Substance Use Among Asian American Adults in 2016-2020: A Difference-in-Difference Analysis of a National Survey on Drug Use and Health Data.

Objectives. To compare substance use among Asian American adults in 2020, when anti-Asian violence increased, with substance use among the same group during the previous 4 years and compare this with that of non-Hispanic Whites. Methods. Using data from the National Survey on Drug Use and Health, 2016 to 2020, we investigated changes in substance use among Asian Americans compared with non-Hispanic Whites before and during the COVID-19 pandemic. We performed difference-in-difference analyses to estimate adjusted changes in past-month substance use in the 2 groups. Results. The incidence rate ratio (IRR) among Asian Americans' past-month alcohol use, cocaine use, and tranquilizer misuse in 2020 versus in 2016 to 2019 was 1.3 times, 3.0 times, and 17.2 times, respectively, the same IRR among Whites. Conclusions. The significant increase in misuse of several substances among Asian Americans relative to Whites in 2020 calls for careful assessment, identification, and treatment of this understudied population group. Public Health Implications. Besides increasing Asian substance users' access to socioculturally responsive treatment programs, policy and resources should be focused on multilevel violence prevention efforts such as antiracial discrimination public education programs. (Am J Public Health. 2023;113(6):671-679. https://doi.org/10.2105/AJPH.2023.307256).

Assessing Community Readiness to Develop a Socioculturally Relevant Intimate Partner Violence Prevention Program.

The prevention of intimate partner violence (IPV), the most prevalent form of gender-based violence, requires initiatives grounded in the values and norms of members of a given community. As part of an ongoing effort to develop a socioculturally responsive prevention program, we assessed levels of readiness to address IPV in an Asian Indian community in the midwestern USA. Consisting of six focus groups (n = 28), individual interviews (n = 6), and surveys (n = 189) of diverse community leaders and members, the assessment indicated that, while there was only vague awareness of IPV in the community as a whole, some limited segments of the community had a higher degree of readiness to address IPV. Capitalizing on the readiness and commitment of selected individuals, we developed a health communications campaign and implemented it in phases. We discuss methodological issues and lessons learned in assessing community readiness, including implications for study design and future research.

Sex Differences in the Pathways from Exposure to Parental Fighting to Risky Sexual Activities Among Adolescents in Urban Neighborhoods.

OBJECTIVES: Adolescents' exposure to violence between parents acts as a precursor to risky behaviors; however, empirical studies that examined the potential pathways from exposure to violence between parents to risky behaviors are rare. Consequently, the prevention and intervention strategies for risky sexual activities are limited without the identification of malleable mediators. METHODS: Mediators on the association between adolescent exposure to parental fighting and risky sexual activities are examined, which include internalizing behaviors, running away from home, and affiliation with risky peers. Relationships between these variables are examined for males and females separately. The sample consists of 673 adolescents in a neighborhood located in Chicago's Southside who completed a survey. RESULTS: Exposure to parental fighting was not directly associated with risky sexual activities for either males or females. However, among females, exposure to parental fighting was significantly and positively related to internalizing behaviors and running away from home, and internalizing behaviors were also positively associated with running away from home. For males, however, only the association between internalizing behaviors and running away from home was found to be significant. Further, the relationship between exposure to parental fighting and risky sexual activities was mediated by running away from home. CONCLUSIONS: Targeted strategies for prevention are critical for improving sexual health outcomes among adolescents in low-resourced urban neighborhoods.

Piloting participatory action research: Community as intermediary to education pathways of Congolese refugee youth.

OBJECTIVES: This pilot participatory action research (PAR) is aimed at increasing educational opportunities for refugee youth by demystifying higher education and providing relevant information. The project also aims to develop empirical knowledge regarding refugee youth's life trajectories and barriers to higher education, which informs collective action to enhance educational policies and programs for refugee youth. METHOD: In collaboration with community and student organizations in a midwestern urban area of the United States, we organized a higher education pathway program for Congolese refugee youth and community leaders aspiring to pursue higher education. Seven individuals attended a 1-day program, with a workshop, campus tour, and meeting with university administrators, and participated, along with two others, in a life history calendar interview. This article analyzes the PAR processes and interviews with participants. RESULTS: In addition to individual-level factors such as limited knowledge about college, various structural-level factors (i.e., school policies, procedures) impede education of refugee youth. Our analysis highlights the community as a source of both support and responsibility for refugee youth. Results show the need to educate the community about higher education but also the need to educate the university about refugee education and the community's pivotal role in doing so. CONCLUSIONS: Our findings offer a three-level (individual, structural, and community) framework of education pathways for resettled refugees. A critical analysis of how factors at multiple levels interact and produce unique challenges and possibilities furthers the field of refugee studies and also informs more holistic, sustainable policies and programs for refugee education. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Help-Seeking Among Battered Immigrant Filipina, Indian, and Pakistani Women in the United States: Perceived Barriers and Helpful Responses.

This study examines the nature of helpful responses received and barriers to seeking help following the experience of intimate partner violence among women of Filipina, Indian, and Pakistani descent (N = 143) in the United States. Instead of aggregating women from diverse backgrounds, we investigated these groups of women separately. A content analysis found that while emotional support was the most helpful response, there were important variations by ethnicity and immigration position in the perceived helpfulness of various assistance resources as well as barriers to help-seeking. This study of disaggregated Asian immigrant groups enhances our understanding of both common and unique challenges faced by each immigrant group, which can inform development of socioculturally relevant intervention programs.

Using interactive theater to create socioculturally relevant community-based intimate partner violence prevention.

This article describes the use of interactive theater, audience response assessment, and peer educators to create community-generated approaches for bystander interventions (i.e., actions taken by people who become aware of controlling, abusive and violent behavior of others) to prevent intimate partner violence (IPV) and to foster change in community norms. We include a case example of an ongoing university-community partnership, which mobilizes community members to develop and implement socioculturally relevant IPV prevention programs in multiple Asian communities. We used interactive theater at a community event--a walk to raise awareness about IPV in South Asian communities--and examined how the enacted bystander interventions reflect specific community contexts. We detail the challenges and limitations we have encountered in our attempts to implement this approach in collaboration with our community partners.

Enculturation and attitudes toward intimate partner violence and gender roles in an asian Indian population: implications for community-based prevention.

This study examined the relationships among enculturation, attitudes supporting intimate partner violence (IPV-supporting attitudes), and gender role attitudes among one of the largest Asian Indian population groups in the US. Data were collected via computer-assisted telephone interviews with a random sample of Gujarati men and women aged 18-64 in Metropolitan Detroit. Using structural equation modeling, we modeled the effects of three components of enculturation (behavior, values, and community participation) on gender role attitudes and IPV-supporting attitudes among married respondents (N = 373). Analyses also accounted for the effects of respondent age, education, religious service attendance, perceived financial difficulty, and lengths of residence in the US. The second-order, overall construct of enculturation was the strongest predictor of IPV-supporting attitudes (standardized B = 0.61), but not gender role attitudes. Patriarchal gender role attitudes were positively associated with IPV-supporting attitudes (B = 0.49). In addition to the overall effect of the enculturation construct, two of the components of enculturation had specific effects. "Enculturation-values" had a specific positive indirect association with IPV-supporting attitudes, through its relationship with patriarchal gender role attitudes. However, "enculturation-community participation" was negatively associated with IPV-supporting attitudes, suggesting the importance of community-based prevention of IPV among this immigrant population group.

Relationships among intimate partner violence, unfair treatment, depressive symptoms, and family support: A community-based study of Gujarati women in the Midwestern USA.

Intimate partner violence (IPV) and unfair treatment can negatively affect the health and well-being of many women, especially women of color. Few studies have investigated the mental health impact of both forms of victimization together. Unlike most research on Asian Indian women, which has used aggregated samples of women of various Asian Indian or South Asian descent, this study focused on a specific group of Asian Indians. Data were collected from a probability sample of Gujarati residents, aged 18-65 years, in a midwestern state of USA via computer-assisted telephone interviews. One third of married women reported having experienced IPV and two thirds received unfair treatment during the previous 6 months. Respondents overall reported a low level of depressive symptoms. Analyses using negative binomial regression models found that while both IPV and unfair treatment were positively associated with depressive symptoms, their interaction effect was not statistically significant. When IPV victimization and support from family were included in the model, the incidence rate ratio for unfair treatment became nonsignificant, but the significant effect of IPV remained. Findings suggest that practitioners not only in mental health and IPV programs but also in alternative settings frequented by Gujarati women should inquire about these types of interpersonal victimization and assist women in connecting with and cultivating supportive networks. More research on the mental health impact of IPV and other types of interpersonal victimization is needed for underresearched yet growing population groups to inform socioculturally responsive assistance programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Day-to-day discrimination and health among Asian Indians: a population-based study of Gujarati men and women in Metropolitan Detroit.

This study examined the relationship between experiences of day-to-day discrimination and two measures of health among Gujaratis, one of the largest ethnic groups of Asian Indians in the U.S. Data were collected via computer-assisted telephone interviews with a random sample of Gujarati men and women aged 18-64 in Metropolitan Detroit (N = 423). Using structural equation modeling, we tested two gender-moderated models of the relationship between day-to-day discrimination and health, one using the single-item general health status and the other using the 4-item emotional wellbeing measure. For both women and men, controlling for socio-demographic and other relevant characteristics, the experience of day-to-day discrimination was associated with worse emotional wellbeing. However, day-to-day discrimination was associated with the single-item self-rated general health status only for men. This study identified not only gender differences in discrimination-health associations but also the importance of using multiple questions in assessing perceived health status.

Everyday Discrimination and Depressive Symptoms among Gujarati Adults: Gender Difference in the Role of Social Support.

Discrimination against Asians in the USA and its impact on their mental health are urgent public health concerns. Most research on discrimination against Asians has used aggregated Asian group samples. Focusing on Gujaratis, a specific subgroup of Asian Indians, the second-largest Asian group in the USA, this study examined the relationships between everyday discrimination and psychological distress and how they vary by gender. Data were collected via computer-assisted telephone interviews with a representative sample of 553 Gujaratis aged 18 to 65 years residing in a Midwestern state. Negative binomial regression analyses were conducted to examine how exposure to unfair treatment and three types of social support, respectively, was associated with depressive symptoms. For both women and men, unfair treatment was positively associated with depressive symptoms, controlling for sociodemographic characteristics. For women, but not for men, the incidence rate ratio became non-significant when adding social support measures to the model. All three social support measures for women, and only satisfaction with social support for men, were significantly associated with lower depressive symptoms. The findings highlight the need for further research on the role of different types of social support and gender differences, which can inform gender- and socioculturally-relevant intervention efforts.

Analysis of Bystander Behavior Towards Intimate Partner Violence via Peerformance.

This study of a South Asian community in the midwestern USA examines what bystanders do when they witness an incident of intimate partner violence (IPV). Because of ethical and safety constraints, in lieu of observation in a natural setting, data were collected at a Peerformance, a peer-led IPV prevention program, using the forum theatre method introduced in Augusto Boal's Theatre of the Oppressed. Event attendees were invited to respond to an IPV incident enacted by peer educators in which a controlling husband's behavior escalates to the point of suggesting physical violence. Using a grounded theory approach, we analyzed the videotaped bystander actions while applying pertinent aspects of visual analysis. Event attendees responded in variety of ways, exploring and/or de-escalating the situation, providing information, and encouraging the couple to resolve their conflict and/or seek outside help. They expressed empathy, support, and (dis)agreement with the husband and the wife. Their actions encompassed a number of dimensions: introductory, investigative, supportive/empathic, informational, instructional, instrumental, and confrontational. Participants' vastly varied responses to IPV within the same scenario suggest difficulty in developing a generic IPV bystander program. The findings also suggest possible directions for developing bystander programs to address IPV. In lieu of prescribing and/or proscribing specific actions in a given risk situation, bystander training can help participants build their repertoire of actions while collectively examining the strengths and limitations of various actions in their sociocultural context. Such bystander training is complex and difficult to manualize; it will involve reflexive and critical discussions and learning and trying out various possible alternatives. A Peerformance is a site of action, a realistic and familiar milieu where community members can imagine and try out interventions that may be different from the norm of indifference and non-intervention. It can open up new possibilities for addressing IPV in diverse communities.

Peerformance: Bystanders Enacting and Challenging Gender Norms in Community-Based Theater to Prevent Domestic Violence.

This study examined the gender beliefs and norms expressed by South Asian community members when intervening as bystanders in Peerformance, a publicly performed scene depicting a husband's controlling behavior toward his wife enacted by a peer-led theater group. Using a grounded theory approach, inductive coding and reiterative visual analysis of videotaped bystander interactions revealed that, while most community members confronted the husband, beliefs about gender roles and relations impacted how these confrontations occurred. The complexity of gender norms in bystanders' interventions calls for sociocultural tailoring; bystander programs must attend to the rich, within-group variations in community members' attitudes and beliefs.

Participatory Action Research in Times of Coronavirus Disease 2019: Adapting Approaches with Refugee-Led Community-Based Organizations.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had a greater health impact on ethnoracial minorities, including migrants. Migrants in marginalized communities are harder to reach for health information sharing. Meanwhile, the pandemic has impacted in-person, community-based research. Such research is important during a pandemic, warranting the adaptation of engagement methods. OBJECTIVES: This study analyzes methodological processes for adapting community-based research to a virtual environment due to COVID-19 restrictions. Our participatory action research, with refugee-and immigrant-run community-based organizations (RI-CBOs) in a U.S. midwestern metropolitan area, sought to understand organizational activities, including COVID-19 responses, and foster organizational capacity building. METHODS: Partnered with one RI-CBO, we co-developed three methods. Netnography facilitated nonparticipant observation of the RI-CBO's online meetings to inform the community about the pandemic. Online surveys were designed to document the RI-CBO's activities while serving as a foundation to develop a sustainable record-keeping system. Remote interviews sought to contextualize the data. RESULTS: The methodological transition to an online environment prioritized interaction, focusing on user friendliness and efficiency. Community partners intensively engaged in the adaptation process. Netnography captured how the RI-CBO used multimedia to connect community members with COVID-19 information and resources. Surveys and interviews provided data about organizational activities as the pandemic spread and community needs increased. CONCLUSIONS: Adapting to online modalities drew on four priorities: ease of access, time sensitivity, capacity building, and co-production of data. Methodological insights may be applicable to participatory action research with RI-CBOs and other CBOs in the face of challenges similar to those prompted by the COVID-19 pandemic.

Visualizing drivers of gender health disparities: Ongoing participatory action research following the 2011 disaster in Japan.

As part of an ongoing participatory action research project initiated following the 2011 Great East Japan Disaster to improve disaster policies and responses, this study examines social factors and processes that affect women's well-being in and after disasters. Using PhotoVoice methodology, the project has engaged women affected by the Great East Japan Disaster in participatory assessment and analysis over the last ten years. Begun in three sites in June 2011, the project is currently operating in seven locations: four in the coastal areas affected by the tsunami in the Iwate and Miyagi prefectures; two in Fukushima Prefecture; and one in the Tokyo Metropolitan Area, where the largest number of out-of-prefecture evacuees reside. Participating members, recruited in collaboration with local NGOs, are women affected by the disaster aged from in their 20s to over 70 years. They take photographs of their lives and attend facilitated group discussions on an ongoing basis. Participatory analysis of their photographs and narratives by members and group facilitators (including the author) uses the analytical approach of grounded theory's open and focused coding with constant comparison. The analysis identifies various ways the disaster affected women, compromising their livelihood, safety, and well-being. It reveals an interconnection between the evacuation of children and women of reproductive age, loss of employment in the female-dominated occupational sectors, and increased dependent care responsibilities, which in turn compromises women's financial and emotional well-being. The analysis also elucidates the gendered division of labor in private and public spheres, shortages of maternal and infant health care, and gender-based violence in the post-disaster context. Notably, many of these issues and connections correspond to known social determinants of health disparities. The study findings add a valuable but often neglected local perspective and call for increased policy attention to eliminating gender disparities in disasters.

From Exposure to Violence between Mother and Her Intimate Partner to Suicidality Experienced by Urban Adolescents in Chicago's Southside.

Although the relationship between exposure to intimate partner violence and youths' psychological and other wellbeing has been widely studied, there is limited research about how youths' exposure to violence between mother and her intimate partner may be related to youth psychological wellbeing. The study used a sample of urban adolescents in Chicago Southbound to examine whether youths' exposure to verbal conflict between mother and her intimate partner is related to their suicidality and whether youth depression and aggression may be in between such a linkage. Our findings indicated that one-third of the youth had suicidal thoughts or suicidal/self-hurting attempts. Youths' exposure to verbal conflict between mother and her intimate partner was associated with their depressive and aggressive symptoms, and depressive symptoms subsequently were linked to suicidality. The findings also showed that youth depressive symptoms and aggressive symptoms were positively correlated, which may influence their associations with suicidality. We concluded that youth exposure to parental intimate partner violence, even comparatively mild forms such as a verbal conflict between mother and her intimate partner, may increase their risk of suicidality by worsening psychological wellbeing. The findings highlight the importance of tackling youth suicidality risks while accounting for their exposure to intimate partner violence including verbal conflicts between parents.

Exposure to mother's verbal conflict with her intimate partner and aggressive behavior of urban adolescents: An empirical test of three criminological theories.

The current study applied the General Strain Theory (GST), Social Disorganization Theory (SDT), and Social Control Theory (SCT) to examine the association between exposure to verbal conflict between a mother and her intimate partner, and aggressive behavior of urban adolescents. The sample included 518 urban adolescents (96% Black), aged 14 to 17 years. Descriptive statistics, structural equation modeling (SEM), and moderation analyses were conducted. Consistent with GST, exposure to verbal conflict between the mother and her intimate partner was indirectly associated with aggression, as mediated by emotional distress. Also, consistent with SDT, neighborhood violence was positively associated with aggression. Neighborhood violence was associated with exposure to verbal conflict between their mother and her intimate partner, which was related to aggressive behavior in urban adolescents. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Social, economic, and political processes that create built environment inequities: perspectives from urban African Americans in Atlanta.

Growing evidence suggests that the built environment features found in many high-poverty urban areas contribute to negative health outcomes. Both built environment hazards and negative health outcomes disproportionately affect poor people of color. We used community-based participatory research and Photovoice in inner-city Atlanta to elicit African Americans' perspectives on their health priorities. The built environment emerged as a critical factor, impacting physical and mental health outcomes. We offer a conceptual model, informed by residents' perspectives, linking social, economic, and political processes to built environment and health inequities. Research, practice, and policy implications are discussed within an environmental justice framework.

Gender (A)Symmetry in Correlates of Perpetration of Intimate Partner Violence: Gender (A) Symmetry in IPV and the Role of Gender Attitudes.

This study examined, using structural equation modeling (SEM), gender differences and similarities in correlates of the perpetration of emotional aggression against intimate partners among one of the largest groups of Asian Indians in the United States, Gujaratis. Although most of the correlates of emotional aggression (e.g., patriarchal attitudes, spousal disagreement, and alcohol use) were similar for men and women, higher support for gendered domestic roles was significantly related to higher perpetration of emotional aggression for men but not for women. Multigroup latent SEM served as a unique analytical strategy to investigate gender (a)symmetry, a controversial but critical debate in the field.

The role of emotional abuse in intimate partner violence and health among women in Yokohama, Japan.

OBJECTIVES: As part of the World Health Organization's cross-national research effort, we investigated the relationship between various health indicators and the experience of intimate partner violence (IPV), which included emotional, physical, and sexual abuse, among women in Yokohama, Japan. METHODS: We used multivariate logistic and negative binomial regression to examine the relationship between health status and IPV in a stratified cluster sample of 1371 women aged 18 to 49 years. RESULTS: In 9 of 11 health indicators examined, the odds of experiencing health-related problems were significantly higher (P < .05) among those that reported emotional abuse plus physical or sexual violence than among those that reported no IPV, after we controlled for sociodemographic factors, childhood sexual abuse, and adulthood sexual violence perpetrated by someone other than an intimate partner. For most health indicators, there were no significant differences between those that reported emotional abuse only and those that reported emotional abuse plus physical or sexual violence. CONCLUSIONS: The similarity of outcomes among those that reported emotional abuse only and those that reported emotional abuse plus physical or sexual violence suggests the need for increased training of health care providers about the effects of emotional abuse.

Violence Against Women and Children Following the 2011 Great East Japan Disaster: Making the Invisible Visible Through Research.

This study reports on 82 unduplicated cases of violence against women and children after the Great East Japan Disaster of March 2011. Data were collected using a structured questionnaire from informants who worked with the disaster-affected populations. In addition to domestic violence, reported cases involved sexual assault and unwanted sexual contact, including quid pro quo assault perpetrated by nonintimates. Perpetrators often exploited a sense of fear, helplessness, and powerlessness and used threats to force compliance with sexual demands in exchange for life-sustaining resources. Findings point to the urgent need to develop measures to prevent and respond to postdisaster gender-based violence.