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BackgroundThe COVID-19 pandemic has exacerbated health and social disparities among US Pacific Islanders (PI). Historically, PIs have experienced a high burden of mental illness yet have underutilized mental health services. These already large treatment gaps in mental health care among PIs may worsen during the COVID-19 pandemic. In the face of pre-existing challenges, little is known about the impacts of the COVID-19 pandemic on mental health outcomes among PIs.MethodsA community-based, cross-sectional survey was administered to members of 13 PI churches across the San Francisco Bay Area. We assessed the burden of psychological distress among PIs and its associations with demographic, sociocultural, and health factors.Key resultsAmong 439 PI respondents, nearly half reported moderate or severe psychological distress. Only about one-tenth took prescription medication for mental health and less than half utilized a mental health provider in the past year. Most trusted PI churches to provide health and social services. Respondents reporting moderate or severe psychological distress were less likely to utilize a mental health provider in the past year and more likely to feel marginalized, excluded, isolated, or alienated from society "most of the time" or "always." Psychological distress was also associated with "fair" or "poor" health status, female gender, older adults, low trust in PI churches to provide health and social services, and concern over household finances.ConclusionPartnerships with faith-based and community-based organizations are essential to address unmet mental health needs and promote support-seeking behaviors among PIs during this ongoing pandemic and beyond.

Background: This study examines how neighborhood socioeconomic status (nSES) and ethnic composition are associated with breast cancer risk for Asian American women. Methods: We linked individual level data from a population-based case–control study of breast cancer among Asian American women with neighborhood level data in the Greater San Francisco Bay Area (cases: n = 118, controls: n = 390). Multivariable logistic regression models examined the association between nSES, ethnic composition, and odds of having breast cancer. Results: Asian American women living in neighborhoods with high nSES and high ethnic composition had the highest odds of breast cancer, compared to those living in neighborhoods with high nSES and low ethnic composition (OR = 0.34, 95% CI [0.16–0.75]) or in neighborhoods with low nSES and high ethnic composition (OR = 0.37, 95% CI [0.17–0.83]). Discussion: Neighborhood socioeconomic and ethnic contexts are associated with breast cancer for Asian American women. We discuss explanations and avenues for future research.

Author(s): Morey, Brittany N; Gee, Gilbert C; von Ehrenstein, Ondine S; Shariff-Marco, Salma; Canchola, Alison J; Yang, Juan; Allen, Laura; Lee, Sandra S-J; Bautista, Roxanna; La Chica, Trish; Tseng, Winston; Chang, Pancho; Gomez, Scarlett Lin | Abstract: IntroductionGiven rising rates of breast cancer in parts of Asia, immigrant Asian American women in the United States may have higher rates of breast cancer than previously anticipated. This study examined breast cancer risk among Asian American women by nativity and percentage of life lived in the United States, accounting for established breast cancer risk factors.MethodsWe analyzed a breast cancer case-control data set of Asian American women living in the San Francisco Bay Area; this data set included 132 cases of women with breast cancer selected from a Surveillance, Epidemiology, and End Results cancer registry and 438 Asian American women without diagnosed breast cancer matched to cases by age and country of origin. We used logistic regression to compare 3 Asian American groups: US-born, immigrants who lived 50% or more of their life in the United States, and immigrants who lived less than 50% of their life in the United States.ResultsIn the minimally adjusted and fully adjusted models, both groups of immigrant Asian American women had higher risk of breast cancer than US-born Asian American women. In the fully adjusted model, compared with US-born Asian American women, immigrant Asian American women who lived more than 50% of their life in United States were on average 3 times as likely (odds ratio = 3.00; 95% confidence interval, 1.56-5.75) and immigrants who lived less than 50% of their life in United States were on average 2.46 times as likely (odds ratio = 2.46; 95% confidence interval, 1.21-4.99) to have breast cancer. We found no difference in fully adjusted odds ratios of having breast cancer between the 2 immigrant groups.ConclusionThis study provides preliminary evidence that breast cancer risk among immigrant Asian American women may be higher than among their US-born counterparts.

Functionally, many CBPR projects operate through a model of academic partners providing research expertise and community partners playing a supporting role.To demonstrate how national umbrella organizations deeply rooted in communities, cognizant of community needs, and drawing on the insights and assets of community partners, can lead efforts to address health disparities affecting their constituents through research.Case studies of two Asian American, Native Hawaiian, and Pacific Islander national organizations.Strategically engaging a diverse range of partners and securing flexible funding mechanisms that support research were important facilitators. Main challenges included limited interest of local community organizations whose primary missions as service or health care providers may deprioritize research.Efforts to make research relevant to the work of community partners and to instill the value of research in community partners, as well as flexible funding mechanisms, may help to promote community-driven research.

Asian American children and adolescents are an under-investigated subpopulation in obesity research. This study aimed to identify specific profiles of Asian subgroups at high risk of adolescent overweight with special attention to Asian ethnicity, socioeconomic status (SES), and their interaction. Multiple logistic regression models were fitted using a sample of 1533 Asian American adolescents ages 12–17 from the 2007–2012 California Health Interview Survey (CHIS). In addition to Asian ethnicity and socioeconomic status (assessed by family income and parental education level), age, gender, nativity, and two lifestyle variables, fast food consumption and physical activity, were also controlled for in these models. Key predictors of overweight in Asian American adolescents included certain Asian ethnicities (Southeast Asian, Filipino, and mixed ethnicities), low family income (, Highlights • Southeast Asian and Filipino ethnicities were associated with adolescent overweight. • Low family income was positively associated with Asian adolescent overweight. • Ethnicity and low family income interacted to increase risk of adolescent overweight.

In the USA, cancer is the leading cause of death for Asian Americans and Pacific Islanders (AAPIs), but little is known about the unmet needs of AAPI cancer survivors, especially from a national perspective. Using a community-based participatory research approach, we partnered with the Asian and Pacific Islander National Cancer Survivors Network and the Asian American Cancer Support Network to design and conduct a cross-sectional survey to understand the unmet needs of a national sample of AAPI cancer survivors. We assessed unmet needs in 10 domains: day-to-day activities, financial expenses, emotional concerns, medical treatment, cancer information, home care, nutrition, physical concerns, family relationships, and spirituality. We also assessed self-reported measures related to quality of life. This national sample of AAPI cancer survivors included people from 14 states and two territories who had been diagnosed with a broad range of cancers, including cancer of the breast, ovary/uterus/cervix, prostate, blood, and other sites. Over 80 % reported at least one unmet need. Participants reported an average of 8.4 unmet needs, spanning an average of 3.9 domains. Most commonly reported were unmet needs pertaining to physical concerns (66 %), day-to-day activities (52 %), and emotional concerns (52 %). This is the first report of unmet needs in a national sample of AAPI cancer survivors with a range of different cancer types. It describes the areas of greatest need and points to the importance of devoting more resources to identifying and addressing unmet needs for the underserved population of AAPI cancer survivors.

Background Data are limited on effective methods for recruiting persons, especially from ethnically diverse populations, into population-based studies. The goal of this study was to evaluate the variation among and representativeness of controls identified using multiple methods for a population-based case–control study of breast cancer among Asian Americans, Native Hawaiians and Pacific Islanders (AANHPIs) in the San Francisco Bay Area. Methods We used a unique combination of targeted recruitment strategies, including address-based sampling, community-based methods, and internet-based and media-based approaches for recruiting controls, frequency matched on age and ethnicity to a population-based sample of cases. To characterise the participating controls, we compared the distribution of sociodemographic characteristics and cancer risk factors between recruitment sources using χ 2 tests. To ensure that the controls we recruited were representative of the underlying at-risk population, we compared characteristics of the controls, by ethnicity and in aggregate, to data from the California Health Interview Survey (CHIS), and adjusted the relative mix of recruitment strategies throughout the study as needed to achieve representativeness. Results As expected, controls (n=483) recruited by any single method were not representative. However, when aggregated across methods, controls were largely representative of the underlying source population, as characterised by CHIS, with regard to the characteristics under study, including nativity, education, marital status and body mass index. Conclusions A multimode approach using targeted recruitment strategies is an effective and feasible alternative to using a single recruitment method in identifying a representative, diverse control sample for population-based studies.

Emphasis has increased recently on disseminating high-impact, population-wide strategies for the prevention of chronic diseases. However, such strategies are typically not effective at reaching Asian Americans, Native Hawaiians, Pacific Islanders, or other underserved communities. The objectives of this article were to 1) present the methods of the Strategies to Reach and Implement the Vision of Health Equity program in which 15 community-based organizations in the United States and the Pacific region implemented evidence-based policy, systems, and environmental improvements in their local communities and 2) provide recommendations for using these tailored approaches in other communities and geographic locations. Further support is needed for organizations in tailoring these types of population-wide strategies. Implementing population health improvements should be adapted to maximize effectiveness to decrease chronic diseases in these populations and ultimately eliminate racial/ethnic health disparities.

We were excited to see the article by Denniston et al.1 describing validity of self-reported hepatitis B immunization using data from the National Health and Nutrition Examination Survey (NHANES). Hepatitis B virus (HBV) affects more than 2 million Americans,2 and many HBV-focused community-based programs rely on self-reported immunization history for assessment of client needs, so a clear understanding of the validity of self-reported immunization is vital. These findings have implications in the design and conduct of HBV prevention programs in many communities. We were disappointed to see that the study could not report on Asian Americans specifically. Asian Americans share more than 50% of the HBV burden in the United State and have by far the highest rates of HBV-associated primary liver cancer.3,4 Asian Americans are more likely than the general population to be immigrants, to have limited English proficiency, and to be uninsured,5,6 so it is conceivable that validity of self-reported immunization could be different for this population. Denniston et al. were clear on their desire to include Asian Americans in the analysis, but limitations of the NHANES sampling methodology prevented it.1 This brings to light the critical need for federally sponsored data sets designed such that researchers may answer scientific questions that are relevant to all Americans. A study on HBV is of limited use in public health practice if the data do not allow comment on the racial group most heavily burdened by HBV. Asian American, Native Hawaiian, and Pacific Islander communities have advocated for improved access to national-level data on their populations for many years.7 We are optimistic that more recent data from NHANES will include much needed baseline health indicators for Asian Americans. We look forward to seeing reports that will include HBV and other relevant data for this group. Shortcomings of this latest data set reporting, however, point to the urgency for national databases to broaden sampling methods and ensure that data supported by American tax dollars provide useful information for as many segments of the population as possible, and that official national and state reports include these diverse communities. It is promising that national surveys such as NHANES and the National Health Interview Survey have been incorporating community feedback and taking on oversampling in Asian Americans. The National Health Interview Survey started Asian oversampling in 2006, and NHANES started Asian oversampling in 2011. The communities that comprise Asian Americans, Native Hawaiians, and Pacific Islanders are growing and diversifying. Therefore, we must continue to make progress.