Chinese Canadians' Experiences of the Dual Pandemics of COVID-19 and Racism: Implications for Identity, Negative Emotion, and Anti-Racism Incident Reporting

De nombreux Canadiens d'origine chinoise ont connu un plus grand nombre d' incidents de racisme et de xénophobie depuis le début de la pandémie de coronavirus (COVID-19). La présente étude porte sur cette discrimination accrue a l'égard des Chinois et en quoi celleci et les menaces liées a la pandémie elle-meme nuisent au bien-etre des Canadiens d' origine chinoise ainsi qu' a leur identité chinoise et canadienne. Nous avons interrogé 874 adultes d'origine chinoise de partout au Canada - M?ge = 42,09;47,7 % de femmes;628 nés a l'étranger, de premiere génération (G1), et 246 nés au Canada, de deuxieme génération (G2) au moins. Les taux rapportés d'expériences discriminatoires sont alarmants : plus de la moitié des répondants ont dit avoir été traités avec moins de respect en raison deleurethnie (G1: 60,6 %;G2: 56,8 %), et plus du tiers ont dit avoir été personnellement menacés ou avoir été victimes d' intimidation (G1 : 35,2%;G2 : 39,8%). Le statut générationnel influait sur les expériences des Canadiens d' origine chinoise durant la pandémie : les membres de la G1 ont ressenti davantage de menaces pour leur santé, leur situation financiere et leur culture durant la pandémie, et les membres de la G2 ont témoigné d'une plus grande discrimination personnelle et a l'égard de leur groupe. La discrimination perçue était associée a l'affect négatif, meme apres avoir tenu compte des menaces liées a la pandémie. Le type de discrimination a des répercussions différentes pour les identités culturelles patrimoniale et dominante. Au sein des deux groupes, la discrimination personnelle était négativement associée a l' identité canadienne, et la discrimination de groupe était positivement associée a l'identité chinoise. Environ 10 % seulement des Canadiens d'origine chinoise qui ont été victimes de harcelement ont rapporté leurs expériences aux autorités ou dans les médias sociaux;leur propre perception d'etre, aux yeux d'autrui, de perpétuels étrangers les a empechés de rapporter le harcelement. Les auteurs discutent des répercussions du signalement du harcelement sur l'acculturation, l'identité, les stratégies antiracistes et la responsabilisation personnelle.Alternate :Many Chinese Canadians (CCs) have experienced increased racism and xenophobia since the beginning of the Coronavirus disease (COVID-19) pandemic. This study focused on how this rise of anti-Chinese discrimination, in addition to the threats posed by the pandemic itself, affects not only CCs' well-being, but also their Chinese and Canadian identities. We surveyed 874 CC adults from across Canada, Mage = 42.09;47.7% females;628 foreign-born, first-generation (G1) and 246 Canadian-born, second or later generation (G2). The reported rates of discriminatory experiences were alarming: More than half of the respondents reported that they had been treated with less respect because of their ethnicity (G1: 60.6%;G2: 56.8%), and over a third reported that they had been personally threatened or intimidated (G1: 35.2%;G2: 39.8%). Generational status moderated CCs' pandemic experiences, such that G1 CCs perceived more health, financial, and cultural threats due to the pandemic, but G2 CCs reported more personal and group discrimination. Perceived discrimination was associated with CCs' negative affect even after controlling for pandemic threats. The type of discrimination had different implications for heritage and mainstream cultural identities. For both groups, personal discrimination was negatively associated with Canadian identity, whereas group discrimination was positively associated with Chinese identity. Only about 10% of CCs who experienced harassment reported their encounters to authorities or on social media;CCs' perceptions that others saw them as perpetual foreigners undermined their reporting of harassment. The findings' implications for acculturation, identity, anti-racism strategies, and empowerment in reporting harassment are discussed.

COVID discrimination experience: Chinese Canadians' social identities moderate the effect of personal and group discrimination on well-being.

OBJECTIVE: The coronavirus disease (COVID-19) pandemic has amplified preexisting racism and xenophobia. In this study, we investigated (a) whether perceived personal and group discrimination make distinct contributions to Chinese Canadians' negative affect and concern that the heightened discrimination they experienced during the pandemic will continue after the pandemic; (b) whether Canadian and Chinese identities and social support moderate the effect of discrimination on this concern; and (c) whether race-based rejection sensitivity (RS) explains why each type of discrimination predicts negative affect and expectation of future discrimination. METHOD: A sample of Chinese Canadian adults across Canadian provinces (N = 516; Mage = 42.74, 53.3% females) completed a questionnaire assessing personal and group discrimination, Chinese and Canadian identity, a short form of race-based RS, negative affect, and expectation of future discrimination. RESULTS: Personal and group discrimination were intercorrelated and positively associated with negative emotion and expectation of future discrimination. Chinese Canadians who identified more strongly as Chinese experienced a less adverse impact related to group discrimination. However, those who identified more (vs. less) strongly as Canadians were more likely to be impacted by personal discrimination. Finally, path analysis revealed that both personal and group discrimination were positively associated with RS, which in turn predicted an expectation that long-lasting racism would continue after the pandemic. CONCLUSION: Group and personal discrimination play different roles in Chinese Canadians' experiences during and expectations after the pandemic. Maintaining Chinese identity can be beneficial to Chinese Canadians, particularly in mitigating the negative effect of group discrimination during the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

"Responsible" or "Strange?" Differences in Face Mask Attitudes and Use Between Chinese and Non-East Asian Canadians During COVID-19's First Wave.

Early in the COVID-19 pandemic, journalists and scholars noted differences between Asians and North Americans in their support for public mask use. These differences were primarily assumed to be due d to variations in ethnocultural norms and practices. To better ascertain people's motives for wearing masks and potential cultural differences in these rationales, this comparative, mixed-methods research examines Chinese and non-East Asian Canadians' mask use attitudes utilizing online group interviews (Study 1) and a nation-wide survey (Study 2) Study 1, conducted in the early stages of the pandemic, captured an ambivalent, yet evolving attitude toward public mask use among the non-East Asian Canadians, which differed from their Chinese counterparts who more uniformly perceived mask use favorably. Study 2, conducted 2 months later, suggests that both groups primarily wore masks for disease protection- and prevention-related reasons. However, age and education appeared to influence the mask wearing frequency of the non-East Asian Canadians, for whom public mask use was less prevalent and normative. The attitudinal differences in public mask use call for targeted strategies to support mask wearing for different ethnocultural groups, which may be achieved partially through enhancing interethnic understanding on the diversified use of and opinions about masks. The findings suggest that favorable social norms, along with evidence-based information campaigns involving personal appeals may encourage greater mask use by the non-East Asian population.

Public Health Messages About Face Masks Early in the COVID-19 Pandemic: Perceptions of and Impacts on Canadians.

Early in the COVID-19 pandemic, Canadians faced much ambiguity in the public health messages around face mask use. As public health messaging plays a pivotal role in the provision of directives during a health crisis, this study examines Canadians' opinions on the early messaging they received regarding personal protection, especially around mask use, with the goal of identifying potential improvements to strengthen future health messaging. Nine online focus group interviews with 47 Canadians were conducted. These natural conversations focused on personal protective equipment (PPE) choices, mask-relevant public health information sources, and advice to Canadian authorities to improve public health messaging on mask use. Responses were imported into NVivo for thematic analysis. Four meta-themes of relevance were identified. Despite demonstrating trust in scientific evidence and public health authorities, the inconsistencies in public health messaging fostered confusion, and induced mistrust toward health professionals. Further, several information deficits were identified pertaining to the scientific efficacy, safe use, and disposal of masks. Rooted in loyalty to healthcare workers, these Canadians eschewed using medical grade masks during PPE shortages to ensure a sufficient supply for medical workers. The findings stress that consistency in public health messages should be prioritized, with necessary changes clearly justified and explained. More information should reach the public on the scientific benefits and proper use of masks. Public health recommendations should be evidence-based, simple, transparent, and realistic in the current circumstances to guide Canadians to make more informed personal protection choices in the rapidly evolving pandemic.

openEHR Archetype Use and Reuse Within Multilingual Clinical Data Sets: Case Study.

BACKGROUND: Despite electronic health records being in existence for over 50 years, our ability to exchange health data remains frustratingly limited. Commonly used clinical content standards, and the information models that underpin them, are primarily related to health data exchange, and so are usually document- or message-focused. In contrast, over the past 12 years, the Clinical Models program at openEHR International has gradually established a governed, coordinated, and coherent ecosystem of clinical information models, known as openEHR archetypes. Each archetype is designed as a maximal data set for a universal use-case, intended for reuse across various health data sets, known as openEHR templates. To date, only anecdotal evidence has been available to indicate if the hypothesis of archetype reuse across templates is feasible and scalable. As a response to the COVID-19 pandemic, between February and July 2020, 7 openEHR templates were independently created to represent COVID-19-related data sets for symptom screening, confirmed infection reporting, clinical decision support, and research. Each of the templates prioritized reuse of existing use-case agnostic archetypes found in openEHR International's online Clinical Knowledge Manager tool as much as possible. This study is the first opportunity to investigate archetype reuse within a range of diverse, multilingual openEHR templates. OBJECTIVE: This study aims to investigate the use and reuse of openEHR archetypes across the 7 openEHR templates as an initial investigation about the reuse of information models across data sets used for a variety of clinical purposes. METHODS: Analysis of both the number of occurrences of archetypes and patterns of occurrence within 7 discrete templates was carried out at the archetype or clinical concept level. RESULTS: Across all 7 templates collectively, 203 instances of 58 unique archetypes were used. The most frequently used archetype occurred 24 times across 4 of the 7 templates. Total data points per template ranged from 40 to 179. Archetype instances per template ranged from 10 to 62. Unique archetype occurrences ranged from 10 to 28. Existing archetype reuse of use-case agnostic archetypes ranged from 40% to 90%. Total reuse of use-case agnostic archetypes ranged from 40% to 100%. CONCLUSIONS: Investigation of the amount of archetype reuse across the 7 openEHR templates in this initial study has demonstrated significant reuse of archetypes, even across unanticipated, novel modeling challenges and multilingual deployments. While the trigger for the development of each of these templates was the COVID-19 pandemic, the templates represented a variety of types of data sets: symptom screening, infection report, clinical decision support for diagnosis and treatment, and secondary use or research. The findings support the openEHR hypothesis that it is possible to create a shared, public library of standards-based, vendor-neutral clinical information models that can be reused across a diverse range of health data sets.

Development of an openEHR Template for COVID-19 Based on Clinical Guidelines.

BACKGROUND: The coronavirus disease (COVID-19) was discovered in China in December 2019. It has developed into a threatening international public health emergency. With the exception of China, the number of cases continues to increase worldwide. A number of studies about disease diagnosis and treatment have been carried out, and many clinically proven effective results have been achieved. Although information technology can improve the transferring of such knowledge to clinical practice rapidly, data interoperability is still a challenge due to the heterogeneous nature of hospital information systems. This issue becomes even more serious if the knowledge for diagnosis and treatment is updated rapidly as is the case for COVID-19. An open, semantic-sharing, and collaborative-information modeling framework is needed to rapidly develop a shared data model for exchanging data among systems. openEHR is such a framework and is supported by many open software packages that help to promote information sharing and interoperability. OBJECTIVE: This study aims to develop a shared data model based on the openEHR modeling approach to improve the interoperability among systems for the diagnosis and treatment of COVID-19. METHODS: The latest Guideline of COVID-19 Diagnosis and Treatment in China was selected as the knowledge source for modeling. First, the guideline was analyzed and the data items used for diagnosis and treatment, and management were extracted. Second, the data items were classified and further organized into domain concepts with a mind map. Third, searching was executed in the international openEHR Clinical Knowledge Manager (CKM) to find the existing archetypes that could represent the concepts. New archetypes were developed for those concepts that could not be found. Fourth, these archetypes were further organized into a template using Ocean Template Editor. Fifth, a test case of data exchanging between the clinical data repository and clinical decision support system based on the template was conducted to verify the feasibility of the study. RESULTS: A total of 203 data items were extracted from the guideline in China, and 16 domain concepts (16 leaf nodes in the mind map) were organized. There were 22 archetypes used to develop the template for all data items extracted from the guideline. All of them could be found in the CKM and reused directly. The archetypes and templates were reviewed and finally released in a public project within the CKM. The test case showed that the template can facilitate the data exchange and meet the requirements of decision support. CONCLUSIONS: This study has developed the openEHR template for COVID-19 based on the latest guideline from China using openEHR modeling methodology. It represented the capability of the methodology for rapidly modeling and sharing knowledge through reusing the existing archetypes, which is especially useful in a new and fast-changing area such as with COVID-19.