Rapidly developing communications materials during public health emergencies: the Âu CÆ¡ campaign in the USA.

During public health emergencies, health communication materials to contain the outbreak are needed promptly, which prevents the use of standard approaches for getting feedback from the intended audience. We propose a strategy for rapidly obtaining community feedback on new health communication materials during the public health emergencies. We illustrate this with COVID-19 testing campaign in a Vietnamese-American enclave in the USA. The project included community-based COVID-19 testing and communication activities to increase the awareness of the testing centers and encourage frequent testing. Our strategy involves two main components: (i) use of a research team with an existing trust relationship with the community and that includes researchers from that community and (ii) co-design of communication materials using community-based gatekeepers and a cultural broker. We developed brochures and posters to increase the awareness of the COVID-19 testing services. The cultural broker and community-based partners identified salient message concepts and worked with the researchers to define the objectives and content of the materials, which were then reviewed by the entire team. In lieu of standard pretesting, we relied on feedback on mockups of the materials and subsequent revisions from the community-based gatekeepers and cultural broker. Our strategy strikes a balance between the need to urgently disseminate new materials and the need for community input. One key takeaway is that effective planning for public health emergencies must start long before the crisis occurs.

The impact of early social support on subsequent health recovery after a major disaster: A longitudinal analysis.

Social support may facilitate disaster recovery. Prior analyses are hampered by the limits of cross-sectional approaches. We use longitudinal data from the KATIVA-NOLA survey to explore whether social support soon after Hurricane Katrina facilitated recovery of health status for a representative sample of 82 Vietnamese New Orleanians. Health and social support were assessed just before Hurricane Katrina (2005), soon afterwards (2006, 2007), and at longer durations post-disaster (2010, 2018). We use random effects regression to examine how social support measured in 2006 influences mental and physical health measured in 2006, 2007, 2010, and 2018. Social support soon after Katrina was positively associated with physical health and mental health years later in 2010, even after controlling for potential confounders such as Katrina-related housing damage and pre-Katrina health and support and modeling an interaction between year and social support in 2006. Other immigrants who are highly impacted by a major disaster could benefit from programs that seek to rapidly reconstruct systems of social support.

Disentangling the effects of migration, selection and acculturation on weight and body fat distribution: results from a natural experiment involving Vietnamese Americans, returnees, and never-leavers.

We distinguish between selection and true migration effects on weight and body fat for Vietnamese immigrants; and examine the role of acculturation on these outcomes. Data (n = 703) were collected among three population-based samples of working-age Vietnamese immigrants, repatriated emigrants and never-migrated Vietnamese nationals. This allows for a decomposition exercise to separate the effects of migration effects from selection effects on body mass index (BMI) and waist-hip ratio (WHR). Immigrants are more likely to be overweight and to have high WHR, relative to both never-leavers and returnees, a pattern reflecting the importance of migration over selection. Among immigrants, coming to the US at a younger age is associated with higher BMI and WHR levels. And longer length of residence in the US is related to higher BMI. While higher Vietnamese language proficiency is related to a lower BMI level, being bilingual (proficient in both English and Vietnamese) is associated with lower risks for being overweight. The distinct pattern of results suggests that more problematic weight status and fat distribution among Vietnamese immigrants relative to Vietnamese nationals are not artifacts of the types of persons choosing to emigrate, but rather are due to acculturation to American diet and lifestyles. While efforts to promote and maintain traditional patterns of diet and lifestyle are likely to help Vietnamese and other immigrants avoid the perils of American patterns, facilitating a bi-cultural orientation is perhaps the most realistic approach for preserving protective features of the culture of origin with regard to body weight and fat distribution.

Mental health consequences of international migration for Vietnamese Americans and the mediating effects of physical health and social networks: results from a natural experiment approach.

Although the existing literature on immigrant mental health is extensive, major substantive and methodological gaps remain. Substantively, there is little population-based research that focuses on the mental health consequences of migration for Vietnamese Americans. More generally, although a wide range of mental health problems among immigrants has been identified, the potential causal or mediating mechanisms underlying these problems remain elusive. This latter substantive shortcoming is related to a key methodological challenge involving the potentially confounding effects of selection on migration-related outcomes. This article addresses these challenges by employing a "natural experiment" design, involving comparisons among three population-based samples of Vietnamese immigrants, never-leavers, and returnees (N=709). Data were collected in Ho Chi Minh City and in New Orleans between 2003 and 2005. The study investigates the long-term impact of international migration on Vietnamese mental health, and the potential mediating effects of social networks and physical health on these migration-related outcomes. The results reveal both mental health advantages and disadvantages among Vietnamese immigrants relative to the two groups of Vietnamese nationals. Selection can be ruled out for some of these differences, and both social networks and physical health are found to play important explanatory roles.

Physical and mental health consequences of Katrina on Vietnamese immigrants in New Orleans: a pre- and post-disaster assessment.

We assessed the health impacts of a natural disaster upon a major immigrant community by comparing pre- and post-event measures for identical individuals. We collected standard health measures for a population-based sample of working-age Vietnamese-Americans living in New Orleans in 2005, just weeks before Katrina occurred. Near the first- and second-year anniversaries of the event, we located and re-assessed more than two-thirds of this original pre-Katrina cohort. We found statistically significant declines in health status for seven of the eight standard SF-36 subscales and for both the physical and mental health component summaries at the first anniversary of the disaster. By the second anniversary, recovery of the health dimensions assessed by these measures was substantial and significant. Most of the SF-36 mental and physical health subscales returned to their original pre-Katrina levels. Being in middle-age, being engaged in professional or self-employed occupations, being unmarried, being less acculturated, and having extensive post-Katrina property damage have statistically significant negative effects on post-Katrina health status, and several of these factors continued to impede recovery by the second anniversary. Hurricane Katrina had significant negative impacts on the mental and physical health of Vietnamese New Orleanians. Several factors present clear opportunities for targeted interventions.

PTSD in Vietnamese Americans following Hurricane Katrina: prevalence, patterns, and predictors.

One year after Hurricane Katrina devastated New Orleans, we assessed 82 adults from a population-based sample of the Vietnamese American community who had participated in a larger study of immigration weeks before the disaster. Although 21% met criteria for partial posttraumatic stress disorder (PTSD), only 5% of the sample met all PTSD criteria. Avoidance/numbing symptoms did not form a coherent cluster and were seldom confirmed, but intrusion, arousal, and interference were common. Severity of exposure to the floodwaters, property loss, and subjective trauma were independently related to PTSD symptoms. Symptoms were highest among participants who were low in acculturation or who had high Katrina exposure in combination with prolonged stays in transition camps during emigration.

Evacuation and Return of Vietnamese New Orleanians Affected by Hurricane Katrina.

Hurricane Katrina struck near New Orleans on August 29, 2005, and resulted in the collapse of the federal protective levee system and the flooding of most of the city. New Orleans East, where the main Vietnamese enclave is located, was especially hard hit. By chance, just weeks before this disaster occurred we collected with our colleagues a wide range of demographic and health data for a population-based sample of working age Vietnamese Americans living in New Orleans. One year after the storm, we re-interviewed everyone from the original sample who had returned to the area. This re-interview sample included about two-thirds of the original sample.Those who had returned by the one year point were more likely than those yet-to-return to have been employed before the storm, to have worked in the skilled sector of the economy, to have been married, and to have been a home owner. Many problems experienced during the immediate aftermath of the storm, such as crowded and unsanitary conditions, had been resolved by the one-year anniversary. Other problems remain, such as a continuing lack of information, lack of access to medical care, and fears of violent crime.

Disparities in health care among Vietnamese New Orleanians and the impacts of Hurricane Katrina.

This paper examines the use of routine health care and disparities by socio-economic status among Vietnamese New Orleanians. It also assesses how these differences may have changed as the result of Hurricane Katrina, which struck the Gulf Coast in late summer 2005, devastating the infrastructure of the health care system of New Orleans. Data for this study come from a panel of Vietnamese New Orleanians who were interviewed in 2005, just weeks before the hurricane, and followed up twice near the disaster's anniversary in 2006 and 2007. Findings show a steep declining trend in routine health care after the hurricane, compared to 2005. Marked differences in health care were already apparent in 2005 (before Katrina) between education levels, home ownership, and health insurance coverage. These differences were significantly reduced one year after the hurricane. We argue, however, that the reduction in disparities was not due to improved health care services or improved health care practice. Instead, it was likely due to the influx of free health care services that were provided to meet urgent needs of hurricane survivors while the area's infrastructure was devastated. By 2007, these free health care services were no longer widely available. Routine health visits dropped further and the temporary reduction in disparities disappeared. The paper also underlines ongoing shortages of essential health care services for Vietnamese New Orleanians. Efforts need to ensure that all members of this community receive the full array of comprehensive and culturally-appropriate health care as they continue to rebuild from the Katrina disaster.

Murder rates in New Orleans, La, 2004-2006.

Murder rates for New Orleans, La, during 2005 and 2006 were calculated with the best available population trajectories for these 2 atypical years. These calculations showed that the murder rate increased substantially during this period compared with 2004. The increase in 2005 from 2004 was 14%. The best estimate of the increase in the murder rate in 2006 compared with 2004 was 69%; the large increase in 2006 began during the second quarter of that year.

Community reaction to persons with HIV/AIDS and their parents: an analysis of recent evidence from Thailand.

We systematically examine community reaction to persons living with HIV/AIDS (PHAs) and their older parents in Thailand. We focus on parents as well as PHAs because parents are major providers of care for their ill adult children. Our analyses are based on several sources of recently collected survey and qualitative data from a wide range of perspectives. We find important variations in community reaction to PHAs and their families, but overall these reactions are much more positive than is widely assumed. We conclude that much existing research on community reaction to AIDS neglects both a rich body of social theory on stigma and a strong tradition of population-based empirical research in sociology. Much existing research also fails to adequately distinguish between key aspects of the social settings where most AIDS cases occur and the social settings where most of the stereotypes surrounding AIDS-related stigma have originated. A closer marriage between empirical and theoretical approaches to social stigma is required to advance our understanding of this critically important dimension of the AIDS epidemic.