Building a home in Chicago: Integration and mental health in a newcomer Rohingya refugee community.

OBJECTIVE: Since 2010, approximately 1,000-1,500 Rohingya refugees have resettled in Chicago, Illinois, but there is limited literature on their postresettlement experiences. This study explored the relationship between integration (economic, linguistic, navigational, psychological, and social) and psychological distress among the Rohingya community in Chicago, and how it relates to age and gender. METHOD: This study was conducted in collaboration with the Rohingya Cultural Center in 2019. The survey was verbally administered to Rohingya community members (N = 308; Mage = 37.03; 52% men). A χ² test of independence was used to assess gender differences in employment status. A Generalized Wilcoxon Test was conducted to compare differences in integration and psychological distress among men and women. Multiple γ generalized regression analysis was used to examine psychological distress as the outcome, predicted by integration, age, and gender. RESULTS: Findings showed that men had higher levels of involvement in the labor force than women, as well as higher levels of linguistic integration. Analyses also revealed that women and older participants were more likely to experience psychological distress. Additionally, higher psychological and navigational integration were associated with lower psychological distress. In contrast, lower social integration was significantly associated with lower psychological distress. CONCLUSION: This study points to the importance of a more nuanced approach to integration, given within-group variability along integration dimensions. Community-level interventions should consider the diverse needs of refugees, particularly those of women and older adults. More research is needed to understand these experiences longitudinally and qualitatively. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Internalization of the model minority myth and sociodemographic factors shaping Asians/Asian Americans' experiences of discrimination during COVID-19.

Despite appearing positive, the model minority myth (MMM), or the perception that Asian Americans are "problem-free" minorities, maintains unfair racial hierarchies and discredits the pervasiveness of systemic racism faced by Asian Americans and other Black, Indigenous, and people of Color. This study investigated the role of internalized MMM in Asian/Asian Americans' (A/AA) experiences during the syndemic of COVID-19 and our society's racial reckoning. Using a mixed methods approach, we analyzed A/AA college students' open-ended responses to a query about their experiences as A/AA during COVID-19, which resulted in qualitative themes of Personal and Vicarious Discrimination, Vigilance, Safety due to Ethnicity, Safety due to Environment, and No Difference during COVID-19. We then conducted a series of logistic and linear regression models to examine how internalized MMM and sociodemographic factors (i.e., ethnic group, gender, and generational status) were associated with qualitative themes and quantitative measures of COVID-related discrimination. Overall, findings demonstrated that greater internalized MMM, as well as identifying as South Asian, male, and an international/first-generation immigrant student, were linked to fewer qualitative and quantitative reports of vicarious discrimination. We conclude with implications for research and practice in community psychology that further examine the racialized experiences among A/AA college students and ultimately seek to challenge the MMM and racial hierarchies perpetuating systems of oppression.

Applying culturalist methodologies to discern COVID-19's impact on communities of color.

The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted communities of color (CoC) amid increasing incidents of racial injustices and racism. In this article, we describe our culturalist methodologies for designing and implementing a multi-ethnic, interdisciplinary national needs assessment developed in partnership with CoC. Instead of a typical western-centric social science approach that typically ignores and perpetuates structural racism and settler colonialism, the research team implemented culturalist and community-partnered approaches that were further contextualized to the context of structural racism and settler colonialism. The culturalist approach yielded two sets of themes both related to the impact of the pandemic on CoC. The first set involved syndemic factors that contribute to the adverse impact of COVID-19. These include historical trauma; racism, racial stress, and discrimination; and cultural mistrust. The second set consisted of factors that potentially mitigate the impact of the COVID-19. These include cultural protective factors; community engagement; communal ethos, and data disaggregation. Our methodologies and the resulting findings encourage research praxis that uplifts the shared effects of the social determinants of health while honoring unique cultural and contextual experiences-a lesson that social science researchers largely have yet to learn.

Laying the groundwork for participatory research with a Rohingya refugee community.

Laying the groundwork in preparation for community-based participatory research (CBPR) is critical, particularly for academic-community partnerships with refugees and immigrants who have not yet engaged in CBPR. OBJECTIVE: In this article, we describe the process of developing and nurturing a CBPR partnership between university researchers and a newly arrived Rohingya refugee community, providing background on the community and our collaborative efforts to date. METHOD: Co-occurring, interdependent, and iterative processes related to relationship building, capacity building, and research and informal data gathering helped to develop and promote the partnership. RESULTS: Case study examples illustrate challenges and possible resolutions. CONCLUSIONS: Particularly for newly arrived refugee and immigrant communities, historical disenfranchisement and current stressors can impact how CBPR partnerships are developed and nurtured, thus, ongoing considerations of chronosystemic factors, attending to community-specific priorities while also connecting with other communities, and embracing multiple roles of academic researcher, advocate, and ally, can facilitate CBPR partnership development and future research projects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

An international systematic review of dementia caregiving interventions for Chinese families.

OBJECTIVES: Older Asians and Chinese are among the least studied populations in the dementia caregiving literature. This review seeks to critically synthesize the literature on intervention characteristics, components and tailoring strategies for dementia family caregivers in Chinese communities globally. METHODS: Five electronic databases (PsychINFO, PubMed, CINAHL, ScienceDirect and Google Scholar) were searched for articles published between 1980 and July 2018. The protocol of this review was registered with PROSPERO (CRD42019132800). RESULTS: Twenty-nine unique interventions across 39 papers met inclusion criteria. Results from descriptive and thematic syntheses revealed that most interventions were psychoeducational, CBT-based, multicomponent, structured, and less than a year in duration. Disease education, management of behavioral and psychological symptoms of dementia, stress coping techniques, and referral to community resources were frequently included in interventions. Community-, culture- and language-focused strategies were used to tailor interventions. The most common tailoring strategies were: (a) using community networks and media for outreach and recruitment; (b) making translations and language adaptations to the intervention materials; and (c) focusing on trust and therapeutic alliance. Most interventions produced desired outcomes, particularly reducing caregiver burden and increasing self-efficacy. CONCLUSIONS: To our knowledge, this is the first review to date that systematically synthesized the characteristics and tailoring of dementia caregiving interventions for Chinese families globally. Current findings suggest that most interventions are effective, although many only superficially address Chinese culture. Future research should incorporate Chinese values and cross-cultural challenges into caregiving interventions for deep-level adaptations that could potentially be more effective to engage and support Chinese caregivers.

Perspectives of Chinese American smoker and nonsmoker household pairs about the creating smokefree living together program.

BACKGROUND: Chinese men smoke at high rates, and this puts household members at risk for tobacco-related diseases. Culturally responsive interventions that provide education and support are needed to promote smokefree living and reduce smoke exposure, particularly for US immigrants who experience changes in smokefree social norms. This qualitative study examines perspectives of Chinese American smoker and nonsmoker household pairs in the Creating Smokefree Living Together program. METHODS: Four focus groups were conducted with 30 Chinese American participants (15 smokers and 15 nonsmokers) who, in household pairs, completed smokefree education interventions of either brief or moderate intensity. Nearly three-quarters of the smokers continued to smoke after the intervention at the time of focus group participation. All smokers were male, and most household nonsmokers were female spouses. All participants had limited English proficiency. Focus group meetings were recorded, and the recordings were translated and transcribed. Transcripts and field notes were thematically analyzed. RESULTS: The following themes, shared by smokers and nonsmokers across interventions, were identified: 1) there was a preference for dyadic and group interventions because of the support offered, 2) increased knowledge of the health harms of smoke exposure within a pair improved the nonsmoker's support for smokefree living, 3) learning communication strategies improved household relationships and assertiveness for smokefree environments, 4) biochemical feedback was useful but had short-term effects, and 5) project magnets provided cues to action. CONCLUSIONS: Involving household partners is critical to smokefree interventions. Simple reminders at home appear to be more powerful than personal biochemical feedback of smoke exposure for sustaining motivation and engagement in ongoing behavioral changes within the household. Cancer 2018;124:1599-606. © 2018 American Cancer Society.

Impact of a smoke-free-living educational intervention for smokers and household nonsmokers: A randomized trial of Chinese American pairs.

BACKGROUND: Chinese American men smoke at a high rate, which puts household nonsmokers at risk. The objective of this study was to evaluate the effectiveness of a brief-intensity versus moderate-intensity smoke-free-living educational intervention for household pairs. METHODS: The authors conducted a randomized controlled trial of Cantonese-speaking Chinese American smoker and household nonsmoker pairs in San Francisco, California. Pairs were randomized to moderate-intensity or brief-intensity group sessions with their household partner. The moderate-intensity group received 2 group sessions, a laboratory report of their baseline smoke exposure, as measured by 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and 3 follow-up calls over 6 months. The brief-intensity group received 1 group session on tobacco-cessation resources. Primary outcomes were biochemically validated, past-month smoking abstinence and elimination of nonsmoker household exposure at 12 months. RESULTS: Participant pairs (n = 203) were male smokers, one-half of whom did not intend to quit within 6 months, with mostly female spouses as household nonsmokers. Approximately three-quarters of nonsmokers in both groups already had smoke-free home rules. At 12 months, smokers in both groups had similar biochemically validated 30-day abstinence rates (moderate-intensity group, 0%-20.7%; brief-intensity group, 0%-20.0%; P = .002 over time). More smokers in the moderate-intensity group used subsequent cessation group classes (moderate-intensity group, 50%; brief-intensity group, 24%; P = .004). Household nonsmokers in both groups had similar biochemically validated rates of no home exposure (moderate-intensity group, 24.5%-42.2%; brief-intensity group, 24.8%-33.3%; P = .0001 over time). CONCLUSIONS: A moderate-intensity smoke-free-living educational intervention for Chinese-speaking household pairs was not more effective than a brief-intensity intervention for smoking abstinence and elimination of household nonsmoker exposure. Abstinence rates were similar to those achieved with standard group counseling. Cancer 2018;124:1590-8. © 2018 American Cancer Society.

A Community-Based "Street Team" Tobacco Cessation Intervention by and for Youth and Young Adults.

Most tobacco users initiate use as youth or young adults. To promote tobacco cessation for this group and encourage non-users' engagement in tobacco control efforts, a community-based organization developed a "Street Team" brief outreach intervention that enlisted youth and young adults to encourage their peers to stop tobacco use through a brief intervention. Street Team members provided education, a Quit Kit, and referrals to cessation resources at a total of 27 community events over a four-year period. Tobacco users (n = 279) completed assessments of tobacco use, quit intention, and quit self-efficacy at baseline. Self-reports of cessation outcomes including past week abstinence were assessed 1-, 3-, and 6-months post-intervention. Perceptions of the intervention were gathered from Street Team members (n = 28) and intervention participants post-intervention. T-tests and χ2-tests were used to compare those who completed at least one follow-up assessment to those lost to follow-up. Time effects were analyzed using fixed effect models. Missing = using analyses indicate 16.1, 18.6, and 12.5% 7-day quit rate at 1-, 3-, and 6-months follow-up. Feedback from intervention participants indicate the intervention was acceptable and that discussions with Street Team members and provision of quit kits motivated tobacco users to consider quitting. All Street Team members responded positively to their participation in the intervention. This Street Team approach for youth and young adults is promising as an effective approach to the promotion of tobacco cessation among users and engagement and empowerment in tobacco control efforts among non-users.

Decreases in implicit self-esteem explain the racial impact of microaggressions among Asian Americans.

Asian Americans are commonly perceived as perpetual foreigners and, therefore, not "true" Americans. Asian Americans report inquiries about nationality and English abilities as the most common forms of racial microaggressions perpetrated by White Americans (Sue, 2015). Race theorists assert that these microaggressions are race-related and marginalize Asian Americans. Scholars have claimed that these subtle acts are harmful, yet only a few studies have uncovered the mechanisms by which racial microaggressions affect mental and physical well-being (Ong, Burrow, Fuller-Rowell, Ja, & Sue, 2013; Wong, Derthick, David, Saw, & Okazaki, 2013). The current study conceptualized racial microaggressions as a stressor to address the major gaps in research. Specifically, this study (a) experimentally tested the race-related nature of the microaggression event to determine whether a White American perpetrator would elicit more stress in Asian Americans compared to an Asian American perpetrator and (b) examined threats to explicit and implicit self-esteem as possible mediators of microaggression-generated stress. Findings confirmed that the race of the perpetrator did have an impact on stress among Asian Americans. In the multiple meditation analysis, experience with a White American perpetrator, compared to an Asian American perpetrator, lowered implicit self-esteem, which resulted in more stress. Implications and strategies for counseling Asian American clients are discussed. (PsycINFO Database Record

The interpersonal shame inventory for Asian Americans: scale development and psychometric properties.

This article reports the development and psychometric properties of the Interpersonal Shame Inventory (ISI), a culturally salient and clinically relevant measure of interpersonal shame for Asian Americans. Across 4 studies involving Asian American college students, the authors provided evidence for this new measure's validity and reliability. Exploratory factor analyses and confirmatory factor analyses provided support for a model with 2 correlated factors: external shame (arising from concerns about others' negative evaluations) and family shame (arising from perceptions that one has brought shame to one's family), corresponding to 2 subscales: ISI-E and ISI-F, respectively. Evidence for criterion-related, concurrent, discriminant, and incremental validity was demonstrated by testing the associations between external shame and family shame and immigration/international status, generic state shame, face concerns, thwarted belongingness, perceived burdensomeness, self-esteem, depressive symptoms, and suicide ideation. External shame and family shame also exhibited differential relations with other variables. Mediation findings were consistent with a model in which family shame mediated the effects of thwarted belongingness on suicide ideation. Further, the ISI subscales demonstrated high alpha coefficients and test-retest reliability. These findings are discussed in light of the conceptual, methodological, and clinical contributions of the ISI.

Trends in Racial Discrimination Experiences for Asian Americans During the COVID-19 Pandemic.

BACKGROUND: Asian Americans (AAs) are experiencing increased rates of anti-Asian racism during COVID-19. Experiences of racism, whether personal or collective, constitute stress and psychosocial trauma that negatively impact mental and physical health. OBJECTIVES: Examine subgroup differences in rates of personal experience of discrimination and COVID-related collective racism and how each is associated with mental and physical health for AAs. METHODS: Nationally representative data from the 2021 Asian American and Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Project were used to estimate prevalence rates of discrimination and average COVID-related collective racism scores for AAs (unweighted N = 3478). We conducted logistic and linear regression models to examine subgroup differences by sociodemographic factors. We also conducted hierarchical logistic regression models to examine associations between racism and psychological distress and health decline. RESULTS: Twenty-four percent of AAs (95% CI: 21.6, 25.6) reported experiencing discrimination during the first year of the COVID-19 pandemic. Subgroup analyses revealed that Chinese, younger adults, and AAs who completed the survey in an Asian language were significantly more likely to experience discrimination compared to their counterparts. For COVID-related collective racism, subgroup analyses revealed that Chinese, women, and adults ages 25-44 were more likely to report experiences of collective racism compared to their counterparts. Both discrimination and collective racism were independently associated with negative mental and physical health. CONCLUSION: Discrimination and COVID-related collective racism are associated with negative mental and physical health outcomes for AAs. Results point to vulnerable AA subgroups and the need for targeted public health efforts to address racism in the context of COVID-19.

Profiles of a COVID-19 Syndemic: Anti-Asian Racism, Economic Challenges, and Mental and Physical Health.

BACKGROUND: During the COVID-19 pandemic, Asians/Asian Americans have experienced co-occurring threats of anti-Asian racism, economic challenges, and negative mental and physical health symptoms. OBJECTIVES: We examined the co-occurrence of COVID-19-related anti-Asian discrimination and collective racism, economic stressors, and mental and physical health challenges for Asians/Asian Americans during the COVID-19 pandemic. We also examined Asian/Asian American subgroups associated with these threats. METHODS: Nationally representative data from the 2021 Asian American and Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Project (unweighted N = 3,508) were used to conduct a latent profile analysis to identify unique typologies of the co-occurrence of these threats. We also conducted chi-square analyses to investigate subgroup differences by latent profile. RESULTS: We identified five distinct latent profiles: multi-threat impact, low impact, collective racism, health challenges, and economic/health challenges. Forty percent of Asians/Asian Americans were in the multi-threat impact profile, indicating high levels across COVID-19-related threats. Subgroup analyses revealed significant differences in profile membership. East Asians, US-born Asians/Asian Americans, and those aged 25-44 seemed to be particularly affected by the proposed syndemic; results also differed by income. CONCLUSION: Asians/Asian Americans have experienced co-occurring and interrelated threats during COVID-19 that suggest the presence of a syndemic. Results from our study point to vulnerable Asian/Asian American subgroups and the need for targeted public health efforts to address racism, health challenges, and economic challenges in the context of COVID-19.

Discrimination and psychological distress among Asian Americans during COVID-19: Gender differences in the moderating role of social support.

Our study aimed to assess the role of social support on the impact of discrimination on psychological distress for Asian American women and men. Using the Asian American sample from the Asian American and Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Study (n = 3,508), we used logistic regression to examine the moderating role of different types of social support on the relationship between discrimination and psychological distress by gender. Among Asian Americans, facing discrimination was associated with higher odds of psychological distress, and receiving emotional support was associated with lower odds of psychological distress. When examining interactions between discrimination, social support, and gender, we found that facing discrimination led to the highest odds of psychological distress for Asian American women who provided emotional support. Our findings highlight different mechanisms by which social support buffers and exacerbates the psychological burden of discrimination for Asian Americans. These findings have overall and gender-informed implications for community policies to promote mental health resilience by actively alleviating the effects of racism among Asian Americans. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Examining gender differences for gambling engagement and gambling problems among emerging adults.

Gambling is fast becoming a public health problem in the United States, especially among emerging adults (18-25 year olds). Since 1995, rates have recently doubled with around 7-11 % of the emerging adult population having problems with gambling (Shaffer et al. in Am J Public Health 89(9):1369-1376, 1999; Cyders and Smith in Pers Individ Diff 45(6):503-508, 2008). Some states have lowered their gambling age to 18 years old; in turn, the gambling industry has recently oriented their market to target this younger population. However, little is known about the gender variation and the factors placing emerging adults at risk for getting engaged and developing problems with gambling. The purpose of the study was to determine the risk factors accounting for gender differences at the two levels of gambling involvement: engagement and problems. Mediation analyses revealed that impulsive coping and risk-taking were significant partial mediators for gender differences on engagement in gambling. Men took more risks and had lower levels of impulsive coping than women, and those who took more risks and had lower levels of impulsive coping were more likely to engage in gambling. Risk-taking and social anxiety were the significant mediators for gender differences in problems with gambling. Men took more risks and were more socially anxious than women, and greater risk-taking and more socially anxious individuals tended to have more problems with gambling. Implications for counseling preventions and intervention strategies are discussed.

Smoking cessation counseling for Asian immigrants with serious mental illness: using RE-AIM to understand challenges and lessons learned in primary care-behavioral health integration.

Engagement in modifiable risk behaviors, such as tobacco use, substantially contributes to early mortality rates in individuals with serious mental illness (SMI). There is an alarmingly high prevalence of tobacco use among subgroups of Asian Americans, such as immigrants and individuals with SMI, yet there are no empirically supported effective smoking cessation interventions that have been tailored to meet the unique cultural, cognitive, and psychological needs of Asian immigrants with SMI. In this article, we share the experiences of clinicians in the delivery of smoking cessation counseling to Asian American immigrants with SMI, in the context of an Asian-focused integrated primary care and behavioral health setting. Through a qualitative analysis of clinician perspectives organized with the RE-AIM framework, we outline challenges, lessons learned, and promising directions for delivering smoking cessation counseling to Asian American immigrant clients with SMI.

Mental Health Needs Among Asian and Asian American Adults During the COVID-19 Pandemic.

OBJECTIVE: Disaggregated data on the mental health of Asian/Asian American people are needed to inform public health interventions related to reports of racism during the COVID-19 pandemic. We describe the prevalence of psychological distress and unmet mental health needs among Asian/Asian American adults during the COVID-19 pandemic across various sociodemographic subgroups. METHODS: We used cross-sectional, weighted data from the US-based 2021 Asian American and Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Study (unweighted n = 3508) to estimate prevalence rates of psychological distress and unmet mental health needs, overall and by nativity status. We conducted population-weighted multivariable logistic regression analyses to examine sociodemographic factors associated with these mental health outcomes. RESULTS: About one-third (1419 of 3508) of Asian/Asian American adults (32.9%; 95% CI, 30.6%-35.2%) reported psychological distress; odds of psychological distress were increased among adults who were female, trans, and nonbinary; aged 18-44 years; US-born; Cambodian; multiracial; and low income. Of those reporting psychological distress (638 of 1419), 41.8% (95% CI, 37.8%-45.8%) reported unmet mental health needs; unmet mental health needs were highest among Asian/Asian American adults who were aged 18-24 years; Korean, Japanese, and Cambodian; US-born female; non-US-born young adults; and non-US-born with ≥bachelor's degree. CONCLUSIONS: The mental health of Asian/Asian American people is an important public health concern, with some groups more vulnerable and in need of services than others. Mental health resources need to be designed for vulnerable subgroups, and cultural and systemic barriers to mental health care need to be addressed.

Modes of COVID-19 Information and Vaccine Hesitancy Among Asian Americans: The Moderating Role of Exposure to Cyberbullying.

Introduction: : COVID-19 vaccination is an important public health intervention to curb the pandemic's magnitude and spread, and racial discrimination is a key predictor of COVID-19 preventive behavior, vaccine hesitancy, and uptake. This study evaluated the association of vaccine hesitancy with various modes of information on COVID-19 (i.e., online, social media) and the moderating role of cyberbullying among Asian Americans. Methods: : We used population-weighted data from the nationwide Asian American & Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Survey, which was conducted from January to April 2021 (unweighted n=3,127). We examined the association of various modes of COVID-19 information and vaccine hesitancy, moderated by exposure to cyberbullying. Results: : In general, 16% of Asian Americans reported vaccine hesitancy; 26% reported experiencing cyberbullying. Asian Americans reported receiving the majority of COVID-19 information from online sources (75%) and social media (52%). In unadjusted models, receiving information online (OR=0.46, 95%CI=0.33, 0.62, p<.001), via social media (OR=0.80, 95%CI=0.52, 0.93, p<.05), and via broadcast (OR=0.60, 95%CI=0.44, 0.81, p<.001) were significantly associated with a lower vaccine hesitancy. However, reporting any cyberbullying was associated with increased vaccine hesitancy (OR=1.39, 95%CI=1.02, 1.90, p<.05). The protective effects for COVID-19 information modes remained when accounting for health and sociodemographic factors, while the effect of cyberbullying was no longer statistically significant. Cyberbullying moderated the protective effect of broadcast information only, so those who received information via broadcast and reported experiencing cyberbullying had similar odds of vaccine hesitancy compared to those who did not receive information via broadcast. Conclusions: : Online, social media, and broadcast remain important sources of information about COVID-19 for Asian Americans; however, experiencing cyberbullying can reduce the effectiveness of these sources in the uptake of the vaccine. COVID-19 information promotion strategies for Asian Americans must account for the role of cyberbullying in social media campaigns.

Transgender Clients' Travel Distance to Preferred Health Care: A Clinic-Specific Study.

Purpose: To examine distance traveled to an urban community health center by gender-expansive and cisgender participants. Methods: Client-reported zip code of residence from archival data (N=2677) was used. A chi-square test of independence and a Mann-Whitney-Wilcoxon test were conducted. Results: Gender-expansive clients travel farther to access health care from this clinic; this is true for clients who live within the city, within the state, and in the neighboring states. Conclusion: Trans people experience travel distance as a barrier to accessing quality health care. Broadening telehealth services and working with rural health care providers to develop transition-related health care knowledge are key.

Socioeconomic Inequities in Vaccine Hesitancy Among Native Hawaiians and Pacific Islanders.

Purpose: COVID-19 vaccine hesitancy exists in communities of color who are disproportionately impacted by COVID-19. In many states, Native Hawaiians and Pacific Islanders (NHs/PIs) experience the highest rates of COVID-19 confirmed cases and mortality among U.S. ethnic/racial groups. National trends regarding vaccine hesitancy among NHs/PIs are currently lacking. Methods: Data were derived from the Asian American and NH/PI COVID-19 Needs Assessment Project, a national survey conducted during January-April 2021. The final analytic sample included 868 NH/PI adults. Logistic regression analyses were conducted to estimate odds ratios for vaccine hesitancy. Results: Vaccine hesitancy ranged from 23% among Other PIs to 56.3% among Tongan adults. Younger adults (18-24 and 25-44 years), those with lower educational attainment, and those with lower income were more vaccine hesitant. Overall, education and income showed a strong association with vaccine hesitancy in bivariate logistic models. However, the associations between vaccine hesitancy and education and income varied by NH/PI groups. NHs, Samoans, and Multiethnic NHs/PIs showed the most consistent associations between the socioeconomic position variables and vaccine hesitancy. Conclusions: The examination of vaccine hesitancy among NHs/PIs follows the socioeconomic gradient for some ethnic groups but not others. More studies are needed to determine what other socioeconomic indicators may be associated with health among specific NH/PI ethnic groups. Policy Implications: Reforms are needed to overcome structural racism underlying NH/PI evidence production, which currently renders NHs/PIs invisible. Innovative solutions based on successful community efforts can help deconstruct racist data inequities experienced by NHs/PIs.

Culture in Asian American community psychology: beyond the East-West binary.

In response to a call to better integrate culture in community psychology (O'Donnell in American Journal of Community Psychology 37:1-7 2006), we offer a cultural-community framework to facilitate a collaborative engagement between community psychologists and ethnic minority communities, focusing on Asian American communities as illustrations. Extending Hays' (Addressing cultural complexities in practice: Assessment, diagnosis, and therapy, American Psychological Association, Washington, DC, 2008) ADDRESSING framework for considering cultural influences on a counseling relationship, the proposed framework provides a broad but systematic guidepost for considering three major cultural-ecological influences on Asian American communities: Race and Ethnicity (R), Culture (C), and Immigration and Transnational Ties (I). We provide a sequence of steps that incorporate the ADDRESSING and the RCI frameworks to facilitate the collaborative community-based research or social action.