94. Implementing Online Public Deliberations on Minor Consent for Biomedical HIV Prevention Research in Diverse Cities

Purpose: Adolescents/young adults (AYA) from racial/ethnic communities have high rates of HIV but little access to biomedical research, due to complexities around consent. Requirement of parental consent for participation in biomedical research is protective and strongly supported by parents, but in biomedical HIV prevention, minors are less likely to participate in research because of concerns about disclosure. Public deliberation (PD) is a process to obtain community input on complex policy issues, by bringing together AYA and adults, who have an investment in an issue, but with potentially opposing views, to provide education, clarify values, and facilitate discussion, reflection, and recommendations. To inform institutional review boards, institutions, and investigators, PDs were held with the goal of obtaining community perspectives and recommendations on minor consent for biomedical HIV prevention research from communities affected by youth HIV. Due to COVID-19 pandemic restrictions, we used an online format and conducted PDs across four evenings. We then conducted post-deliberation interviews to describe participants' experiences in the online PD. Methods: As part of an IRB approved PD, we conducted semi-structured interviews with youth and adult community members who had participated in the deliberations, held in Tampa and Baltimore. The interviews, which were conducted over Zoom, queried deliberants about their experiences voicing their perspectives, their comfort level, their degree of trust in the deliberation process, and ideas for how to better engage future deliberants. Interviews were audio-recorded, transcribed, and field notes were generated. Data were analyzed using thematic analysis. Results: We interviewed 13 community members: seven from Tampa (African American=3, White=3, Latinax=1;AYA=2) and six from Baltimore (African American=6;AYA=1). Facilitators: Deliberants from both communities indicated that personal connections were important for building consensus and understanding. When other participants shared personal stories and perspectives, deliberants were more receptive to hearing and accepting new ideas and opinions that differed from their own. Challenges: Tampa deliberants reported that they preferred an online deliberation because it helped overcome practical barriers to in-person deliberations, such as access to transportation and long commutes. Baltimore participants indicated they would have preferred in-person interactions to build trust, increase comfort, and augment engagement. Participants from both communities discussed distrust in research due to the historical legacy of racism in research and medicine. Due to this legacy, they reported that distrust influenced their views of minor-self-consent and impacted the deliberation process around building consensus. For example, concerns about coercion of minor human subjects influenced their views on minor consent. Recommendations: Participants recommend that strategies be developed to increase engagement in the virtual space. These strategies include use of (a) breakout sessions to increase comfort with sharing;(b) personal storytelling and reviewing group agreements to increase trust, (c) early polling activities to ensure engagement, (d) and asking adults to provide space for youth to voice their perspectives. Conclusions: While online public deliberation on sensitive topics with a vulnerable population is possible, it is important for researchers to focus on providing a safe environment, to acknowledge historical racism in research, and to use methods to maximally engage participants. Sources of Support: PCORI.

Fear, Political Legitimization, and Racism: Examining Anti-Asian Xenophobia During the COVID-19 Pandemic

Unfortunately, there is a long history linking pandemics to Anti-Asian prejudice and xenophobia;these negative outcomes have been particularly pronounced during the COVID-19 pandemic. Some scholars have suggested that these relationships are driven by fear, wherein individuals respond to disease threat by "othering” that threat. Other research has implicated the role of the state, including the political rhetoric of former President Trump, in exacerbating bias by enabling a divisive political environment. Yet, very few existing studies have been able to assess the nature of these impacts or examine the mechanisms behind observed increases in xenophobia. To that end, this research presents results from a survey administered in May 2020 to respondents residing in the U.S., which assessed COVID-19-related attitudes and behaviors, as well as anti-Asian prejudicial attitudes. Using these data, we assessed the direct and interactive relationship between perceptions of risk (i.e., fear), exposure to COVID-19 information, support for Trump, and anti-Asian prejudice. Results reveal that fear—and support for Trump—are associated with increased anti-Asian prejudice, but that exposure to more information about COVID-19 is associated with decreased prejudice;we also note complex interactions between each of these factors. © The Author(s) 2022.

A Deadly Triple Threat: Three Layers of U.S. Racial Inequity in COVID Infections and Deaths

COVID-19 infections and deaths in the United States have affected racial groups differentially. Until now, there has been no analysis of the role that structural racism plays in those health outcomes. We use three models of ascending complexity to quantify the state-level impact of reporting bias, socioeconomic difference, and endogenous policy choices in a treatment model. Even after controlling for confounding factors like Black Lives Matter and other public demonstrations, multivariate regressions conclude that all three explain the phenomenon. We estimate massive avoidable costs of over 870,000 infections and 39,000 deaths due to unequal health outcomes by race. © 2021 Informa UK Limited, trading as Taylor & Francis Group.

Examining the relationship between discrimination, access to material resources, and black children's behavioral functioning during COVID-19

Systemic racism and discriminatory practices continue to disproportionally expose Black children and families to less than optimal health and economic resources. COVID-19 sheds existing light on how longstanding systemic inequalities affecting Black children and families create racial disparities in accessing material resources. The purpose of this study (N = 704 Black caregivers) is to better understand the relationship between experiences of racial discrimination, access to material resources (i.e., health-promoting resources and economic resources), and Black children's behavioral functioning during the pandemic. Through the application of ordinary least squares regression analysis, we find that inadequate material resources (both health-related risks and economic hardship) during the pandemic were associated with heightened caregiver report that their child was frequently fussy or defiant (externalizing) and frequently anxious or fearful (internalizing). The study found no significant links between caregivers' experiences of discrimination during the pandemic and children's behavioral functioning. However, the study found a significant link between caregivers' concern for their children's experiences of discrimination and their children's externalizing behaviors. Findings from this study offer an important contribution to understanding how factors rooted in systemic racism—access to material resources—and experiences of discrimination affect Black children's well-being during COVID-19. © 2022 Elsevier Inc.

Black Student-Athletes and racism pandemic: Building antiracist practices in athletics

The year 2020 was filled with injustices, fear, and uncertainty that has disproportionately affected Black communities in the United States and abroad. From the unprecedented number of deaths inflicted by COVID-19, specifically on minority groups, to the horrific murders of Black citizens by those in positions of authority and power, the world was once again reminded that racism is still alive. Black student-athletes are among those enduring trauma that has been consistent over centuries and are contending with the chronic nature of systemic racism as it pertains to being a Black athlete within the world of athletics and their respective schools. Through grounded theory, researchers captured the lived experiences of 14 Black student-athletes through qualitative interviews to ensure that sports psychology practitioners and researchers are equipped with the correct resources, knowledge, and skills, to aid in the healing of Black student-athletes although also advocating for expedited social reform and representation within the realm of education, law enforcement, politics, and mental health services. Five key domains emerged from this study including Identity Development, Perception and Expectations, Mental Health, Privilege, and Systems. The authors offer best practices within each domain in an effort to develop anti-racist practices to be implemented within athletic institutions and beyond. Lay summary: Black student-athletes are faced with systemic racism within all the worlds they live in, and as it pertains to being an athlete of color within the National Collegiate Athletic Association (NCAA). Black student-athletes are also coping with major life stressors and, as such, this paper gathered the lived experiences of student-athletes identifying as Black and explored how they experienced support during their tenure as student-athletes in an attempt to establish anti-racist and supportive practices within athletic communities. Develop strategies for athletes to understand and evaluate their identity. Integrate anti-racist practices into large systems including implicit bias training, undoing racism, and privilege education. Create tools and visuals for athletes of color, illustrating the institution's commitment to diversity, equity and inclusion.

COVID-19 job and income loss and mental health: the mediating roles of financial assets and well-being and the moderating role of race/ethnicity

Prior research shows unemployment has a negative effect on mental health, yet whether this relationship is affected by financial factors is unknown. For example, having money in savings may mitigate the impact of job loss on mental health. We use structural equation modeling with data from the Socio-Economic Impacts of COVID-19 Survey with a nationally representative sample (N = 3,341) to examine COVID-19 related job loss and mental health as partially mediated by liquid assets and Financial Well-Being (FWB) and moderated by race and ethnicity as moderators. More than a quarter (28.34%) of participants said they experienced a job or income loss due to COVID-19, which was associated with greater psychological distress as measured by the PHQ-4. The structural model had excellent fit (RMSEA = 0.021);FWB partially mediated the relationship between job/income loss and mental health (p <.001), accounting for 49% of the total effect. However, liquid financial assets did not partially mediate this relationship. Black participants experienced very different direct and indirect effects. Social workers should assess and intervene concerning financial factors when individuals experience job loss. Job loss is different among Black individuals who face greater challenges related to structural racism yet also have greater resilience.

Covid, schooling and race in England: a case of necropolitics

In this paper, I focus on the UK government's Covid-19 pandemic response to schooling in England with regards to the impact on race inequality, an area which has received comparatively little attention. I review the existing research, drawing on work by academics, think tanks, lobbying organisations and media reports, conducted between spring 2020 and autumn 2021, and argue that this evidence suggests that the UK government's pandemic response firstly has increased existing racial disadvantage for Black, Asian and Minority Ethnic (BAME) pupils in education, and secondly, it has potentially increased the exposure of BAME households to illness and death. I further argue that not only can education policy in response to Covid be considered to be an example of white supremacy, but it is an example of necropolitics, defined as ‘the power and the capacity [of the state] to dictate who may live and who must die' (Mbembe 2013, 161). I conclude by making some recommendations for wide-reaching social and educational change. © 2022 Informa UK Limited, trading as Taylor & Francis Group.

Assessment of Mental Health and Coping Disparities Among Racial and Ethnic Groups Amid COVID-19 From the "How Right Now" Campaign

Objectives: How Right Now (HRN) is an evidence-based, culturally responsive communication campaign developed to facilitate coping and resilience among US groups disproportionately affected by the COVID-19 pandemic. To inform the development of this campaign, we examined patterns in emotional health, stress, and coping strategies among HRN's audiences, focusing on differences among racial and ethnic groups. Methods: We used a national probability panel, AmeriSpeak, to collect survey data from HRN's priority audience members in English and Spanish at 2 time points (May 2020 and May 2021). We conducted statistical testing to examine differences between time points for each subgroup (Hispanic, non-Hispanic Black, and non-Hispanic White) and differences among subgroups at each time point. Results: We found disparities in COVID-19–related mental health challenges and differences in coping strategies. Non-Hispanic Black respondents were more likely than non-Hispanic White respondents to report challenges related to the social determinants of health, such as affording food and housing (26.4% vs 9.4% in May 2020) and experiencing personal financial loss (46.6% vs 29.2% in May 2020). In May 2021, 30.6% of Hispanic respondents reported being unable to meet basic food or housing needs versus 8.2% of non-Hispanic White respondents, and 51.6% reported personal financial loss versus 26.5% of non-Hispanic White respondents. Conclusions: Our study further illuminates what is needed to build emotional well-being pathways for people who historically have been economically and socially marginalized. Our findings underscore the need for public health interventions to provide culturally responsive mental health support to populations disproportionately affected by COVID-19 during the pandemic and into the future, with a focus on racial and ethnic disparities.

Pandemics and Management of "Dangerous Communities”: Ebola, COVID-19, and Africans in China

How do we unpack and make sense of anti-African/Black sentiments in the pandemic control and mitigation practices in China? This article responds to the question by drawing a parallel between the experiences of Africans in China during the Ebola virus disease and COVID-19 outbreaks. Focusing specifically on Nigerians as a subsection of the African community in Guangzhou City, China, it explores how the COVID-19-inspired discrimination against Africans reflects much of the experiences of Africans in China during the Ebola crisis of 2014. The article combines sixteen "Ebola experience” data points, obtained from Nigerians in Guangzhou in 2017, with four COVID-19 experience virtual interviews, media reports, and social media archive and netnographic analysis covering April to June 2020. The experiences of Africans in Guangzhou in the early months of the COVID-19 outbreak reflect a patterned response to Africans and Blackness in the context of pandemic in China. The article contributes to the literature by examining the question of racial discrimination and the construction of African immigrant community in China as dangerous within the new geography of Afro-mobilities in East Asia. © 2022 by American Association of Geographers.

Racial bias in perceptions of disease and policy

Narratives about Africa as dark, depraved, and diseased justified the exploitation of African land and people. Today, these narratives may still have a hold on people's fears about disease. We test this in three (pre-COVID-19) experiments (N = 1,803). Across studies, we find that participants report greater worry about a pandemic originating in Africa (vs. elsewhere). In turn, they report greater support for travel bans and for loosening abortion restrictions. We then document these narratives in an archival study of newspaper articles of the 2015–2016 Zika pandemic (N = 1,475). We find that articles were more negative—for example, they included more death-related words—if they mentioned Africa. Finally, we replicate the experimental results within the COVID-19 context, using a representative sample (N = 1,200). Taken together, the studies make clear that reactions to pandemics are biased, and in a way consistent with historical narratives about race and Africa. © The Author(s) 2022.

Caregivers of Black and Latino/a/x Students and School Personnel Perspectives on School-Based SARS-CoV-2 Testing: Implications for Testing and Test-to-Stay Programs in K-12 Schools.

BACKGROUND: "Test-to-stay" (TTS) is an effective approach for keeping students in school post-exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To prepare for school-based SARS-CoV-2 testing, we implemented formative research to gather perspectives on school-based testing among school personnel, as well as caregivers of Black and Latino/a/x students given systemic racism, existing school inequalities, and the disproportionate effect of COVID-19 on Black and Latino/a/x populations. METHODS: We conducted in-depth interviews with caregivers of K-12 grade Black and Latino/a/x students and focus group discussions with K-12 school personnel. We described the forthcoming school-based SARS-CoV-2 testing program and explored potential benefits and concerns, including concerns about testing-related stigma and discrimination, particularly toward Black and Latino/a/x students, and implementation recommendations. RESULTS: Perceived testing benefits included school community reassurance and preventing school outbreaks. Concerns included potential student anxiety, classroom disruption, inaccurate results, and limited information for caregivers. Some participants mentioned that testing-related stigma and discrimination could happen based on the testing selection process or results but not due to race or ethnicity. Participants provided numerous testing recommendations, including suggestions to prevent negative outcomes. CONCLUSIONS: Participants believed that stigma and discrimination from SARS-CoV-2 testing is possible, although differential treatment based on race or ethnicity was not anticipated. Participants' narratives provide support for school-based testing and the testing component of TTS.

An exploration of structural determinants driving racial disparities in COVID-19 deaths in Michigan.

Aim: Racial disparities in COVID-19 death rates have largely been driven by structural racism in health, housing, and labor systems that place Black, Brown, and Indigenous populations at greater risk for COVID-19 exposure, transmission, and severe illness, compared to non-Hispanic White populations. Here we examine the association between taxable property values per capita, an indicator influenced by historical and contemporary housing policies that have disproportionately impacted people of color, and COVID-19 deaths. Methods: Taxable values serve as a proxy for fiscal health providing insight on the county's ability to address imminent needs, including COVID-19 responses. Therefore, higher taxable values indicate local governments that are better equipped to deliver these public services. We used county-level data from the American Community Survey, the Michigan Community Financial Dashboard, The Atlantic's COVID Tracking Project, and the Community Health Rankings and Roadmap for this cross-sectional study. Maps were created to examine the geographic distribution of cumulative death rates and taxable values per capita, and regression models were used to examine the association between the two while controlling for population density, age, education, race, income, obesity, diabetes, and smoking rates. Results: Seventy-five counties were included. The mean taxable value per capita was $43,764.50 and the mean cumulative death rate was 171.86. Findings from the regression analysis showed that counties with higher taxable values were associated with lower COVID-19 death rates (B = -2.45, P < 0.001). Conclusion: Our findings reveal a need to reevaluate current policies surrounding taxable property values in the state of Michigan, not solely for their inequitable impact on local governments' financial solvency and service quality, but also for their negative consequences for population health and racial health equity. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-022-01817-w.

Change Management Strategies Towards Dismantling Race-Based Structural Barriers in Radiology.

Political momentum for antiracist policies grew out of the collective trauma highlighted during the COVID pandemic. This prompted discussions of root cause analyses for differences in health outcomes among historically underserved populations, including racial and ethnic minorities. Dismantling structural racism in medicine is an ambitious goal that requires widespread buy-in and transdisciplinary collaborations across institutions to establish systematic, rigorous approaches that enable sustainable change. Radiology is at the center of medical care and renewed focus on equity, diversity, and inclusion (EDI) provides an opportune window for radiologists to facilitate an open forum to address racialized medicine to catalyze real and lasting change. The framework of change management can help radiology practices create and maintain this change while minimizing disruption. This article discusses how change management principles can be leveraged by radiology to lead EDI interventions that will encourage honest dialogue, serve as a platform to support institutional EDI efforts, and lead to systemic change.

New considerations of health disparities within allergy and immunology.

The pandemic, political upheavals, and social justice efforts in our society have resulted in attention to persistent health disparities and the urgent need to address them. Using a scoping review, we describe published updates to address disparities and targets for interventions to improve gaps in care within allergy and immunology. These disparities-related studies provide a broad view of our current understanding of how social determinants of health threaten patient outcomes and our ability to advance health equity efforts in our field. We outline next steps to improve access to care and advance health equity for patients with allergic/immunologic diseases through actions taken at the individual, community, and policy levels, which could be applied outside of our field. Key among these are efforts to increase the diversity among our trainees, providers, and scientific teams and enhancing efforts to participate in advocacy work and public health interventions. Addressing health disparities requires advancing our understanding of the interplay between social and structural barriers to care and enacting the needed interventions in various key areas to effect change.

COVID-19 Vaccine Hesitancy and Racial Discrimination among US Adults.

Vaccination is a critical preventive measure to reduce COVID-19 health risks. We utilize full information maximum likelihood (FIML) logistic regression to analyze COVID-19 vaccine hesitancy in a national sample of United States (US) adults (N=2,022). Online survey data was collected between September 7th and October 3rd, 2021. Before weighting, the racial composition of the sample was as follows: Asian American (15.0%), Black/African American (20.0%), Hispanic/Latino (20.0%), American Indian or Alaska Native (12.6%), Native Hawaiian or Pacific Islander (12.5%), and White (20.0%). Informed by the Increasing Vaccination Model (IVM), we assessed the relationship between COVID-19 vaccine hesitancy and experiences of racial discrimination (Krieger's 9-item measure). Odds of COVID-19 vaccine hesitancy were greater for most younger age groups, women (OR=1.96; 95% CI[1.54, 2.49]), Black/African American respondents (OR=1.68; 95% CI[1.18, 2.39]), those with a high school education or less (OR=1.46; 95% CI[1.08, 1.98]), Independent (OR=1.77; 95% CI[1.34, 2.35]) or Republican political affiliation (OR=2.69; 95% CI[1.92, 3.79]), and prior COVID-19 infection (OR=1.78; 95% CI[1.29, 2.45]). Odds of COVID-19 vaccine hesitancy were 1.04 greater for every one unit increase in lifetime experiences of racial discrimination (95% CI[1.02, 1.05]). Odds of COVID-19 vaccine hesitancy were lower for Asian American respondents (OR=.682; 95% CI[.480, .969]), and those who had a primary care doctor had reduced odds of COVID-19 vaccine hesitancy (OR=.735; 95% CI[.542, .998). Our primary finding provides support for a link between experiences of racial discrimination and hesitancy towards a COVID-19 vaccine among US adults. We discuss implications for public health officials and future research.

A commitment to hope

On April 1, we made the decision to reconfigure our scheduled special issue on Behavioral Health to the topic of this issue - Sustaining a Focus on Human Experience in the Face of COVID-19. In the midst of crisis, we were uncertain how people would respond to this call or even if they could in the face of the realities they were addressing each day. Yet, the research, cases and stories started to arrive. The contributions in this special issue represent a patchwork of powerful insights and a historic record to document this moment. What we have brought together includes the best of real-time insights and research, powerful stories and personal reflections that are so central to this time, one that has called on all of us to dig deeper, ask ourselves personal and essential questions and remind ourselves what really matters overall. We are deeply moved and inspired by the speed, thoughtfulness and comprehensive nature with which our contributors engaged, many of whom were tackling this crisis but still took time to contribute to a conversation beyond themselves. That may be the most powerful lesson of all: that in struggling with each of our own personal or individual organizational issues, we remained called to come together to share something beyond ourselves. As you review the pages that follow, we challenge you to uncover a new idea or practice;discover an inspiration or opportunity to reflect, release or breathe;find a seed of hope. For in the generous and both heartful and thoughtful words of our contributors, we not only capture this moment in our history, we also feed the roots of possibility from which we will all spring in the days ahead. © The Author(s), 2020.

Moving from talk to action: A commitment to ensuring equity must ground our efforts to transform the human experience

When we first introduced the call for submissions for this special issue last August, we were still churning in the first wave of the COVID pandemic. Just three to four months from the start of an unending rash of unexpected and harsh realities that we were faced with in healthcare and in society at large, we too found that the moment was revealing all the weaknesses and wounds that had existed in the foundations of the healthcare system from well before the pandemic hit. Our own research at The Beryl Institute in 2020 reinforced a quiet reality: that people do experience discrimination in healthcare. In fact, 35% of Black Americans reported experiencing some sort of discrimination often or sometimes, 1 and this unquestionably has an impact on their care. The challenges that healthcare has long faced in ensuring equitable access, care, treatment and outcomes were only further laid bare by the crisis. And there is still much work to do. The road that led to this Special Issue reveal that truth and the articles shared on these pages confirm it. But they too show us seeds of possibility, that when we focus on what is right for all who healthcare aspires to serve, then we can truly achieve the greatest in human experience for all. And that is exactly what every person ultimately deserves. © The Author(s), 2021.

Getting comfortable with being uncomfortable: A conversation with Marsha Sinanan-Vasishta

We find ourselves managing two critical moments and a powerful confluence of events, one a crisis in health. We are still facing the COVID crisis, and we are trying very hard to rely on evidence and truth that will lead us forward in addressing that in the best way possible. We are also in a crisis of humanity, one that has been simmering beneath the surface for years, the issue of systemic racism and disparities in healthcare, further highlighted by the COVID crisis. This article shares the conversation I had with Marsha Sinanan-Vasishta, MSN, MBA, RN, NEA-BC, CPXP, Deputy Chief Nursing Officer, Patient Care Services Mount Sinai/Morningside as part of The Beryl Institute's bi-weekly community briefing series on the special topic of addressing systemic racism and health disparities in a time of crisis. Ultimately Marsha called us on to seize this moment to act, to find ways to get comfortable in being uncomfortable with relentlessness and ultimately to take this moment, which could be one of fear and doubt, to truly be brave. © The Author(s), 2020.

Using diverse community feedback to inform inclusive community action: Insights from the Louisiana Community Engagement Alliance

Purpose of Study: Clinical trial participation remains low among US minority groups, who account for <1/10 of trial participants.1,2 Diverse, equitable and inclusive participation is needed to lessen disparities in health status and clinical outcomes.3 Community-based participatory research (CBPR) strategies identify salient community issues, and may be useful for understanding and addressing participation barriers among minority groups.4,5 The Louisiana Community Engagement Alliance Against COVID-19 Disparities (LA-CEAL) - a partnership of universities, community pharmacies, faith-based organizations (FBOs), and federally qualified health centers (FQHCs) - aims to strengthen and leverage community relationships to address barriers to uptake of preventive/therapeutic strategies in underserved populations. This study examines the utility of LA-CEAL's CBPR approach in facilitating inclusive participation in clinical trials. Methods Used: Listening forums were held with a diverse group of LA community stakeholders, including healthcare providers, community pharmacists, FBO leaders and other trusted community members, to gather views on the need for and challenges to inclusive trial participation. Ongoing discussions between community representatives and leaders, academics and program staff facilitated outreach and guided development of informational strategies targeting minority groups. Summary of Results: Listening forums (N = 4;20 participants) revealed limited awareness, mistrust and fear stemming from historical and present injustices, and difficulty accessing opportunities as key themes underlying barriers to participation. To address identified barriers, 8 video testimonials featuring participants, investigators, and health advocates (62.5% Black;12.5% Hispanic;50% female) were developed to educate on expectations and experiences, motivations to participate, human subject protections, and the importance of diversity. Two animated videos featuring trusted community leaders and cultural ambassadors (e. g., New Orleans cultural icon, Irma Thomas) were created to explain trial processes, discuss participation benefits, and address the history of racism in medicine. Finally, connections between the Tulane Clinical Translational Unit and rural FQHCs enabled clinical trial study buses to visit and recruit in diverse LA communities. Conclusion(s): Via LA community stakeholder discussions, targeted strategies to address barriers to minority participation in clinical trials were developed and applied. Use of CBPR strategies was critical to developing intentional action reflective of LA community needs. Copyright © 2023 Southern Society for Clinical Investigation.

Being (Asian) American children: children's exploration of racial/cultural identity and racism

This study explores young Asian American children's emerging ideas of racial identity and experiences of racism through multimodal representations during the COVID-19 Pandemic. To explore children's identity and understanding of racial experience, we used Suda (수다) with children, which refers to deeply engaged conversations and often involves participants' emotions. Adopting autoethnography, we used multiple data sources, including documentation of children's conversations with family relating to their identity and experiences of racism and a collection of children's artifacts. Findings showed that our children explored their racial identity in various aspects surrounding them, ranging from their body, classroom materials, and passports to their family origins. Suda provided the space for our children to freely explore their racial identities and experiences of Asian racism/Hate Crime. [ FROM AUTHOR]