Evaluating a School-Based Intervention on Adolescents' Ethnic-racial Identity in Sweden.

Finding developmentally appropriate ways to support youth in understanding their own ethnic-racial identity is needed, particularly in contexts like Sweden where such support is not the norm. This preregistered longitudinal study examined whether an 8-week school-based intervention, the Identity Project, impacted youth ethnic-racial identity exploration (participation and search), resolution, private regard, and centrality. Participants were 509 adolescents in the 10th grade (Mage = 16.28, SD = 0.80; 65% self-identified girls; 52% minoritized ethnic background), who were randomized into an intervention or wait-list control group and assessed at baseline and three times post-intervention. The findings indicated an initial and simultaneous effect of the intervention only for exploration participation and resolution but did not show the expected chain of effects with earlier exploration predicting later resolution. Growth models indicated a greater increase in exploration participation over time for the intervention group than the control group. The findings indicate a mixed picture about the effectiveness of the intervention, with effects primarily narrowly targeted to exploration participation, but nevertheless highlight the potential for supporting Swedish youth in engaging with their ethnic-racial identities.

Using structural topic modeling to understand ethnicity-related narratives.

OBJECTIVE: Narrative identity is a promising approach for understanding the content of individuals' ethnic identities but can be limited by the time-intensive nature of human coding and the reliance on preestablished coding systems. BACKGROUND: The aim of our preregistered study is to elucidate the content of individuals' ethnicity-related experiences using a novel statistical approach. METHOD: We applied structural topic modeling (STM), a natural language processing tool, to narratives written by an ethnically diverse sample of 1149 young adults about a moment they felt aware of their ethnicity. RESULTS: We identified 14 topics within ethnicity narratives and analyzed how each topic related to both the participant's ethnicity and the human-coded themes of agency and communion. For example, the topic Gained perspective of structural inequality was associated with greater agency, whereas Peer dynamics was associated with greater communion. Ethnic/cultural celebration was associated with both. CONCLUSIONS: This study introduces STM as a useful tool for extracting topic content in narrative data and demonstrates how the multi-method assessment of ethnicity narratives provides greater insight into the content of ethnic experiences. These findings contribute to our understanding of contextualized aspects of personality, including the innovative ways we might examine them.

Differential item functioning of the revised Multigroup Ethnic Identity Measure (MEIM-R) in racially and income diverse youth with type 1 diabetes.

OBJECTIVE: Racially minoritized youth with T1D are made vulnerable to disproportionately adverse health outcomes compared to White peers due to enduring systems of oppression. Thus, understanding modifiable psychosocial factors associated with diabetes-related outcomes in racially minoritized youth may help to buffer deleterious effects of racism. One factor meriting exploration is racial-ethnic identity. There is currently limited research on measures fit to assess ethnic identity in youth with chronic illnesses. This study's purpose is to examine the factor structure, reliability, and validity of the revised Multigroup Ethnic Identity Measure (MEIM-R) in a racially- and income-diverse sample of youth with T1D across sociodemographic and illness-related proxies for one's positionality in oppressive systems. METHOD: As part of a larger study examining resilience, 142 youth with T1D ages 12-18 (Mage = 14.66, SDage = 1.62, 55.6% Black/African-American, 44.4% White) completed the MEIM-R and various psychosocial measures. HbA1c levels and illness duration were extracted from medical records and caregivers reported income information. Confirmatory factor analyses compared the structural validity of competing MEIM-R models, and uniform and non-uniform differential item functioning (DIF) was explored across sociodemographic and illness-related factors. RESULTS: While a bifactor structure was supported, the MEIM-R was found to exhibit DIF by race and gender on multiple MEIM-R items and did not demonstrate linear bivariate relations with other psychosocial factors. CONCLUSIONS: Since different MEIM-R item response patterns were observed across racial/ethnic and gender groups, caution is warranted in using this measure in racially and gender diverse youth with T1D.

Examining ethnic identity, school climate, and academic futility among minoritized students.

The present causal-comparative study examined the relation between school climate, ethnic identity, and academic futility among racially and ethnically minoritized students. The sample included 1721 racially and ethnically minoritized students identifying as Black, Asian, Latine, and Multiracial from 11 schools in the northeastern region of the United States. Regression models indicated a direct relation between the school climate subscales including School Connectedness, Safety, Character, Peer Support, Adult Support, Cultural Acceptance, Physical Environment, and Order and Discipline and academic futility for all groups in the study. Ethnic identity moderated the relation between school climate subscales and academic futility, although the impact differed across racial and ethnic groups. The present study's results highlight the similarities and differences in the educational experiences of minoritized students. The discussion provides recommendations for cultivating educational environments that are culturally affirming and informed to meet the needs of an increasingly diverse student population. Limitations and future directions are discussed.

Examining where to go: pediatric psychology trainees' perception of their graduate training in culture and diversity.

OBJECTIVE: Culture and diversity-related training is critical to the development of competent pediatric psychologists. Evaluation of training efforts have been conducted at the program level, yet evaluation of trainee experiences in culture and diversity-related training remains unassessed. This trainee-led study was the first formal assessment of pediatric psychology trainee experiences of culture and diversity-related training and the impact of training on their own cultural humility. METHODS: Study overview and a survey link was distributed across 2 listservs associated with the American Psychological Association (Division 53, Division 54) and sent directly to directors of graduate, internship, and fellowship training programs with a request to share with trainees. Surveys assessing integration of cultural training and trainee cultural humility were completed. Trainees also provided qualitative feedback regarding their multicultural training and development. RESULTS: Pediatric psychology trainees (N = 90) reported inconsistent integration of culture and diversity topics into their training. Of the 34 training areas assessed, 10 were perceived as thoroughly integrated into formal training by at least half of the respondents. Trainees often sought independent cultural training outside of their programs, and no relationship was detected between perceived integration of cultural training and trainee cultural competence. DISCUSSION: Results indicate room for improvement regarding integration of cultural training and a need to better understand driving forces behind trainees independently seeking training outside of their formal training programs. Moreover, understanding the aspects of training that are most contributory to trainee development is needed given that no relationship between training and development emerged in the current study.

Examining Indirect and Direct Effects of Risk and Resilience on the Relation Between Perceived Discrimination and Eating Disorder Symptoms in Ethnic Minority American Women.

Direct relationships between perceived discrimination and eating pathology in ethnic minorities are well-documented. However, theoretical work examining unique risk and resilience factors that strengthen or weaken the relation between these constructs in ethnic minorities is lacking. The current study aims to address this gap by incorporating stress-process and tripartite frameworks to examine social and personal resources as they relate to perceived discrimination and eating pathology. In a sample of Black, Asian, and Latine women (N = 296, M age = 30.82), social support did not mediate the relationship between perceived discrimination and eating pathology. A significant interaction effect was observed for thin-ideal internalization strengthening the relation between perceived discrimination and negative emotional eating. Thin-ideal internalization moderated the relation between perceived discrimination and negative emotional eating in Latine Women, and disordered eating in Black Women. Overall, findings suggest ethnic minority Women have both personal and social resources that may influence the strength of effect on the relation between perceived discrimination on eating pathology.

Forensic Assessments of Racial-Ethnic Differences in Genuine and Malingered Psychotic Presentations.

Competent forensic practice has required continued training and professional practice in differentiating between genuine and malingered presentations, especially within the spectrum of psychotic disorders. Historically, practitioners valued racial, ethnic, and cultural differences but often considered them as peripheral matters. In contemporary forensic practice, however, language and culture play preponderant roles. This commentary is focused on core features of malingering via a cultural lens. Three core, race-informed principles, such as biases against the African American Language, are highlighted and discussed. Related subjects for forensic practice include relevant clinical constructs such as malingering bias and "imposed etics," specifically, the imposition of mainstream values and discounting of cultural differences.

Friendship Homophily Trajectories among Asian American Youth from High School to College.

Friendship racial homophily, the tendency to form friendships with individuals who share the same racial background, is a normative developmental phenomenon that holds particular significance for youth of color in a racialized society. Yet, there exists a paucity of longitudinal research elucidating the stability and change of friendship racial composition across developmental span. This study aimed to examine the friendship racial homophily trajectories over a six-year period encompassing four time points. The sample comprised 437 Asian American youth (MAge = 16.52, SDAge = 1.36, 53% female), with 197 Filipino and 240 Korean participants. Using logistic multilevel modeling analyses, it was found that both Filipino and Korean American youth demonstrated an increase in friendship racial homophily from high school to college, but that Filipino youth overall reported lower levels of racial homophily compared to their Korean counterparts. The study findings also pinpointed several influential factors impacting these trajectories, including proficiency in heritage languages, ethnic identity, and encounters with racial discrimination from both White Americans and other People of Color. These results highlight the continuous evolution of friendship racial composition from high school to college and emphasize the crucial role of ethnic identity and experiences of discrimination in influencing these dynamics, with ethnic identity exerting more enduring effects and experiences of discrimination showing more situational impacts on the levels of racial homophily.

Long-term impact of familismo and ethnic identity on latinx college student drinking and high-risk consequences.

Familismo, ethnic pride, and ethnic shame were examined as longitudinal predictors of Latinx college student alcohol use and high-risk alcohol-related consequences. Latinx students completed measures during the fall of their first (T1), second (T2), and fourth (T4) year of college. T1 familismo was positively associated with T2 ethnic pride and negatively associated with T2 ethnic shame. T2 ethnic pride was negatively associated with T4 drinking, while T2 ethnic shame was positively associated with T4 drinking. T4 drinking was positively associated with T4 consequences. Results suggest that Latinx ethnic pride and ethnic shame during the second-year of college act as mediators between first-year familismo and fourth-year drinking and consequences.

Ethnic Identity Protects and Internalized Racism Harms Health and Coping in Asian Americans Following COVID-19 Discrimination: A Mixed-Methods Study.

Mechanisms underlying the link between COVID-19 anti-Asian racial discrimination and psychological health are underexplored. This mixed-methods study examined the moderating effects of ethnic identity and internalized racism on the relationship between COVID discrimination and behavioral health outcomes among Asian Americans. We hypothesized that individuals with lower ethnic identity and higher internalized racism levels would demonstrate more adverse outcomes, including worsened psychological trauma and identity-avoidant behaviors, post-discrimination. Asian American participants (N = 215) responded to a Qualtrics survey, including qualitative and quantitative questions on COVID-related racism experiences, ethnic identity, internalized racism, trauma, and other subsequent effects. For qualitative analysis, participants were sorted into four subgroups defined by low- and/or high-ethnic identity and internalized racism scores, and we explored themes in participant reports of identity-related coping effects after racism. We additionally used hierarchical multiple regression analyses to quantitatively assess the moderating impact of ethnic identity and internalized racism on the relationship between COVID discrimination and trauma. Analyses revealed no moderating effects from the two identity variables. However, qualitative analyses identified themes of identity-promoting and identity-avoidant behavioral responses, and moderation analyses revealed that ethnic identity had a main effect on mitigating racial trauma, while internalized racism exacerbated both racial trauma and PTSD levels. This study identified ethnic identity and internalized racism as underlying causes to behavioral health outcomes for Asian Americans. Results offer mental health providers serving Asian clients insight into identity-related influences to help optimize culturally appropriate interventions and support initiatives of identity promotion to foster community engagement for this population.

Perceived discrimination and multiple indicators of positive development among second-generation Chinese-American youth: The moderating role of ethnic identity.

BACKGROUND: The present study examined the associations among ethnic identity, perceived discrimination and multiple indicators of positive youth development (PYD; i.e., intrapersonal-oriented competence, interpersonal-oriented competence, confidence, caring, character, family connection, peer connection, school and community connection, positive attitudes towards diversity and cultural pride) that were specifically identified among second-generation Chinese-American youth. METHODS: Participants were 196 second-generation Chinese-American youth (N girl = 93; M age = 14.56, SD age = 1.75) primarily from the greater Boston area in MA, United States. Multivariate regression models were estimated to examine the associations between ethnic identity, perceived discrimination, and each potential indicator of PYD, as well as the moderating role of ethnic identity, controlling for key demographics. RESULTS: (1) Ethnic identity was positively related to all PYD indicators, ßs = .32 to .72, ps < .01; (2) perceived discrimination was negatively associated with all indicators of PYD (ßs = -.15 to -.32, ps < .05), except for interpersonal-oriented competence and caring; and (3) ethnic identity significantly moderated the relationship between perceived discrimination and family connection (ß = .23, p < .01). CONCLUSIONS: Findings indicate that whereas discrimination has potential negative effects on the positive development of second-generation Chinese-American youth, ethnic identity may be a key strength that should be considered in PYD promotion practices for these youth.

Black Adolescent Self-Perceptions: The Roles of Ethnic Identity and Stress Exposure.

Ethnic identity is associated with various positive outcomes for Black adolescents, but more information is needed about its potential to protect adolescents exposed to stress. Stressful life events predict a range of health outcomes, yet few studies have examined their association with adolescent self-perception. Ethnic identity may serve as protection from stress. This study examines longitudinal data to understand relationships between ethnic identity, stressful life events, and self-perception (i.e., social competence, behavioral conduct, and global self-worth). The sample included 140 adolescents (65% female; 93% Black) with an average age of 12.55 (SD = 0.85). Results indicate stressful life events are associated with behavioral conduct self-perception, and ethnic identity is associated with global self-worth. Ethnic identity behavior and other group orientation are associated with self-perception. Ethnic identity and ethnic identity behavior moderate the relationship between stressful life events and behavioral conduct self-perception. Understanding the connections between adolescent stressors and strengths provides insight into research, practice, and policy directions to promote positive outcomes.

Psychosocial factors associated with 7-year change in cognition among middle-aged and older Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) and Sociocultural ancillary studies.

INTRODUCTION: Few studies have examined the associations of psychosocial factors with cognitive change in Hispanics/Latinos. METHODS: Data from the Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (HCHS/SOL INCA) and Sociocultural studies were used (n = 2,155; ages ≥45 years). Psychosocial exposures included intrapersonal (ethnic identity, optimism, purpose in life), interpersonal (family cohesion, familism, social networks, social support), and social factors (ethnic discrimination, loneliness, subjective social status). Survey-linear regression models examined associations between psychosocial exposures and 7-year cognitive change (global cognition [GC], verbal learning, memory, word fluency [WF], and digit symbol substitution [DSS]). RESULTS: Familism predicted decline in GC, verbal learning, and memory; family cohesion predicted DSS decline; and loneliness predicted memory decline. Ethnic identity was protective against decline in GC and memory, optimism and social support were protective against decline in memory, and purpose in life was protective against WF decline. DISCUSSION: Psychosocial factors are differentially related to cognitive changes. Culturally relevant factors should be explored in Hispanic/Latino cognitive aging research. HIGHLIGHTS: Psychosocial factors are differentially related to cognitive changes in Latinos. Role of culturally relevant factors on cognition should be further explored. Familism predicted decline in global cognition, verbal learning, and memory. Ethnic identity predicted increase in global cognition and memory.

Uncovering the relationship between community participation and socio-political control among the migrant population.

Prior research on psychological empowerment has found that community participation is associated with socio-political control, which takes place when people perceive control in their socio-political contexts. However, the process by which this relationship occurs remains an understudied area for migrants. This study aims to: (a) analyze the differences in socio-political control, critical thinking, and ethnic identity according to membership in migrant community-based organizations; and (b) propose a predictive model of socio-political control. A total of 239 first-generation migrants living in northern Italy completed a questionnaire (48.4% belonged to a migrant community-based organization). Members were found to have higher levels than nonmembers in all the variables. A moderated mediation model was proposed, whereby ethnic identity was a mediator between community participation and socio-political control, and critical thinking was a negative moderator between ethnic identity and socio-political control. Practical implications for enhancing socio-political control among migrants in receiving societies are discussed.

Profiles of identity and discrimination and the psychological, health, and academic outcomes of Korean ethnic minority youth in China.

Korean Chinese is one of the 55 officially recognized ethnic minorities in China. The protective effects of strong bicultural (ethnic and national) identities and the detrimental effects of ethnic discrimination on adjustment outcomes are well documented for ethnic minority youth in W.E.I.R.D. societies. Yet, ethnic minority youth in non-W.E.I.R.D. societies, such as Korean Chinese, may experience a unique form of discrimination-national discrimination. It is not known how multiple social identities and experiences of dual discrimination may intersect to predict youth adjustment. Thus, this study explored profiles of ethnic and national identities and ethnic and national discrimination among Korean Chinese youth and examined their psychological, health, and academic adjustment. The analytic sample included 267 Korean Chinese youth aged from 12 to 18 (M = 15.21, SD = 1.65) residing in Northeast China. Three latent profiles were identified. The dominant profile of Korean Chinese youth was characterized by high bicultural identity and low ethnic and national discrimination (BILD; n = 171). The second profile was characterized by high bicultural identity and high national discrimination (BIND, n = 50). The third profile was characterized by moderate ethnic and national identities and moderate ethnic and national discrimination (MIMD, n = 46). Regression analyses found that the BILD profile showed fewer depressive symptoms compared to the BIND profile and showed better perceived physical health compared to the MIMD profile. The findings highlight strong bicultural identities as a cultural asset and discrimination-particularly national discrimination-as a contextual risk to Korean Chinese adolescents' well-being.

Ethnic Identity and Mechanisms of Mental Health Service Engagement Among Young Adults with Serious Mental Illnesses.

PURPOSE: Young adults from minoritized racial and ethnic groups have lower rates of engagement in treatment for serious mental illnesses (SMI). Previous research suggests a relationship between ethnic identity development and engagement in mental health services, but it remains unclear how a sense of belonging and attachment to one's racial and ethnic group influences participation in treatment among young adults with SMI. METHODS: Bivariate analyses and structural equation modeling (SEM) were used to examine whether ethnic identity was associated with treatment engagement (attendance and investment in treatment) and how ethnic identity might influence engagement through theoretical proximal mediators. Eighty-three young adults with SMI (95% from minoritized racial and ethnic groups) were recruited from four outpatient psychiatric rehabilitation programs and assessed at least 3 months after initiating services. RESULTS: Stronger ethnic identity was associated with greater investment in treatment but not with treatment attendance. The SEM analysis indicated that stronger ethnic identity may improve investment in treatment by enhancing hope (0.53, p < .05) and beliefs that mental health providers are credible (0.32, p < .05), and by increasing self-efficacy (-0.09, p < .05). Proximal mediators of engagement were associated with investment in treatment (hope and credibility, p < .05, and self-efficacy p = 0.055). CONCLUSIONS: Findings provide preliminary evidence of an empirical and theoretical relationship between ethnic identity development and engagement in treatment among young adults with SMI. Assessment and strengthening of a young person's ethnic identity may be a promising approach for improving their engagement in services and reducing inequities in their care.

Differing Perceptions of Criminal Justice and Views of Law Enforcement: A Cluster-Analytic Approach to Racial-Ethnic Identities.

Race and ethnicity within psycholegal research have often been treated as nominal variables which ignores their rich within-cultural diversity and can sometimes lead to sweeping pejorative conclusions (e.g., higher prevalence of arrests). The development of several salient measures of racial-ethnic attitudes-such as the CERIS-A and MEIM-has sparked a refocusing on dimensional perspectives of race and ethnicity. This refocus becomes especially important when examining views of law enforcement and criminal justice in light of unwarranted deaths of minoritized groups while in police custody. The current study recruited a juror-eligible, online community sample (i.e., MTurk) to study their views of justice and police. Using the seven subscales of the CERIS-A, four cluster groups were identified that spanned participants' race and ethnicity. Unique patterns emerged when comparing the four groups. For example, the cluster high on both multiculturalism and their own racial-ethnic identity had far more negative views of police conduct regarding its lawfulness and fairness. Further differences emerged for views of criminal justice including the death penalty. The research implications of these findings were discussed.

How do the identities of ethnic and left-behind children influence their depression? Evidence from ethnic minority areas of Sichuan Province, China.

Millions of ethnic children in China live without their parents due to financial constraints and the lure of job opportunities elsewhere, staying in their hometowns primarily for education. Yet, current research inadequately addresses the mental health status of these left-behind children from ethnic minority communities in China. This study aimed to explore the effects of the combined identities-ethnic and left-behind-on depression among children in rural ethnic minority areas. We recruited a sample of 1131 children aged 12 to 16 from the Garzê Tibetan Autonomous Prefecture (also known as Ganzi Prefecture) in Sichuan Province. The Children's Depression Inventory was employed to assess depression levels. Results indicated that left-behind children in this region exhibited significantly higher depression levels than their counterparts who lived with their parents. Notably, children of Han ethnicity were more depressed than other ethnic groups. However, no interactive effects were observed between the dual identity factors. Intriguingly, Han children, despite being the majority ethnicity in China, perceived themselves as ethnic minorities in these areas. Their self-perception of ethnic pressure and differences, coupled with a potential lack of acceptance of their ethnic differences from the native minorities, might be subdued. This study underscores that parental relocation poses a risk to the mental health of adolescents in rural China. While policies and programs supporting left-behind children are crucial, further research is imperative to comprehend the nuances of their experiences fully.

The relative contribution of ethnic identity and ethnic discrimination on alcohol, tobacco, and other drug use disorders among Hispanic/Latin American individuals.

INTRODUCTION: Racial/ethnic discrimination and ethnic identity, the affiliation and connection to one's ethnic group, are important for understanding alcohol, tobacco, and drug use disorders (AUD, TUD, DUD, respectively) among Hispanic/Latin American individuals. Although discrimination is a well-recognized risk factor, the role of ethnic identity is less understood. Moreover, no study has examined which of these factors is more important for informing AUD, TUD, and DUD. This information is necessary for creating effective prevention and treatment programs tailored for Hispanic/Latin American people. Herein we examined the role and relative importance of racial/ethnic discrimination and Hispanic ethnic identity on past year AUD, TUD, and DUD. METHODS: Hispanic/Latin American participants of the National Epidemiologic Survey on Alcohol and Related Conditions-III constituted the sample for this cross-sectional secondary data analysis. Participants (N = 7037) were 39.93 years old on average (SD = 15.32). More than half were female (56.1 %) and had family incomes below the median household income in the United States (58.7 %). Most had national origins in North America (79.3 %), including US dependent territories and Mexico. Confirmatory factor analysis (CFA) verified the psychometric properties of the discrimination and Hispanic ethnic identity measures. Logistic regressions, supplemented with dominance analysis, estimated the role and relative contribution of discrimination and Hispanic ethnic identity on the probability of past year AUD, TUD, and DUD. RESULTS: The CFAs yielded adequate convergent validity and reliability for each construct. More racial/ethnic discrimination and a higher Hispanic ethnic identity related to a higher and lower probability of AUD, TUD, and DUD, respectively. The magnitude of the association between Hispanic ethnic identity and the probability of TUD exceeded that of racial/ethnic discrimination, but the converse was the case for AUD and DUD. CONCLUSIONS: Prevention and treatment programs for TUD that highlight the value of having a strong sense of self as a member of a Hispanic ethnic group, and that encourage the individual to explore their Hispanic ancestry may prove effective among Hispanic/Latin American individuals, particularly those who have experienced racial/ethnic discrimination. Programs for AUD and DUD tailored for Hispanic Latin/American adults should also incorporate coping strategies to address experiences with racial/ethnic discrimination.

Brief report: Revealing the nuance: Examining approaches for research with adolescents who identify with multiple racial/ethnic groups.

INTRODUCTION: Increasing racial/ethnic diversity in the United States calls for methodological approaches that capture participants who identify with multiple racial/ethnic groups. Existing approaches are oriented toward large samples (N > 500); yet, we do not know how effective these approaches are with more common smaller convenience samples. We explored how several approaches were associated with the sample distribution of racial/ethnic groups and ethnic identity using a small convenience sample. METHODS: In 2017, 320 U.S. adolescents (Mage = 16.04 years, SDage = 1.33; 59% female) responded to an open-ended question regarding their racial/ethnic group(s) in a cross-sectional survey. Seventy-five (23%) adolescents identified with multiple racial/ethnic groups. Remaining adolescents identified solely with the Asian/Hawaiian Native/Pacific Islander (19%), Black/African American (3%), European American (21%), Latinx (34%), or Native American/Alaska Native (<1%) group. RESULTS: Three approaches for adolescents with multiple racial/ethnic groups were employed. Findings indicated that the sample distributions differed across the approaches. The greatest differences were shown for Black/African American, Native American/Alaska Native, and Other Race/Ethnicity groups. Descriptively, ethnic identity also differed across the approaches. For example, multiracial/ethnic adolescents reported greater ethnic identity-exploration than their European American counterparts in one approach than in others. CONCLUSIONS: Researchers should carefully consider approaches to research with adolescents who identify with multiple racial/ethnic groups given implications for the literature. This study demonstrates the critical need to further develop approaches for capturing the complexity of race/ethnicity.