Dissemination of colorectal cancer information among Hispanic patients and their social network.

BACKGROUND: Colorectal cancer (CRC) screening decision aids can inform patients about CRC screening benefits, costs, and procedures. Patients who receive the decision aid report wanting to share the information with their families and friends. We evaluated a CRC screening decision aid on Hispanic patients' communication to their alters and whether patient-alter communication leads to alters' CRC screening intention. METHODS: We conducted a one-arm pre/post study of Hispanic patients and their alters; patients (n = 42) and their alters (n = 19) were recruited from a clinic site in Yakima County, Washington State. Patients viewed a CRC screening decision aid at the clinic site. Survey data from patients and alters were collected via telephone including patients' communication with their alters about CRC screening after viewing the decision aid and alters' intention to be screened for CRC after talking to the patient. RESULTS: Most participants reported sharing CRC information with their alters after viewing the decision aid, and most alters confirmed they had received CRC information from participants (68%). The decision aid was associated with participants' own intention to undergo CRC screening and with alters' intention to be screened for CRC using a fecal occult blood test (p = 0.014) and sigmoidoscopy (p = 0.011). CONCLUSIONS: Patient decision aids have the potential to increase CRC screening behavior beyond the decision aid recipients to their social network. TRIAL REGISTRATION: Trials Registration Number: NCT04444232 "Retrospectively registered."

Factors impacting implementation of nutrition and physical activity policies in rural schools.

BACKGROUND: Rural Latino children have higher rates of obesity compared to non-Latino Whites. Schools are in a unique position to address rural childhood obesity through policies. While evidence exists on factors that promote or impede school-based physical activity (PA) and nutrition policies, only a fraction has been in rural communities. This study seeks to understand 1) the knowledge and perceptions of school nutrition and PA policies and 2) barriers and facilitators to their implementation among rural school stakeholders from Washington State. METHODS: We conducted 20 semi-structured, in-depth interviews with school stakeholders (e.g., principals and school nutrition directors) from four K-12 school districts in the Lower Yakima Valley of Eastern Washington State. Thematic analysis was conducted using inductive, constant comparison approach to identify themes around knowledge and perceptions of policies and barriers and facilitators of policy implementation. RESULTS: Three main themes were identified: perceptions and knowledge of school PA and nutrition policies, barriers to policy implementation, and facilitators of policy implementation. The majority of stakeholders were supportive of school-based policies promoting PA and a healthy diet, even when lacking a specific understanding of these policies. Four subthemes were identified as barriers to policy implementation: viewing PA as a low priority, misuse of recess time, funding constraints, and lack of strong leadership. Facilitators of implementation included strong leadership at the district level, creating healthy norms through school-community linkages and pooling community resources to improve nutrition and PA among children. CONCLUSIONS: Schools provide a unique setting to promote healthy diet and PA behaviors among children and their families. Study findings show that while knowledge of specific nutrition and PA policies may vary, support for such policies were high among rural stakeholders. Study findings can inform policy development and support strategies for policy implementation in rural settings. Future studies may want to examine whether implementation of strategies addressing the barriers and enhancing facilitators lead to success in rural school settings.

When home becomes classroom: The shifting roles of Korean immigrant mothers in the management of children's education during COVID-19 in the US.

COVID-19 has disrupted women's lives by increasing their childcare and household labor responsibilities. This has detrimentally affected immigrant women with limited resources, who invest in their children's education for upward mobility. Based on a content analysis of 478 posts on the MissyUSA website, this study explores the ways in which Korean immigrant mothers in the U.S. navigate the management of middle and high school children's online education during lockdown. Before the pandemic, mothers' tasks were largely limited to scheduling and coordinating private-paid after-school programs that occurred outside the home. However, the pandemic transformed mothers into active coordinators of public middle and high school classes and of private online tutoring, and de facto schoolteachers at home. This breakdown of boundaries between the home and tasks normally relegated to the outside world has burdened mothers with augmented roles managing the ordinary functioning of their children's education during the pandemic.

The impact of medical tourism on cervical cancer screening among immigrant women in the U.S.

BACKGROUND: Research on the relationship between medical tourism-traveling abroad for healthcare and cervical cancer screening is lacking. This study examines (1) the association between medical tourism and cervical cancer screening among immigrant women and (2) whether the association varies across years in the U.S. METHODS: We analyzed the New Immigrant Survey data of immigrant women aged 21-65 (n = 999). The outcome was having had a Pap smear since becoming a permanent resident, and the main predictor was medical tourism. Logistic regressions were conducted. RESULTS: Immigrant women who engaged in medical tourism had higher cervical cancer screening rates compared to those who did not engage in medical tourism (84.09% vs. 71.68%). This relationship was statistically significant only among women who have recently immigrated, after controlling for covariates. CONCLUSIONS: Immigrant women who engaged in medical tourism had 2.18 higher odds of receiving a Pap smear than immigrant women who did not, after controlling for other covariates. Health educators should be aware of the practice of medical tourism and consider providing education on adherence to cancer screening guidelines and follow up abnormal results to ensure that immigrant women receive continuous cancer care.

Development of a theory-based HPV vaccine promotion comic book for East African adolescents in the US.

BACKGROUND: Human Papillomavirus (HPV) vaccine uptake is low among East African adolescents in the US. Adolescents' preferences influence HPV vaccine decisions, yet few interventions exist that address East African adolescents' beliefs about HPV vaccines. We describe a multi-step process on how to create a theory-based comic book by integrating empirical findings, theory and focus group data from East African parents in the US. METHODS: Our multi-methods process included conducting focus groups with Somali, Ethiopian, and Eritrean mothers (n = 30) to understand mothers and adolescents socio-cultural beliefs and information needs about the HPV vaccine, creating comic book messages integrating the focus group findings, and assessing the acceptability of the finalized comic book among Somali, Ethiopian, and Eritrean adolescents (n = 134). RESULTS: We identified categories around socio-cultural beliefs (such ethnic representation and concerns about pork gelatin in vaccines), HPV vaccine information needs, and diffusion of information. We then mapped the categories to theoretical constructs and operationalized them into the comic book. Finally, we describe the overall acceptability of the comic book and specifics on comic book structure, appeal of characters, and message relevance. CONCLUSIONS: A rigorous multi-step process that integrates theory and focus group data can help create culturally appropriate health messages that can educate and appeal to the community.

Enhancing or Compensating? Role of On- and Offline Social Capital and Technological Self-Efficacy on Subjective Well-Being among Immigrants and Natives.

The ability and self-efficacy to utilize the internet and technological devices has become critical during the COVID-19 pandemic. By examining the role of on- and offline social capital as a moderator in the relationship between technological self-efficacy (TSE) and subjective well-being, this study aims to contribute to the understanding of whether the social compensation or social enhancement hypotheses explain the well-being of immigrants in South Korea during the COVID-19 pandemic. We analyzed data from the 2020 Digital Divide Survey of immigrants (n = 700) and native-born Koreans (n = 6,910) aged ≥18 years. In the ordinary least squares regression model, subjective well-being (SWB) was the dependent variable and TSE was the independent variable. Online social capital, including bonding and bridging, was the moderating variable. Moreover, we tested the moderated moderation of nativity and on- and offline social capital. The results showed that bonding and bridging on- and offline social capital played a positive role in the SWB of both immigrants and native-born Koreans; bridging played a greater role among immigrants than among native-born Koreans. Furthermore, the interaction between TSE and online bonding social capital has a stronger association with the SWB of immigrants, as supported by the moderated moderation model. In line with the social enhancement hypothesis, immigrants with more online bonding social capital showed a stronger positive association between TSE and subjective well-being. Our results suggest that culturally adapted technological education for immigrants can be tailored to meet their unique needs and experiences.

Does social empathy moderate fear-induced minority blaming during the COVID-19 pandemic?

This study investigated the minority-blaming phenomenon in South Korea during the COVID-19 pandemic. The pandemic amplified fear, discrimination, and structural inequalities among minoritized groups during the COVID-19 pandemic. This study identified who was blamed for the spread of COVID-19 and the sociodemographic characteristics associated with this blame. Additionally, it examines the roles of individual and interpersonal fear and social empathy in minority blaming. We measured the fear of COVID-19 at both individual and interpersonal levels. Individual fear was assessed through personal health concerns, while the fear of transmitting the virus to others was measured as interpersonal fear. Social empathy was defined by macro perspective-taking, cognitive empathy, self-other awareness, and affective responses. The study was conducted through an online survey involving a quota sample of 1,500 South Korean participants aged 19-69 years, based on age, gender, and residential area. The response was collected in December 2020, when mass infections in specific communities received attention from mass and social media before the national spread of the COVID-19 pandemic. Analytical strategies, including OLS and hierarchical regression models, were employed to examine the roles of socioeconomic factors, individual and interpersonal fear, and social empathy in minority blaming. This study found varying correlations between sociodemographic factors and attitudes toward ethnic, religious, sexual, economic, and age-minority groups. Individual fear of contracting COVID-19 was associated with increased blame across all minority groups. In contrast, interpersonal fear was associated with increased blame only for ethnic and religious minority groups. Similarly, social empathy presented mixed associations, as it displayed a buffering role on blaming ethnic, religious, and sexual minorities when considered alongside interpersonal fear, yet mildly intensified blame for economic and age minorities. These findings provide an understanding on fear-induced minority blaming during the pandemic and the potential role of social empathy in mitigating blame.

Stalking Discourse on Reddit: A Comparative Analysis of Pre- and Post-COVID-19 Pandemic Using Big Data.

Stalking, a widespread and distressing phenomenon, has recently garnered considerable attention. The advent of digital platforms has revolutionized the landscape of stalking, presenting new avenues and challenges for research. However, the impact of the coronavirus disease (COVID)-19 pandemic on stalking remains underexplored, despite extensive studies on similar crimes such as intimate partner violence and domestic violence. To address this gap, our study focused on Reddit, a prominent online platform with a diverse user base and open discussion. Through an analysis of posts from the subreddit (https://www.reddit.com/r/Stalking/), we sought to compare the discourse on stalking before and after the COVID-19 pandemic. We found notable shifts in stalking-related posts before and after the COVID-19 pandemic, particularly with the emergence of new topics centered on cyberstalking. We also observed that the experiences of stalking victims have significantly changed following the COVID-19 pandemic. Based on our findings, we discussed the implications for policies to help stalking victims.

Understanding and comparing risk factors and subtypes in South Korean adult and adolescent women's suicidal ideation or suicide attempt using survey and social media data.

Objective: This study aimed to investigate the similarities and differences in risk factors for suicide among adult and adolescent women in South Korea and identify subtypes of suicidal ideation or suicide attempt in each group. Methods: Multifaceted data were collected and analyzed by linking survey and social media data. Interpretable machine learning models were constructed to predict suicide risk and major risk factors were extracted by investigating their feature importance. Additionally, subtypes of suicidal adult and adolescent women were identified and explained using risk factors. Results: The risk factors for adult women were primarily related to mental disorders, while those for adolescent women were primarily related to interpersonal experiences and needs. Two subtypes of suicidal adult women were one with high psychiatric symptoms and mental disorders of them and/or their families and the other with excessive social media use and high online victimization. Two subtypes of suicidal adolescent women were one with high psychiatric symptoms, high ACEs, and high social connectedness, and the other with frequent social media use, high online sexual victimization, and high social assurance. Conclusions: These findings enable a stratified and targeted understanding of suicide in women and help develop customized suicide prevention plans in South Korea.

"I can wait until I return home": healthcare utilization among Korean international students in the U.S.

ObjectiveThis study aimed to understand healthcare utilization behavior among Korean international students in the U.S. Participants and methods: Seventeen Korean international students in New York City participated in in-depth personal interviews. Results: The participants passively utilized U.S. healthcare by minimizing, avoiding, or delaying needed healthcare. However, they actively utilized transnational healthcare (in Korea) as an alternative strategy. Participants' negative perception of the U.S. healthcare system (as a predisposing factor) influenced healthcare utilization in the U.S. The enabling transnational factors influenced their transnational healthcare utilization. Low perceived need for healthcare (as a need factor) determined the country where they utilized healthcare. Conclusion: Andersen's healthcare utilization model is applicable in explaining healthcare utilization behavior among Korean international students, who could be considered a nontraditional vulnerable population. On-campus health education and promotion may help international students receive timely healthcare, especially those who do not return to their home country routinely.

Perceived household financial decline and physical/mental health among adolescents during the COVID-19 crisis: Focusing on gender differences.

COVID-19 has worsened adolescents' mental and physical health. Several studies have reported that the effect may be greater in girls; however, relevant socio-ecological factors have not been examined. This study aimed to examine the factors associated with physical and mental health status among adolescents and the moderating role of gender on the relationship between physical and mental health status and perceived household financial decline. We analyzed the cross-sectional 2020 Korea Youth Risk Behavior Web-based Survey (KYRBS) collected between August and November 2020 in South Korea. It included 54,809 adolescents (28,269 males and 26,540 females), on average aged 15.1. We conducted ordinary least squares (OLS) regressions to examine the factors associated with physical and mental health outcomes. Gender differences were observed in associated factors. Then, we tested the moderating effect of gender by including an interaction term between gender and perceived household financial decline due to the COVID-19 pandemic. Perceived household financial decline due to COVID-19 negatively affected both groups. Perceiving moderate and severe financial decline due to COVID-19 is negatively associated with self-rated health among female adolescents than male counterparts. Female adolescents were also more vulnerable to mental health outcomes (i.e., distress, anxiety, and loneliness) when they perceived severe or moderate household financial decline due to COVID-19 compared to their male peers. Our findings suggest that female adolescents are more vulnerable to household financial shocks due to COVID-19, especially in households that have experienced a severe decline. We suggest the need for gender-sensitive policy interventions for adolescent mental health.

Stress or Buffer: The Impact of Social Transnational Ties on Depressive Mood and Suicidal Ideation Among Female Marriage Migrants in South Korea.

This study examines whether and to what extent transnational ties with the home country influence female marriage migrants' depressive mood and suicidal ideation in South Korea. We analyzed the multicultural adolescent panel survey (2011-2018), which included multicultural adolescents born to a foreign-born parent. We adopted fixed-effects ordered logistic regression models for eight time periods. While suicidal ideation increased over time, no change in depressive mood was found among female marriage migrants. The inflow transnational ties was negatively associated with depressive mood and suicidal ideation. The outflow transnational ties did not significantly predict depressive mood and suicidal ideation. Supporting female marriage migrants to maintain transnational ties with their home country could improve their mental health. More policy support is also essential for vulnerable female marriage migrants with limited human and social capital. Future studies need to expand the impact of other types of transnational ties on mental health among immigrants in Korea.

Multilevel Factors Associated With Obesity Among South Korean Adolescents Before and During the COVID-19 Pandemic.

Background: Coronavirus disease 2019 (COVID-19)-necessitated lockdowns and school closures have limited social interactions among adolescents, which result in unhealthy behaviors. This study compared the multilevel factors associated with obesity among adolescents in South Korea before and during the pandemic. Method: We applied the social-ecological model and analyzed the 2019 and 2020 Korea Youth Risk Behavior Web-based Survey (KYRBS), including middle and high school students. We considered factors at the individual, family, and community levels in the logistic regression. Age and gender-adjusted obesity (body mass index ≥ the 95th percentile) was the dependent variable. Result: The prevalence of obesity slightly increased from 11.31% before the pandemic to 12.48% during it; the odds of obesity were 1.12 times (95% confidence interval [CI] = 1.08-1.16) as high during the pandemic compared to before it. Several individual factors (e.g., age, gender, fast-food consumption) and perceived family economic status were commonly associated with obesity before and during the COVID-19 pandemic. Physical activity and city type were related to obesity only before the pandemic. Downgraded economic status owing to COVID-19 was adversely related to obesity during the pandemic. Conclusion: Inclusive multilevel support is needed to combat obesity in adolescence during the pandemic and those economically impacted require additional support.

Stage distinctive communication networks of the online breast cancer community.

In this study, we reveal the distinctive communication network structures and contents of online breast cancer community posts in accordance with different cancer stages. Using data collected from community.breastcancer.org, a major online breast cancer community (28,139 original posts and 663,748 replies), we traced the communication network structures and contents of replies associated with its severity. By combining network and quantitative content analyses, we deciphered the functions and utilities of health-related online communication. We found an inverse relationship between offline epidemiological prevalence and online communication activation. Despite the relatively small percentage of breast cancer patients, it was found that the more severe the condition of breast cancer, the more active online communication was. We further found that as pathological severity advances, communication networks move from informational exchange to emotional support. The capture of online social networks based on the cancer stage can help unpack the distinctive communication patterns found across different cancer severities. Our results provide insights into a possible online communication intervention design tailored to symptom severity.

Relationship Between Perceived Discrimination and Somatic Symptom Disorder Among Young Adults With Immigrant Background in South Korea.

Insufficient research has compared the impact of subtle and overt discrimination on somatic symptom disorder (SSD) among young adults with immigrant backgrounds in South Korea, a country that is becoming increasingly racially and ethnically diverse. Therefore, this study sought to examine this. A cross-sectional survey was conducted in January 2022 involving 328 young adults aged 25 to 34 years who had at least one foreign-born parent or were foreign-born immigrants. We used ordinary least squares (OLS) regression with SSD as the dependent variable. The results showed that subtle and overt discrimination were positively associated with SSD among young immigrant adults. Subtle discrimination seems more strongly related to SSD among Korean-born immigrant adults (N = 198) than foreign-born immigrant young adults (N = 130). This result partially supported the theory that both forms of discrimination were differently related to increased SSD tendencies by place of birth.

The community voices program to facilitate community-academic researcher partnerships: Stakeholder perspectives on the program's usefulness.

Introduction: The Institute of Translational Health Sciences (Clinical and Translational Science Awards Program hub) developed a program coined Community Voices to invite communities to submit project ideas and be matched with academic researchers. We describe formative research to understand community and academic researcher perspectives on how the program could facilitate collaborations addressing community priorities. Methods: We conducted four focus groups with 31 community-based organization (CBO) representatives and 11 semi-structured interviews with academic researchers in the Washington, Wyoming, Alaska, Montana, and Idaho regions. Questions included the appeal of Community Voices to engage community and academic partners, potential program usefulness, and Community Voices' potential role in building community-academic partnerships. We used an inductive, constant comparison approach to code transcripts and thematic analysis to generate themes. Results: Most CBO representatives were female (87.1%) and Hispanic/Latino (61.3%). Most academic researchers had a PhD (63.6%) and worked at a university (81.8%). The themes were: (1) community-academic partnerships built on trust will offer mutual benefit, (2) community-initiated project ideas should prioritize community needs, (3) matchmaking will accelerate connections but should not replace time to foster partnership, (4) Community Voices should go beyond matchmaking and provide ongoing support/training, and (5) fostering effective communication is key to partnership success. Conclusions: Community Voices is a novel, bidirectional community engagement program model that advances current practices of prioritizing researchers' project ideas. This community-driven program may shift the future direction of community engagement practices where prioritizing community's ideas becomes the norm of community-academic partnerships in clinical and translational science.

Weight changes and characteristics of patients associated with weight gain during inpatient psychiatric treatment.

This study investigated weight changes and patient characteristics associated with weight gain in a public psychiatric hospital. A retrospective chart review was conducted on a multi-racial population admitted for psychiatric inpatient treatment. Patients gained an average of 5.41 pounds during psychiatric hospitalization. Patients with normal weight at admission were significantly more likely to gain weight compared to overweight or obese patients. Black patients showed the greatest weight gain, while Asian patients showed the smallest weight gain. This study suggests that it may be possible to identify specific demographic characteristics that warrant more intensive clinical evaluation, although additional research is necessary.

Disparities in COVID-19 Information Sources and Knowledge in South Korea.

Applying Dervin's sense-making theory, this study aims to examine the factors associated with the numbers and types of COVID-19 information sources, and the association between information sources and knowledge during the COVID-19 pandemic in South Korea. An online survey was conducted among adults (19-69 years old) in December 2020. Ordinary least squares (OLS) and logistic regression were conducted to examine (1) the associated factors with the numbers and types of COVID-19 information sources, and (2) whether the number and types of COVID-19 information sources predict the correct COVID-19 knowledge. On average, the participants utilized five different sources to find COVID-19 information. The information need was related to the number and type of information sources, while the information barrier was only related to the number of sources. Participants who utilized more sources and who utilized online sources were more likely to possess the correct knowledge regarding COVID-19 while utilizing the government website; however, doctors, as a source, were negatively related to COVID-19 knowledge. There should be more support for individuals with lower socioeconomic status, as they tend to look for fewer sources, while finding more sources is positively related to better COVID-19 knowledge.

Social-ecological factors related to preventive behaviors during the COVID-19 pandemic in South Korea.

Most studies on COVID-19 preventive behaviors have focused on single-level factors such as national policy, community social capital, or individuals' sociodemographic characteristics. Through a social-ecological model, this study attempts to comprehensively examine the multilevel factors associated with COVID-19 preventive practices in South Korea. Accordingly, a web survey involving 1,500 participants was conducted in December 2020. An ordinary least squares (OLS) regression was used to examine the multilevel factors (individual, interpersonal, community, and policy levels) related to COVID-19 preventive measures, which are based on wearing a mask, washing hands, covering the mouth when coughing or sneezing, and social distancing. When factors at each level were investigated, higher scores of COVID-19 fear and correct knowledge at the individual level, COVID-19 information share at the interpersonal level, and better evaluation of the national government policies in regard to COVID-19 at the policy level were positively associated with COVID-19 preventive behaviors. Community-level factors-neighborhood perception and community participation-were negatively significantly related to COVID-19 preventive behaviors. Additionally, older age, being female, and having a graduate-level education were positively related to better preventive behaviors. The findings of the current study suggest that multilevel efforts are needed to promote preventive behaviors. Specifically, more effort to alleviate COVID-19-related fear and disseminate correct knowledge among Korean citizens is needed as the individual-level characteristics explained the preventive behaviors more than the factors at upper levels.