Faculty Bibliography

Background: Asian Americans have experienced increased mental health challenges since the onset of the COVID-19 pandemic. Substantial research documents the salubrious effects of social support on mental and overall health among Asian Americans. However, the role of social support in mental health and health behaviors like vaccine willingness for Asian American older adults during the pandemic remains underexplored despite the importance of social support for health and quality of life in this population.
Objective(s): This study examines the relationship between social support, mental health, and COVID-19 vaccine willingness among Asian American older adults during the pandemic.
Method(s): The Asian American, Native Hawaiian, and Pacific Islander COVID-19 Needs Assessment Survey was a national survey administered between January 18 - April 9, 2021 (n=3,736). Adults aged 50 years and older who self-identified as Asian American were included. Logistic regressions were conducted to analyze associations among depression symptoms, anxiety symptoms, COVID-19 vaccine willingness, and social support types (receiving or providing emotional and instrumental support).
Result(s): The sample (n=654) was 59% East Asian, 22% Southeast Asian, 10% South Asian, and 9% Multiethnic/Other. About 12.5% screened positive for depression symptoms, 16.7% for anxiety symptoms, 20.6% for depression or anxiety symptoms, and 75.2% were willing to get the COVID-19 vaccine. Compared to adults not receiving emotional support, adults who received emotional support were less likely to have depression [0.42 (0.25, 0.70)] and anxiety [0.56 (0.35, 0.90)], and they were more likely to get the COVID-19 vaccine [1.63 (1.00, 2.64)]. Adults who provided emotional support to others were also less likely to have depression [0.54 (0.31, 0.95)].
Conclusion(s): Receiving emotional support was not only associated with better mental health outcomes but also COVID-19 vaccine willingness. This may have implications for developing supportive programming for this population that not only includes instrumental or practical support, but also emotional support

Introduction/UNASSIGNED:Community-based organizations (CBOs) have provided critical resources during the pandemic, particularly for marginalized communities, and are trusted liaisons who connect socially and linguistically isolated community members, such as the highly diverse Asian American population, to care during public health emergencies. Stereotypes such as the model minority myth have permeated public perception of Asian Americans' health status and health care access needs, fueling widespread belief that Asian Americans do not experience health disparities, and mask the high rates of coronavirus disease 2019 (COVID-19) infection, hospitalization, and mortality among Asian Americans. The unequal burden of COVID-19 on Asian American communities has largely remained absent from the public health and national discourse, with exceptions such as community voices that have directed news media coverage and leading roles of CBOs in offering culturally adapted, in-language programming on COVID-19 infection prevention and control. Methods/UNASSIGNED:CBOs and their staff are well-equipped with the cultural acuity, language capacity, and familiarity with local norms to improve structural gaps affecting health outcomes and support health care delivery. Results/UNASSIGNED:We discuss the roles and responsibilities of CBOs in strengthening the health care workforce and expanding community-clinic linkages and provide two case studies illustrating the efforts of two community organizations serving Asian American and immigrant communities, who have been disproportionally affected by the COVID-19 pandemic. Discussion/UNASSIGNED:CBOs are essential to supporting health service coordination and care delivery for structurally vulnerable populations, and are vital to sustaining the coordinated, multilevel public health response to improving community health. Conclusion/UNASSIGNED:Bolstering the current infrastructure to support CBOs is necessary to facilitating immediate responses to serve community needs.

Purpose/UNASSIGNED:Despite the small but growing number of studies documenting the increasing prevalence of diabetes among Korean Americans, no culturally adapted interventions have been developed for Korean Americans at risk for diabetes. We evaluate the efficacy of a culturally tailored lifestyle intervention among Korean American immigrants at risk for diabetes in New York City (NYC). Methods/UNASSIGNED:-tests and chi-square tests assessed group differences for each group for each outcome measure. Results/UNASSIGNED:The treatment group reported significant positive changes in recommended weekly PA, PA self-efficacy, PA barriers, nutrition self-efficacy, diabetes knowledge, weight, BMI, and systolic blood pressure compared with control participants. Generalized estimated equations models for repeated measures assessed change across time while adjusting for study arm, time point, and the interaction between study arm and time point. The intervention effect was significant for weekly moderate and vigorous PA, recommended weekly PA, PA self-efficacy, and diabetes knowledge. Conclusions/UNASSIGNED:Results suggest that a culturally adapted lifestyle intervention for Korean American immigrants at risk for diabetes have the potential to improve behaviors associated with cardiovascular disease outcomes and diabetes prevention. Further research among Korean Americans is warranted.

The COVID-19 pandemic has disrupted the social, economic, and health care systems in the United States and shined a spotlight on the burden of disease associated with social determinants of health (SDOH). Addressing SDOH, while a challenge, provides important opportunities to mitigate cardiovascular disease incidence, morbidity, and mortality. We present a conceptual framework to examine the differential effects of the COVID-19 pandemic on SDOH across demographically diverse populations, focusing on the short- and long-term development of cardiovascular disease, as well as future research opportunities for cardiovascular disease prevention. The COVID-19 pandemic exerted negative shifts in SDOH and cardiovascular risk factors (ie, smoking, body mass index, physical activity, dietary behavior, cholesterol, blood pressure, and blood sugar). For example, evidence suggests that unemployment and food insecurity have increased, whereas health care access and income have decreased; changes to SDOH have resulted in increases in loneliness and processed food consumption, as well as decreases in physical activity and hypertension management. We found that policy measures enacted to mitigate economic, social, and health issues inadequately protected populations. Low-income and racial and ethnic minority communities, historically underserved populations, were not only disproportionately adversely affected by the pandemic but also less likely to receive assistance, likely attributable in part to the deep structural inequities pervasive in our society. Effective and culturally appropriate interventions are needed to mitigate the negative health impacts of historical systems, policies, and programs that created and maintain structural racism, especially for immigrants, racial and ethnic minorities, and populations experiencing social disadvantage.

The aim of the current study was to collect qualitative data to understand the nature of sleep and sleep difficulties among Asian American older adults and identify daily routines that may lend insight into modifiable targets for future nursing interventions. We recruited Chinese and Bangladeshi older adults with low English proficiency from community-based settings in New York City. Eligible participants were aged ≥55 years and reported China or Bangladesh as their country of origin. Focus groups were conducted in their native language. Participants completed a questionnaire before joining the discussion. Participants (N = 32) were 57% Chinese American and 43% Bangladeshi American. Average age was 73 years, 50% of the sample reported diabetes, and 22% reported sleep apnea. Our analysis revealed the daily routines among Chinese and Bangladeshi American older adults. Both groups reported general sleep difficulties and sleep difficulties related to health conditions as well as some subgroup differences. Future research may consider designing tailored nursing interventions to improve sleep among these groups. [Journal of Gerontological Nursing, 47(12), 35-41.].

Dyspnoea self-management is often suboptimal for patients with COPD. Many patients with COPD experience chronic dyspnoea as distressing and disabling, especially during physical activities. Breathing therapy is a behavioural intervention that targets reducing the distress and impact of dyspnoea on exertion in daily living. Using a qualitative design, we conducted interviews with 14 patients after they participated in a novel mind-body breathing therapy intervention adjunct, capnography-assisted respiratory therapy (CART), combined with outpatient pulmonary rehabilitation. Comprehensive CART consisted of patient-centred biofeedback, tailored breathing exercises, a home exercise programme and motivational interviewing counselling. We assessed participants' perceptions and reported experiences to gauge the acceptability of CART and refine CART based on feedback. Constant comparative analysis was used to identify commonalities and themes. We identified three main themes relating to the acceptability and reported benefits of CART: (1) self-regulating breathing; (2) impact on health; and (3) patient satisfaction. Our findings were used to refine and optimise CART (i.e. its intensity, timing and format) for COPD. By addressing dysfunctional breathing behaviours and dysregulated interoception, CART offers a promising new paradigm for relieving dyspnoea and related anxiety in patients with COPD.