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PURPOSE: Alternative high schools (AHS) are designed to provide individualized education, more flexible scheduling, and smaller class sizes for students referred out of traditional high school. AHS students report higher levels of substance use (SU) and face disproportionately higher levels of trauma and toxic stress than their traditional high school peers. We sought to examine whether generational immigration (GenIm) status modifies the association of mental health and SU among AHS students using a longitudinal study of 1,060 Southern California AHS students. METHODS: Subscales from the 21-item Depression Anxiety Stress Scale were administered. Effect modification was examined by GenIm status defined as first generation (born outside of the United States), second generation (born in the United States with a parent born outside the United States), or third generation (born in the United States with US-born parent(s)). Main outcomes included the number of times different substances were used in the past year over a 3-year period. RESULTS: Multilevel, negative binomial, covariate-adjusted latent growth curve models generated incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of the time-varying association between depression, anxiety, or stress and the use of cigarettes, e-cigarettes, cigars, alcohol, or marijuana. Multiple-group models examined effect modification by GenIm status. DISCUSSION: The link between mental health and SU was stronger among first- and second-generation students than third-generation students. For example, a one-unit increase in stress relative to the average stress of students from the same school was associated with an increase in the rate of e-cigarette use among first-generation (IRR = 2.03, 95% CI = 1.07-3.85), second-generation (IRR = 2.25, 95% CI = 1.86-2.72), and third-generation (IRR = 1.68, 95% CI = 1.31-2.16) students. Effective strategies tailored to subgroups of AHS students are needed to counter disparities between traditional and alternative school systems that may contribute to long-term trajectories of SU.
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Evaluators utilize a variety of qualitative and quantitative methods to assess outcomes and make recommendations; however, we were unable to find any reference in the literature regarding the incorporation of oral histories for evaluation purposes. Based on our use of oral histories to evaluate a Critical Race Theory (CRT)-based undergraduate research and mentoring program, we learned how oral histories can be used effectively-and meaningfully-for evaluations seeking a deeper understanding of the program participants' lived experiences. By sharing our (and our narrators') experiences as we delved into this new methodology, as well as lessons learned about the benefits, limitations, and considerations when incorporating oral histories into evaluations, we show how both can be adapted to honor oral history while also meeting our evaluation needs.
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BACKGROUND: Lung cancer represents the leading cause of cancer death for Pacific Islanders in the United States, but they remain underrepresented in studies leading to the lack of evidence-based cessation programs tailored to their culture and lifestyle. OBJECTIVES: This paper aims to describe the development of culturally tailored and community informed recruitment materials, and provide lessons learned regarding implementation and adaptation of strategies to recruit Pacific Islander young adult smokers into a randomized cessation study. METHODS: Development of recruitment materials involved a series of focus groups to determine the cessation program logo and recruitment video. The initial recruitment strategy relied on community-based participatory research partnerships with Pacific Islander community-based organizations, leaders and health coaches with strong ties to the community.Results/Lessons Learned: While the recruitment materials were well received, initial strategies tapered off after the first 3 months of recruitment resulting in the need to revise outreach plans. Revised plans included the creation of a list with more than 200 community locations frequented by Pacific Islander young adult smokers, along with the hiring of part-time recruitment assistants who reflected the age and ethnicities of the desired cessation study participants. These materials and strategies ultimately yielded 316 participants, 66% of whom were recruited by the revised strategies. CONCLUSIONS: Community-based participatory research approaches not only inform the design of culturally tailored intervention recruitment material and strategies, but also result in innovative solutions to recruitment challenges to address the National Cancer Institute's gaps in science regarding small populations.
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Pueblos Isleños del Pacífico , Ensayos Clínicos Controlados Aleatorios como Asunto , Cese del Hábito de Fumar , Humanos , Adulto Joven , Investigación Participativa Basada en la Comunidad , Etnicidad , Selección de PacienteRESUMEN
Recent studies have found high levels of stress among Americans, particularly amongst young adults and ethnic minority groups. The purpose of this secondary data analysis was to explore the association between stress and social support among a sample of 276 young adult smokers of Pacific Islander ancestry, specifically Samoans and Tongans with an average age of 25.3 years. Previous research had documented the protective role of social support on stress, and thus it is hypothesized that young adult Pacific Islander smokers who perceived higher levels of social support will have less perceived stress. Social support was assessed using a 12-item scale which measured participant's perceived social support from family, friends, and significant others. Perceived stress was measured using a 10-item scale with 2 subscales - self efficacy and helplessness. Standardized parameter estimates from structural equation modeling indicated a statistically significant inverse relationship between perceived social support from family and perceived stress related to helplessness. More specifically, young adult Samoans and Tongans who report higher levels of social support from family do not feel as much stress stemming from being helpless. The results highlight the importance of family social support on stress management among this population. Most importantly, these findings add to the limited research around mental health within Pacific Islander (Samoan and Tongan) communities in the US.
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Etnicidad , Pueblos Isleños del Pacífico , Humanos , Adulto Joven , Estados Unidos , Adulto , Fumadores , Grupos Minoritarios , Apoyo SocialRESUMEN
Health outcomes for Asian American subgroups are often aggregated, masking unique experiences and disparities exacerbated by the COVID-19 pandemic, specifically among Filipino Americans (FilAms). The FILLED (Filipino Lived Experiences during COVID-19) Project launched a cross-sectional online survey between April-August 2021 among FilAm adults in Southern California to document community issues and outcomes during the pandemic. Among 223 participants, 47.5% were immigrants, 50.9% identified as essential workers, and 40.6% had a pre-existing health condition before the pandemic. Despite high rates of health insurance (93.3%), 24.4% of the sample did not have a regular health care provider. During the pandemic, 32.7% needed mental health help but did not get it and 44.2% did not know where to get such services. Most respondents felt that the COVID-19 vaccination was a personal responsibility to others (76.9%) and the majority had received at least one dose of a COVID-19 vaccine (82.4%). Regarding COVID-19 impact, participants reported moderate-severe changes in their daily routines (73.5%), access to extended social support (38.9%), housing issues (15.4%), and access to medical care (11.6%). To our knowledge, this study is the first community-driven effort highlighting FilAm community experiences in Southern California, where the highest proportion of FilAms in the United States reside, specifically after the COVID-19 vaccine was made widely available. The observational findings may help community leaders, policy makers, and public health researchers in the design, development, and implementation of post-pandemic intervention strategies used by community-partnered projects that address FilAm and sub-Asian group health disparities at grassroots to societal levels.
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COVID-19 , Adulto , COVID-19/epidemiología , Vacunas contra la COVID-19 , Estudios Transversales , Personal de Salud/psicología , Humanos , Pandemias , Estados UnidosRESUMEN
Objective: To explore and document the experiences and impacts of COVID-19 among Pacific Islander (PI) adults living in Los Angeles County. Methods: Study participants completed a brief online demographic questionnaire followed by a 45- to 60-min semi-structured one-on-one interview conducted via Zoom. Participants were asked about two main areas: (1) reasons for high rates of COVID-19 cases among the PI community and its impacts on their community and (2) the impacts of COVID-19 on them as individuals. Results: A total of 14 PI adults, a majority of whom were females (76%) with an average age of 39.2 years took part in the study. Participants cited underlying medical conditions, overrepresentation in the essential workforce, multigeneration households, and the collectivistic culture of PIs as possible reasons for high rates of COVID-19 cases in their communities. Impacts of the pandemic included loss of jobs, loss of family and friends, and poor mental health which have been exacerbated by the pandemic. Conclusion: This study documents the perspectives of PIs on why rates of COVID-19 are high in their community, their experiences with COVID-19 testing, and the impacts that the pandemic has had on themselves and their community. Findings from this study will assist public health professionals and health care providers in refining services and programs for the PI community.
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Faculty at teaching institutions carry high teaching loads, leaving little time to write manuscripts or grant applications, let alone getting them published or awarded. This manuscript describes the impact of protected writing time for faculty at a higher education, teaching institution who committed to focused, uninterrupted writing time on a weekly basis and exchanged writing challenges and tips with colleagues. A mixed methods approach was used to assess the impacts of the writing group which found increased productivity (manuscripts and publications, proposals and grants) and sense of a research community with enhanced structural knowledge, camaraderie, and morale.
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This study tested the feasibility of collecting saliva samples from Pacific Islanders (PIs) via a community-based participatory research approach. Collection of saliva samples were conducted by trained and trusted PI community leaders at various partner sites. A total of 214 saliva samples were donated by PIs living in Southern California, more than half of whom were females between the ages of 18 and 35 years. Donors indicated that they donated because they wanted to help science and their community. A majority of donors reported a very positive experience with the donation process and were willing to donate saliva and hair samples in the future. The positive findings of this article highlight the importance of community input and participation.
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Investigación Participativa Basada en la Comunidad/organización & administración , Conocimientos, Actitudes y Práctica en Salud , Nativos de Hawái y Otras Islas del Pacífico , Manejo de Especímenes/métodos , Manejo de Especímenes/psicología , Adolescente , Adulto , Femenino , Humanos , Masculino , Saliva/citología , Confianza , Adulto JovenRESUMEN
INTRODUCTION: Despite the high burden of tobacco-related diseases experienced by Samoans and Tongans, there is relatively little understanding of the factors that influence their smoking behaviors which could inform effective smoking cessation strategies. This study examined several psychosocial characteristics that intertwine to predict smoking patterns in these Pacific Islander subgroups. METHODS: Samoans and Tongans between the ages of 18 and 33, who consumed at least 100 cigarettes in their lifetime and were current smokers, were categorized as light, moderate, or heavy smokers. Baseline data from a randomized controlled smoking cessation trial were analyzed. Participants (nâ¯=â¯278) were measured on self-efficacy, perceived stress, sensation seeking, hostility, depression, and impulsivity. Least square means estimated from General Linear Models were used to compare psychosocial characteristics across smoking groups, as well as by gender and ethnicity. RESULTS: Samoan male heavy smokers reported higher levels of self-efficacy compared to light smokers, and greater stress, hostility, depression, and urgency over moderate smokers. Samoan female heavy smokers demonstrated greater stress and hostility than moderate and light smokers. Tongan female heavy and light smokers had significantly elevated levels of sensation seeking compared to moderate smokers. Tongan male smokers did not display any meaningful associations with these psychosocial constructs. CONCLUSIONS: This study underscores the important distinctions between smoking patterns, gender, and ethnic subgroups. Interventions that rely on aggregated smoking profiles or general Pacific Islander data may not adequately address the complex array of mental health factors that contribute to tobacco use.
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Despite increasing rates of cancer, biospecimen donations for cancer research remains low among Pacific Islanders (PIs). To address this disparity, researchers partnered with PI community organizations to develop and test a theory-based culturally tailored educational intervention designed to raise awareness about the issues surrounding biospecimen research. A total of 219 self-identified PI adults in Southern California were recruited to participate in a one-group pre-post design study. Participants completed questionnaires that assessed their knowledge and attitude regarding biospecimen research before and after viewing an educational video and receiving print materials. Results showed that participants' overall knowledge and attitude increased significantly from pre-test to post-test (p < .0001). Over 98% of participants also reported that they would be willing to donate at least one type of biospecimen sample. Efforts such as these that utilize culturally tailored education interventions may be instrumental in improving biospecimen donation rates in the PI community as well as other minority populations.
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Bancos de Muestras Biológicas/organización & administración , Educación en Salud/métodos , Conocimientos, Actitudes y Práctica en Salud , Nativos de Hawái y Otras Islas del Pacífico/educación , Neoplasias/etnología , Participación del Paciente/estadística & datos numéricos , Obtención de Tejidos y Órganos/estadística & datos numéricos , Adolescente , Adulto , Bancos de Muestras Biológicas/tendencias , California/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/terapia , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Pacific Islanders (PIs) have one of the highest rates of cigarette use, but evidence-based smoking cessation programs designed specifically for PIs are practically nonexistent. OBJECTIVES: This paper reports on the development of a culturally tailored smoking cessation curriculum designed specifically for young adult PIs using a community-based participatory research (CBPR) approach. This paper demonstrates the shared leadership and equal contribution of community and academic partnerships. METHODS: Together community and academic partners conceptualized and developed a smoking cessation curriculum. Data from formative studies shaped the various components of the educational modules. RESULTS: Eight educational modules were developed through CBPR. Information on the dangers of cigarettes, benefits to cessation, and ways to cope with cravings and stress through cognitive behavioral therapy were offered in both narrative and non-narrative formats. CONCLUSIONS: Use of CBPR is critical in the development of the curriculum because it allowed for the sharing of ideas and knowledge between academics and community members.
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Curriculum , Educación en Salud/organización & administración , Internet , Nativos de Hawái y Otras Islas del Pacífico/educación , Cese del Hábito de Fumar/métodos , Investigación Participativa Basada en la Comunidad , Relaciones Comunidad-Institución , Competencia Cultural , Práctica Clínica Basada en la Evidencia , Disparidades en el Estado de Salud , Humanos , Nativos de Hawái y Otras Islas del Pacífico/psicología , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Fumar/etnología , Adulto JovenRESUMEN
BACKGROUND AND SIGNIFICANCE: Despite high rates of chronic diseases like cancer, diabetes and cardiovascular disease, Pacific Islanders (PIs) are underrepresented in clinical and genetic studies designed to identify the physiological causes of poor health outcomes. There are limited genetic data and biospecimen samples from PIs under study. This paper described why PIs have reservations about donating their biospecimen samples for research. METHODS: Data were drawn from a pilot study designed to assess the knowledge, attitudes and beliefs surrounding biospecimen research among PIs in southern California. Utilizing a community-based participatory research approach, community and academic partners collected quantitative and qualitative data from a total of 60 PI adults with a mean age of 61 years (SD 13 years). RESULTS: "Fear", "God or Spirituality" and "Lack of Information or Knowledge" were the most cited reasons for not participating in biospecimen research. Respondents younger than age 65 years expressed more concerns about donating their biospecimen samples than those older than age 65 years (p<0.012). No significant gender differences were found (p=0.84). CONCLUSION: Our results emphasize the need to conduct relevant and appropriate biospecimen education among minority communities in order to address misconceptions and build support to increase PI and other minority participation in biospecimen-related studies.
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OBJECTIVE: To examine the association between individual drug use and peer leaders use. METHOD: Analysis of drug use behaviors of 525 students randomized into three arms-control, standard, and networked where peers serve as group leaders. RESULTS: Among the combined male and female group, there was no association between peer leader and individual use. Among males, peer leader use at baseline was positively associated with individual alcohol use at post-test. Among females, peer leader use at post-test was negatively associated with marijuana and cigarette use. CONCLUSION: Having peer leaders in the network condition decreased the odds of marijuana and cigarette use among females. The opposite effect was found in males.
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Conducta del Adolescente/psicología , Alcoholismo/psicología , Liderazgo , Abuso de Marihuana/psicología , Grupo Paritario , Fumar/psicología , Adolescente , Alcoholismo/epidemiología , California/epidemiología , Femenino , Humanos , Modelos Logísticos , Masculino , Abuso de Marihuana/epidemiología , Instituciones Académicas , Factores Sexuales , Fumar/epidemiología , Apoyo Social , Factores Socioeconómicos , Estudiantes , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
Objectives. The purpose of this article is to describe a community-based participatory research pilot project conducted to investigate the knowledge, attitudes, and beliefs that Pacific Islanders (PIs) hold toward biospecimen collection, use, and banking, all of which will help drive higher PI participation rates in both medical and behavioral research studies. Method. Academic and community partners worked side by side to develop a conceptual model, study measures, and study protocols. PI community partners screened, recruited, and conducted data collection, which consisted of a paper-and-pencil survey and a 1-hour semistructured interview administered by trained community workers. Results. A total of 60 PI adults representing various PI ethnic groups completed the surveys and interviews. Results showed a general support for biospecimen studies that would benefit the community, and many are willing to provide their biospecimen samples if asked. Conclusion. Due to the established level of trust, community partners were able to successfully recruit and collect data for the study. Many of those interviewed also called for more outreach and education about the importance of biospecimen research in their communities.