East Asian Population.

This article explores the ways East Asian American (EAA) children and adolescents have experienced disparities in the United States throughout the COVID-19 pandemic. The history of racism toward Asian American and Pacific Islanders (AAPI) and the complexities of acculturation are reflected through this contemporary lens. Traditional East Asian (EA) values were disrupted during this period. Implications for children and families are discussed. Persistent underlying xenophobia and racism, such as the model minority myth or perpetual foreigner stereotype, rose to new prominence, furthering emotional distress in EA and EAA youths beyond those already experienced universally by AAPI families during the pandemic.

Acculturation, Work-Related Stressors, and Respective Coping Strategies among Male Indonesian Migrant Workers in the Manufacturing Industry in Taiwan: A Post-COVID Investigation.

Globalization has prompted cross-cultural migration in search of employment opportunities, and poor adaptation during acculturation is widely known to cause additional psychosocial stress. Hence, the objective of this study was to investigate migrant workers' perceptions of acculturation, identify work-related stressors, and understand the respective coping strategies among male Indonesians in the manufacturing industry, particularly during the COVID-19 pandemic. Fifteen workers were recruited and interviewed on their acculturation experiences. We found that the workers were susceptible to forced adaptation to stressful conditions relating to work organization, economic distress, interaction with the manpower agencies, language barriers, and so on. During the pandemic, workers experienced overload, economic hardship, suspended home visits, isolation, discrimination, and fear of cluster infection in the crowded dormitory. We also found that workers were able to adopt coping strategies by capitalizing on resources at the individual, institutional, and governmental policy levels to actively solve problems, increase emotional support, and fortify self-appraisals. The identified coping strategies could inform policy development to assist with positive adaptation and promote the well-being of the migrant worker population.

Anti-Asian Hatred and Japanese Parents' Support of Their Children's Acculturation to the United States.

This ethnographic study explores how Japanese immigrant and temporary resident parents support their children's acculturation to U.S. society. Anti-Asian hatred is a neglected social justice issue with a long history extending to hate crimes during the COVID-19 pandemic. Yet the U.S. population includes an increasing number of Asian immigrants. Some of them, such as recent Japanese immigrants and temporary residents, are from majority groups in their countries of origin, and do not have cultural socialization practices to protect their children from racism and xenophobia. This article focuses on in-depth, individual interviews with 14 Japanese immigrant and temporary resident parents of children attending U.S. local schools. Parents described their cultural socialization as centering on developing a Japanese cultural self, for example, through participation in a Japanese supplementary school. Parents also reported experiences of anti-Asian racism and xenophobia, including social exclusion. However, they typically did not describe preparing children directly for responding to and coping with anti-Asian bias. Rather, they and their children took responsibility for bias directed against them, and avoided drawing attention to their differences. Authors discuss implications for how social workers can recognize distress in Japanese children and effectively support them and others experiencing similar acculturation challenges.

How Does Migration Background Affect COVID-19 Vaccination Intentions? A Complex Relationship Between General Attitudes, Religiosity, Acculturation and Fears of Infection.

Objectives: The aim of the study is to investigate the relationship between migration background and COVID-19 vaccine intentions, exploring multiple mediation paths. We argue that the migrational and sociocultural background influences general attitudes toward health and political/public institutions. The effects of these general attitudes on vaccination intentions are mediated by fears of infection. Additionally, we analyze a migrant-only model including acculturation variables (years since migration, foreign and host country media consumption) and region of origin (European vs. Non-European). Design: The data (n = 1027) stem from an online access panel collected between March 15 and March 25, 2021. Quotas for gender and age were set according the online population of Germany. The use of an oversampling framework for first generation migrants resulted in a sample with 50% first generation migrants and 50% native Germans without migration background. Models were calculated using a Structural Equation Modeling approach. Results: Migration background both increases and decreases antecedents of vaccination intentions. Being a migrant increases positive antecedents like religiosity, which in turn positively influence general attitudes and thus fears of infection and vaccination intentions. But being a migrant has also a significant direct negative association with vaccination intentions, implying missing mediators. Increasing years since migration increase host country (German) media consumption and decrease consumption of media from the country of origin. Both media variables are positively associated with political trust and health consciousness. Additionally, European compared to Non-European migrants have less political trust, fear of personal infection and lower vaccination intentions on the whole. Conclusions: The study found that vaccination intentions can be understood by applying the proposed hypothetical structure. We found complex associations of the migration and sociocultural background and COVID-19 vaccination intentions, where antecedents of vaccination intentions are both increased and decreased by migration background and migration specific factors.

Hispanic/Latino Acculturation Profiles and Telomere Length: Latent Class Analysis on a Nationally Representative Sample.

Background: Acculturation profiles and their impact on telomere length among foreign-born Hispanics/Latinos living in the United States (US) are relatively unknown. The limited research available has linked acculturation with shortened telomere length. Objectives: To identify acculturation profiles among a US representative sample of Hispanics/Latinos and to then examine telomere length differences between profiles. Methods: We conducted a latent class analysis among a non-institutionalized US-representative sample of Hispanics/Latinos using the 1999-2002 National Health and Nutrition Examination Survey (N = 2,292). The latent variable of acculturation was assessed by length of time in the US and language used as a child, read and spoken, usually spoken at home, used to think, and used with friends (i.e., Spanish and/or English). Telomere length assessed from leukocytes was used as the distal continuous outcome. Results: We identified five profiles: (1) low acculturated [33.2% of sample]; (2) partially integrated [18.6% of sample]; (3) integrated [19.4% of sample]; (4) partially assimilated [15.1% of sample]; and (5) assimilated [13.7% of sample]. Acculturation profiles revealed nuanced differences in conditional probabilities with language use despite the length of time spent in the US. While telomere length did vary, there were no significant differences between profiles. Conclusion: Profiles identified revealed that possible life-course and generational effects may be at play in the partially assimilated and assimilated profiles. Our findings expand public health research using complex survey data to identify and assess the dynamic relationship of acculturation profiles and health biomarkers, while being among the first to examine this context using a person-centered approach.

Integrative Review of Disparities in Mode of Birth and Related Complications among Mexican American Women.

INTRODUCTION: Cesarean rates are particularly high among Hispanic women in some regions of the United States, placing a disproportionate health burden on women and their newborns. This integrative review synthesized the literature on mode of birth (vaginal vs cesarean) and related childbirth complications (hemorrhage, surgical site infection, perineal trauma) among Mexican American women living in the United States. METHODS: Four electronic databases, PubMed, Embase, CINAHL, and SCOPUS, were searched to identify studies meeting the inclusion criteria, research studies that included Mexican American women who were pregnant or postpartum. Results were limited to English language and publications that were peer-reviewed and published before May 2020. Covidence was used in article identification, screening, and assessment. Critical appraisal of the research was performed using the Quality Assessment Tool for Studies with Diverse Designs. RESULTS: Ten articles met inclusion criteria. In some studies, Mexican American women born in the United States were more likely to have cesareans than women born in Mexico; in other studies, these findings were reversed. Mexican American women often had lower unadjusted cesarean rates compared with non-Hispanic white women, but adjusting for birth facility (some facilities perform more cesareans than others), sociodemographic, and risk factors often revealed Mexican American women have a higher adjusted risk for cesarean birth. Women with higher socioeconomic status had higher cesarean rates compared with women with lower socioeconomic status. In studies of birth outcome by level of acculturation, women who were US-oriented had higher rates of cesarean and more frequent perinatal complications. By ethnic subgroup, rates of cesarean and complications varied among Hispanic women. DISCUSSION: Birth facility was associated with perinatal outcomes for Mexican American women; those who gave birth at higher-performing facilities had better outcomes when compared with women who gave birth at lower-performing facilities. After adjusting for pregnancy complications, Mexican American women had a greater risk for cesarean birth compared with non-Hispanic white women, a finding that may have clinical practice implications. Level of acculturation affected birth outcomes, but more research using precise instruments is needed.

How stress, discrimination, acculturation and the gut microbiome affect depression, anxiety and sleep among Chinese and Korean immigrants in the USA: a cross-sectional pilot study protocol.

INTRODUCTION: Although a considerable proportion of Asians in the USA experience depression, anxiety and poor sleep, these health issues have been underestimated due to the model minority myth about Asians, the stigma associated with mental illness, lower rates of treatment seeking and a shortage of culturally tailored mental health services. Indeed, despite emerging evidence of links between psychosocial risk factors, the gut microbiome and depression, anxiety and sleep quality, very few studies have examined how these factors are related in Chinese and Korean immigrants in the USA. The purpose of this pilot study was to address this issue by (a) testing the usability and feasibility of the study's multilingual survey measures and biospecimen collection procedure among Chinese and Korean immigrants in the USA and (b) examining how stress, discrimination, acculturation and the gut microbiome are associated with depression, anxiety and sleep quality in this population. METHOD AND ANALYSIS: This is a cross-sectional pilot study among first and second generations of adult Chinese and Korean immigrants in the greater Atlanta area (Georgia, USA). We collected (a) gut microbiome samples and (b) data on psychosocial risk factors, depression, anxiety and sleep disturbance using validated, online surveys in English, Chinese and Korean. We aim to recruit 60 participants (30 Chinese, 30 Korean). We will profile participants' gut microbiome using 16S rRNA V3-V4 sequencing data, which will be analysed by QIIME 2. Associations of the gut microbiome and psychosocial factors with depression, anxiety and sleep disturbance will be analysed using descriptive and inferential statistics, including linear regression. ETHICS AND DISSEMINATION: This study has been approved by the Institutional Review Board at Emory University (IRB ID: STUDY00000935). Results will be made available to Chinese and Korean community members, the funder and other researchers and the broader scientific community.

Mixed methods study protocol to explore acculturation, lifestyles and health of immigrants from the Community of Portuguese-Speaking Countries in two Iberian contexts: how to face uncertainties amidst the COVID-19 pandemic.

INTRODUCTION: Studies which focus on the process of acculturation in the lifestyles, nutritional status and health of immigrants from the Community of Portuguese-Speaking Countries (CPLP) in the Iberian Peninsula are still scarce. This study aims to explore the influence of the acculturation process and dietary acculturation on the lifestyle and nutritional and health status of CPLP immigrants in Portugal and Spain, focusing on two Iberian contexts: Lisbon Metropolitan Area and the Basque Country. METHODS AND ANALYSIS: A mixed methods sequential explanatory design, combining cross-sectional studies and semistructured interviews. Official data will also be analysed. Primary data will be collected through a questionnaire and assessment of nutritional status and body composition. The estimated samples sizes are 1061 adults (≥18 years old) in the Lisbon Metropolitan Area and 573 in the Basque Country. Time-location sampling will be used for the quantitative component and non-probabilistic sampling for the qualitative component. If safety conditions are not guaranteed due to the COVID-19 pandemic, online studies will be conducted. The semistructured interviews will complement the questionnaire data and extend knowledge about the process of acculturation of CPLP immigrants and their relationship with eating habits and physical activity. Thematic analysis will be used for qualitative data. Triangulation of data derived from different methods will be carried out. An integrative approach will be used to address potential discrepancies in findings and limitations inherent to the study design. As inter-method discrepancies may occur, triangulation protocol will be used, elaborating a 'convergence coding matrix' to display findings emerging from each component of the study. ETHICS AND DISSEMINATION: Ethical approval was obtained through the IHMT Ethics Council (Doc No 20/2020), Portugal, and it was submitted to the Ethics Committee of the UPV/EHU (Doc No under revision), Spain.

International Medical Graduates: Promoting Equity and Belonging.

International medical school graduates (IMGs) play a vital role in the health care system of the United States. They constitute roughly one-quarter of the physician workforce, comprising a significant proportion of the primary care providers in high-need rural and urban areas, where they provide equal and, in some instances, better care than U.S. graduates. Nonetheless, they face a series of hurdles in entering U.S. residency programs and throughout their training experiences.IMGs must expend significant resources to obtain Education Commission for Foreign Medical Graduates certification, which includes Steps 1, 2 Clinical Knowledge and 2 Clinical Skills of the United States Medical Licensing Examination. They encounter the uncertainty of matching and, if successful, obtaining a visa to enter the United States. Once here, they need to adapt to the complexities of the health care system and familiarize themselves with the cultural nuances, professional behaviors, and communication skills of another country. They encounter biases and microaggressions and lack support groups and mentors. Those who choose an academic career are less likely to obtain leadership positions.This Perspective provides an overview of these challenges and highlights opportunities for change at local and national levels. Specifically, it identifies strategies that would assist IMGs before entry, at entry, during training, at the transition to practice, and in practice. The current COVID-19 pandemic highlights the shortage of physicians in the United States and illustrates the importance of ensuring that IMGs, who are essential health care workers, feel welcome, valued, and recognized for their contributions.