Challenges and Successes in Health Communication Messaging With Asian Americans.

Asians are the fastest growing racial and ethnic group in the United States, and in Michigan, Asians represent 3.4% of the state's population. Asians have long been aggregated as a homogeneous group and stereotyped as a "model minority." Asians, however, are very diverse, and each subgroup has different values, histories, beliefs, and dialects. The diversity among populations and variations in chronic disease risks demonstrate the importance of disaggregating Asian American ethnicities with respect to health promotion, which must be culturally and linguistically tailored to make the biggest impact. This article describes our challenges and successes in health communication messaging with Asian Americans during the 4 years of our Racial and Ethnic Approaches to Community Health (REACH) Cooperative Agreement.

Food Insecurity and Diabetes: An Investigation of Underserved Asian Americans in Michigan.

Asian Americans are at increased risk for nutrition-related chronic diseases, including type 2 diabetes. The prevalence of type 2 diabetes among Asian Americans in the United States is 16.7% compared to 11.3% among the general U.S. population. Genetic factors such as higher body fat and lower muscle mass result in a predisposition for the development of diabetes at a lower body mass index (BMI). Social determinants including food insecurity and physical environment may also impact risk and need further examination. This study investigated type 2 diabetes-related indicators and food insecurity and satisfaction with types and quality of foods provided through food box distributions with a focus on Asian American populations in Michigan. Data were collected via a survey implemented in partnership with community organizations that administer food box distributions. Nearly half of respondents were not aware that Asian Americans are at increased risk of developing type 2 diabetes. The mean BMI for overall study participants was 25.6, and 61.8% of participants had a BMI of ≥23. Food insecurity was also negatively associated with BMI with study participants who were overweight reporting less food insecurity. Overall, participants reported being satisfied with both the types and quality of foods provided in the food boxes. Findings support the need for increased diabetes education and testing among Asian Americans and assessment of the types of culturally relevant foods offered by food distribution organizations.

Utilizing Listening Sessions to Assess COVID-19 Vaccine Acceptance among Asian Americans in Michigan.

SARS-CoV-2 (COVID-19) hospitalizations and deaths have been in the forefront of healthcare and public health for the past two years. Despite widespread vaccinations campaigns, infection rates and serious illness and death remain high among immigrant and minority communities. There are many factors that increase the risk of hospitalization and death, including overall health of the individual as well as environmental and socioeconomic factors. Seven virtual listening sessions with 39 Asian American adults were conducted to assess acceptance of COVID-19 vaccines. Lack of access, confusion on eligibility, distrust of mass vaccination sites, and fear of long-term side effects were primary barriers to vaccine acceptance. Perspectives on the vaccines varied by ethnic groups, with Bangladeshi and Yemeni participants more likely to have negative views. Our findings show that while national statistics of the broad category "Asian" indicate higher COVID-19 vaccination rates than other minority groups, there are Asian ethnic groups that may not follow these trends. These groups are important to prioritize as they may be at increased risk for exposure and severe illness. However, these groups can be difficult to access for reasons such as language barriers and cultural norms. Information from these listening sessions was used to create resources and programs to clarify misconceptions and increase access to COVID-19 vaccines.

Perceptions of COVID-19 Vaccine, Racism, and Social Vulnerability: An Examination among East Asian Americans, Southeast Asian Americans, South Asian Americans, and Others.

As COVID-19 vaccines are readily available and most U.S. adults who are enthusiastic about the vaccine have received it, motivating those who have not been vaccinated to accept it has become a challenge. The purpose of this study was to understand the mechanisms behind COVID-19 vaccine acceptance in Asian American ethnic groups, including how sociodemographic characteristics and racism predict COVID-19 and vaccine perceptions. The study also examined associations between social vulnerability and COVID-19 and vaccine perceptions. Social vulnerability is defined as the degree to which a community is able to prepare and respond to a natural or man-made disaster. This cross-sectional study used community-based survey data collected from April to September 2021. Study measures included demographics, perceptions of COVID-19 and COVID-19 vaccines, and racism-related experiences. The results showed that, compared to Non-Asians, East Asians reported that they had significantly more challenges accessing COVID-19 vaccines, and South Asians reported significantly higher safety concerns about COVID-19 vaccines. Our study also found that racism experience mediates the association between race/ethnicity and safety concerns about COVID-19 vaccines. Three Asian subgroups (East Asians, South Asians, and Southeast Asians) experienced more racism (compared to Non-Asians), and more experience of racism was related to greater safety concerns. Geographical Information System (GIS) maps revealed that residents of lower social vulnerability index (SVI) areas reported fewer unfairness perceptions and that higher SVI areas had lower vaccine accessibility and trust in public health agencies. Our study advances the understanding of racism, social vulnerability, and COVID-19 vaccine-related perceptions among Asian Americans. The findings have implications for policymakers and community leaders with respect to tailoring COVID-19 program efforts for socially vulnerable populations and Asian American groups that experience greater challenges regarding vaccine safety concerns and accessibility.

Using Community Engagement and Geographic Information Systems to Address COVID-19 Vaccination Disparities.

The COVID-19 pandemic has exacerbated existing health disparities and had a disproportionate impact on racial and ethnic minority groups in the United States. Limited COVID-19 data for Asian Americans have led to less attention for this population; nevertheless, available statistics have revealed lesser known impacts of COVID-19 on this population. Even with significant increases in vaccine supply and recent increases in COVID-19 vaccination rates, racial and ethnic disparities in vaccine uptake still persist. These disparities are amplified for individuals with limited English proficiency (LEP). The purpose of this paper is to apply community-engaged and geographic information system (GIS) strategies to increase equitable access to COVID-19 vaccination uptake by decreasing the structural barriers to COVID-19 vaccine uptake, with a particular focus on Asian Americans with LEP. Building upon existing community-academic partnerships between the academic unit and community-based organizations, the project team established community-led mobile and pop-up COVID-19 vaccination clinics to reach underserved individuals in their communities, worked with commercial pharmacies and reserved appointments for community-based organizations, used GIS to establish COVID-19 vaccination sites close to communities with the greatest need, and deployed trusted messengers to deliver linguistically and culturally relevant COVID-19 vaccine messages which built vaccine confidence among the community members. The implementation of mobile clinics expanded COVID-19 vaccine access and community-driven, multi-sector partnerships can increase the capacity to enhance efforts and facilitate access to COVID-19 vaccination for hard-to-reach populations.