The covid-19 pandemic: A double threat to Chinese americans' mental health

Objective: To explore the double psychosocial threats of the COVID-19 pandemic, targeted behavior toward Chinese Americans, and the correlates to their mental health. Methods: A quantitative, cross-sectional, and descriptive design was utilized by using a purposive convenience sample of 301 Chinese Americans over the age of 18 residing in the United States. Online data collection was conducted through the social media platform WeChat from April 8–21, 2021. Descriptive statistical analysis was used for the participants' demographic characteristics, Multidimensional Scale of Perceived Social Support (MSPSS), Double Threat Situations, COVID-19 Racial Discrimination, and General Anxiety Disorder-7 (GAD-7). Stepwise logistic regression was conducted to verify predictors for anxiety levels by GAD-7. Results: In this sample (N = 301), 127 (42.19%) were male and 174 (57.81%) were female. The average age was 41.67 (SD = 5.89). Among MSPSS subscales, social support from family (MSPSS-Fam, 79.73%, n = 240) and social support from significant others (MSPSS-SO, 73.75%, n = 222) were high. 231 (76.74%) reported threats due to their Chinese ethnic background during the COVID-19 outbreak. Predictors for the high anxiety level by GAD-7 were COVID-19 racial discrimination from the local community (OR = 0.47, 95% CI = 0.39–0.71, p < 0.001), media/online (OR = 0.36, 95% CI = 0.26–0.53, p < 0.001), the perceived threat from the COVID-19 virus (OR = 0.33, 95% CI = 0.23–0.51, p < 0.001) and Perceived racism threat from Chinese background related to COVID-19 (OR = 0.31, 95% CI = 0.21–0.49, p < 0.001). Conclusions: COVID-19 double-threats (The virus and racial discrimination) situations are significantly related to the high level of anxiety among Chinese Americans. The sense of belonging and social perceptions of Chinese immigrants is closely related to public health problems in Western societies and needs to be addressed at all levels. Our findings call for the attention of healthcare workers to specific racism double-threatened situations and high mental health risks, as well as direct and indirect ethnic discrimination that Chinese Americans are experiencing during this pandemic, the long-term influences and effective coping ways related to this issue should be explored in further research. © 2023, Tech Science Press. All rights reserved.

"Virtual Ethnic Town Hall": WeChat and Suburban Chinese Migrants' Multidirectional Activism

The so-called rise of the Chinese American right, particularly suburban migrants from mainland China who have become vocal in local and national politics, has gained both public and scholarly attention in recent years. This article focuses on a suburban Chinese community in Greater Boston and examines its 2017 and 2018 debates on WeChat (the most popular social media platform among ethnic Chinese) concerning the controversial Asian American data disaggregation bill H.3361. Along with in-depth interviews with community members and activists, these WeChat discussions show four different and subtle positions on the bill, revealing that suburban Chinese migrants are not a monolithic group and those opposing the bill are not always conservatives. Although some observers describe WeChat as the "virtual Chinatown," this article argues that it has been a "virtual ethnic town hall" where migrants can debate community issues, understand American society, and practice democracy. This article also provides a much-needed analysis of the sending country's impacts on migrants' views of race, class, mobility, and sovereignty. It ends with migrants' responses to more recent events such as the COVID-19 pandemic and the increasing China-bashing and anti-Asian hate (including the proposed WeChat ban), highlighting the community's vociferousness and resilience in defending its rights and redefining its identity at a historical crossroads. [ FROM AUTHOR] Copyright of Journal of American Ethnic History is the property of University of Illinois Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Drawings + Talk: Capturing the Multimodal Authoring of Emergent Bilinguals through Culturally Responsive Teaching

Hao and Brown explore how a teacher-researcher team created a virtual learning space that embraced culturally relevant/responsive literacy practices and supported multimodal authoring practices for emergent bilingual children during COVID-19. The extenuating circumstances of the pandemic closed many heritage language schools, and there was a need to continue literacy learning for Chinese American children. These factors caused to rethink the best ways to maintain culturally responsive and relevant literacy instruction with young learners in a distance-learning format given the power of this approach to move children toward academic success, cultural competence, and an ability to navigate critical consciousness. Their central question was: How did emergent bilingual children make meaning of stories during a virtual book club driven by culturally responsive literacy practices and a multimodal approach to authoring? In this case, they invited eight children and their parents from Ling's Chinese class to join a virtual book club that met once a week to participate in multimodal authoring surrounding read-alouds of texts connected to Chinese culture and language.

Emotion Focused Therapy and Chinese American Clients: An Exploration Using the Cultural Lens Approach

Asian Americans are the fastest growing ethnic group in the United States and of this group, Chinese Americans represent the largest subgroup. Some scholars have speculated that more symptom-focused and directive psychotherapeutic approaches may be more congruent with Chinese Americans' conceptualization of treatment than traditional Western modalities. Although these approaches may be more culturally appropriate and efficacious for some Chinese American clients, they presuppose that Chinese American clients have difficulties or an inability to express or communicate underlying emotional distress. As a consequence of this generalization, mental health therapists may assume that emotion-oriented psychotherapeutic approaches such as Emotion Focused Therapy (EFT) will not benefit this population. Notwithstanding efforts to expand the relevance of EFT, there remains little research examining the cultural validity of EFT across cultural groups, particularly for Chinese American clients. In this article, we use the Cultural Lens Approach to assess the relevance and applicability of EFT for Chinese American individuals and couples. The aim of this article is to provide clinical direction for therapists using EFT with Chinese American clients and energize the field to conduct further research examining the relevance and applicability of psychotherapeutic approaches with this client group. Further, this article aims to combat stereotypes and Western notions of mental health, which may be limiting clinical and research perspectives on mental healthcare for Chinese Americans. This exploration comes at a time when Chinese Americans are at increased risk of adverse mental health outcomes due to race-based violence and discrimination observed during the COVID-19 pandemic.Copyright © 2023 Taylor & Francis Group, LLC.

Relative validity of a Diet Risk Score (DRS) for Chinese American adults

ObjectiveThe objective of this study was to evaluate the relative validity of the nine-item Diet Risk Score (DRS) among Chinese American adults using Healthy Eating Index (HEI)-2015 scores. We provide insights into the application of the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) for this population, and report on lessons learned from carrying out participant recruitment during the COVID-19 pandemic.MethodsThirty-three Chinese American adults (mean age=40;36% male) were recruited from the community and through ResearchMatch. Participants completed the DRS and two 24-hour food records, which were entered into the ASA 24-Hour Dietary Assessment Tool (ASA24) by community health workers (CHWs). HEI-2015 scores were calculated from each food record and an average score was obtained for each participant. One-way analysis of variance and Spearman correlations were used to compare total and component scores between the DRS and HEI-2015.ResultsMean HEI-2015 score was 56.7/100 (SD 10.6) and mean DRS score was 11.8/27 (SD 4.7), with higher scores reflecting better and worse diets, respectively. HEI-2015 and DRS scores were inversely correlated (r=−0.43, p<0.05). The strongest correlations were between HEI-2015 Total Vegetables and DRS Vegetables (r=−0.5, p<0.01), HEI-2015 Total Vegetables and Green Vegetables (r=−0.43, p=0.01) and HEI-2015 Seafood/Plant Protein and DRS Fish (r=−0.47, p<0.01). The inability to advertise and recruit for the study in person at community centres due to pandemic restrictions impeded the recruitment of less-acculturated individuals. A lack of cultural food items in the ASA24 database made it difficult to record dietary intake as reported by participants.ConclusionThe DRS can be a valuable tool for physicians to identify and reach Chinese Americans at risk of cardiometabolic disease.

Exploring Factors Associated with Chinese-Americans' Willingness to Receive an Additional Hypothetical Annual Dose of the COVID-19 Vaccine.

Chinese-Americans are one of the largest groups of Asian-Americans in the US with distinctive behavioral and cultural characteristics that influence health service use. Although Chinese-Americans have significantly higher COVID-19-related mortality rates, relative to other racial and ethnic groups, limited literature is available examining their willingness to accept the COVID-19 vaccine. With recent development of the combination influenza-COVID-19 vaccine by biotechnology companies to mitigate COVID-19 infection, we examined factors associated with Chinese-Americans' acceptance of hypothetical annual doses of COVID-19 vaccination before the vaccine rollout. A total of 241 Chinese-Americans who received at least one dose of the COVID-19 vaccine completed an online questionnaire developed and based on health behavior theories. Our results indicated that Chinese-American participants who were satisfied with their prior COVID-19 vaccination experience, who had more accurate knowledge and perceived higher susceptibility of getting COVID-19, were more willing to receive the annual COVID-19 vaccine in the future. The findings of our current study may be used to guide the development of strategic messages to promote uptake of the annual COVID-19 vaccine by Chinese-Americans in the U.S.

The influence of cultural values on caregiving stress for Chinese American dementia/Alzheimer's family caregivers

Literature review revealed that stress and coping strategies utilized in caring for a family member with Alzheimer's and other forms of dementia were understudied among Chinese American caregivers in the United States in relation to cultural values. The focus of the study was to examine the lived experiences of the Chinese American caregivers caring for a family member with Alzheimer's and other forms of dementia. The purpose of the study was to explore Chinese American caregivers' stress and coping strategies and how cultural values and attitudes towards traditional values affected the experiences. Alzheimer's can be a burdensome disease to the individuals who live with the disease and to their families and informal caregivers (often are family members), which appeared to have increased in recent years. Though there has been much research on dementia care, there is a lack of studies on racial and ethnic minorities, the impact of the cultures, and the generational differences and attitudes towards caregiving. The participants met the following criteria: (a) must be self-identified as a Chinese American, (b) must currently live in the San Francisco Bay Area, (c) must be 21 years and older, (d) must be fluent in English, (e) must have a family member who has been diagnosed with Alzheimer's or other forms of dementia, and (f) must be providing care for a family member with Alzheimer's or other dementia. Eight Chinese American caregivers participated in a virtual interview, due to COVID-19 restrictions. A Conventional Content Analysis approach was used to understand the participants' lived experiences by examining emerging categories (themes). Four categories emerged regarding caregiving stressors: Care Recipient's Diagnosis and Treatments, Finances, Care Recipient's Behaviors, and Physical Strains. Five categories emerged regarding emotional reactions towards caregiving: Happiness, Anger, Inadequacy, Fear, and Remorse. Three categories emerged regarding cultural factors: Acculturation, Stigma, and Family Dynamics. Four categories emerged regarding coping strategies: Physical Escape, Social Supports, Problem-Solving, and Unhelpful Coping. Study results provided a better understanding of the types of stressors and of the emotional responses, further insights into the influence of the Chinese values, and the coping strategies among Chinese American caregivers. Implications for clinicians working with the Chinese American families were provided to help mental health professionals understand the importance of developing culturally appropriate and sensitive interventions and programs to meet the needs of the Chinese American Alzheimer's and other dementia caregivers and care recipients. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Harming and Shaming through Naming: Examining Why Calling the Coronavirus the “COVID-19 Virus,” Not the “Chinese Virus,” Matters

In an effort to stave off racial and geographic prejudices, The World Health Organization (WHO) has advised against naming pathogens for geographic regions. Despite this, some media reports, and prominent politicians, have persisted in calling the coronavirus the “Chinese Virus,” or some variant thereof. In this pre-registered online experiment (N = 614), we examined the effect media frames and individual factors (i.e., political affiliation and party) had on perceptions of COVID-19, prejudice against Chinese- and Asian-Americans, and attributing blame to China for the coronavirus. We found that articles that labeled the coronavirus the “Chinese Virus” (versus the “COVID-19 Virus”) were perceived less favorably by Democrats and liberals, in comparison to Republicans and conservatives, who were also more likely to express greater racial prejudice against Chinese- and Asian-Americans and to blame China for the pandemic. Findings from this study suggest that amongst a host of other variables, media framing has an effect on the public’s attitudes and feelings of blame for the pandemic.

CHINESE RESTAURANTS: A HISTORY OF RESILIENCE

Chin asserts that before the COVID-19 pandemic, over 40,000 Chinese restaurants were operating across America. That's more than all the McDonalds, KFC's, Wendy's and Pizza Huts combined. Located in nearly every community and corner of the country, these ubiquitous establishments, big and small, are as American as apple pie, and, of course, more delicious. The $15 billion Chinese restaurant industry, which includes many independently owned family businesses, was amongst the first to be hit, and hit hard, by the economic crisis wrought by the coronavirus. The first Chinese restaurant in America, the Canton Restaurant, opened in San Francisco in 1849. Thousands of Chinese men had left Southern China to mine for treasures on Gold Mountain. These bachelors needed a place to eat. By 1850, there were five such establishments. However, the growing wave of anti-Asian immigration policies, including the Chinese Exclusion Act, kept the community small and limited the number of Chinese restaurants to a dozen or so.

Chinese Americans' Use of Patient Portal Systems: Scoping Review.

BACKGROUND: Electronic patient portals are increasingly used in health care systems as communication and information-sharing tools and show promise in addressing health care access, quality, and outcomes. However, limited research exists on portal use patterns and practices among diverse patient populations, resulting in the lack of culturally and contextually tailored portal systems for these patients. OBJECTIVE: This study aimed to summarize existing evidence on the access and use patterns, barriers, and facilitators of patient portals among Chinese Americans, who represent a growing patient population in the United States with unique health care and health technology needs. METHODS: The authors conducted a literature search using the PRISMA Protocol for Scoping Reviews (Preferred Reporting Items for Systematic Reviews and Meta-Analyses-ScR) for extracting articles published in major databases (MEDLINE, Embase, and PsycINFO) on patient portals and Chinese Americans. Authors independently reviewed the papers during initial screening and full-text review. The studies were analyzed and coded for the study method type, sample population, and main outcomes of interest. RESULTS: In total, 17 articles were selected for inclusion in the review. The included articles were heterogenous and varied in their study aims, methodologies, sample populations, and outcomes. Major findings identified from the articles include variable patterns of portal access and use among Chinese Americans compared to other racial or ethnic groups, with limited evidence on the specific barriers and facilitators for this group; a preference for cross-sectional quantitative tools such as patient surveys and electronic health record-based data over qualitative or other methodologies; and a pattern of aggregating Chinese American-related data into a larger Asian or Asian American designation. CONCLUSIONS: There is limited research evaluating the use patterns, experiences, and needs of Chinese Americans who access and use patient portal systems. Existing research is heterogeneous, largely cross-sectional, and does not disaggregate Chinese Americans from larger Asian demographics. Future research should be devoted to the specific portal use patterns, preferences, and needs of Chinese Americans to help ensure contextually appropriate and acceptable design and implementation of these digital health tools.

Acceptability of a community health worker intervention to improve the oral health of older Chinese Americans: A pilot study.

OBJECTIVE: To evaluate the acceptability of a community health worker (CHW) intervention designed to improve the oral health of low-income, urban Chinese immigrant adults. BACKGROUND: Given that both dental caries and periodontitis are behaviourally mediated, biofilm-based diseases that are largely preventable with attention to regular oral hygiene practices and preventive dental visits, strategies to arrest or even heal carious lesions and high-quality maintenance care and plaque control without the need to resort to aerosol-generating surgical approaches are evidence-based best practices. Older immigrants have poorer oral health than older US-born natives, motivating the need for delivery of more effective and affordable services to this vulnerable population. MATERIALS AND METHODS: CHWs were trained by the NYU College of Dentistry dental hygienist faculty members using dental models and flip charts to instruct patients on proper brushing and flossing techniques. In addition, they discussed the presented oral health promotion information one-on-one with patients, addressed any expressed concerns and encouraged prevention of oral conditions through regular dental visits and brushing with fluoride toothpaste. RESULTS: More than 98% of the 74 older Chinese adult participants strongly agreed/agreed that the CHWs helped them to improve how they take care of their health, the CHWs answered their questions and concerns, the information and topics were informative, and the in-person demonstrations were helpful in improving oral health. CONCLUSION: The health of all communities depends on access to comprehensive care, including oral health care, in the wake of COVID-19. CHW interventions are acceptable to and may reach marginalised and immigrant communities.