RESUMEN

Objective: Asian Americans include heterogeneous subpopulations with unique burden as the only racial group with cancer as the leading cause of death. The purpose of the study was to identify differences in clinical stage and survival of patients with lung cancer between Asian Americans and its subgroups relative to other racial groups. Methods: Patients with lung cancer from 2016 National Cancer Database were divided into East Asian, Southeast Asian, South Asian subgroups based on geographic origins, and a composite Asian American group with White non-Hispanic, Black, and Hispanic comparison groups. Columnar z score analysis with adjusted residuals was employed and the terms underrepresented and overrepresented were utilized to describe significant statistical findings. Results: A total of 825,448 patients were analyzed. Asian Americans were underrepresented relative to White non-Hispanics in all clinical stages except IIIB and IV. In clinical stage IV, Asian Americans (51.0%), East Asians (47.2%), Southeast Asians (57.4%), and South Asians (52.2%) were overrepresented relative to White non-Hispanics (42.2%) and Southeast Asians were overrepresented relative to East Asians and South Asians. For survival across all stages, Asian Americans were overrepresented relative to White non-Hispanics and Blacks, but in clinical stage IV, Southeast Asians (17.9%) were underrepresented relative to East Asians (26.0%) and South Asians (26.6%). Conclusions: This is the first study to address lung cancer disparity in Asian American subgroups employing a novel analytical approach. Asian American subgroups demonstrated more advanced lung cancer diagnosis yet higher survival compared with White non-Hispanics, Blacks, and/or Hispanics with differences between subgroups. Interplay of complex factors may contribute to Asian American health disparities.

RESUMEN

Latinos form the largest ethnic population in the United States (18.5%), and the majority are Mexican Americans (61.4%). Many Mexican Americans have unique dietary behaviors, yet few food frequency questionnaires explicitly define Mexican American diets. The objective of this work was to engage with a population of rural Mexican Americans to develop a Mexican American food frequency questionnaire. Because acculturation is linked to dietary intake, we also examined acculturation by diet. We used mixed methods with three phases: (1) a qualitative phase in which a sample of rural Mexican-Americans (N = 15) identified and provided rich data about foods they ate; (2) a developmental phase in which 4 day food records were completed sequentially by two new and different samples of Mexican Americans (N = 19); and 3) a preliminary assessment phase where a new sample of Mexican Americans (N = 49) completed the final food frequency questionnaire. The final questionnaire included many traditional Mexican foods and beverages identified by study participants as part of their typical diet. Traditional Mexican foods and beverages were consumed regularly; little variation in diet was seen by level of acculturation. Respondents perceived diets containing commercial sugar-sweetened beverages as unhealthful, but not those with traditional Mexican drinks, which may represent an unappreciated source of added sugar in the diet. Future work includes studies examining dietary patterns in other urban and rural communities with traditional Mexican diets.

RESUMEN

The prevalence of traditional and complementary medicine (T&CM) use is significant globally and within the United States, especially among Chinese Americans. However, there are misconceptions regarding the efficacy and safety of herbal medicines in comparison with conventional Western medications, and limited education, training, clinical application, and resources among pharmacists and pharmacy students. Pharmacists should be well equipped to holistically treat patients through required undergraduate education on the culture and foundation of T&CM along with interprofessional education experiences, a standardized and structured approach towards T&CM in the clinical practice setting, as well as systematic changes through advocacy among professional organizations and public health policies.

RESUMEN

AIMS: Visceral fat predicts the development of metabolic syndrome (MetS), but it is not known whether the visceral to subcutaneous fat area ratio (VSR) measured using imaging predicts MetS risk as well or better. Thus, we aimed to examine if VSR predicted future risk of MetS over 10-years. METHODS: We followed 329 participants in the longitudinal Japanese American Community Diabetes Study without MetS at baseline for its development over 10 years. Intra-abdominal (VFA) and subcutaneous abdominal (SFA) fat areas were measured at baseline and 10-years and used to calculate VSR. Logistic regression was used to estimate the odds of incident MetS by baseline and 10-year change in VSR and other adipose depots with and without adjustment for baseline MetS features. Areas under ROC curves were calculated in predicting the development of MetS. RESULTS: 99 participants developed MetS over 10-years. Logistic regression models showed a higher odds of incident MetS with greater VSR and 10-year VSR change (OR = 1.67, 95 % CI 1.11-2.51; OR = 1.46, 95 % CI 1.06-2.01, respectively) adjusting for age, sex, and MetS features at baseline. However, VSR alone performed poorly at discriminating (AUROC 0.5807) compared to VFA (AUROC 0.6970, p < 0.001) or a logistic model incorporating VFA and SFA (AUROC 0.7221, p = 0.001). CONCLUSIONS: VSR and VFA predict 10-year MetS risk in Japanese Americans, confirming the importance of relatively greater fat distribution in the visceral depot in the development of MetS. However, VSR is a weaker predictor of MetS development and provides less information compared to VFA alone, and its further use in predicting metabolic abnormalities is not recommended.

RESUMEN

BACKGROUND: Immigrants experience changes in cardiovascular risk factors and racial disparities in both cardiovascular health prevention and outcomes upon immigration. We aimed to examine cardiovascular risk factors and outcomes among Chinese American immigrants enrolled in the MESA (Multi-Ethnic Study of Atherosclerosis) cohort. METHODS AND RESULTS: We analyzed data from 746 Chinese American immigrants in the MESA study with a median follow-up period of 17.8 years. The mean age of the cohort was 62.3 years, with 52.7% being women. Kaplan-Meier curves and Cox proportional hazards models were used to assess the association of immigration history, geographic location, biomarkers, and cardiac imaging parameters with cardiovascular risk factors and cardiovascular outcomes. The Cox hazards models were adjusted for known family history of heart disease, education level, sex, diabetes, hypertension, age, and body mass index. Although immigration history categorized as earlier (<20 years) versus later (≥20 years) showed no association with cardiovascular outcomes, the duration of residence in the United States emerged as a strong predictor for an increased risk of cardiovascular disease death (hazard ratio 1.39 [95% CI, 1.07-1.8]; P=0.012). All-cause mortality differed significantly between the Chinese immigrants from Los Angeles and those from Chicago, with higher survival probability in Chicago (log-rank test, P=0.018). Furthermore, elevated levels of N-terminal pro-brain natriuretic peptide levels, left ventricular mass, and coronary artery calcium scores were associated with the risk of cardiovascular disease among Chinese immigrants. CONCLUSIONS: Within the MESA cohort, the duration of residence and geographic location were associated with the risk of cardiovascular disease outcomes among Chinese immigrants.

Asunto(s)

RESUMEN

The Dietary Guidelines for Americans (DGA) recommend twice-weekly consumption of seafood for health benefits, yet many U.S. consumers have historically fallen short of this target. The economic and societal impacts of the COVID-19 pandemic brought concern about further declines in seafood intake. This study evaluated the influence of COVID-19 on seafood intake among U.S. residents, toward understanding potential public health implications. A nationally representative cross-sectional survey of 1200 U.S. residents conducted in June 2021 evaluated the frequency and types of seafood consumed, and purchase methods used, before and during the early stages of the COVID-19 pandemic. The results (weighted data) indicate most U.S. consumers (90%) eat seafood, yet only 19% meet the seafood DGA. The likelihood of meeting the DGA was higher among consumers who were Asian, Black, or Hispanic; older; unmarried; of higher income; familiar with the DGA; choosing seafood for health reasons; and living in Atlantic or Gulf coast states. During COVID-19, some increased seafood intake for health reasons (45%), while others reduced intake due to factors such as cost (29%), limited availability (16%), and challenges with preparation (11%). Fresh salmon (68%), frozen shrimp (59%), and cooked oysters (41%) were most frequently purchased by consumers of these foods. More consumers indicated purchasing wild salmon (62%), shrimp (44%), and oysters (51%) than farm-raised products, though many were unsure. Fewer consumers included seafood in online grocery orders (36%) than meal kit orders (61%) when using these services. Though many consumers continued to eat seafood despite decreased restaurant patronage, most did not reach the intake level needed to maximize health benefits. Educational and marketing efforts promoting the health benefits of seafood and the convenience of procurement via online purchase methods may encourage intake across demographic groups to benefit public health outcomes in the U.S.

RESUMEN

Research has reported health care disparities, including low rates of health care utilization, among racial and ethnic minority groups compared to Whites. Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs) have experienced these disparities, attributed to various barriers such as limited access to linguistically and culturally concordant health care services. Telehealth may offer a viable mode of health service delivery for AANHPIs. The coronavirus disease of 2019 (COVID-19) pandemic sparked the adoption of technology for receiving health services. However, the literature on telehealth utilization before and during the COVID-19 pandemic among AANHPIs is limited. To address this gap, we conducted a scoping review of telehealth intervention empirical studies serving AANHPIs published between January 2010 and February 2024, using five databases. Twenty-four articles met our inclusion criteria, which required the use of a telehealth intervention program, provision of disaggregated AANHPIs, and targeting of physical and/or mental health outcomes. Our review revealed positive findings of telehealth interventions in helping AANHPIs access health care, with a primary focus on education and consultation for self-management. The review highlighted a range of technological platforms used in AANHPIs telehealth interventions, including web-based, mobile, and blended approaches. Additionally, the review emphasized the need for improved access to technology and reduction in digital exclusion. The findings affirm the usefulness and potential of telehealth interventions, providing implications for how health professionals can serve AANHPIs. Telehealth technology offers the ability for greater accessibility and individualization to address health care disparities in AANHPIs.

RESUMEN

BACKGROUND: South Asian Americans bear a high burden of atherosclerotic cardiovascular disease (ASCVD), but little is known about the sustainability of evidence-based interventions (EBI) to prevent ASCVD in this population. Using community-based participatory research, we previously developed and implemented the South Asian Healthy Lifestyle Intervention (SAHELI), a culturally-adapted EBI targeting diet, physical activity, and stress management. In this study, we use the Integrated Sustainability Framework to investigate multisectoral partners' perceptions of organizational factors influencing SAHELI sustainability and strategies for ensuring sustainability. METHODS: From 2022 to 2023, we conducted a mixed-methods study (quant- > QUAL) with 17 SAHELI partners in the Chicago area. Partners' settings included: community organization, school district, public health department, and healthcare system. Descriptive statistics summarized quantitative results. Two coders used a hybrid thematic analysis approach to identify qualitative themes. Qualitative and quantitative data were integrated and analyzed using mixed methods. RESULTS: Surveys (score range 1-5: higher scores indicate facilitators; lower scores indicate barriers) indicated SAHELI sustainability facilitators to be its "responsiveness to community values and needs" (mean = 4.9). Barriers were "financial support" (mean = 3.5), "infrastructure/capacity to support sustainment" (mean = 4.2), and "implementation leadership" (mean = 4.3). Qualitative findings confirmed quantitative findings that SAHELI provided culturally-tailored cardiovascular health education responsive to the needs of the South Asian American community, increased attention to health issues, and transformed perceptions of research among community members. Qualitative findings expanded upon quantitative findings, showing that the organizational fit of SAHELI was a facilitator to sustainability while competing priorities were barriers for partners from the public health department and health system. Partners from the public health department and health system discussed challenges in offering culturally-tailored programming exclusively for one targeted population. Sustainability strategies envisioned by partners included: transitioning SAHELI to a program delivered by community members; integrating components of SAHELI into other programs; and expanding SAHELI to other populations. Modifications made to SAHELI (i.e., virtual instead of in-person delivery) had both positive and negative implications for sustainability. DISCUSSION: This study identifies common sustainability barriers and facilitators across different sectors, as well as those specific to certain settings. Aligning health equity interventions with community needs and values, organizational activities, and local context and resources is critical for sustainability. Challenges also arise from balancing the needs of specific populations against providing programming for broader audiences.

RESUMEN

We implemented a pilot study to investigate symptoms and functional outcomes of Asian Americans treated in urban community mental health centers for a diagnosis of schizophrenia spectrum disorder. Furthermore, we investigated whether these outcomes differed between East and Southeast Asians. We collected quantitative data from 75 participants recruited using a nonprobability sampling strategy from six urban community mental health centers. We used the Positive and Negative Syndrome Scale (Kay et al. in Schizophrenia Bulletin 13(2):261-276, 1987) and the Strauss and Carpenter Outcome Scale (Strauss and Carpenter in Archives of General Psychiatry 27(6):739-746, 1972) to measure their symptoms and functional outcomes. To compare the outcomes between East and Southeast Asians, we used a multivariable logistic regression model, which adjusted for the estimated effects of age, sex assigned at birth, and age at onset of illness for each outcome examined. The data shows that the treatment outcomes for this group are poor. Only a small number of participants experienced symptomatic remission (30.67%), role restoration (34.67%), and clinical recovery (21.33%). The majority of those who did not experience clinical recovery had difficulties sustaining symptomatic remission and restoring role functioning (54.67%). However, more participants achieved social restoration (68.00%). The results did not vary by national origin groups and sex assigned at birth. However, the participant's age, the age at which the illness began, or both determined whether the treatment outcomes were favorable. Findings underscore the need for interventions that improve symptom control to increase the likelihood of other favorable outcomes.

RESUMEN

This study examines whether a key psychosocial factor-perceiving racial discrimination in health care-is associated with worse patient activation, communication self-efficacy, and physical health outcomes for Black veterans with chronic pain. Moreover, we explore the role of physician-patient working alliance as a moderator that may alleviate the potential consequences of perceiving racial discrimination. This work is a secondary analysis of baseline data from a clinical trial with 250 U.S. Black veterans with chronic musculoskeletal pain. Participants were recruited from primary care clinics at a Midwestern VA hospital between 2018 and 2021. Perceiving racial discrimination in health care was associated with lower patient activation, lower self-efficacy in communicating with one's physician, higher pain intensity, and lower pain management self-efficacy (ps < .049) but was unrelated to reports of pain interference or use of pain coping strategies (ps > .157). Although the relationship between perceived discrimination and patient activation was moderated by working alliance (P = .014), having a stronger working alliance improved patient activation to varying degrees across levels of perceived discrimination (rather than buffering against negative outcomes when perceiving higher levels of discrimination). Moderation was not significant on any other measures. This study deepens our understanding of the broad range of health outcomes that are (not) associated with perceiving racial discrimination in health care. Contrary to prior theorizing, this work also indicates that having a strong working alliance does not attenuate the consequences of perceiving discrimination among Black individuals living with pain. These results highlight the need for system-level interventions to address perceptions of racial mistreatment in health care. PERSPECTIVE: This work has important public health implications by identifying the broad range of outcomes associated with perceived discrimination in health care among Black Americans. Importantly, a strong physician-patient relationship did not buffer Black individuals from the consequences of perceiving discrimination. These findings inform intervention targets to mitigate racial health disparities.

RESUMEN

BACKGROUND: This study aims to explore racial disparities in immediate outcomes of Transjugular Intrahepatic Portosystemic Shunt (TIPS) among Native Americans, a group that have higher prevalence of liver cirrhosis but were the "invisible group" in previous TIPS studies due to their small population size. METHODS: The study identified Native Americans and Caucasians who underwent TIPS in National/Nationwide Inpatient Sample (NIS) database from Q4 2015-2020. Preoperative factors, including demographics, indications for TIPS, comorbidities, etiologies for liver disease, primary payer status, and hospital characteristics, were matched by 1:5 propensity score matching. In-hospital post-TIPS outcomes were then compared between the two cohorts. RESULTS: There were 6,658 patients who underwent TIPS, where 101 (1.52%) were Native Americans and 4,574 (68.70%) were Caucasians. Native Americans presented as younger, with a lower socioeconomic status, and displayed higher rates of alcohol abuse and related liver diseases. After propensity-score matching, Native Americans had comparable in-hospital post-TIPS outcomes including mortality (8.33% vs 9.09%, p = 1.00), hepatic encephalopathy (18.75% vs 25.84%, p = 0.19), acute kidney injury (28.13% vs 30.62%, p = 0.71), and other adverse events. Native Americans also had similar wait from admission to operation (2.15 ± 0.30 vs 2.87 ± 0.21 days, p = 0.13), hospital length of stay (7.43 ± 0.63 vs 8.62 ± 0.47 days, p = 0.13), and total costs (158,299 ± 14,218.2 vs 169,425 ± 8,600.7 dollars, p = 0.50). CONCLUSION: Native Americans had similar immediate outcomes after TIPS compared to their propensity-matched Caucasians. While these results underscore effective healthcare delivery of TIPS to Native Americans, it is imperative to pursue further research for long-term post-procedure outcomes.

RESUMEN

BACKGROUND:  General criminological theories contend that African Americans' substance use is due to overexposure to criminological risk factors. However, some scholars suggest that racial injustices (i.e., racial discrimination and criminal justice injustices) and racial socialization practices, which includes religiosity (church involvement), impact African American substance use. OBJECTIVE:  Drawing on Unnever and Gabbidon's theory of African American offending, which considers racial injustices and racial socialization when explaining African American offending, the current research examined African American college students' substance use behavior. METHODS:  African American college students (n = 131) completed an online and anonymous survey measuring substance use, criminal justice injustices, racial discrimination, racial socialization, religiosity, negative emotions, and school bonds. RESULTS:  African American college students who reported marijuana use had less confidence in the police and those who engaged in heavy/binge drinking reported more negative emotions and negative encounters with the police. Additionally, negative police encounters and racial socialization practices increased the odds of heavy/binge drinking, whereas religiosity decreased the odds of heavy/binge drinking. CONCLUSION:  These results suggest that a relationship exists among criminal justice injustices, perceived racial bias, racial socialization, religiosity, and African American college students' substance use. As such, the current research provides partial support for the Theory of African American Offending while demonstrating the need to consider racial experiences when examining African American substance use.

RESUMEN

Purpose: The purpose of this study is to describe diabetes distress and related factors among Chinese Americans with type 2 diabetes in New York City (NYC). Methods: We conducted a secondary data analysis of the baseline data from three research studies conducted among community-dwelling Chinese American adults with type 2 diabetes. Diabetes Distress Scale (DDS) was used to measure sources of diabetes distress including emotional-, regimen-, interpersonal-, and physician-related distress. A score of 2 or greater indicates moderate diabetes distress or higher. Patient Health Questionnaire-2 (PHQ-2) was used to measure depressive symptoms. Participants' sociodemographic information was also collected. Descriptive statistics were used to describe diabetes distress, and logistic least absolute shrinkage and selection operator (LASSO) regression was used to examine factors associated with diabetes distress level. Results: Data from 178 participants (mean age 63.55±13.56 years) were analyzed. Most participants were married (76.40%), had a high school degree or less (65.73%), had a household annual income < $25,000 (70.25%), and reported limited English proficiency (93.22%). About 25.84% reported moderate or higher overall distress. The most common sources of distress were emotional burden (29.78%), followed by regimen- (28.65%), interpersonal- (18.54%), and physician-related distress (14.04%). Participants who were younger, female, limited English proficient, and had elevated depressive symptoms were more likely to have higher diabetes distress. Conclusion: Diabetes distress is prevalent among Chinese immigrants with type 2 diabetes, especially emotional- and regimen-related distress. Given the known link between diabetes distress and poor glycemic control, it is critical to screen for diabetes distress at primary care clinics and incorporate psychological counseling in diabetes care in this underserved population.

RESUMEN

This study examines the complex interplay of genetic and environmental interactions that shape chronic illness risk. Evidence is mounting for the role of genetic expression and the immune response in the pathogenesis of chronic disease. In the Rio Grande Valley of south Texas, where 90% of the population is Mexican American, chronic illnesses (including obesity, diabetes, nonalcoholic liver disease, and depression) are reaching epidemic proportions. This study leverages an ongoing family study of the genetic determinants of risk for obesity, diabetes, hypertension, hyperlipidemia, and depression in a Mexican American population. Data collected included blood pressure, BMI, hepatic transaminases, HbA1c, depression (BDI-II), acculturation/marginalization (ARSMA-II), and liver health as assessed by elastography. Heritability and genotype-by-environment (G×E) interactions were analyzed, focusing on the marginalization/separation measure of the ARSMA-II. Significant heritabilities were found for traits such as HbA1c (h2 = 0.52), marginalization (h2 = 0.30), AST (h2 = 0.25), ALT (h2 = 0.41), and BMI (h2 = 0.55). Genotype-by-environment interactions were significant for HbA1c, AST/ALT ratio, BDI-II, and CAP, indicating that genetic factors interact with marginalization to influence these traits. This study found that acculturation stress exacerbates the genetic response to chronic illness. These findings underscore the importance of considering G×E interactions in understanding disease susceptibility and may inform targeted interventions for at-risk populations. Further research is warranted to elucidate the underlying molecular pathways and replicate these findings in diverse populations.

Asunto(s)

RESUMEN

BACKGROUND: Distress related to systemic racism in the public service and healthcare systems is linked to adverse mental health sequelae in racial and ethnic minority populations. Emerging research has found that distress related to racism may impact military veterans, an increasingly racially and ethnically diverse segment of the US population who are at increased risk of mental health problems relative to non-veterans. To date, however, no known study has examined longitudinal trends in distress related to systemic racism in this population. METHODS: A nationally representative sample of 2361 US military veterans completed a baseline assessment in 2020 and a 2-year follow-up in 2022. A multinomial logistic regression analysis was conducted to examine longitudinal courses and baseline predictors of systemic racism-related distress. RESULTS: Relative to the veterans with no racism-related distress, those who reported racism-related distress across the 2-year study period were older, more likely to be female, Black, or Hispanic, and to have completed college or higher education, and reported more lifetime traumas and stressors. Nearly 4-of-5 of Black veterans endorsed distress related to systemic racism over the 2-year study period. LIMITATIONS: Use of self-report and abbreviated measures of distress related to systemic racism. CONCLUSIONS: Results suggest that distress related to systemic racism may pose a significant emotional burden on subgroups of US veterans. They further underscore the importance of training clinicians to provide culturally-informed assessments and treatments for Black and other racial and ethnic minority veterans who bear the weight of racial discrimination.

Asunto(s)

RESUMEN

BACKGROUND: Despite greater care needs, patients with limited English proficiency (LEP) are less likely to use telemedicine. Given the expansion of telemedicine since the COVID-19 pandemic, identifying ways to narrow the telemedicine care gaps experienced by people with LEP is essential. OBJECTIVE: Examine the telemedicine experiences of Mandarin-speaking adults with LEP, with a focus on perceived differences between in-person care, video, and telephone telemedicine. PARTICIPANTS: Random sample of Kaiser Permanente Northern California (KPNC) members who completed at least one primary care telemedicine visit in August 2021, aged 40 years or older, and had electronic health record-documented need for a Mandarin interpreter. The sample was stratified by telemedicine visit type (video or phone). APPROACH: Semi-structured Mandarin-language telephone interviews with a bilingual and bicultural research assistant collected patient experiences with telemedicine in general and telemedicine visits assisted by interpreters. Two coders used rapid qualitative analytic techniques to capture themes. KEY RESULTS: Among 20 respondents (n = 12, 60% women) age 41-81, all had prior experience with telephone visits and 17 (85%) had experience with video visits. Patients reported three major themes: (1) communication, language skills, and how patience impacts care quality; (2) the importance of matching patient preferences on communication modality; and (3) the need for comprehensive language services throughout the continuum of healthcare delivery. CONCLUSION: Mandarin-speaking adults with LEP see telemedicine as a convenient and necessary service. Issues with healthcare providers' and interpreters' communication skills and impatience were common. The lack of wrap-around language-concordant care beyond the visit itself was cited as an ongoing and unaddressed care barrier. Healthcare provider and interpreter training is important, as is availability of personalized and comprehensive language services in promoting patient autonomy, alleviating the burden on patients' families, and thus ensuring equitable healthcare access.

RESUMEN

Research emphasizes the importance of considering how sociocultural factors affect the disordered eating behaviors of Asian American adults. The present study thus investigated how internalized racism and racial collective self-esteem are associated with disordered eating among Asian American adults, as well as the potential mediating role of psychological distress. A final sample of 796 Asian American adults completed a cross-sectional survey that contained the study's questionnaires. Regression analyses revealed that internalized racism was positively associated with disordered eating, whereas racial collective self-esteem was negatively associated with disordered eating among Asian American adults. Psychological distress mediated both of the aforementioned associations. Researchers and practitioners are encouraged to be cognizant about how Asian American adult clients' experiences of internalized racism and psychological distress may affect their disordered eating. Researchers and practitioners may also strive to increase racial collective self-esteem among this population. Future researchers may consider building upon these findings by conducting longitudinal research or focusing on specific Asian ethnic groups for further studies about disordered eating among Asian Americans.

Asunto(s)

RESUMEN

Relatively little is known about the extent to which multiracial people stand in solidarity with their parent groups. Here, we draw from social identity theory to examine predictors of Asian-White multiracial people's solidarity with Asian and White people, Asian monoracial people's meta-perceptions of these solidarity levels, and consequences of these meta-perceptions for intergroup relations. Studies 1a-b show that Asian-White multiracial people stand in solidarity more strongly with Asian people than White people, especially when they perceive high levels of anti-Asian discrimination, and even when they believe they physically look White. Studies 2a-b demonstrate that Asian monoracial people incorrectly believe that physically White-looking Asian-White multiracial people stand in solidarity more strongly with White people, and these pessimistic meta-perceptions are associated with more rejection of multiracial people. Study 3 provides a causal link between meta-perceptions and rejection while providing preliminary evidence that correcting these solidarity meta-perceptions can improve intergroup attitudes.

RESUMEN

Black women are sorely underrepresented in studies of Alzheimer's disease and related dementias (ADRD) despite higher rates of ADRD diagnoses than in non-Hispanic White women. There are many reasons for underrepresentation, including medical mistrust, limited access to clinical studies, and restrictive study inclusion criteria. These pervasive barriers to research participation are often not considered during study development and, if eventually thought of tend to be after the fact. Community-engaged research (CER) approaches are an effective method for reducing participation barriers. This article describes how CER approaches were used to develop the Black Women Inflammation and Tau Study (BWITS), a prospective study to identify biopsychosocial risk factors for ADRD in Black women. Guidelines discussed here for future ADRD research in diverse populations are informed by Community-Based Participatory Research (CBPR), the National Institute on Minority Health and Health Disparities (NIMHD), and the Patient-Centered Outcomes Research Institute (PCORI). HIGHLIGHTS: Understand the historical tragedies related to medical practices and research designs that may contribute to the underrepresentation of Black Americans in research studies today. Highlight community-engaged research approaches that effectively reduce participation barriers in minoritized groups. Review Community-Based Participatory Research, National Institute of Minority Health and Health Disparities, and the Patient-Centered Outcomes Research Institute guidelines for conducting research with minoritized communities. Describe using the three frameworks to inform the study development protocol for the Black Women Inflammation and Tau Study. Conclude by offering study design considerations that we hope can be a helpful starting point for others conducting research with minoritized communities.

RESUMEN

This study aimed to describe how African American family caregivers of people living with Alzheimer's disease manage caregiving. A qualitative study design using a descriptive phenomenological approach was used to understand the lived experiences of African American family caregivers. Fifteen individual semi-structured and in-depth interviews were conducted via telephone or videoconference between January and June 2023 to address the research question. Guided by Swanson's theory of caring, the data transcribed verbatim from the audio-recorded interviews were analyzed using Colaizzi's methodology. Eight themes emerged from the data: (a) Parenting all over again, (b) Self-sacrifice, (c) Caring for the caregiver, (d) Connecting to God, (e) Responsibility to care, (f) Trapped, (g) Beyond exhaustion, and (h) Loss of self. The findings of the study indicate that African American family caregivers of people living with Alzheimer's disease often experience physical, mental, and emotional exhaustion while managing care. Thus, there is a considerable need for greater support, health promotion, and development of appropriate interventions to alleviate the challenges experienced so that they can continue in their caregiving role with some respite.