles
- Brigham Young University College of Nursing, Provo, UT, USA
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Jones AS, Deitch J, Yates C, Hamblin PS, Teale G, Kevat D, Lee IL. Antenatal health and perinatal outcomes of Pacific Islander women in Australia with and without gestational diabetes: A ten-year retrospective cohort study. Aust N Z J Obstet Gynaecol 2024. [PMID: 38661099 DOI: 10.1111/ajo.13826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/03/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Pacific Islander (PI) women in Australia have an increased risk of gestational diabetes (GDM); however, their perinatal outcomes are poorly understood. AIM The aim was to determine the maternal characteristics and perinatal outcomes of PI women with and without GDM compared to Australian/European (AE)-born women. METHODS A retrospective analysis of perinatal outcomes of singleton deliveries >20 weeks' gestation between 1 January 2011 and 31 December 2020 was conducted at a tertiary provider (Melbourne, Australia). Antenatal details and birth outcomes were extracted from the Birth Outcome Systems database. t-Tests and χ2, univariate and multivariable logistic regression analyses assessed the relationship between ethnicity and outcomes. RESULTS Of 52,795 consecutive births, 24,860 AE women (13.3% with GDM) and 1207 PI-born women (20.1% with GDM) were compared. PI women had significantly greater pre-pregnancy body mass index (BMI) and significantly lower rates of smoking and nulliparity. PI women with GDM had higher rates of pre-eclampsia (P < 0.001), large-for-gestational age (LGA) neonates (P = 0.037) and neonatal hypoglycaemia (P = 0.017) but lower rates of small-for-gestational age neonates (P = 0.034). Neonatal intensive care unit (NICU)/special care nursery requirements did not increase. After having adjusted for covariates, PI women's risk of LGA neonates (adjusted odds ratio (aOR): 1.06, 95% confidence interval (CI): 0.86-1.31) was attenuated; however, risk of pre-eclampsia (aOR: 1.49, 95% CI: 1.01-2.21) and neonatal hypoglycaemia (aOR: 1.40, 95% CI: 1.01-1.96) still increased. They were less likely to require a primary caesarean section (aOR: 0.86, 95% CI: 0.73-0.99). CONCLUSION PI women have higher BMI and GDM rates, contributing to an increased likelihood of adverse perinatal outcomes. BMI is a modifiable risk factor that could be addressed prenatally.
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Affiliation(s)
- Annabel S Jones
- Department of Endocrinology and Diabetes, Western Health, St Albans, Victoria, Australia
- Department of Medicine, University of Melbourne, St Albans, Victoria, Australia
| | - Jessica Deitch
- Department of Endocrinology and Diabetes, Western Health, St Albans, Victoria, Australia
- Department of Medicine, University of Melbourne, St Albans, Victoria, Australia
| | - Christopher Yates
- Department of Endocrinology and Diabetes, Western Health, St Albans, Victoria, Australia
- Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Peter Shane Hamblin
- Department of Endocrinology and Diabetes, Western Health, St Albans, Victoria, Australia
| | - Glyn Teale
- Women's and Children's Division, Western Health, St Albans, Victoria, Australia
| | - Dev Kevat
- Department of Endocrinology and Diabetes, Western Health, St Albans, Victoria, Australia
- Department of Medicine, University of Melbourne, St Albans, Victoria, Australia
- Women's and Children's Division, Western Health, St Albans, Victoria, Australia
| | - I-Lynn Lee
- Department of Endocrinology and Diabetes, Western Health, St Albans, Victoria, Australia
- Department of Medicine, University of Melbourne, St Albans, Victoria, Australia
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Ormiston CK, Strassle PD, Boyd E, Williams F. Discrimination is associated with depression, anxiety, and loneliness symptoms among Asian and Pacific Islander adults during COVID-19 Pandemic. Sci Rep 2024; 14:9417. [PMID: 38658790 PMCID: PMC11043456 DOI: 10.1038/s41598-024-59543-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 04/11/2024] [Indexed: 04/26/2024] Open
Abstract
In the United States, Asian and Pacific Islander (A/PI) communities have faced significant discrimination and stigma during the COVID-19 pandemic. We assessed the association between discrimination and depression, anxiety, and loneliness symptoms among Asian or Pacific Islander adults (n = 543) using data from a 116-item nationally distributed online survey of adults (≥ 18 years old) in the United States conducted between 5/2021-1/2022. Discrimination was assessed using the 5-item Everyday Discrimination Scale. Anxiety, depression, and loneliness symptoms were assessed using the 2-item Generalized Anxiety Disorder, 2-item Patient Health Questionnaire, and UCLA Loneliness Scale-Short form, respectively. We used multivariable logistic regression to estimate the association between discrimination and mental health. Overall, 42.7% of participants reported experiencing discrimination once a month or more. Compared with no discrimination, experiencing discrimination once a month was associated with increased odds of anxiety (Adjusted Odds Ratio [aOR] = 2.60, 95% CI = 1.38-4.77), depression (aOR = 2.58, 95% CI = 1.46-4.56), and loneliness (aOR = 2.86, 95% CI = 1.75-4.67). Experiencing discrimination once a week or more was associated with even higher odds of anxiety (aOR = 6.90, 95% CI = 3.71-12.83), depression, (aOR = 6.96, 95% CI = 3.80-12.74), and loneliness (aOR = 6.91, 95% CI = 3.38-13.00). Discrimination is detrimental to mental health, even at relatively low frequencies; however, more frequent discrimination was associated with worse mental health symptoms. Public health interventions and programs targeting anti-A/PI hate and reducing A/PI mental health burden are urgently needed.
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Affiliation(s)
- Cameron K Ormiston
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Rockville, MD, 20852, USA
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paula D Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Rockville, MD, 20852, USA
| | - Eric Boyd
- Information Management Services, Inc., Calverton, MD, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Rockville, MD, 20852, USA.
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Heinsberg LW, Niu S, Arslanian KJ, Chen R, Bedi M, Unasa-Apelu F, Fidow UT, Soti-Ulberg C, Conley YP, Weeks DE, Ng CA, Hawley NL. Characterization of per- and polyfluoroalkyl substances (PFAS) concentrations in a community-based sample of infants from Samoa. Chemosphere 2024; 353:141527. [PMID: 38401869 PMCID: PMC10997188 DOI: 10.1016/j.chemosphere.2024.141527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/08/2024] [Accepted: 02/21/2024] [Indexed: 02/26/2024]
Abstract
Per- and polyfluoroalkyl substances (PFAS) are persistent contaminants with documented harmful health effects. Despite increasing research, little attention has been given to studying PFAS contamination in low- and middle-income countries, including Samoa. Using data and biosamples collected through the Foafoaga o le Ola ("Beginning of Life") Study, which recruited a sample of mothers and infants from Samoa, we conducted an exploratory study to describe concentrations of 40 PFAS analytes in infant cord blood collected at birth (n = 66) and infant dried blood spots (DBS) collected at 4 months post-birth (n = 50). Of the 40 PFAS analytes tested, 19 were detected in cord blood, with 10 detected in >50% of samples (PFBA, PFPeA, PFOA, PFNA, PFDA, PFUnA, PFTrDA, PFHxS, PFOS, and 9Cl-PF3ONS); and 12 analytes were detected in DBS, with 3 detected in >50% of samples (PFBA, PFHxS, and PFOS). PFAS concentrations were generally lower than those reported in existing literature, with the exception of PFHxS, which was detected at higher concentrations. In cord blood, we noted suggestive (p < 0.05) or significant (p < 0.006) associations between higher PFHxS and male sex; higher PFPeA and residence in Northwest 'Upolu (NWU) compared to the Apia Urban Area (AUA); lower PFUnA and 9Cl-PF3ONS and greater socioeconomic resources; lower PFOA and higher parity; higher PFDA and higher maternal age; and lower PFUnA, PFTrDA, and 9Cl-PF3ONS and higher maternal BMI. In DBS, we found suggestive (p < 0.05) or significant (p < 0.025) associations between lower PFBA and residence in NWU versus AUA; lower PFBA and PFHxS and higher maternal age; and higher PFBA and higher maternal BMI. Finally, we observed associations between nutrition source at 4 months and DBS PFBA and PFHxS, with formula- or mixed-fed infants having higher concentrations compared to exclusively breastfed infants. This study represents the first characterization of PFAS contamination in Samoa. Additional work in larger samples is needed to identify potentially modifiable determinants of PFAS concentrations, information that is critical for informing environmental and health policy measures.
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Affiliation(s)
- Lacey W Heinsberg
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Shan Niu
- Department of Civil and Environmental Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Kendall J Arslanian
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA.
| | - Ruiwen Chen
- Department of Civil and Environmental Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Megha Bedi
- Department of Civil and Environmental Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Folla Unasa-Apelu
- Obesity, Lifestyle and Genetic Adaptations Study Group, Apia, Samoa.
| | | | | | - Yvette P Conley
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Daniel E Weeks
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Carla A Ng
- Department of Civil and Environmental Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, CT, USA.
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Holman-Allgood I, Cline C, Durand C, Purvis RS, Mendoza Kabua P, Ayers BL. Providers' Perspectives of a Culturally Adapted CenteringPregnancy Intervention for Marshallese Women in Arkansas. Nurs Womens Health 2024; 28:117-127. [PMID: 38460942 PMCID: PMC10999336 DOI: 10.1016/j.nwh.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/26/2023] [Accepted: 12/07/2023] [Indexed: 03/11/2024]
Abstract
OBJECTIVE To explore health care providers' perspectives on the successes, challenges, and suggestions for future directions regarding the implementation of CenteringPregnancy for Marshallese women in Arkansas. DESIGN A descriptive qualitative design was used as an exploratory method. SETTING/LOCAL PROBLEM This study took place in northwest Arkansas. Arkansas is home to the largest Marshallese Pacific Islander population in the United States. Marshallese Pacific Islanders residing in the United States have disproportionally high rates of poor maternal and infant health outcomes, even compared to other Pacific Islanders. PARTICIPANTS Seven CenteringPregnancy providers from the University of Arkansas for Medical Sciences Northwest. INTERVENTION/MEASUREMENTS Individual interviews were conducted from February to March of 2023. Data were managed using MAXQDA12 software. Content analysis was used to analyze the data. Initial coding was completed to identify each data segment with short summations of emergent themes. The focused thematic codes that emerged were used to identify and develop the most salient thematic categories of the data, which became the thematic codes. RESULTS Three overarching themes emerged: Implementation Successes, Challenges to Implementation, and Future Suggestions to Improve Implementation and Sustainability. Each theme had representative subthemes. CONCLUSION Findings provide insight for future implementation of CenteringPregnancy for Marshallese and other Pacific Islander individuals.
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Ng R, Indran N. #ProtectOurElders: Analysis of Tweets About Older Asian Americans and Anti-Asian Sentiments During the COVID-19 Pandemic. J Med Internet Res 2024; 26:e45864. [PMID: 38551624 PMCID: PMC10984343 DOI: 10.2196/45864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/12/2023] [Accepted: 09/14/2023] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND A silver lining to the COVID-19 pandemic is that it cast a spotlight on a long-underserved group. The barrage of attacks against older Asian Americans during the crisis galvanized society into assisting them in various ways. On Twitter, now known as X, support for them coalesced around the hashtag #ProtectOurElders. To date, discourse surrounding older Asian Americans has escaped the attention of gerontologists-a gap we seek to fill. Our study serves as a reflection of the level of support that has been extended to older Asian Americans, even as it provides timely insights that will ultimately advance equity for them. OBJECTIVE This study explores the kinds of discourse surrounding older Asian Americans during the COVID-19 crisis, specifically in relation to the surge in anti-Asian sentiments. The following questions guide this study: What types of discourse have emerged in relation to older adults in the Asian American community and the need to support them? How do age and race interact to shape these discourses? What are the implications of these discourses for older Asian Americans? METHODS We retrieved tweets (N=6099) through 2 search queries. For the first query, we collated tweets with the hashtag #ProtectOurElders. For the second query, we collected tweets with an age-based term, for example, "elderly" or "old(er) adults(s)" and either the hashtag #StopAAPIHate or #StopAsianHate. Tweets were posted from January 1, 2020, to August 1, 2023. After applying the exclusion criteria, the final data set contained 994 tweets. Inductive and deductive approaches informed our qualitative content analysis. RESULTS A total of 4 themes emerged, with 50.1% (498/994) of posts framing older Asian Americans as "vulnerable and in need of protection" (theme 1). Tweets in this theme either singled them out as a group in need of protection because of their vulnerable status or discussed initiatives aimed at safeguarding their well-being. Posts in theme 2 (309/994, 31%) positioned them as "heroic and resilient." Relevant tweets celebrated older Asian Americans for displaying tremendous strength in the face of attack or described them as individuals not to be trifled with. Tweets in theme 3 (102/994, 10.2%) depicted them as "immigrants who have made selfless contributions and sacrifices." Posts in this section referenced the immense sacrifices made by older Asian Americans as they migrated to the United States, as well as the systemic barriers they had to overcome. Posts in theme 4 (85/994, 8.5%) venerated older Asian Americans as "worthy of honor." CONCLUSIONS The COVID-19 crisis had the unintended effect of garnering greater support for older Asian Americans. It is consequential that support be extended to this group not so much by virtue of their perceived vulnerability but more so in view of their boundless contributions and sacrifices.
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Affiliation(s)
- Reuben Ng
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore
- Lloyd's Register Foundation Institute for the Public Understanding of Risk, National University of Singapore, Singapore, Singapore
| | - Nicole Indran
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore
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Kim DY, Dee EC, Cheng I, Hartman RI. Advanced melanoma presentation and disease-specific survival disparities among disaggregated Asian American, Native Hawaiian, and Pacific Islander populations. J Am Acad Dermatol 2024; 90:623-626. [PMID: 37923219 DOI: 10.1016/j.jaad.2023.10.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/21/2023] [Accepted: 10/22/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Daniel Y Kim
- Harvard-MIT Health Sciences and Technology Program, Harvard Medical School, Boston, Massachusetts
| | - Edward C Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - Rebecca I Hartman
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Dermatology Section, VA Integrated Service Network 1 (VISN-1), Jamaica Plain, Massachusetts.
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Huang AE, Shih JJ, Sunwoo JB, Pollom E, Taparra K. Racial Disparities in 30-day Readmissions after Surgery for Head and Neck Cancer. Laryngoscope 2024; 134:1282-1287. [PMID: 37610178 DOI: 10.1002/lary.30997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/21/2023] [Accepted: 08/10/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Native Hawaiians and other Pacific Islanders (NHPI) patients with head and neck cancer are often aggregated with Asian individuals despite evidence of heterogeneous health outcomes and mortality. The aim of this study was to determine the association of race with unplanned 30-day hospital readmission rate after head and neck surgery across the five federally recognized racial categories. METHODS This retrospective cohort study used a national hospital-based database and included patients ≥18 years old with diagnostically confirmed, nonmetastatic head and neck cancer of any subsite treated surgically between 2004 and 2017. The primary endpoint was unplanned readmission within 30 days of discharge after primary surgery. RESULTS A total of 365,834 patients were included who were predominantly White (87%), treated at academic cancer centers (47%), lower income (63%), with early-stage disease (60%), and with thyroid (47%) or oral cavity (23%) cancers. Median follow-up duration was 47 months. Of the 10,717 (3%) readmissions, 5,845 (1.6%) were unplanned. Adjusted for confounders and compared with White patients, NHPI patients had the highest likelihood of unplanned (aOR 2.07, 95%CI 1.16-3.40, p = 0.008) readmissions. Within the NHPI group, patients with lower income (aOR 4.27, 95%CI 1.28-20.4, p = 0.035) and those residing in an urban or rural area (aOR 7.42, 95%CI 1.14-49.5, p = 0.034) were more likely to be readmitted. CONCLUSIONS NHPI patients with head and neck cancers experience significantly higher 30-day readmissions following definitive surgical treatment. These results highlight the importance of racial disaggregation in clinical studies. LEVEL OF EVIDENCE 4 Laryngoscope, 134:1282-1287, 2024.
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Affiliation(s)
- Alice E Huang
- Department of Otolaryngology-Head & Neck Surgery, Stanford University, Stanford, California, USA
| | - Jonathan J Shih
- University of California-San Francisco School of Medicine, San Francisco, California, USA
| | - John B Sunwoo
- Department of Otolaryngology-Head & Neck Surgery, Stanford University, Stanford, California, USA
| | - Erqi Pollom
- Department of Radiation Oncology, Stanford University, Stanford, California, USA
| | - Kekoa Taparra
- Department of Radiation Oncology, Stanford University, Stanford, California, USA
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Huang HC, Guadamuz JS, Hoskins KF, Ko NY, Calip GS. Risk of contralateral breast cancer among Asian/ Pacific Islander women in the United States. Breast Cancer Res Treat 2024; 203:533-542. [PMID: 37897647 DOI: 10.1007/s10549-023-07140-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/25/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE While breast cancer studies often aggregate Asian/Pacific Islander (API) women, as a single group or exclude them, this population is heterogeneous in terms of genetic background, environmental exposures, and health-related behaviors, potentially resulting in different cancer outcomes. Our purpose was to evaluate risks of contralateral breast cancer (CBC) among subgroups of API women with breast cancer. METHODS We conducted a retrospective cohort study of women ages 18 + years diagnosed with stage I-III breast cancer between 2000 and 2016 in the Surveillance, Epidemiology and End Results registries. API subgroups included Chinese, Japanese, Filipina, Native Hawaiian, Korean, Vietnamese, Indian/Pakistani, and other API women. Asynchronous CBC was defined as breast cancer diagnosed in the opposite breast 12 + months after first primary unilateral breast cancer. Multivariable-adjusted subdistribution hazard ratios (SHR) and 95% confidence intervals (CI) were estimated and stratified by API subgroups. RESULTS From a cohort of 44,362 API women with breast cancer, 25% were Filipina, 18% were Chinese, 14% were Japanese, and 8% were Indian/Pakistani. API women as an aggregate group had increased risk of CBC (SHR 1.15, 95% CI 1.08-1.22) compared to NHW women, among whom Chinese (SHR 1.23, 95% CI 1.08-1.40), Filipina (SHR 1.37, 95% CI 1.23-1.52), and Native Hawaiian (SHR 1.69, 95% CI 1.37-2.08) women had greater risks. CONCLUSION Aggregating or excluding API patients from breast cancer studies ignores their heterogeneous health outcomes. To advance cancer health equity among API women, future research should examine inequities within the API population to design interventions that can adequately address their unique differences.
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Affiliation(s)
- Hsiao-Ching Huang
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois Chicago, Chicago, IL, USA
| | - Jenny S Guadamuz
- School of Public Health, University of California, Berkeley, CA, USA
| | - Kent F Hoskins
- Division of Hematology and Oncology, Department of Medicine, University of Illinois Chicago, Chicago, IL, USA
| | - Naomi Y Ko
- Section of Hematology/Oncology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Gregory S Calip
- Titus Family Department of Clinical Pharmacy, Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, 1985 Zonal Ave, Los Angeles, 90089, CA, USA.
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Cha L, Thai J, True M, Le T, Ve'e T, Soon NA, Bautista R, Tseng W. A Community Assessment of Psychological Distress in Pacific Islanders Across San Francisco Bay Area Churches During the COVID-19 Pandemic. J Racial Ethn Health Disparities 2024; 11:339-347. [PMID: 36745263 PMCID: PMC9901373 DOI: 10.1007/s40615-023-01522-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/06/2023] [Accepted: 01/16/2023] [Indexed: 02/07/2023]
Abstract
BACKGROUND The COVID-19 pandemic has exacerbated health and social disparities among US Pacific Islanders (PI). Historically, PIs have experienced a high burden of mental illness yet have underutilized mental health services. These already large treatment gaps in mental health care among PIs may worsen during the COVID-19 pandemic. In the face of pre-existing challenges, little is known about the impacts of the COVID-19 pandemic on mental health outcomes among PIs. METHODS A community-based, cross-sectional survey was administered to members of 13 PI churches across the San Francisco Bay Area. We assessed the burden of psychological distress among PIs and its associations with demographic, sociocultural, and health factors. KEY RESULTS Among 439 PI respondents, nearly half reported moderate or severe psychological distress. Only about one-tenth took prescription medication for mental health and less than half utilized a mental health provider in the past year. Most trusted PI churches to provide health and social services. Respondents reporting moderate or severe psychological distress were less likely to utilize a mental health provider in the past year and more likely to feel marginalized, excluded, isolated, or alienated from society "most of the time" or "always." Psychological distress was also associated with "fair" or "poor" health status, female gender, older adults, low trust in PI churches to provide health and social services, and concern over household finances. CONCLUSION Partnerships with faith-based and community-based organizations are essential to address unmet mental health needs and promote support-seeking behaviors among PIs during this ongoing pandemic and beyond.
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Affiliation(s)
- Leah Cha
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Jessica Thai
- Berkeley School of Public Health, University of California, 2199 Addison St, Room 50, Berkeley, CA, 94720-7358, USA
| | - Makayla True
- Berkeley School of Public Health, University of California, 2199 Addison St, Room 50, Berkeley, CA, 94720-7358, USA
| | - Thomas Le
- Berkeley School of Public Health, University of California, 2199 Addison St, Room 50, Berkeley, CA, 94720-7358, USA
| | - Taunuu Ve'e
- Regional Pacific Islander Taskforce, Hayward, CA, USA
| | | | | | - Winston Tseng
- Berkeley School of Public Health, University of California, 2199 Addison St, Room 50, Berkeley, CA, 94720-7358, USA.
- Regional Pacific Islander Taskforce, Hayward, CA, USA.
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Short E, Council SK, Bennett Milburn A, Ammerman A, Callaghan-Koru J, Mendoza Kabua P, Ayers BL. Assessing the acceptability and implementation feasibility of a culturally adapted parenting intervention for Marshallese mothers: A study protocol. Contemp Clin Trials Commun 2024; 37:101240. [PMID: 38261960 PMCID: PMC10796808 DOI: 10.1016/j.conctc.2023.101240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/21/2023] [Accepted: 12/02/2023] [Indexed: 01/25/2024] Open
Abstract
Background Pacific Islanders, including the Marshallese, face higher rates of obesity and obesity-related chronic conditions. Early-life interventions targeting eating patterns during the first 1000 days of life are essential to promote proper nutrition and growth. Marshallese mothers and caregivers are important decision-makers for feeding practices that could affect childhood obesity rates in Marshallese children. However, little is known about dietary patterns and practices of Marshallese families from birth to 12 months. Culturally-adapted approaches using community-based assets and Pacific Islander cultural values/practices have demonstrated effectiveness in reducing obesity but have not been developed for children. Methods This article describes the protocol for a study to culturally adapt the Centering Parenting intervention for Marshallese mothers in Arkansas. Conclusion This will be the first study to culturally adapt and implement Centering Parenting with Marshallese women in the United States. This study will be an important first step to assess the feasibility and acceptability of an abbreviated parenting intervention to reduce childhood obesity in Marshallese communities.
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Affiliation(s)
- Eliza Short
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Sarah K. Council
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | | | - Alice Ammerman
- University of North Carolina at Chapel Hill, 1700 MLK, Chapel Hill, NC, 27599, USA
| | - Jennifer Callaghan-Koru
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Philmar Mendoza Kabua
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Britni L. Ayers
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
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12
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Arroyo AC, Ko J, Chandra M, Huang P, Darbinian JA, Palaniappan L, Lo JC. Risk of Incident Asthma Among Young Asian American, Native Hawaiian, and Pacific Islander Children from Age 3 to 7 Years in a Northern California Healthcare System. J Pediatr 2024; 265:113802. [PMID: 37898424 DOI: 10.1016/j.jpeds.2023.113802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 10/30/2023]
Abstract
Incident childhood asthma risk has not been examined among diverse Asian American, Native Hawaiian, and Pacific Islander subgroups. In a large California healthcare system, incident asthma was higher among young Filipino/a, Native Hawaiian/Pacific Islander, and South Asian children compared with non-Hispanic White children, whereas Chinese and Japanese children were similar.
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Affiliation(s)
- Anna Chen Arroyo
- Division of Pulmonary, Allergy & Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA; Stanford Center for Asian Health Research and Education, Stanford, CA
| | - Jimmy Ko
- Permanente Medical Group, Department of Allergy, Kaiser Permanente Fremont Medical Center, Fremont, CA
| | - Malini Chandra
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Polly Huang
- Department of Medicine, Kaiser Permanente Oakland Medicine Center, Oakland, CA
| | - Jeanne A Darbinian
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Latha Palaniappan
- Stanford Center for Asian Health Research and Education, Stanford, CA; Division of Cardiovascular Medicine and Division of Epidemiology and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Joan C Lo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA.
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13
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Parsa AA, Azama KA, Vawer M, Ona MA, Seto TB. Prevalence Study of MASLD in Adolescent and Young Adult Pacific Islanders and Asians Living in Hawai'i. J Endocr Soc 2024; 8:bvad165. [PMID: 38249431 PMCID: PMC10797323 DOI: 10.1210/jendso/bvad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Indexed: 01/23/2024] Open
Abstract
Context Nonalcoholic fatty liver disease, renamed metabolic dysfunction-associated steatotic liver disease (MASLD), is the most common cause of chronic liver disease with an estimated worldwide prevalence of 30.1% while clinical practice observations reflect a disproportionately lower prevalence of 1.9%, indicating a condition that is underrecognized in clinical care settings. Screening for MASLD is rarely performed, and little is known about the prevalence in Hawai'i. Objective This pilot aims to develop an understanding of the prevalence and factors associated with MASLD in Hawai'i's adolescent and young adult (AYA) population. Design/Methods Cross-sectional observational pilot study: We used Fibroscan®-liver ultrasonographic vibration-controlled transient elastography (VCTE) to identify MASLD based on controlled attenuation parameter (CAP) scores ≥238 (dB/m) and collected biometric, anthropometric, and Beverage Intake Questionnaire (sugar-sweetened beverage) survey data. Setting The study took place at community clinics in Hawai'i on the island of O'ahu. Participants One hundred individuals were evaluated, age 14 to 34 years. Main Outcome Measures We used VCTE Fibroscan® with CAP scoring to identify the presence of hepatocyte steatosis (fatty liver). Results Overall MASLD prevalence in the sample was 44% (95% confidence interval: 34.1%-54.3%). In participants with MASLD, obese Native Hawaiian and other Pacific Islanders (62%) and nonobese Asians (43%) had the highest rates of MASLD. Conclusion This pilot evaluation of the AYA NHOPI and Asian MASLD population in Hawai'i shows a higher rate of MASLD than those reported in other parts of the United States. Larger population health studies are indicated to expand our knowledge of MASLD in the Hawaiian Islands.
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Affiliation(s)
- Alan A Parsa
- John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA
- Diabetes Research and Education Center of the Pacific, Honolulu, HI 96813, USA
- Department of Medicine, The Queen's Medical Center, Honolulu, HI 96813, USA
| | - Katie A Azama
- Department of Medicine, The Queen's Medical Center, Honolulu, HI 96813, USA
- Nancy Atmospera-Walch School of Nursing, University of Hawai’i, Honolulu, HI 96822, USA
| | - May Vawer
- Diabetes Research and Education Center of the Pacific, Honolulu, HI 96813, USA
- Department of Medicine, The Queen's Medical Center, Honolulu, HI 96813, USA
| | - Mel A Ona
- John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA
| | - Todd B Seto
- John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA
- Department of Medicine, The Queen's Medical Center, Honolulu, HI 96813, USA
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14
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Kuo C, Jasczynski M, Yoo JH, Robinson JL, Reynolds K, Anoruo L, Bae K, Ka'opua LS, Chavez R, Tellei J, Aparicio EM. "I Need to Get My Culture Back": Youth and Provider Perspectives on Integrating Culturally Based Approaches into Sexual and Reproductive Health Programs for Native Hawaiian and Pacific Islander Youth Experiencing Homelessness. Prev Sci 2023; 24:209-221. [PMID: 37566201 PMCID: PMC10764447 DOI: 10.1007/s11121-023-01573-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 08/12/2023]
Abstract
There is growing interest in decolonizing sexual and reproductive health (SRH) and embedding cultural practices into social and medical services in Hawai'i. Wahine ("woman") Talk is a multilevel, comprehensive SRH program for female youth experiencing homelessness (YEH) led by community health, social work, and medical providers. This study examines youth and program provider perspectives of culturally based approaches that may strengthen SRH programs. The study team conducted three focus groups and ten in-depth interviews with participating youth and program providers after the program's conclusion. Youth participants were aged 14 to 22 years (M = 18.1) and of Native Hawaiian or Pacific Islander ancestry. Interview transcripts were analyzed using structured thematic analysis. The youth described feeling estranged from their ancestral cultures and suggested incorporating multiple cultural practices to enhance their connection to community, body, and land into SRH programming for YEH. They identified several 'āina ("land")-based approaches, hands-on learning, hula, and language as possible practices to weave into the program. While youth felt estranged from their ancestral cultures, they discussed Native Hawaiian and Pacific Islander health perspectives where 'āina and relationships are considered life-sustaining. Youth and program staff stressed incorporating culture respectfully, caring for the whole person, and providing trauma-informed care. Future policy, practice, and research should consider protecting and integrating Native Hawaiian conceptions of health into SRH policy and practice and include youths' cultural identities in SRH intervention development.
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Affiliation(s)
- Charlene Kuo
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA.
| | - Michelle Jasczynski
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
| | - Jee Hun Yoo
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
| | - Jennifer L Robinson
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
| | - Katelyn Reynolds
- College of Computer, Mathematical, & Natural Sciences, Department of Biology, University of Maryland, College Park, MD, USA
| | - Lisa Anoruo
- School of Public Health, Department of Public Health Science, University of Maryland, College Park, MD, USA
| | - Kayla Bae
- School of Public Health, Department of Public Health Science, University of Maryland, College Park, MD, USA
| | - Lana Sue Ka'opua
- Thompson School of Social Work & Public Health (Retired), Department of Social Work, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Rebecca Chavez
- Waikiki Health, Honolulu, HI, USA
- PATH Clinic and Youth Outreach, Honolulu, HI, USA
| | - Jacqueline Tellei
- Waikiki Health, Honolulu, HI, USA
- PATH Clinic and Youth Outreach, Honolulu, HI, USA
| | - Elizabeth M Aparicio
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
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Swaminath M, Clayton HB, Lowry R, Hertz MF, Underwood JM. Health-Risk Behaviors and Experiences Among Asian American and Native Hawaiian/ Pacific Islander Adolescents in the United States, 2011-2019. Public Health Rep 2023; 138:925-935. [PMID: 36633365 PMCID: PMC10576474 DOI: 10.1177/00333549221137325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Understanding the health-risk behaviors of racial and ethnic groups when disaggregated is an important step in improving the health outcomes of racial and ethnic minority groups. We compared national prevalence estimates for selected health-risk behaviors and experiences of Asian American and Native Hawaiian/Pacific Islander (NHPI) students with those of non-Hispanic White, non-Hispanic Black, and Hispanic students. METHODS We analyzed data from the Youth Risk Behavior Survey, a nationally representative survey of US high school students. To generate a sufficient sample of Asian American and NHPI students for analyses, we combined data from 5 survey administrations, conducted in 2011, 2013, 2015, 2017, and 2019 (N = 73 074). We calculated the prevalence and 95% CIs; we analyzed data on Asian American and NHPI adolescents separately to unmask important differences. RESULTS Compared with students of other races and ethnicities, Asian American students had the lowest prevalence of alcohol use (16.7%) and marijuana use (10.3%). In contrast, NHPI students were more likely than Asian American students to participate in several health-risk behaviors and experiences, such as substance use (ranging from 4.8% for ever injecting an illegal drug to 31.5% for current alcohol use), having been in a physical fight (15.4%), and having been threatened or injured with a weapon (11.6%). Differential patterns in the prevalence of ever having missed school due to feeling unsafe among NHPI and Asian American students were observed among male and female students. CONCLUSION Further disaggregating racial subgroups within broad categories of Asian American and NHPI populations may reveal differences from overall group prevalence, and additional strategies to identify these differences should be investigated.
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Affiliation(s)
- Meera Swaminath
- Department of Family Medicine and Public Health, University of California–San Diego, La Jolla, CA, USA
- Public Health Leader Fellowship Program, Morehouse College, Atlanta, GA, USA
| | - Heather B. Clayton
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Richard Lowry
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marci F. Hertz
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J. Michael Underwood
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Monteith LL, Kittel J, Miller C, Schneider AL, Holliday R, Gaeddert LA, Spark T, Brenner LA, Hoffmire CA. Identifying U.S. regions with the highest suicide rates and examining differences in suicide methods among Asian American, Native Hawaiian, and Pacific Islander Veterans. Asian J Psychiatr 2023; 89:103797. [PMID: 37847965 DOI: 10.1016/j.ajp.2023.103797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/19/2023]
Abstract
The suicide rate among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) Veterans increased from 2001 to 2020. Identifying regions where suicide rates are elevated and increasing among AANHPI Veterans would inform targeted prevention efforts for members of this cohort. We conducted a population-based retrospective cohort study of 377,833 AANHPI Veterans to examine suicide rates and methods (2005-2019) by United States (US) region and over time (2005-2009, 2010-2014, 2015-2019), using US Veteran Eligibility Trends and Statistics and Joint DoD/VA Mortality Data Repository data. AANHPI Veterans across most regions experienced increases in suicide rates from the earliest to latest period; however, patterns differed by region. Age-adjusted suicide rates increased across all three periods among those in the Northeast and West, but increased, then declined in the Midwest and South. In 2015-2019, the age-adjusted suicide rate among AANHPI Veterans was highest in the Northeast (42.0 per 100,000) and lowest in the West (27.5). However, the highest percentages of AANHPI Veteran suicide deaths in 2005-2019 occurred in the West (39.5%) and South (34.7%), with lower percentages in the Midwest (15.0%) and Northeast (10.8%). Across regions, those ages 18-34 had the highest suicide rates. Firearms were the most frequently used suicide method across regions (44.4%-60.2%), except the Northeast (35.2%), where suffocation was more common (38.3%). Results suggest particular needs for suicide prevention efforts among AANHPI Veterans in the Northeast and to ensure that lethal means safety initiatives for AANHPI Veterans encompass both firearms and suffocation, with some variations in emphasis across regions.
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Affiliation(s)
- Lindsey L Monteith
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 1890 N Revere Ct, Suite 4003, Mail Stop F546, Aurora, CO 80045, USA; Firearm Injury Prevention Initiative, 12401 East 17th Avenue, 7th Floor, Aurora, CO 80045, USA.
| | - Julie Kittel
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, USA
| | - Christin Miller
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA
| | - Alexandra L Schneider
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA
| | - Ryan Holliday
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 1890 N Revere Ct, Suite 4003, Mail Stop F546, Aurora, CO 80045, USA
| | - Laurel A Gaeddert
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA
| | - Talia Spark
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA
| | - Lisa A Brenner
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 1890 N Revere Ct, Suite 4003, Mail Stop F546, Aurora, CO 80045, USA
| | - Claire A Hoffmire
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, USA
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Maunakea AK, Juarez R, Maunakea-Forth JK. The Mauli Ola Study: A Unique Academic-Community Partnership With MA'O Organic Farms to Understand and Address Health Inequities Among Native Hawaiians and Other Pacific Islanders in Hawai'i. Health Promot Pract 2023; 24:1087-1090. [PMID: 37877635 PMCID: PMC10978560 DOI: 10.1177/15248399231190356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Indigenous peoples, including Native Hawaiians and Pacific Islanders (NHPIs), experience significant cardiometabolic health disparities arising in large part from rapid changes to their diets and food systems. Innovative food sovereignty initiatives led by NHPIs are needed to address these disparities. This article describes a community-based participatory research study that incorporates social and biological measures to examine the impact of an Indigenous-led land-based food sovereignty youth leadership program on health disparities among NHPI youth in Hawai'i. Grounded in the Indigenous knowledge that holistic health and wellbeing of people is inseparable from that of the environment and to counter rampant food insecurity in their community of Wai'anae, O'ahu, MA'O Organic Farms developed a Youth Leadership Training (YLT) program that offers education, nutrition, physical activity, and access to health care. The program also engages YLT interns and their social networks in health education and research in the ongoing Mauli Ola study. Preliminary data from this study affirm the need to address the disproportionately high rates of obesity, type 2 diabetes mellitus (T2D), and poor mental health conditions among young NHPIs in the Wai'anae community, and how the YLT program may provide an effective approach to address this need. Our unique academic-community partnership underscores the importance of social and biomedical research to understand health disparities in the NHPI population, which present novel avenues to enable disease prevention. The outcomes of the Mauli Ola study may serve as a valuable model for health disparities research while leveraging ongoing social programs that support Indigenous food sovereignty.
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Affiliation(s)
- Alika K. Maunakea
- University of Hawai‘i at Mānoa, Honolulu, HI, USA
- Hawai‘i Integrated Analytics, LLC, Honolulu, HI, USA
| | - Ruben Juarez
- University of Hawai‘i at Mānoa, Honolulu, HI, USA
- Hawai‘i Integrated Analytics, LLC, Honolulu, HI, USA
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18
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Vakalahi HO, Okamoto SK, Horgen FD, Lim E, Phan N, Kaumatule BS, Sheikhattari P. Promoting Health Research among Underrepresented Students through the HUI SRC. Hawaii J Health Soc Welf 2023; 82:36-43. [PMID: 37901664 PMCID: PMC10612418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
The Hawai'i Pacific University Undergraduate Infrastructure Student Research Center (HUI SRC) is focused on increasing participation of historically underrepresented populations, such as Native Hawaiians, other Pacific Islanders (NHPI), and Filipinos, in tomorrow's biomedical and health research workforce. This is achieved by promoting engagement and competency in entrepreneurial biomedical and health research among undergraduate students. The HUI SRC was modeled after the Morgan State University ASCEND SRC funded by the National Institute of General Medical Sciences. The HUI SRC is rooted in the Hawaiian cultural values of ho'oku'i, hui pu'ana, and lokahi, referring to the physical gathering space of the Student Research Center and the joining of people together around a unifying theme, in this case the pursuit of science. It is committed to intentionally engaging Indigenous knowledge and ways of doing in decolonizing research. This article describes the project and presents evaluation findings of the first year of implementation of the HUI SRC. The center was effective in increasing undergraduate students' science identity, academic self-concept, social self-concept, social support, peer support, and self-efficacy. These HUI SRC findings highlight the potential impact of undergraduate SRCs in expanding the pipeline of biomedical and health researchers from underrepresented populations, particularly among NHPI and Filipinos.
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Affiliation(s)
- Halaevalu O. Vakalahi
- Hawai‘i Pacific University, Honolulu, HI (HOV, SKO, DH, NP, BSK)
- Council on Social Work Education, Alexandria, VA (HOV)
| | - Scott K. Okamoto
- Hawai‘i Pacific University, Honolulu, HI (HOV, SKO, DH, NP, BSK)
- University of Hawai‘i Cancer Center, Honolulu, HI (SKO)
| | - F. David Horgen
- Hawai‘i Pacific University, Honolulu, HI (HOV, SKO, DH, NP, BSK)
| | - Eunjung Lim
- University of Hawai‘i at Manāoa, Honolulu, HI (EL)
| | - Ngoc Phan
- Hawai‘i Pacific University, Honolulu, HI (HOV, SKO, DH, NP, BSK)
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Delafield R, Watkins-Victorino L, Quint JJ, Freitas SM, Kamaka M, Hostetter CJ, Matagi CE, Ku T, Kaholokula JK. No Kākou, Na Kākou - For Us, By Us: Native Hawaiians and Pacific Islanders Informing Race Data Collection Standards for Hawai'i. Hawaii J Health Soc Welf 2023; 82:73-76. [PMID: 37901657 PMCID: PMC10612412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
This article describes recommendations for standardized race data collection developed by the Hawai'i Native Hawaiian and Pacific Islander COVID-19 Response, Recovery, and Resilience Team (NHPI 3R Team). These recommendations attempt to address the expressed desires of Native Hawaiians and the diverse Pacific Islander communities in Hawai'i who seek greater visibility in data and research. The Native Hawaiian and Pacific Islander (NHPI) racial category is 1 of the 5 racial categories listed in the 1997 Statistical Policy Directive #15 issued by the Office of Management and Budget (OMB). The OMB directive sets the minimum standard for collection of race data in federal surveys, administrative forms, records, and other data collection. The NHPI 3R Team's recommendation provides a standard for detailed data collection that could improve smaller communities' ability to identify, advocate for, and address their own needs. The article also describes lessons learned through the collaborative and iterative process that was led by members and leaders of NHPI communities impacted by data driven decisions and policies. The NHPI 3R Team focused on expanding and standardizing race data collection as part of their COVID-19 response efforts, but implementation of the recommendations could produce benefits well beyond the pandemic.
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Affiliation(s)
- Rebecca Delafield
- John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (RD, MK, JKK)
| | | | | | - Sharde Mersberg Freitas
- Native Hawaiian Pacific Islander COVID-19 Response, Recovery, and Resiliency Team - Data and Research Committee, Honolulu, HI (SMF)
| | - Martina Kamaka
- John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (RD, MK, JKK)
| | | | | | - Tercia Ku
- Papa Ola Lōkahi, Honolulu, HI (JJQ, CEM, TK)
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Rainer MA, Palmer PH, Xie B. Sleep Duration and Chronic Disease Among Older Native Hawaiians or Other Pacific Islanders and Asians: Analysis of the Behavioral Risk Factor Surveillance System. J Racial Ethn Health Disparities 2023; 10:2302-2311. [PMID: 36109435 DOI: 10.1007/s40615-022-01409-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Older adults are particularly vulnerable to unhealthy sleep. This study examines the relationship between sleep duration and chronic diseases among older Native Hawaiians or Other Pacific Islanders (NHOPIs) and identifies variations with older Asians. METHODS In this cross-sectional study, data were analyzed using the 2016 Behavioral Risk Factor Surveillance System. The total sample of adults 50 years and older included 1277 NHOPIs and 4655 Asians. Weighted, survey logistic regressions were employed to analyze the relationship between sleep duration (i.e., short, healthy, and long) and seven chronic diseases: coronary heart disease, stroke, heart attack/myocardial infarction, pre-diabetes, diabetes, chronic obstructive pulmonary disease, and depressive disorder. Sleep duration was categorized into short sleep (SS; ≤ 6 h), healthy sleep (7-8 h), and long sleep (LS; ≥ 9 h), with healthy sleep as the reference group. RESULTS Among NHOPIs, SS and LS were significantly related to stroke (OR 3.19, 95% CI: 1.35-7.53 for SS and OR 9.52, 95% CI: 2.99-30.34 for LS) and SS was associated with pre-diabetes (OR 2.22 CI: 1.07-4.59), after adjusting for all covariates. In contrast, Asians with SS and LS reported higher odds of depression (OR 2.40, 95% CI: 1.20-4.79 and OR 5.03, 95% CI: 1.57-16.13, respectively). CONCLUSIONS Findings suggest older NHOPIs with SS or LS experience worse health. NHOPIs and Asians varied on the relationship between sleep and chronic disease, underscoring the need to disaggregate Asian/NHOPI data to understand health disparities.
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Affiliation(s)
- Michelle A Rainer
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA, 91711, USA.
| | - Paula Healani Palmer
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA, 91711, USA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA, 91711, USA
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21
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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. Hawaii J Health Soc Welf 2023; 82:67-72. [PMID: 37901675 PMCID: PMC10612414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [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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Taafaki MR, Taira D, Braun KL. Scoping Review of Interventional Studies in Chronic Disease for Native Hawaiian, Pacific Islander, and Filipino Populations in the United States. Hawaii J Health Soc Welf 2023; 82:58-66. [PMID: 37901666 PMCID: PMC10612424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Native Hawaiians (NHs), Pacific Islanders (PIs), and Filipinos experience health disparities in the United States (US) and need interventions that work for them. The purpose of this paper is to present a review of interventions designed to address chronic disease in Native Hawaiian, Pacific Islander, and Filipino populations in the US that were tested for clinical impact through a randomized controlled trial (RCT). Articles were identified through a search of 4 databases, citation chasing, and colleagues. The 23 included articles reported on 21 interventions addressing 4 chronic conditions-cancer, obesity, cardiovascular disease, and diabetes. All projects were guided by advisory groups, and all interventions were theory-based and tailored to the population, with culturally- and language-appropriate educational materials delivered by same-race individuals in familiar church, club, or home settings. About half were tested through cluster RCT. The majority of the interventions were successful, confirming the value of developing and delivering interventions in partnership with community. Given the growing numbers of NHs, PIs, and Filipinos in the US, more investigational studies are needed to develop and test culturally tailored and grounded interventions that meet the health needs of these populations.
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Affiliation(s)
- Munirih R. Taafaki
- John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (MRT)
| | - Deborah Taira
- Daniel K. Inouye College of Pharmacy, University of Hawai’i at Hilo, Hilo, HI (DT)
| | - Kathryn L. Braun
- Thompson School of Social Work & Public Health, University of Hawai’i at Mānoa, Honolulu, HI (KLB)
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Matagi CE, Worthington JK, Palakiko DM. Using Talanoa, a Pan Pacific Indigenous Approach, To Identify Solutions to Public Health Issues. Hawaii J Health Soc Welf 2023; 82:14-17. [PMID: 37901661 PMCID: PMC10612422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
The COVID-19 pandemic was a public health emergency that required various public health policies and programs at the state and federal level to be established to protect the health and safety of the nation. These mainstream policies and programs proved to be inadequate in addressing the specific needs of Native Hawaiian and Pacific Islander (NHPI) communities as evidenced by the high case counts and low vaccination rates in these communities. In an effort to better understand and address the high case counts and low vaccination rates, a partnership was developed between the Hawai'i State Department of Health (HDOH), medical providers, and a network of NHPI-serving organizations. After the failure of Western approaches for data gathering, leaders of the partnership used an Indigenous qualitative interview method called Talanoa situated within a cultural safety framework to learn reasons for low vaccine uptake and identify NHPI-specific solutions. Findings suggest that the use of Talanoa and its ingrained cultural safety framework allowed us to gather richer data, identified solutions grounded in community, and assisted with building sustainable trusting partnerships.
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Affiliation(s)
- Chantelle E. Matagi
- Center for Pacific Islands Studies, University of Hawai‘i at Mānoa, Honolulu, HI (CEM)
| | - J. Ke‘alohilani Worthington
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (JKW)
| | - Donna-Marie Palakiko
- Nancy Atmospera-Walch School of Nursing, University of Hawai‘i at Mānoa, Honolulu, HI (DP)
- Papa Ola Lōkahi, Honolulu, HI (DP)
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Lim E, Davis J, Prabhudesai D, Taira D. Inventory of Survey Databases for Native Hawaiian, Pacific Islander, and Filipino Health Disparities Research. Hawaii J Health Soc Welf 2023; 82:104-110. [PMID: 37901663 PMCID: PMC10612417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
The aim of this scoping review was to assist researchers who want to use survey data, either in academic or community settings, to identify and comprehend health disparities affecting Native Hawaiian (NH), Pacific Islander (PI), and/or Filipino populations, as these are groups with known and numerous health disparities. The scoping review methodology was used to identify survey datasets that disaggregate data for NH, PI, or Filipinos. Healthdata.gov was searched, as there is not an official index of databases. The website was established by the United States (US) Department and Health and Human Services to increase accessibility of health data for entrepreneurs, researchers, and policy makers, with the ultimate goal of improving health outcomes. Using the search term 'survey,' 332 datasets were retrieved, many of which were duplicates from different years. Datasets were included that met the following criteria: (1) related to health; (2) disaggregated NH, PI, and/or Filipino subgroups; (3) administered in the US; (4) publicly available; (5) individual-level data; (6) self-reported information; and (7) contained data from 2010 or later. Fifteen survey datasets met the inclusion criteria. Two additional survey datasets were identified by colleagues. For each dataset, the dataset name, data source, years of the data availability, availability of disaggregated NH, PI, and/or Filipino data, data on health outcomes and social determinants of health, and website information were documented. This inventory of datasets should be of use to researchers who want to advance understanding of health disparities experienced by NH, PI, and Filipino populations in the US.
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Affiliation(s)
- Eunjung Lim
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai’i at Mānoa, Honolulu, HI (EL, JD, DP)
| | - James Davis
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai’i at Mānoa, Honolulu, HI (EL, JD, DP)
| | - Devashri Prabhudesai
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai’i at Mānoa, Honolulu, HI (EL, JD, DP)
- Statistics Consulting Lab, Health Sciences & BIO5 Institute, University of Arizona, Tucson, AZ (DP)
| | - Deborah Taira
- Department of Pharmacy Practice, Daniel K. Inouye College of Pharmacy, University of Hawai’i at Hilo, Hilo, HI (DT)
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Matsunaga M, Roman M, Lim E. Systematic Review for Survey Instruments to Measure Cultural Identification of Native Hawaiians, Pacific Islanders, and Filipinos. Hawaii J Health Soc Welf 2023; 82:18-28. [PMID: 37901674 PMCID: PMC10612411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Numerous studies have used survey instruments to measure the degree of cultural identity/identification for a racial group to examine how they identify with their heritage or cultural group. However, only a few systematic reviews have summarized the survey instruments for Native Hawaiians, Pacific Islanders, and Filipinos. This systematic review aimed to summarize reliable and validated survey instruments that assessed the cultural identity/identification of Native Hawaiians, Pacific Islanders, and Filipinos in 3 steps: (1) identifying studies that meet the inclusion and exclusion criteria; (2) evaluating the psychometric properties of the instrument with reported validity and reliability test results; and (3) summarizing the selected studies. A search was conducted in PubMed, PsycINFO, Web of Science, and Health and Psychosocial Instruments databases for published articles related to the cultural identification for the 3 racial groups. Sixteen unique articles met the inclusion/exclusion criteria: 7 for Filipinos, 3 for Native Hawaiians, 1 for Pacific Islanders, 2 for Asian Americans, and 3 for non-specific Indigenous people. Three reviewers assessed the psychometric properties of the 16 articles using the pre-determined criteria and summarized the survey instruments and study outcomes. All the selected articles discussed their survey instrument's validity. This review can serve as a resource for researchers who want to apply a culturally tailored survey instrument for Native Hawaiians, Pacific Islanders, and Filipinos in their research studies.
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Affiliation(s)
- Masako Matsunaga
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI
| | - Meliza Roman
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI
| | - Eunjung Lim
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI
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Delafield R, Kwon H, Mar A, Hermosura AH, De Sousa EBC, Levinson J, Pauker K. Examining Implicit Racial Attitudes among College Students in Hawai'i, a Project of the Hawai'i Implicit Bias Initiative. Hawaii J Health Soc Welf 2023; 82:29-35. [PMID: 37901673 PMCID: PMC10612416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
For the past 2 decades, investigations into implicit racial bias have increased, building evidence on the impact of bias on health and health care for many minority communities in the US. However, few studies examine the presence and impacts of implicit bias in Hawai'i, a context distinct in its history, racial/ethnic diversity, and contemporary inequities. The absence of measures for major racialized groups, such as Native Hawaiians, Pacific Islanders, and Filipinos, impedes researchers' ability to understand the contribution of implicit bias to the health and social disparities observed in Hawai'i. The purpose of this study was to measure bias toward these underrepresented groups to gain a preliminary understanding of the implicit racial bias within the distinctive context of this minority-majority state. This study measured implicit racial bias among college students in Hawai'i using 3 implicit association tests (IATs): (1) Native Hawaiian compared to White (N = 258), (2) Micronesian comparedto White (N =257), and (3) Filipino compared to Japanese (N = 236). Themean IAT D scores showed implicit biases that favored Native Hawaiiansover Whites, Whites over Micronesians, and Japanese over Filipinos. Multipleregression was conducted for each test with the mean IAT D score as theoutcome variable. The analysis revealed that race was a predictor in the vastmajority of tests. In-group preferences were also observed. This investigationadvances the understanding of racial/ethnic implicit biases in the uniquelydiverse state of Hawai'i and suggests that established social heirarchies mayinfluence implicit racial bias.
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Affiliation(s)
- Rebecca Delafield
- Dept. Of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (RD, AM, AHH)
| | - Heewon Kwon
- Dept. Of Psychology, College of Social Sciences, University of Hawai‘i at Mānoa, Honolulu, HI (HK, KP)
| | - Amy Mar
- Dept. Of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (RD, AM, AHH)
| | - Andrea H. Hermosura
- Dept. Of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (RD, AM, AHH)
| | - Elizabeth B. Chapman De Sousa
- Institute for Teacher Education – Elementary Education and Multilingual Learning Program, College of Education, University of Hawai‘i at Mānoa, Honolulu, HI (CD)
| | - Justin Levinson
- William S. Richardson School of Law, University of Hawai‘i at Mānoa, Honolulu, HI (JL)
| | - Kristin Pauker
- Dept. Of Psychology, College of Social Sciences, University of Hawai‘i at Mānoa, Honolulu, HI (HK, KP)
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You AS, Norris KC, Kataoka-Yahiro M, Davis J, Page V, Hayashida G, Narasaki Y, Cheng SF, Ng R, Wong LL, Lee LY, Kalantar-Zadeh K, Rhee CM. Racial Disparities in End-Stage Kidney Disease Outcomes among Asians and Native Hawaiians and Other Pacific Islanders across Geographic Residence. Am J Nephrol 2023; 55:115-126. [PMID: 37725913 DOI: 10.1159/000534052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/24/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION While Asian and Native Hawaiian and other Pacific Islander (NHOPI) patients have a high prevalence of kidney disease risk factors, there are sparse data examining their end-stage kidney disease (ESKD) outcomes. As Hawaii has high representation of Asian and NHOPI individuals, we compared their ESKD outcomes based on residence in the mainland USA versus Hawaii/Pacific Islands (PIs). MATERIALS AND METHODS Using United States Renal Data System data, we examined the impact of geographic residence in the mainland versus Hawaii/PIs on race-mortality associations among incident ESKD patients transitioning to dialysis over January 1, 2000-December 31, 2016 using Cox regression. We examined likelihood of post-dialysis kidney transplantation using Cox models and cumulative incidence curves. RESULTS Compared with White patients in the mainland, Asian and NHOPI patients in the mainland had lower mortality: adjusted HRs (95% CIs) 0.67 (0.66-0.67) and 0.72 (0.70-0.73), respectively. When examining Asian and NHOPI patients in Hawaii/PIs, survival benefit was attenuated in Asian and diminished to the null in NHOPI patients (ref: mainland White patients). Cumulative incidence curves comparing Asian, NHOPI, and White patients showed Asian and NHOPI patients in the mainland had the highest likelihood of transplantation, whereas NHOPI and Asian patients in Hawaii/PIs had the lowest likelihood. CONCLUSION In the mainland, Asian and NHOPI patients had lower mortality versus White patients, whereas in Hawaii/PIs, this survival benefit was diminished in Asian and mitigated in NHOPI patients. NHOPI and Asian patients in Hawaii/PIs had less transplantation versus those in the mainland. Further research is needed to uncover factors contributing to differential ESKD outcomes among Asian and NHOPI patients across geographic residence.
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Affiliation(s)
- Amy S You
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Orange, California, USA
| | - Keith C Norris
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Merle Kataoka-Yahiro
- Department of Nursing, Nancy Atmospera-Walch School of Nursing, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - James Davis
- Office of Biostatistics and Quantitative Health Sciences, John A. Burns School of Medicine, Honolulu, Hawaii, USA
| | - Victoria Page
- National Kidney Foundation-Hawaii, Honolulu, Hawaii, USA
| | - Glen Hayashida
- National Kidney Foundation-Hawaii, Honolulu, Hawaii, USA
| | - Yoko Narasaki
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Orange, California, USA
| | - Shiuh Feng Cheng
- Department of Medicine, John A. Burns School of Medicine, Honolulu, Hawaii, USA
| | - Roland Ng
- Department of Medicine, John A. Burns School of Medicine, Honolulu, Hawaii, USA
| | - Linda L Wong
- Department of Surgery, John A. Burns School of Medicine, Honolulu, Hawaii, USA
- Department of Surgery, Queens Medical Center, Honolulu, Hawaii, USA
| | - Lung-Yi Lee
- Department of Surgery, John A. Burns School of Medicine, Honolulu, Hawaii, USA
- Department of Surgery, Queens Medical Center, Honolulu, Hawaii, USA
| | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Orange, California, USA
- Nephrology Section, Tibor Rubin Veterans Affairs Medical Center, Long Beach, California, USA
| | - Connie M Rhee
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Orange, California, 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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Acoba JD, Hirano T, Nakasone R, Rho YS. Pancreatic cancer among Pacific Islanders: a comprehensive analysis of an understudied racial group. Ethn Health 2023; 28:650-660. [PMID: 36036201 DOI: 10.1080/13557858.2022.2116631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 08/18/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Racial disparities in care and outcome have been demonstrated for several cancers, but it is not clear that a similar discrepancy exists for pancreatic cancer. Furthermore, there are limited data describing the pancreatic cancer experience of Pacific Islanders. The primary objective of this study was to analyze the clinical characteristics, treatment, and outcomes of Pacific Islander patients with pancreatic cancer. DESIGN We obtained data for a consecutive sample of pancreatic adenocarcinoma patients who presented to the largest hospital in Hawaii from 1 January 2000, through 31 December 2019. Analyses were performed for the entire population and separately for patients who had their cancer resected. Overall survival was calculated by the Kaplan-Meier method. Cox proportional hazards regression models were constructed to determine the prognostic capacity of clinical and pathologic factors. RESULTS A total of 1040 patients were included in the final analysis. Pacific islanders presented at a significantly younger age compared to Whites or Asians and had the highest Medicaid rate. There were no statistically significant racial differences in stage at presentation or treatments. We did not demonstrate an association between race and survival on univariate analysis, nor after adjusting for demographic and tumor factors. Age, stage, and treatment were significantly associated with survival for both univariate and multivariate analyses. CONCLUSION We did not demonstrate disparate outcomes among Pacific Islanders with pancreatic cancer. This is likely due in part to the absence of a screening test and the notable poor prognosis of pancreatic adenocarcinoma. Furthermore, equity in treatment may have contributed to racial parity in survival.
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Affiliation(s)
- Jared D Acoba
- University of Hawaii Cancer Center, Honolulu, HI, USA
- John A. Burns School of Medicine, Honolulu, HI, USA
- Queen's Medical Center, Honolulu, HI, USA
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Waitzfelder B, Palaniappan L, Varga A, Frankland TB, Li J, Daida YG, Kaholokula JK, Bacong AM, Rawlings AM, Chung S, Howick C, Fortmann SP. Prevalence of cardiovascular disease among Asian, Pacific Islander and multi-race populations in Hawai'i and California. BMC Public Health 2023; 23:885. [PMID: 37189145 PMCID: PMC10184427 DOI: 10.1186/s12889-023-15795-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 05/03/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) remains the leading cause of death in the US. CVD incidence is influenced by many demographic, clinical, cultural, and psychosocial factors, including race and ethnicity. Despite recent research, there remain limitations on understanding CVD health among Asians and Pacific Islanders (APIs), particularly some subgroups and multi-racial populations. Combining diverse API populations into one study group and difficulties in defining API subpopulations and multi-race individuals have hampered efforts to identify and address health disparities in these growing populations. METHODS The study cohort was comprised of all adult patients at Kaiser Permanente Hawai'i and Palo Alto Medical Foundation in California during 2014-2018 (n = 684,363). EHR-recorded ICD-9 and ICD-10 diagnosis codes were used to indicate coronary heart disease (CHD), stroke, peripheral vascular disease (PVD), and overall CVD. Self-reported race and ethnicity data were used to construct 12 mutually exclusive single and multi-race groups, and a Non-Hispanic White (NHW) comparison group. Logistic regression models were used to derive prevalence estimates, odds ratios, and confidence intervals for the 12 race/ethnicity groups. RESULTS The prevalence of CHD and PVD varied 4-fold and stroke and overall CVD prevalence varied 3-fold across API subpopulations. Among Asians, the Filipino subgroup had the highest prevalence of all three CVD conditions and overall CVD. Chinese people had the lowest prevalence of CHD, PVD and overall CVD. In comparison to Native Hawaiians, Other Pacific Islanders had significantly higher prevalence of CHD. For the multi-race groups that included Native Hawaiians and Other Pacific Islanders, the prevalence of overall CVD was significantly higher than that for either single-race Native Hawaiians or Other Pacific Islanders. The multi-race Asian + White group had significantly higher overall CVD prevalence than both the NHW group and the highest Asian subgroup (Filipinos). CONCLUSIONS Study findings revealed significant differences in overall CVD, CHD, stroke, and PVD among API subgroups. In addition to elevated risk among Filipino, Native Hawaiian, and Other Pacific Islander groups, the study identified particularly elevated risk among multi-race API groups. Differences in disease prevalence are likely mirrored in other cardiometabolic conditions, supporting the need to disaggregate API subgroups in health research.
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Affiliation(s)
- Beth Waitzfelder
- Center for Integrated Health Care Research, Kaiser Permanente Hawai'i, Honolulu, HI, USA
| | | | - Alexandra Varga
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA
| | - Timothy B Frankland
- Center for Integrated Health Care Research, Kaiser Permanente Hawai'i, Honolulu, HI, USA
| | - Jiang Li
- Palo Alto Medical Foundation Research Institute, Center for Health Systems Research, Sutter Health, Palo Alto, CA, USA
| | - Yihe G Daida
- Center for Integrated Health Care Research, Kaiser Permanente Hawai'i, Honolulu, HI, USA
| | | | | | - Andreea M Rawlings
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA
| | | | - Connor Howick
- Center for Integrated Health Care Research, Kaiser Permanente Hawai'i, Honolulu, HI, USA
| | - Stephen P Fortmann
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA.
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, USA.
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Kawamura MY, Kimata C, Wong Ramsey K. Racial Disparities in Breastmilk Receipt and Extremely Low Gestational Age Neonatal Morbidities in an Asian Pacific Islander Population. J Racial Ethn Health Disparities 2023; 10:952-60. [PMID: 35297496 DOI: 10.1007/s40615-022-01283-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Racial disparities in breastmilk provision and neonatal morbidities of extreme prematurity have been documented in previous studies but are not as well-documented in Asian and Pacific Islander (API) infants. The objectives of this study were to evaluate a predominantly API neonatal intensive care unit (NICU) population for racial disparities in (1) the receipt of breastmilk within 24 h of admission and at discharge and (2) neonatal morbidities among infants ≤ 28 weeks gestational age. METHODS A retrospective chart review of 2528 infants from 2018 to 2020 born at the largest level 3 NICU in Honolulu, Hawai'i, was conducted. Multivariable logistic regression analysis was performed on NICU outcomes to calculate adjusted odds ratios (aOR) and confidence intervals (CI). RESULTS Native Hawaiian (NH) (aOR 0.73 [0.54, 0.98]), Pacific Islander (PI) (aOR 0.57 [0.41, 0.79]), and Filipino infants (aOR 0.66 [0.49, 0.89]) were less likely to receive breastmilk at discharge compared to Asian infants. PI infants were also more likely to experience necrotizing enterocolitis (aOR 7.89 [1.07, 58.10]) and intraventricular hemorrhage (aOR 3.86 [1.15, 13.02]) compared to Asian infants. CONCLUSION In a predominantly API population, disparities in breastmilk receipt and neonatal morbidities exist among NH, PI, and Filipino infants in the NICU. Our findings call for better understanding of the underlying inequities to guide directed efforts, including standardization of care through staff trainings on implicit biases and trauma-informed care, as well as provision of culturally sensitive education and lactation support for these patients.
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Hong JH, Swami N, Dee EC, Gomez SL, Lam MB. Non-small cell lung cancer disparities in stage at presentation and treatment for Asian American, Native Hawaiian, and Pacific Islander women. J Surg Oncol 2023; 127:882-890. [PMID: 36719164 DOI: 10.1002/jso.27204] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/06/2023] [Accepted: 01/17/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND OBJECTIVES Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) represent the fastest-growing group in the United States. While described in aggregate, great variations exist within the community. We aimed to determine whether there were differences in stage at presentation and treatment status among AANHPI women with non-small cell lung cancer (NSCLC). METHODS Between 2004 and 2016, we identified 522 361 female patients with newly diagnosed NSCLC from the National Cancer Database. Multivariable logistic regression models were used to define adjusted odds ratios (aORs) of presenting with stage IV disease and not receiving treatment. RESULTS AANHPI women were more likely to present with stage IV disease compared to White (54.32% vs. 40.28%, p < 0.001). Aside from Hawaiian, Pakistani, and Hmong women, all other ethnic groups had greater odds of presenting with stage IV disease than White women. AANHPI women <65 years were more likely to present with stage IV disease (p = 0.030). Only Vietnamese women showed a significant difference (aOR = 1.30 [1.06-1.58], p = 0.010) for likelihood of receiving treatment compared to White. CONCLUSIONS Differences in stage at presentation and treatment status in women with NSCLC were observed among AANHPI ethnic groups when populations were disaggregated.
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Affiliation(s)
- Ji Hyun Hong
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nishwant Swami
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Scarlett Lin Gomez
- Department of Epidemiology & Biostatistics and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA
| | - Miranda B Lam
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Pacheco M, Warfield SK, Hatzistavrakis P, Mochida-Meek S, Moskowitz D, Matson M, Mustanski B. "I don't see myself represented:" Strategies and considerations for engaging gay male Native Hawaiian and Other Pacific Islander teens in research and HIV prevention services. AIDS Behav 2023; 27:1055-1067. [PMID: 36097088 PMCID: PMC9466349 DOI: 10.1007/s10461-022-03843-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 12/02/2022]
Abstract
Significant efforts have been applied to the development of sexual health programs for minority young gay males. Given the absence of research with Native Hawaiian and other Pacific Islander (NHOPI) gay teen males, this study was done to assess how to reach them. Interviews were conducted with 20 NHOPI gay males ages 19-24 as near peers that can inform reaching teens. Data was analyzed using the Reflexive Thematic Analysis method. Three themes were identified: (1) Culture is a crucial factor for recruitment and engagement-whether participants realized it or not; (2) Confidentiality is key in recruitment to provide a safe space for NHOPI gay teen male research participation; and (3) NHOPI gay teen males experience multiple identity conflicts that must be considered for recruitment and engagement initiatives. Online recruitment efforts are optimal and should reflect distinct NHOPI cultures. More research is needed when it comes to understanding the cultural acceptance and understanding of homosexuality in NHOPI communities and how to integrate cultural education into recruitment methods and interventions.
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Affiliation(s)
- Misty Pacheco
- Department of Kinesiology and Exercise Sciences, University of Hawai'i at Hilo, 200 W Kawili Street, 96720, Hilo, HI, USA.
| | | | - Patti Hatzistavrakis
- Department of Kinesiology and Exercise Sciences, University of Hawai'i at Hilo, 200 W Kawili Street, 96720, Hilo, HI, USA
| | - Summer Mochida-Meek
- Department of Kinesiology and Exercise Sciences, University of Hawai'i at Hilo, 200 W Kawili Street, 96720, Hilo, HI, USA
| | - David Moskowitz
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA
| | - Margaret Matson
- Department of Medical Social Sciences, Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
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Monteith LL, Holliday R, Iglesias CD, Sherrill A, Brenner LA, Hoffmire CA. Suicide risk and prevention in Guam: Clinical and research considerations and a call to action. Asian J Psychiatr 2023; 83:103546. [PMID: 36958139 DOI: 10.1016/j.ajp.2023.103546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/06/2023] [Accepted: 03/14/2023] [Indexed: 03/25/2023]
Abstract
The suicide rate in Guam, a United States (U.S.) territory, is markedly higher than the suicide rate within the U.S. There are also important differences in who is most at risk for suicide in Guam, relative to within the general U.S. Understanding these distinctions is important for implementing effective suicide prevention initiatives in this region. In the current article, we discuss considerations for preventing suicide in Guam, including distinctions in suicide risk, relative to within the general U.S. For example, suicide rates in Guam are highest for those who are Pacific Islander, young, or male. Further, suicide in Guam more commonly involves hanging and less commonly involves firearms, a pattern that differs from suicide methods used within the general U.S. Additional considerations include the large military and Veteran population in Guam, as well as cultural and religious beliefs regarding suicide. Finally, given the geographic isolation of Guam, access to healthcare is likely an important facet of suicide risk. Considering these characteristics, it is imperative to develop and implement culturally-sensitive suicide prevention interventions for individuals residing in this region. We conclude by discussing future research avenues to address critical knowledge gaps to prevent suicide in Guam.
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Affiliation(s)
- Lindsey L Monteith
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 1890 N Revere Ct, Suite 4003, Mail Stop F546, Aurora, CO 80045, USA.
| | - Ryan Holliday
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 1890 N Revere Ct, Suite 4003, Mail Stop F546, Aurora, CO 80045, USA
| | - Christe'An D Iglesias
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA
| | - Ashley Sherrill
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA
| | - Lisa A Brenner
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 1890 N Revere Ct, Suite 4003, Mail Stop F546, Aurora, CO 80045, USA
| | - Claire A Hoffmire
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, USA
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Spencer SD, Pokhrel P, Helm S, Wilczek K, Galimov A, Sussman S. Emerging Adulthood Attributes, Discrimination, Mental Health, and Substance Use in a Sample of Asian, Native Hawaiian/ Pacific Islander, and White College Students. Asian Am J Psychol 2023; 14:51-62. [PMID: 37362322 PMCID: PMC10289252 DOI: 10.1037/aap0000254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Although Asian/Pacific Islanders are considered a single ethnic/racial category in national studies, Native Hawaiians/other Pacific Islanders (NHOPIs) and Asians show marked disparities in health outcomes and risk behaviors, including substance use. Currently, knowledge regarding the psychosocial mechanisms by which NHOPI ethnicity is associated with increased substance use, compared with Asian or White, is limited, especially among emerging adults. The present study tested a model in which the relationship between NHOPI ethnicity and higher substance use (i.e., current tobacco, alcohol, marijuana, and illicit drug use) was hypothesized to be mediated through higher emerging adulthood stress (e.g., feeling "in-between," instability), higher self-reported racial/ethnic discrimination, substance use in one's social networks, and poorer mental health symptomology (i.e., depression, anxiety). Data collected at a single time-point from 2,344 college students (M age = 21.2 [SD = 2.1]; 54% Women; 24% NHOPI, 49% Asian, 27% White) were analyzed by employing structural equation modeling. NHOPI and Asian ethnicity were dummy coded with reference to White, and separate analyses were run for NHOPI and Asian groups, with White as the reference group. Results indicated that the association between NHOPI ethnicity and higher substance use was mediated in two steps, via higher racial/ethnic discrimination and poorer mental health symptomatology. NHOPI ethnicity, but not Asian, was associated with higher identification with emerging adulthood attributes, which in turn was associated with increased substance use. Implications are discussed in the context of reducing health disparities faced by NHOPIs.
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Affiliation(s)
| | - Pallav Pokhrel
- University of Hawaiʻi Cancer Center, University of Hawaiʻi at Mānoa
| | - Susana Helm
- Department of Psychiatry, University of Hawaiʻi at Mānoa
| | | | - Arthur Galimov
- Department of Preventative Medicine, University of Southern California
| | - Steve Sussman
- Department of Preventative Medicine, University of Southern California
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Zhang JZ, Heinsberg LW, Krishnan M, Hawley NL, Major TJ, Carlson JC, Hindmarsh JH, Watson H, Qasim M, Stamp LK, Dalbeth N, Murphy R, Sun G, Cheng H, Naseri T, Reupena MS, Kershaw EE, Deka R, McGarvey ST, Minster RL, Merriman TR, Weeks DE. Multivariate analysis of a missense variant in CREBRF reveals associations with measures of adiposity in people of Polynesian ancestries. Genet Epidemiol 2023; 47:105-118. [PMID: 36352773 PMCID: PMC9892232 DOI: 10.1002/gepi.22508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/02/2022] [Accepted: 10/05/2022] [Indexed: 11/11/2022]
Abstract
The minor allele of rs373863828, a missense variant in CREB3 Regulatory Factor, is associated with several cardiometabolic phenotypes in Polynesian peoples. To better understand the variant, we tested the association of rs373863828 with a panel of correlated phenotypes (body mass index [BMI], weight, height, HDL cholesterol, triglycerides, and total cholesterol) using multivariate Bayesian association and network analyses in a Samoa cohort (n = 1632), Aotearoa New Zealand cohort (n = 1419), and combined cohort (n = 2976). An expanded set of phenotypes (adding estimated fat and fat-free mass, abdominal circumference, hip circumference, and abdominal-hip ratio) was tested in the Samoa cohort (n = 1496). In the Samoa cohort, we observed significant associations (log10 Bayes Factor [BF] ≥ 5.0) between rs373863828 and the overall phenotype panel (8.81), weight (8.30), and BMI (6.42). In the Aotearoa New Zealand cohort, we observed suggestive associations (1.5 < log10 BF < 5) between rs373863828 and the overall phenotype panel (4.60), weight (3.27), and BMI (1.80). In the combined cohort, we observed concordant signals with larger log10 BFs. In the Samoa-specific expanded phenotype analyses, we also observed significant associations between rs373863828 and fat mass (5.65), abdominal circumference (5.34), and hip circumference (5.09). Bayesian networks provided evidence for a direct association of rs373863828 with weight and indirect associations with height and BMI.
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Affiliation(s)
- Jerry Z. Zhang
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Lacey W. Heinsberg
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Mohanraj Krishnan
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, CT
| | - Tanya J. Major
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Jenna C. Carlson
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | | | - Huti Watson
- Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti, New Zealand
| | - Muhammad Qasim
- Ngāti Porou Hauora Charitable Trust, Te Puia Springs, Tairāwhiti, New Zealand
| | - Lisa K. Stamp
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Rinki Murphy
- Department of Medicine, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
| | - Guangyun Sun
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH
| | - Hong Cheng
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH
| | - Take Naseri
- Ministry of Health, Government of Samoa, Apia, Samoa
| | | | - Erin E. Kershaw
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Ranjan Deka
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH
| | - Stephen T. McGarvey
- International Health Institute, Department of Epidemiology, School of Public Health, Brown University, Providence, RI
- Department of Anthropology, Brown University, Providence, RI
| | - Ryan L. Minster
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Tony R. Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
- Division of Clinical Immunology and Rheumatology, University of Alabama Birmingham, Birmingham, AL
| | - Daniel E. Weeks
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA
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Sperling MM, Leonard SA, Blumenfeld YJ, Carmichael SL, Chueh J. Prepregnancy body mass index and gestational diabetes mellitus across Asian and Pacific Islander subgroups in California. AJOG Glob Rep 2023; 3:100148. [PMID: 36632428 PMCID: PMC9826825 DOI: 10.1016/j.xagr.2022.100148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The American College of Obstetricians and Gynecologists recommends early screening for gestational diabetes mellitus among pregnant Asian people with a prepregnancy body mass index ≥23.0 kg/m2, in contrast with the recommended screening at a body mass index ≥25 kg/m2 for other races and ethnicities. However, there is significant heterogeneity within Asian and Pacific Islander populations, and gestational diabetes mellitus and its association with body mass index among Asian and Pacific Islander subgroups may not be uniform across all groups. OBJECTIVE This study aimed to analyze the association between body mass index and gestational diabetes mellitus among Asian and Pacific Islander subgroups in California, specifically gestational diabetes mellitus rates among those with a body mass index above vs below 23 kg/m2, which is the cutoff point for the designation of being overweight among Asians populations. STUDY DESIGN Using a linked delivery hospitalization discharge and vital records database, we identified patients who gave birth in California between 2007 and 2017 and who self-reported to be 1 of 13 Asian and Pacific Islander subgroups, which was collected from birth and fetal death certificates. In each subgroup, we evaluated the association between body mass index and gestational diabetes mellitus using multivariable logistic regression models adjusted for age, education, parity, payment method, the trimester in which prenatal care was initiated, and nativity. We fit body mass index nonlinearly with splines and categorized body mass index as being above or below 23 kg/m2. Predicted probabilities of gestational diabetes mellitus with 95% confidence intervals were calculated across body mass index values using the nonlinear regression models. RESULTS The overall prevalence of gestational diabetes mellitus was 14.3% (83,400/584,032), ranging between 8.4% and 17.1% across subgroups. The highest prevalence was among Indian (17.1%), Filipino (16.7%), and Vietnamese (15.5%) subgroups. In these subgroups, gestational diabetes mellitus was diagnosed in 10% to 13% of those with a body mass index <23.0 kg/m2 and in 22% of those with a body mass index ≥23 kg/m2. Gestational diabetes mellitus was least common among Korean (8.4%), Japanese (9.0%), and Samoan (9.8%) subgroups with a gestational diabetes mellitus rate of 5% to 7% among those with a body mass index <23.0 kg/m2 and in 10% to 15% among those with a body mass index ≥23 kg/m2. Although Samoan patients had the highest rate of obesity, defined as body mass index ≥30 kg/m2 (57.4%), they had the third lowest prevalence of gestational diabetes mellitus. Conversely, Vietnamese patients had the second lowest rate of obesity (2.4%) but the highest rate of gestational diabetes mellitus at a body mass index of ≥23 kg/m2 (22.3%). CONCLUSION Gestational diabetes mellitus and its association with body mass index varied among Asian subgroups but increased as body mass index increased. Subgroups with the lowest prevalence of obesity trended toward a higher prevalence of gestational diabetes mellitus and those with a higher prevalence of obesity trended toward a lower prevalence of gestational diabetes mellitus.
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Affiliation(s)
- Meryl M. Sperling
- Departments of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA (Drs Sperling, Leonard, Blumenfeld, Carmichael, and Chueh)
| | - Stephanie A. Leonard
- Departments of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA (Drs Sperling, Leonard, Blumenfeld, Carmichael, and Chueh)
| | - Yair J. Blumenfeld
- Departments of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA (Drs Sperling, Leonard, Blumenfeld, Carmichael, and Chueh)
| | - Suzan L. Carmichael
- Departments of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA (Drs Sperling, Leonard, Blumenfeld, Carmichael, and Chueh)
- Pediatrics (Dr Carmichael), Stanford University School of Medicine, Stanford, CA
| | - Jane Chueh
- Departments of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA (Drs Sperling, Leonard, Blumenfeld, Carmichael, and Chueh)
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Lindholm DE, Whiteman IJ, Oliver J, Cheung MMH, Hope SA, Brizard CP, Horton AE, Sheridan B, Hardy M, Osowicki J, Steer AC, Engelman D. Acute rheumatic fever and rheumatic heart disease in children and adolescents in Victoria, Australia. J Paediatr Child Health 2023; 59:352-359. [PMID: 36478625 PMCID: PMC10946565 DOI: 10.1111/jpc.16305] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022]
Abstract
AIM To describe the epidemiology and clinical profile of children and adolescents with acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in Victoria, Australia. METHODS A retrospective audit was undertaken of children and adolescents with ARF and RHD attending the Royal Children's and Monash Children's Hospitals in Victoria, Australia between 2010 and 2019. Potential cases were identified by searching multiple sources for relevant ICD-10-AM codes and keywords, then reviewed manually. For confirmed cases, we collected data on patient demographics, clinical features, comorbidities and management. RESULTS Of 179 participants included, there were 108 Victorian residents and 71 non-Victorian residents. 126 had at least one episode of ARF during the study period and 128 were diagnosed with RHD. In the Victorian resident group, the overall incidence of ARF was 0.8 per 100 000 5-14 year olds. This incidence was higher in Victorian Aboriginal and/or Torres Strait Islander (3.8 per 100 000) and Pacific Islander (32.1 per 100 000) sub-populations. Of 83 Victorian residents who had an ARF episode, 11 (13%) had a recurrence. Most Victorian residents with RHD had mixed aortic and mitral valve pathology (69.4%) and moderate to severe disease (61.9%). Most non-Victorian residents were Aboriginal and/or Torres Strait Islander people (80.3%) and were commonly transferred for tertiary or surgical management of RHD (83.1%). CONCLUSIONS ARF and RHD continue to affect the health of significant numbers of children and adolescents living in Victoria, including severe and recurrent disease. Specialised services and a register-based control program may help to prevent complications and premature death.
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Affiliation(s)
- Daniel E Lindholm
- Tropical Diseases Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Ida J Whiteman
- Department of CardiologyRoyal Children's HospitalMelbourneVictoriaAustralia
- Paediatric Cardiology ServicesMonashHeart/Monash Children's HospitalMelbourneVictoriaAustralia
| | - Jane Oliver
- Tropical Diseases Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- The Peter Doherty Institute for Infection and Immunity, Department of Infectious DiseasesUniversity of MelbourneMelbourneVictoriaAustralia
| | - Michael M H Cheung
- Department of CardiologyRoyal Children's HospitalMelbourneVictoriaAustralia
- Heart Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Sarah A Hope
- Paediatric Cardiology ServicesMonashHeart/Monash Children's HospitalMelbourneVictoriaAustralia
- Monash Cardiovascular Research CentreVictorian Heart InstituteMelbourneVictoriaAustralia
- Department of PaediatricsMonash UniversityMelbourneVictoriaAustralia
| | - Christian P Brizard
- Heart Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Cardiac Surgery UnitRoyal Children's HospitalMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
| | - Ari E Horton
- Paediatric Cardiology ServicesMonashHeart/Monash Children's HospitalMelbourneVictoriaAustralia
- Monash Cardiovascular Research CentreVictorian Heart InstituteMelbourneVictoriaAustralia
- Department of PaediatricsMonash UniversityMelbourneVictoriaAustralia
| | - Bennett Sheridan
- Department of CardiologyRoyal Children's HospitalMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
- Cardiac Intensive Care UnitRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Myra Hardy
- Tropical Diseases Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
| | - Joshua Osowicki
- Tropical Diseases Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
- Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Andrew C Steer
- Tropical Diseases Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
- Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Daniel Engelman
- Tropical Diseases Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
- Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
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Frontiers Production Office. Erratum: Engaging Community Health Centers to understand their perceptions and interest in longitudinal cohort research on diabetes mellitus in Native Hawaiian communities: Initial insights from the Waimānalo community. Front Public Health 2023; 11:1143145. [PMID: 36761139 PMCID: PMC9907082 DOI: 10.3389/fpubh.2023.1143145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 01/26/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2022.1035600.].
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Rhee CM, You AS, Page V, Hayashida G, Kataoka-Yahiro M, Davis J, Wong LL, Narasaki Y, Kalantar-Zadeh K. Racial and Ethnic Differences in Chronic Kidney Disease and Its Risk Factors among Asian-Americans and Pacific Islanders in Hawaii. Nephron Clin Pract 2023; 147:373-382. [PMID: 36603561 PMCID: PMC10272063 DOI: 10.1159/000527990] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 09/12/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Several studies suggest that Asian-American and Native Hawaiian and Other Pacific Islander (NHOPI) racial/ethnic groups have a heightened risk of chronic kidney disease (CKD), but provide limited inference due to the aggregation of these groups into a single racial/ethnic category. We thus examined the association of granularly defined racial/ethnic groups with specific CKD indicators among a diverse group of participants from the National Kidney Foundation of Hawaii's Kidney Early Detection Screening (KEDS) Program. METHODS Among 1,243 participants enrolled in 19 KEDS screening events over 2006-2009, we examined the association between Asian-American and NHOPI groups and specific CKD indicators, defined as self-reported CKD, microalbuminuria, and macroalbuminuria, using multivariable logistic regression. We then examined associations of race/ethnicity with various CKD risk factors. RESULTS The most predominant racial/ethnic groups were White (22.0%), Multiracial (18.9%), Japanese (19.2%), Filipino (13.4%), NHOPI (8.4%), and Chinese (4.5%) participants. NHOPI and Chinese participants had a higher risk of microalbuminuria (adjusted ORs [aORs] [95% CIs] 2.48 [1.25-4.91] and 2.37 [1.07-5.27], respectively), while point estimates for all other minority groups suggested higher risk (reference: Whites). NHOPI participants also had a higher risk of macroalbuminuria and self-reported CKD. While most minorities had a higher risk of diabetes and hypertension, NHOPI and Multiracial participants had a higher risk of obesity, whereas the East Asian groups had a lower risk. CONCLUSIONS In this community-based cohort, compared with Whites, Asian-Americans had a higher risk of early CKD indicators, whereas NHOPIs had a higher risk of more severe CKD indicators. Further studies are needed to elucidate the distinct pathways leading to CKD across diverse racial/ethnic groups in Hawaii.
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Affiliation(s)
- Connie M. Rhee
- Division of Nephrology and Hypertension, University of California Irvine School of Medicine, Orange, CA
| | - Amy S. You
- Division of Nephrology and Hypertension, University of California Irvine School of Medicine, Orange, CA
| | - Victoria Page
- National Kidney Foundation - Hawaii Chapter, Honolulu, HI
| | - Glen Hayashida
- National Kidney Foundation - Hawaii Chapter, Honolulu, HI
| | - Merle Kataoka-Yahiro
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI
| | - James Davis
- Office of Statistics and Quantitative Health Sciences, University of Hawaii John A. Burns School of Medicine, Honolulu, HI
| | - Linda L. Wong
- Department of Surgery, University of Hawaii John A. Burns School of Medicine, Honolulu, HI
- Department of Surgery, Queen’s Medical Center, Honolulu, HI
| | - Yoko Narasaki
- Division of Nephrology and Hypertension, University of California Irvine School of Medicine, Orange, CA
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension, University of California Irvine School of Medicine, Orange, CA
- Tibor Rubin Veterans Affairs Medical Center, Long Beach, CA
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Playdon M, Rogers TN, Brooks E, Petersen EM, Tavake-Pasi F, Lopez JA, Quintana X, Aitaoto N, Rogers CR. Sociocultural influences on dietary behavior and meal timing among Native Hawaiian and Pacific Islander women at risk of endometrial cancer: a qualitative investigation. Cancer Causes Control 2023; 34:23-37. [PMID: 36208351 PMCID: PMC9547093 DOI: 10.1007/s10552-022-01628-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 09/06/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE Determine sociocultural influences on dietary behavior, body image, weight loss, and perceptions of the cultural appropriateness of a meal-timing intervention design and menu among Native Hawaiian and Pacific Islander (NHPI) women at risk of endometrial cancer. METHODS Six 90-min videoconference focus groups among NHPI women (n = 35) recruited by a community champion in Utah. Eligible women were aged ≥ 18 years at risk of endometrial cancer (i.e., BMI ≥ 25 kg/m2, history of non-insulin-dependent diabetes or complex atypical endometrial hyperplasia) had a working cell phone capable of downloading a phone app, could use their cell phone during the day, and were not night-shift workers. Twelve semi-structured questions were posed during the focus groups. Using inductive qualitative methods based on Hatch's 9-step approach, de-identified transcript data were analyzed. RESULTS Overarching themes included economic factors, cultural influences, meal choice and timing, and perceptions of health. Subthemes included affordability, waste avoidance, inundated schedules, and cultural influences. Perceptions of body size and weight loss were influenced by family, community, and social media, whose messages could be conflicting. Important intervention components included satisfying, convenient pre-made meals, while barriers included the need to cook for family members. CONCLUSIONS Dietary interventions targeting metabolic health among NHPI women should consider the multitude of sociocultural and economic factors that influence food choices and meal timing in this population, including affordability, hectic schedules, and immigrant adjustment. Promoting the link between physical and mental well-being as opposed to weight loss is a key approach to reaching this population.
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Affiliation(s)
- M. Playdon
- grid.223827.e0000 0001 2193 0096Department of Nutrition and Integrative Physiology, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112 USA ,grid.223827.e0000 0001 2193 0096Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, RN4511, Salt Lake City, UT 84112 USA
| | - T. N. Rogers
- grid.223827.e0000 0001 2193 0096University of Utah David Eccles School of Business, Sorenson Impact Center, 85 Fort Douglas Blvd, Building #602, Salt Lake City, UT 84113 USA
| | - E. Brooks
- grid.223827.e0000 0001 2193 0096Department of Family & Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108 USA
| | - E. M. Petersen
- grid.223827.e0000 0001 2193 0096Department of Family & Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108 USA
| | - F. Tavake-Pasi
- National Tongan American Society, 5296 S Commerce Dr., Suite 204, Murray, UT 84117 USA
| | - J. A. Lopez
- grid.223827.e0000 0001 2193 0096Department of Family & Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108 USA
| | - X. Quintana
- grid.223827.e0000 0001 2193 0096Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, RN4511, Salt Lake City, UT 84112 USA
| | - N. Aitaoto
- grid.223827.e0000 0001 2193 0096Department of Nutrition and Integrative Physiology, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112 USA
| | - C. R. Rogers
- grid.30760.320000 0001 2111 8460Medical College of Wisconsin, Institute for Health & Equity, 8701 W Watertown Plank Rd., Milwaukee, WI 53226 USA
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Johnson DL, Okamoto SK, Rosario MH, Pokhrel P. Tobacco product use and cultural connectedness among Native Hawaiian/ Pacific Islander, Asian American, and Filipino American young adults in Hawai'i. J Ethn Subst Abuse 2022:1-15. [PMID: 36579697 PMCID: PMC10307923 DOI: 10.1080/15332640.2022.2161082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Tobacco product use rates among Native Hawaiian/Pacific Islander (NHPI), Asian American, and Filipino American young adults in Hawai'i have risen rapidly in recent years following the introduction of electronic nicotine delivery systems. Though some research has examined tobacco use correlates for these demographics of young adults, research examining protective factors, such as cultural connectedness, is lacking. Additionally, research that disaggregates Asian Americans from Pacific Islanders is scarce, despite the differing risk and protective factors that have been determined for each group. This study separately examined cultural connectedness among NHPIs, Asian Americans, and Filipino Americans to help fill the gaps in the current tobacco product literature. The findings indicated that Asian Americans and Filipino Americans who identify more with their own cultures are less likely to use e-cigarettes; however, this relationship was not supported for NHPIs. No significant evidence was found to indicate a relationship between cultural connectedness and combustible cigarette use among any of the sampled groups. The lack of relationship between cultural connectedness and e-cigarette use among Native Hawaiians may be explained by measurement limitations in the study, and suggest the need for more culturally competent scales (e.g., an enculturation scale) that account for Indigenous status.
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Affiliation(s)
| | - Scott K. Okamoto
- School of Social Work, Hawai‘i Pacific University
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center
| | | | - Pallav Pokhrel
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center
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Mavragani A, Yin C, Meno M, Abe J, Pagano I, Tamashiro S, Fujinaga K, Braun-Inglis C, Fukui J. Racial Disparities in Patient-Provider Communication During Telehealth Visits Versus Face-to-face Visits Among Asian and Native Hawaiian and Other Pacific Islander Patients With Cancer: Cross-sectional Analysis. JMIR Cancer 2022; 8:e37272. [PMID: 36485021 PMCID: PMC9789492 DOI: 10.2196/37272] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 07/21/2022] [Accepted: 08/10/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Telehealth visits increase patients' access to care and are often rated as "just as good" as face-to-face visits by oncology patients. Telehealth visits have become increasingly more common in the care of patients with cancer since the advent of the COVID-19 pandemic. Asians and Pacific Islanders are two of the fastest growing racial groups in the United States, but there are few studies assessing patient satisfaction with telemedicine among these two racial groups. OBJECTIVE Our objective was to compare satisfaction with communication during telehealth visits versus face-to-face visits among oncology patients, with a specific focus on Asian patients and Native Hawaiian and other Pacific Islander (NHOPI) patients. METHODS We surveyed a racially diverse group of patients who were treated at community cancer centers in Hawaii and had recently experienced a face-to-face visit or telehealth visit. Questions for assessing satisfaction with patient-physician communication were adapted from a previously published study of cancer survivors. Variables that impact communication, including age, sex, household income, education level, and cancer type and stage, were captured. Multivariable logistic models for patient satisfaction were created, with adjustments for sociodemographic factors. RESULTS Participants who attended a face-to-face visit reported higher levels of satisfaction in all communication measures than those reported by participants who underwent a telehealth encounter. The univariate analysis revealed lower levels of satisfaction during telehealth visits among Asian participants and NHOPI participants compared to those among White participants for all measures of communication (eg, when asked to what degree "[y]our physician listened carefully to you"). Asian patients and NHOPI patients were significantly less likely than White patients to strongly agree with the statement (P<.004 and P<.007, respectively). Racial differences in satisfaction with communication persisted in the multivariate analysis even after adjusting for sociodemographic factors. There were no significant racial differences in communication during face-to-face visits. CONCLUSIONS Asian patients and NHOPI patients were significantly less content with patient-physician communication during telehealth visits when compared to White patients. This difference among racial groups was not seen in face-to-face visits. The observation that telehealth increases racial disparities in health care satisfaction should prompt further exploration.
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Affiliation(s)
| | - Chelsea Yin
- Kaiser Permanente, Oakland, CA, United States
| | - Michael Meno
- University of Washington, Seattle, WA, United States
| | - Justin Abe
- University of Southern California, Los Angeles, CA, United States
| | - Ian Pagano
- University of Hawaii Cancer Center, Honolulu, HI, United States
| | | | | | | | - Jami Fukui
- University of Hawaii Cancer Center, Honolulu, HI, United States
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Mau MKLM, Baumhofer Merritt NK, Werner K, Oneha MF. Engaging Community Health Centers to understand their perceptions and interest in longitudinal cohort research on diabetes mellitus in Native Hawaiian communities: Initial insights from the Waimānalo community. Front Public Health 2022; 10:1035600. [PMID: 36568795 PMCID: PMC9780047 DOI: 10.3389/fpubh.2022.1035600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Despite decades of research on diabetes mellitus (DM) and other health disparities affecting Native Hawaiian and Pacific Islander (NHPI) populations, little is known about the disease mechanisms that underlie these health disparities. Ideally, a longitudinal cohort study is one of the best research design tools to examine underlying mechanisms of disease in health disparity conditions such as DM. The study purpose is to understand the perspectives and insights of people (n = 29) living in NHPI communities about conducting longitudinal cohort studies aimed at understanding mechanisms of health disparities in NHPI populations. Methods All interviews were audio-recorded, transcribed and de-identified into written transcripts for thematic content analysis. Results Four major themes emerged: 1) Diabetes and other health disparities is a community priority because these diseases touch nearly everyone; 2) Cohort-type research and its outcomes should extend beyond data collection to include data sharing using a cultural context approach; 3) Cohort-type research can directly benefit everyone, especially youth, through education on new, locally-derived knowledge; 4) A longterm benefit of cohort-type research should be to support "generational change" in the community. Discussion In summary, potential "cohort-type research" (a.k.a. longitudinal cohort study designs) was perceived as a worthy endeavor because health disparities, such as DM, affects nearly everyone in the community. Cohort-type research is important to NHPI communities as it holds promise for impacting "generational change" on health and wellbeing through the sharing of new community-derived knowledge.
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Affiliation(s)
- Marjorie K. Leimomi Mala Mau
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States,*Correspondence: Marjorie K. Leimomi Mala Mau
| | - Nicole Kau'i Baumhofer Merritt
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States,Division of Mathematics, Natural and Health Sciences, University of Hawai'i - West O'ahu, Kapole, HI, United States
| | - Kamuela Werner
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
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Heinsberg LW, Carlson JC, Pomer A, Cade BE, Naseri T, Reupena MS, Weeks DE, McGarvey ST, Redline S, Hawley NL. Correlates of daytime sleepiness and insomnia among adults in Samoa. Sleep Epidemiol 2022; 2:100042. [PMID: 36338277 PMCID: PMC9635619 DOI: 10.1016/j.sleepe.2022.100042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective To describe daytime sleepiness and insomnia among adults in Samoa and identify modifiable factors associated with these measures. Design/setting Cross-sectional analysis of data from the Soifua Manuia ("Good Health") study (n = 519, 55.1% female); Upolu island, Samoa. Methods Daytime sleepiness and insomnia were assessed with the Epworth Sleepiness Scale (ESS) and the Women's Health Initiative Insomnia Rating Scale (WHIIRS), respectively. Detailed physical, sociodemographic, and behavioral factors were collected. Sleep measures were characterized using multiple linear regression with backwards elimination and a bootstrap stability investigation. Results Excessive daytime sleepiness (ESS>10) and insomnia (WHIIRS>10) were reported by 20% and 6.3% of the sample, respectively. ESS scores were higher in individuals reporting more physical activity (Estimate=1.88; 95% CI=1.12 to 2.75), higher material wealth (0.18; 0.09 to 0.28), and asthma (2.85; 1.25 to 4.51). ESS scores were lower in individuals residing in periurban versus urban regions (-1.43; -2.39 to -0.41), reporting no work versus day shift work (-2.26; -3.07 to -1.41), and reporting greater perceived stress (-0.14; -0.23 to -0.06). WHIIRS scores were lower in individuals reporting "other" shift work (split/irregular/on-call/rotating) versus day shift work (-1.96; -2.89 to -1.14) and those who perceived their village's wealth to be poor/average versus wealthy (-0.94; -1.50 to -0.34). Conclusions Participants had a generally higher prevalence of excessive daytime sleepiness, but lower prevalence of insomnia, compared with individuals from high-income countries. Factors associated with sleep health differed compared with prior studies, emphasizing potential cultural/environmental differences and the need for targeted interventions to improve sleep health in this setting.
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Affiliation(s)
- Lacey W. Heinsberg
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Corresponding author at: Department of Human Genetics, School of Public Health, University of Pittsburgh, Public Health 3102A, 130 De Soto Street, Pittsburgh, PA 15261. (L.W. Heinsberg)
| | - Jenna C. Carlson
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alysa Pomer
- Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Brian E. Cade
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | | | - Daniel E. Weeks
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen T. McGarvey
- International Health Institute and Department of Epidemiology, School of Public Health, and Department of Anthropology, Brown University, Providence, Rhode Island, USA
| | - Susan Redline
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, USA
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Delafield R, Hermosura A, Ahn HJ, Kaholokula JK. Implicit Racial Attitudes and Associations Among Obstetricians in Hawai'i: a Pilot Study. J Racial Ethn Health Disparities 2022; 9:2395-2403. [PMID: 34973153 PMCID: PMC9633441 DOI: 10.1007/s40615-021-01176-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/15/2021] [Accepted: 10/21/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Pacific Islanders living in Hawai'i with ancestral ties to islands in the western Pacific region of Micronesia are common targets of uninhibited forms of prejudice in multiple sectors, including healthcare. Whether the explicit societal-level attitudes toward this group are reflected in implicit attitudes among healthcare providers is unknown; therefore, we designed a pilot study to investigate this question. Our study measures implicit racial bias toward Pacific Islanders from Micronesia among Obstetrician-Gynecologists (OB-GYNs) in Hawai'i. METHODS We developed 4 new implicit association tests (IATs) to measure implicit attitudes and associations (i.e., stereotypes) toward Pacific Islanders from Micronesia in 2 conditions: (1) Micronesians vs. Whites and (2) Micronesians vs. Japanese Americans. Participants were practicing OB-GYNs in Hawai'i. The study was conducted online and included survey questions on demographic and physician practice characteristics in addition to IATs. The primary outcome was the mean IAT D score. Associations between IAT D scores and demographic and practice characteristics were also analyzed. RESULTS Of the 49 OB-GYNs, 38 (77.6%) were female, mean age was 40 years, 29.5% were Japanese, 22.7% were White, and none were from a Micronesian ethnic group. The mean IAT D score in the Micronesian vs. White condition (N = 29) was 0.181, (SD: 0.465, p < 0.05) for the Attitude IAT and 0.197 (SD: 0.427; p < 0.05) for the Stereotype IAT. CONCLUSION The findings from this pilot suggest a slight degree of implicit bias favoring Whites over Micronesians within this sample of OB-GYNs and warrant a larger investigation into implicit biases toward this unique and understudied Pacific Islander population.
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Affiliation(s)
- Rebecca Delafield
- Department of Native Hawaiian Health, University of Hawai'i, John A. Burns School of Medicine, 677 Ala Moana Blvd., Ste. 1016B, Honolulu, HI, 96813, USA.
| | - Andrea Hermosura
- Department of Native Hawaiian Health, University of Hawai'i, John A. Burns School of Medicine, 677 Ala Moana Blvd., Ste. 1016B, Honolulu, HI, 96813, USA
| | - Hyeong Jun Ahn
- Department of Quantitative Health Sciences, University of Hawai'i, John A. Burns School of Medicine, 651 Ilalo St. Medical Education Bldg., Ste 411, Honolulu, HI, 96813, USA
| | - Joseph Keaweʻaimoku Kaholokula
- Department of Native Hawaiian Health, University of Hawai'i, John A. Burns School of Medicine, 677 Ala Moana Blvd., Ste. 1016B, Honolulu, HI, 96813, USA
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Bhat S, Bir S, Schreve F, Bergin CJ, Jones PG, Waqanivavalagi SWFR. Ethnic Disparities in CT Aortography Use for Diagnosing Acute Aortic Syndrome. Radiol Cardiothorac Imaging 2022; 4:e220018. [PMID: 36601460 PMCID: PMC9806728 DOI: 10.1148/ryct.220018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 08/31/2022] [Accepted: 10/13/2022] [Indexed: 11/19/2022]
Abstract
Purpose To determine whether CT aortography was performed in proportion to patient risk for acute aortic syndrome (AAS) and incidence of AAS for different ethnic groups. Materials and Methods All atraumatic thoracic aorta CT aortographic examinations performed in adults (age > 15 years) suspected of having AAS between January 2009 and December 2019 at Auckland City Hospital (New Zealand) were included. Patients were risk stratified using the aortic dissection detection risk score (ADD-RS). The primary outcomes were the ratio of CT aortography rates to rates of positive CT aortographic examinations and the incidence of AAS. Population census data were used to determine age-standardized incidence of AAS in the emergency department (ED). Results In total, 1646 CT aortographic examinations were performed in 1543 patients (mean age, 62 years ± 16 [SD]; 877 male patients). Māori (34% [68 of 203]) and Pacific Islanders (35% [80 of 229]) were more likely to be at high risk of AAS (ADD-RS > 1) compared with patients from other ethnic groups (25% [308 of 1214]); in the ED catchment population, age-standardized AAS incidence was significantly higher in Māori (6.9 per 100 000 person-years [95% CI: 4.3, 10.4]) and Pacific Islanders (5.3 [95% CI: 3.4, 7.8]) than in other ethnic groups (2.3 [95% CI: 1.8, 2.8]). Despite this higher incidence, disproportionately fewer CT aortographic examinations were requested in the ED for Māori (9.2 CT aortographic examinations per AAS diagnosis) and Pacific Islanders (9.2 CT aortographic examinations per AAS diagnosis) compared with other ethnic groups (13.8 CT aortographic examinations per AAS diagnosis). Conclusion Māori and Pacific Islanders were at disproportionately higher risk of AAS but had fewer requested CT aortographic examinations compared with other ethnic groups. This increased risk of AAS in Pacific Islander and indigenous Māori patients should be considered by clinicians when investigating AAS.Keywords: Ethnicity, Māori, Pacific Islander, Aortic Dissection Detection Risk Score, Acute Aortic Syndrome, Aortic Dissection, CT Angiography Supplemental material is available for this article. © RSNA, 2022.
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Pacheco M, Agner JL, Myers TK, Franco J, Barile JP, Kaholokula JK, Baldwin JA. Health outcomes and healthcare utilization of Native Hawaiians and other Pacific Islanders living with HIV in Hawai'i: A mixed-methods study. Ethn Health 2022; 27:1841-1858. [PMID: 34647505 PMCID: PMC9008070 DOI: 10.1080/13557858.2021.1990219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Past research shows mixed outcomes in terms of HIV-related disparities among Native Hawaiians and Pacific Islanders (NHOPI). This study investigates HIV-related disparities among NHOPI living with HIV in Hawai'i. DESIGN An explanatory sequential design was utilized. The quantitative portion analyzed survey data from a statewide Ryan White Needs Assessment (N = 398) to examine the differences in viral suppression and satisfaction with care between NHOPI and other ethnic groups. Utilizing the behavioral model for vulnerable populations (BMVP), semi-structured interviews (N = 16) were conducted next to explain what factors play a role in satisfaction with care and viral suppression when it comes to NHOPI living with HIV in Hawai'i. RESULTS Among the 398 participants 13% were NHOPI. NHOPI were more likely to have a viral load of ≥10,000 copies/mL compared to those who didn't identify as NHOPI. However, there were no significant differences for other viral load levels (20-199 or 200-9999), and only 20 participants (5.2%) had a viral load of 10,000 copies/mL or more. No significant ethnic differences were found in satisfaction with medical care. In the qualitative phase, factors from all domains of the BMVP were represented within the four themes identified: (1) Care coordination is essential- with AIDs service organizations taking the lead; (2) HIV care, as well as overall health, is defined by the effectiveness of medication; (3) Initial diagnosis is a critical moment for intervention; and (4) Aspects of culture are intangible. CONCLUSION Among NHOPI in Hawai'i who are engaged in case management, there appears to be no substantial disparities in either viral load or satisfaction with care compared to other ethnic groups. Despite this, qualitative findings provide insights on how ethnicity and culture may still be playing a role. Addressing all domains of the BMVP is crucial to addressing this.
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Affiliation(s)
- Misty Pacheco
- Department of Kinesiology and Exercise Sciences, University of Hawaii at Hilo, Hilo, HI, USA
| | - Joy Lynn Agner
- Department of Psychology, University of Hawaii at Hilo, Hilo, USA
| | - Tara K Myers
- Department of Psychology, University of Hawaii at Hilo, Hilo, USA
| | - Jeena Franco
- Department of Kinesiology and Exercise Sciences, University of Hawaii at Hilo, Hilo, HI, USA
| | - John P Barile
- Department of Psychology, University of Hawaii at Hilo, Hilo, USA
| | - Joseph Keawe'aimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Julie A Baldwin
- Center for Health Equity Research and Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
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Mouttapa M, Cunningham M, Tanjasiri SP. Awareness of and Support for HPV Vaccination Among Pacific Islander Women in Southern California. J Cancer Educ 2022; 37:1372-1377. [PMID: 33539008 PMCID: PMC8333191 DOI: 10.1007/s13187-021-01965-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/22/2021] [Indexed: 06/12/2023]
Abstract
Pacific Islander (PI) women experience disproportionately high rates of cervical cancer and mortality and have lower rates of Pap testing. Since up to 70% of cervical cancers could be prevented by being vaccinated for human papilloma virus (HPV), this cross-sectional study explored the predictors of HPV and vaccine awareness, receipt of the vaccine, and attitudes toward vaccinating children among adult PI women in southern California, who historically have low rates of HPV vaccination and high rates of cervical cancer that could be prevented with HPV vaccination. Participants (n=148) consist a subsample of Chamorro, Samoan, and Tongan women, ages 21 to 65 years, who were in a larger randomized community study to promote Pap testing. Overall, younger age and higher American acculturation were significantly associated with ever hearing about HPV and the vaccine. However, American acculturation was also associated with negative attitudes toward vaccinating their children for HPV. This paper provides preliminary insights into barriers and facilitators to HPV vaccination among PIs in the USA and also informs the development of educational programs to reduce cervical cancer incidence and mortality in this underserved population.
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Affiliation(s)
- Michele Mouttapa
- Department of Public Health, California State University, Fullerton, CA, USA.
| | - Melissa Cunningham
- Department of Public Health, California State University, Fullerton, CA, USA
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Daily RS, Vana G'B, Andrade JKL, Pruett J. Evaluating Native Youth: Issues and Considerations in Clinical Evaluation and Treatment. Child Adolesc Psychiatr Clin N Am 2022; 31:779-788. [PMID: 36182224 DOI: 10.1016/j.chc.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This article provides an overview of the clinical evaluation and clinical treatment on multiple levels of American Indian, Alaskan Native, Native Hawaiian, and Pacific Islander youth, and their families. Included are basic cultural beliefs and practices shared among multiple tribes and nations within this diaspora, where the most important concept is balance and harmony in healing. Readers are provided with current practice approaches to core issues of substance abuse, anxiety, depression, and suicidal ideation including case examples, psychopharmacology, and therapy.
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Affiliation(s)
- Rebecca Susan Daily
- Behavioral Health, Oklahoma State University-College of Osteopathic Medicine at the Cherokee Nation, Cherokee Nation, PO Box 948, Tahlequah, OK 74465-0948, USA.
| | - George 'Bud' Vana
- Department of Integrated Psychiatry, University of Washington; Department of Psychiatry & Behavioral Sciences, University of Washington, 2592 Kwina Road, Bellingham, WA 98226, USA
| | - Joy K L Andrade
- Department of Psychiatry, University of Hawaii John A. Burns School of Medicine, 1356 Lusitania Street, UH Tower 4th Floor, Honolulu, HI 96813, USA
| | - John Pruett
- Bellin Health, Green Bay Wisconsin Bellin Psychiatric Center, 301 East Street Joseph Street, Green Bay, WI 54301, USA
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