Asian American Research Articles

What happens after anti-Asian racism at work? A moral exclusion perspective on coworker confrontation and mechanisms.

Despite Americans' recent heightened awareness of racial inequality, anti-Asian racism at work remains underrecognized and largely unaddressed. In this research, we aim to understand why White bystander coworkers may fail to confront anti-Asian racism. Integrating the moral exclusion perspective and research on racial positions, we propose that due to perceiving Asian Americans as more foreign than other non-White coworkers, White coworkers are less likely to feel anger and engage in confrontation when witnessing anti-Asian racism at work. We first conducted a survey study (Study 1), demonstrating the external validity of the phenomenon that White coworkers are less likely to confront racism when the victim is Asian American versus Black. We then conducted two experiments (Studies 2 and 3) with a realistic, interactive design and behavioral measures of confrontation, supporting our hypothesized mechanisms (i.e., perceived target foreignness and anger). Study 3 further generalized our theory by including Hispanic/Latinx American targets as an additional comparison group and showing that the relative perceived foreignness among Asian American, Hispanic/Latinx American, and Black targets reduced White coworkers' anger and confrontation. We then conclude by discussing the theoretical and practical implications of our work. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Gendered Racial Microaggressions and Depressive Symptoms Among Emerging Adult Asian American Women: Racial/Ethnic Differences Among Asian and White Romantic Partners.

Discrimination can contribute to adverse mental health outcomes among individuals in romantic partnerships. However, research has yet to examine how differences in partner race/ethnicity can shape the link between gendered racial microaggressions, an intersectional form of discrimination, and depressive symptoms among Asian American women. Accordingly, we assessed the link between gendered racial microaggressions and depressive symptoms, and whether partner race/ethnicity (White vs. Asian) moderated the link. Using a sample of 156 Asian American women (Mage = 26.5, SD = 5.33), we conducted multiple regressions to assess the main effects between four gendered racial microaggression stress subscale factors and depressive symptoms. We then examined partner race/ethnicity as a moderator in these associations. All four gendered racial microaggression stress subscale factors of ascribed submissiveness, assumptions of universal appearance, Asian fetishism, and media invalidation significantly predicted greater depressive symptoms. However, only Asian fetishism experiences maintained a significant and positive association with depressive symptoms for Asian American women with White male partners. The association between Asian fetishism and depressive symptoms was no longer significant for Asian American women with Asian male partners. Results indicate that Asian fetishization may be a uniquely oppressive experience for Asian American women with White partners that can contribute to greater depressive symptoms. These findings demonstrate an increased need for the development of critical consciousness in individual and couples counseling sessions to help Asian American women and their romantic partners identify and mitigate the negative effects of gendered racial microaggressions.

Differential prevalence of psychiatric disorders and mental health characteristics associated with lifetime suicide attempts in the Asian American and Pacific Islander adult population

BackgroundAsian American and Pacific Islander (AAPI) adults are an understudied group in terms of their mental health and mental healthcare needs. This has been complicated by the difficulty of recruiting adequate national samples of AAPI adults for research. ObjectiveThis study aimed to analyze national data to examine the lifetime prevalence of major psychiatric disorders among AAPI adults relative to non-AAPI adults, as well as to identify and compare sociodemographic and clinical characteristics associated with lifetime suicide attempts among AAPI and non-AAPI adults. MethodsCross-sectional data on 36,109 adults, including 1801 AAPI adults, from the National Epidemiological Survey of Alcohol and Related Conditions-III (NESARC-III), were analyzed with a series of chi-square and logistic regression analyses. ResultsWe found a significantly lower lifetime prevalence of mental health disorders in the AAPI versus the non-AAPI population nationally, including 2% of AAPI adults reporting lifetime suicide attempts as compared to about 5% of non-AAPI adults. Female sex and a history of major depressive disorder diagnosis were associated with lifetime suicide attempts in the AAPI and non-AAPI populations. Several unique factors were associated with having a history of suicide attempts in only the AAPI population, including a military service history and a diagnosis of panic disorder. DiscussionOur analysis demonstrated the significant sectors of the AAPI population that merit research, support, and intervention, including the AAPI veteran population. This study identifies several characteristics among AAPI adults that may make them particularly vulnerable to psychiatric problems and suicide risk, which may inform targeted prevention and efforts to provide culturally competent care to this population.

Differences in Femoral Medullary Canal Dimensions in the USA and East Asian Populations

With emerging technologies and improved operative techniques, cementless total hip arthroplasty is becoming more popular and showing better results. The femoral prosthesis and intramedullary nail should precisely fit in the medullary canal to prevent micromotion and loosening. Most of the femoral prosthesis and nail designs are made from the data obtained from Caucasian femur and may not press fit if used in Asian populations. This study compares the femoral medullary canal diameter in American and Oriental populations at different bony levels. A total of 245 dry femora were collected which included 47 from United States, 77 from China, 44 from Japan, 50 from Korea and 27 from Taiwan, and plan radiographs were taken. Radiographs were digitized to measure the medullary canal width at 20% (lesser trochanter; LT), 35% (supra-isthmus; SI), 50% (mid-isthmus; MI), 65% and 80% of the total femur length. The results revealed significant differences in the medullary canal width between the US and East Asian Oriental populations. The medullary canal in the US population was significantly larger at the LT, SI, MI, and 65% but significantly smaller at 80% of the femoral shaft length compared to the East Asian populations. Among the East Asian populations, significant differences were obse4rved between the Chinese and Taiwanese populations as well as the Japanese and Taiwanese populations. The Taiwanese population had the smallest femoral medullary canal size among the east Asian populations. We conclude that there are significant differences in the femoral medullary width between the American and East Asian populations. These results will be useful for surgeons operating on the proximal or distal femur.

Understanding Engineering Identity Experiences for Asian American Women in Higher Education

Understanding Engineering Identity Experiences for Asian American Women in Higher Education

Parents' anti-Black messages, empathic reactions toward racism, fear of Black individuals, and perceived ability to engage in anti-racism advocacy among Asian American emerging adults.

Asian Americans, historically oppressed and influenced by White supremacist norms, may internalize anti-Blackness (beliefs of behaviors that minimize, marginalize, or devalue Black individuals) as they navigate White-dominated environments to survive and seek acceptance. However, there is limited research addressing the intergenerational socialization of anti-Blackness within Asian American communities and its impact as a barrier to cross-racial solidarity and involvement in anti-racism efforts. Thus, we tested whether parents' anti-Black messages were associated with fear of Black individuals and lack of empathic reactions to anti-Black racism, and in turn, related to hindrance in the perceived ability to engage in anti-racism advocacy among Asian American emerging adults. With data from 205 participants (Mage = 19.92, SD = 2.64, online convenience sample), we conducted a path analysis of parents' anti-Black messages indirectly associated with perceived ability in advocacy against anti-Black racism through fear of Black individuals and empathic reactions to anti-Black racism. Parents' anti-Black messages were associated with greater fear of Black individuals, which was associated with lower empathic reactions to racism, and in turn, ultimately associated with a lower perceived ability to engage in advocacy against anti-Black racism. This pathway was the best-fitting model compared with an alternative parallel model (fear and empathy as separate mediators) and a model with empathy as the first mediator. Our study suggests that clinicians, educators, and researchers should target parents' anti-Black messages and Asian American emerging adults' emotional responses (fear, empathy) to anti-Black racism in disrupting anti-Blackness at parental/family and individual levels.

The role of changes in peer victimization from elementary to high school and autonomic reactivity on adolescent reactive aggression.

The goals of the present study were to investigate links between changes in peer victimization from elementary to high school and adolescent reactive aggression (Goal 1), whether heightened autonomic nervous system (ANS) reactivity to social and nonsocial stress increases risk for adolescent reactive aggression (Goal 2), and whether increased ANS reactivity strengthens the association between changes in victimization and adolescent reactive aggression (Goal 3). Participants included 145 adolescents (Mage = 16; 54% female; 76% European American, 13% African American, 11% Latino American, 7% Asian American, 5% of mixed race or ethnicity; 60% with family incomes of $100,000 or greater). We collected self-report data in elementary (Time 1 [T1]); (Time 2 [T2]); middle (Time 3 [T3]); and high school (Time 4 [T4]) to assess victimization. At T4, we measured self-reported reactive and proactive aggression, and ANS reactivity (preejection period [PEP], respiratory sinus arrhythmia [RSA]) to peer rejection and nonsocial frustration. More positive victimization slope over time (meaning both less decreasing slopes and increasing slopes) predicted greater adolescent reactive, but not proactive aggression (Goal 1). Greater RSA augmentation to peer rejection and more PEP reactivity to nonsocial frustration predicted more reactive, but not proactive aggression (Goal 2). The link between victimization slope and reactive aggression emerged only for adolescents exhibiting RSA augmentation to peer rejection (marginal; Goal 3). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

COVID-19-related discrimination, campus safety, loneliness, and psychological distress among Asian and Asian American college students: a moderated mediation model

Objective: This study explored the relations between campus safety and loneliness among Asian and Asian American college students. We investigated the mediation effect of psychological distress and the moderation effect of COVID-19-related discrimination in these relations. Participants: 1,685 Asian and Asian American college students who participated in the Fall 2020, American College Health Association – National College Health Assessment III survey. Method: The moderated mediation analysis was conducted. Results: The findings revealed a negative correlation between campus safety and both psychological distress (b = −0.05, p < 0.001) and loneliness (b = −0.12, p < 0.001), but this weakened for those experiencing COVID-19 discrimination. Psychological distress consistently mediated the safety-loneliness link regardless of discrimination. Conclusions: The current findings highlight the support from the university for Asian and Asian American college students. The specific implications for practice and policy are discussed.

Multi-ancestry population attributable risk assessment of common genetic variation in Alzheimer's and Parkinson's diseases.

Multiple scientific studies, mostly performed within European populations, have unraveled many of the genetic factors associated with Alzheimer's disease (AD) and Parkinson's disease (PD) etiologies, improving our understanding of the molecular pathways implicated in the pathogenesis of these conditions. However, there is increasing evidence that the genetic architecture of these diseases differs across ancestral populations. This raises concerns about the efficacy of therapeutic interventions crafted around genetic targets prevalent only in European ancestry populations. Such interventions neglect potentially distinctive etiological profiles, including Latino, Black/African American, and East Asian populations. In the current study, we explore Population Attributable Risk (PAR) in AD and PD etiologies and assess the proportion of disease attributed to specific genetic factors across diverse populations. Leveraging data from genome-wide association studies across four ancestries, we explore distinct and universal therapeutic targets across diverse populations. Multi-ancestral genetics research is critical to the development of successful therapeutics and treatments for neurodegenerative diseases. By offering insights into genetic disparities, we aim to inform more inclusive and effective therapeutic strategies, advancing personalized healthcare.

A longitudinal investigation of parenting, depression, and counseling use among Asian American adolescents.

Asian American adolescents are equally or more likely to experience depression but less likely to seek treatment for depression than adolescents from other racial and ethnic groups in the US. The current study examined the long-term effects of parental care, parental control, and parental closeness on depression and counseling use among Asian American adolescents. Using data from the National Longitudinal Study of Adolescent Health (Add Health), we conducted a cross-lagged path analysis with 270 Asian American adolescents (48.1% female; 51.9% male). The study used data from Waves I, II, and III (1994-2002) with participants' mean ages ranging from 14 to 23. Findings indicated that the cross-sectional relationships between parenting characteristics and depression were stronger than the longitudinal relationships suggesting that parenting practices may be a stronger proximal, rather than distal, predictor of depression. Specifically, parental closeness was associated with less depression in early and mid-adolescence (age 12-18), but the relationship changed direction in young adulthood (age 18-26). Additionally, a significant interaction suggested that parental care was related to fewer depressive symptoms for those who reported high, compared to low, parental control in mid-adolescence (age 14-18). Furthermore, high parental care was associated with more counseling use at high levels of control. However, high parental care was associated with less counseling use at low levels of parental control in early adolescence. These results highlight the importance of understanding parenting characteristics using longitudinal designs when examining the development of depression and help-seeking behaviors among Asian American adolescents.

Spatiotemporal trends in the burden of colorectal cancer incidence and risk factors at country level from 1990 to 2019.

Worldwide, the incidence of colorectal cancer (CRC) continues to rise and remains a major public health concern. This study aimed to analyze the temporal and spatial trends in CRC incidence and related risk factors at the country level. Data on CRC and related risk factors were obtained from the Global Burden of Disease Study (GBD) 2019 study. Temporal trends were evaluated using estimated annual percentage change while spatial trends were analyzed using spatial autocorrelation and autoregression. Additionally, linear mixed-effects models were employed to identify risk factors linked to CRC incidence. Globally, from 1990 to 2019, the incidence cases of CRC increased by 157.23%. At the national level, the incidence of CRC increased in most countries, with the highest increases of age-standardized incidence rate (ASIR) in Equatorial Guinea, Vietnam, and China. In both 1990 and 2019, global spatial clustering of CRC ASIR highlighted hotspots in Europe, characterized by elevated CRC ASIR levels. A comparative analysis of risk factors between hotspot countries and others indicated that gender and alcohol use exerted greater influence in hotspots than elsewhere. Although from 1990 to 2019, the highest growth in ASIR of CRC has been observed in African, Asian, and Latin American countries, the hotspots are still concentrated in Europe. In the identified hotspots, gender and alcohol use exert a more significant impact on CRC incidence compared with other countries. Thus, we should pay attention to countries where the CRC incidence is increasing and these risk factors.

Asian American mental health help-seeking: An Asian value-informed health belief model.

Asian American mental health help-seeking: An Asian value-informed health belief model.

The Chinese Freedom Schools: Historicizing and intersecting Lau with Brown

AbstractThe Chinese of Chinatown, San Francisco largely opposed the city-wide racial integration plan that would bus their children across the city beginning in 1971. Claiming that it was a violation of their language rights, a need for cultural preservation and continued autonomy from the San Francisco that had long excluded them, Chinatown instituted its own school system called the Chinese Freedom Schools. With this boycott of the public schools, the Chinese were constituted as oppositional to the aims of racial integration, searing constructions of them as being pro-White, anti-Black, and separatist. Yet, such a simplistic and binary argument omits the long history of exclusion including employment, schooling, housing, and voting discrimination as evidenced by the Chinese Exclusion Act (1882–1965), the only law to exclude a specifically named ethnolinguistic group. To historicize and understand the Chinese Freedom Schools, I analyze this phenomenon using a racial matrix where Asians have long occupied a liminal, in-between space as perpetually foreign, unassimilable, and as a suspect class. Drawing from the theories and concepts of LangCrit, raciolinguistic ideologies and Asian American studies, I examine how agents, institutions, the press, and policies imposed, assumed, or negotiated specific identities of the Chinese during the development, implementation, and dissolution of the Chinese Freedom Schools. I analyze how the Chinese were constructed as uncooperative, creating a competitive cleavage among Asians and Blacks, while dismissing the centrality of White families who largely moved out of the system, avoiding critique. Implications for language-in-education policy are proposed for Lau’s 50th anniversary.

Community-Led Climate Preparedness and Resilience in Boston: New Evidence from Communities of Color

Communities of color have been historically excluded and marginalized in the ongoing conversations about climate preparedness and resilience at local, national, and global levels. Using focus groups composed of Boston communities of color (Asian American, Black, Latino, and Native American), this study aimed to understand their perspectives on climate change, providing in-depth knowledge of its impact and their views on preparedness and resilience. Research shows that these communities have long been concerned about climate change and emphasize the urgent need to improve climate preparedness. A multi-pronged approach is crucial: listening to communities of color to leverage local knowledge and leadership, engaging in community organizing, advocating for policy change, redirecting attention to institutional resources, and addressing systemic inequalities that exacerbate vulnerabilities. The findings of this study highlight the need for policy changes driven by collaboration and collective action, which can benefit those most negatively impacted by climate change and the lack of preparedness and resilience in Boston and beyond.

Abstract A069: Leading causes of death among Asian American individuals compared with Pacific Islander individuals in the United States, 2018-2020

Abstract Background: Asian American and Pacific Islander races are two distinct groups that continue to be aggregated in many large, national mortality statistics in the United States (US), which leads to structural biases encoded into databases and inaccurate health implications that may deprive Pacific Islander individuals from opportunities for interventions aimed at reducing health disparities. Examining mortality rates for disaggregated Asian American and Pacific Islander populations across all 50 states was not possible until 2018. We compared the leading causes of death between Asian American and Pacific Islander individuals in the US during 2018-2020, stratified by sex and age. Methods: Cause of death among non-Hispanic Asian American and Pacific Islander individuals aged ≥20 years who died during 2018-2020 were obtained from the US National Center for Health Statistics. Age-standardized all-cause mortality rates (MRs) and the 5 leading causes of death were reported per 100,000 person-years separately for Asian American and Pacific Islander individuals, by sex (female/male) and age (20-54/55-64/65-74/75- 84 years). MR ratios (MRRs) were calculated by comparing MRs among Pacific Islander with Asian American individuals (reference group), by sex and age. Results: During 2018-2020, 63,338 female and 85,601 male deaths occurred among Asian American adults, and 4,116 female and 5,512 male deaths occurred among Pacific Islander adults. Compared to Asian American individuals, all-cause mortality was higher for Pacific Islander females (MRR=2.50,95%CI=2.43-2.59) and males (MRR=2.10,95%CI=2.04-2.16). Cancer was the leading cause of death for Asian American (MR=93.8) and Pacific Islander females (MR=181.6) and second for Asian American (MR=100.4) and Pacific Islander males (MR=185.2) after heart disease. Death rates for leading causes were substantially higher for Pacific Islander compared to Asian American females: cancer (MRR=1.93,95%CI=1.82-2.06), heart disease (MRR=3.18,95%CI=2.95-3.42), stroke (MRR=2.41,95%CI=2.13-2.73), diabetes (MRR=4.03,95%CI=3.55-4.56), and COVID-19 (MRR=2.60,95%CI=2.25-3.01) and for Pacific Islander compared to Asian American males: heart disease (MRR=2.56,95%CI=2.42-2.71), cancer (MRR=1.52,95%CI=1.42-1.62, diabetes (MRR=3.14,95%CI=2.81-3.50), accidental death (MRR=2.60,95%CI=2.33-2.88), and COVID-19 (MRR=2.04,95%CI=1.82-2.27). The largest relative cancer mortality rate disparity occurred in those aged 20-54 years and declined with older age among women (MRR range=1.37-2.67) and men (MRR range=1.16-2.26). Conclusion: Cancer was among the leading cause of death for both Asian American and Pacific Islander individuals, but cancer mortality rates were twice as high among Pacific Islander women and men compared to Asian American women and men. These disparities persisted among Pacific Islander individuals for nearly all leading causes of death, regardless of sex and age, underscoring the need to disaggregate Pacific Islander from Asian American race data to improve tailored health equity-focused interventions. Citation Format: Jacqueline B. Vo, Jazmyn L Bess, Kekoa Taparra, Paloma R. Mitra, Amy Berrington de Gonzalez, Neal D. Freedman, Meredith S. Shiels, Jaimie Z. Shing. Leading causes of death among Asian American individuals compared with Pacific Islander individuals in the United States, 2018-2020 [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A069.

Abstract C040: Racial and ethnic differences in breast cancer prognosis and survival in a multiethnic cohort of Asian American breast cancer patients compared with non-Latina White patients at Kaiser Permanente Northern California

Abstract Background: In the U.S., breast cancer (BC) survival differs significantly by race and ethnicity, with Asian American (AA) patients consistently showing more favorable survival relative to other racial and ethnic groups. Factors contributing to the survival advantage of AA females, a heterogeneous population, are unknown. Methods: We included 5,294 AA female patients diagnosed with incident AJCC stage I-IV BC from 2000-2015 at Kaiser Permanente Northern California, and a random sample of 5,294 non-Latina White (NLW) patients. Follow-up was through 12/31/2020 for recurrence, second primary cancer, BC death, and all-cause death. Survival analysis was conducted using multivariable, cause-specific Cox proportional hazards models. Results: The AA cohort consisted of 41% Filipina, 27% Chinese, 9% Japanese, 9% South Asian, 7% Other Asian, 3% Korean, and 5% Southeast Asian females. AA and NLW females had similar stage (12% III/IV) and ER/PR status (15-18% ER-/PR-), yet more AA females were diagnosed with HER2+ or borderline disease (19% vs. 14%). More AA females had chemotherapy (48% vs. 39%) and mastectomy (47% vs. 36%) with less radiation therapy (38% vs. 46%) than NLW females. Receipt of endocrine therapy was similar between AA and NLW females (72-73%). Compared with NLW females, AA females were younger (mean=56.9 vs. 63.2 years), lived in higher SES neighborhoods (census tract-level education and income), had no comorbidities (45% vs. 36%), lower BMI (mean=25.5 vs. 28.6 kg/m2), and were never smokers (77% vs. 50%) at diagnosis. Fewer AA vs. NLW females met national guidelines of 150 minutes/week of moderate-vigorous exercise (27% vs. 33%). In multivariable Cox models adjusted for diagnosis year, diagnosis age, stage, ER/PR and HER2 status, chemotherapy, radiation therapy, endocrine therapy, and surgery type, AA females had 20% lower risk of BC death and all-cause death compared with NLW females. Similar lower risks were seen across AA ethnicities. Specifically, Japanese and Chinese females had lower risks of BC death (hazard ratio, HR=0.66; 95% confidence interval, CI: 0.47-0.93 and HR=0.78; 95% CI: 0.63-0.97) and all-cause death (HR=0.67; 95% CI: 0.53-0.84 and HR=0.78; 95% CI: 0.67-0.92). South Asian females also had lower risk of all-cause death (HR=0.71; 95% CI: 0.53-0.96). AA females had 17% lower risk of second primary cancer compared with NLW females, specifically for Japanese, South Asian, and Other Asian females (HR range: 0.60-0.66). No difference in risk of recurrence was observed for AA vs. NLW females (HR=1.08; 95% CI: 0.90-1.29), including by Asian ethnicities. Conclusions: In this large, multiethnic cohort in an integrated health care system, clear differences in sociodemographic, clinical, and lifestyle factors exist between AA and NLW BC patients. After accounting for these factors, AA females had a survival advantage over NLW females, mostly in Japanese, South Asian, and Chinese females. These findings identify contributors to outcomes that may be specific to Asian ethnicities and can inform improving survival in all BC patients. Citation Format: Marilyn , Lia D'Addario, Janise Roh, Isaac Ergas, Catherine Lee, Salma Shariff-Marco, Iona Cheng, Valerie McGuire, Julie Von Behren, Katherine Lin, Esperanza Castillo, Mi-Ok Kim, Esther John, Anna Wu, Lenora Woo, Allison Kurian, Angela Omilian, Christine Ambrosone, Song Yao, Scarlett Gomez, Lawrence Kushi. Racial and ethnic differences in breast cancer prognosis and survival in a multiethnic cohort of Asian American breast cancer patients compared with non-Latina White patients at Kaiser Permanente Northern California [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C040.

Abstract A064: Patient-provider trust and immigration experiences and h. pylori knowledge among Asian Americans

Abstract Background: Asian Americans experience a disproportionately higher prevalence of Helicobacter pylori (H. pylori) infection. However, there persists limited awareness about H. pylori infection and the associated factors among this population. Methods: To assess the level of H. pylori-related knowledge and its association with immigration and provider-related factors, we conducted a cross-sectional pilot study involving 131 Asian American individuals aged 30-75 in the greater Philadelphia and NYC areas. Participants administered a questionnaire covering topics including migration experiences, provider characteristics, medical encounters, and other relevant covariates. Poisson regression was used to evaluate the relationship between these factors and H. pylori knowledge scores. Results: Among all participants, 78% (102/131) were not racially concordant with their PCP, and 39% (51/131) had limited English proficiency. Vietnamese participants had the highest mean H. pylori knowledge score (10.8, SD: 1.4), followed by Chinese (7.2, SD: 4.7) and Korean (5.7, SD: 4.4). In the crude model, racial concordance with PCPs showed a positive relationship (IRR: 1.33, 95% CI: 1.14–1.56) with knowledge scores, while length of immigration demonstrated a weak negative relationship (IRR: 0.98, 95% CI: 0.97–0.99). In the adjusted model, personal health experiences (aIRR: 1.3, 95% CI: 1.10–1.54) and patient-provider communication (aIRR: 1.71, 95% CI: 1.43–2.06) as key determinants of H. pylori knowledge. Conclusion: H. pylori knowledge in Asian Americans is influenced by immigration experiences and the trust between patients and providers, which affects information exchange, medical comprehension, and treatment adherence. Therefore, interventions aimed at improving H. pylori knowledge within the Asian American community should prioritize fostering trust between patients and their healthcare providers. This trust serves as a crucial foundation for facilitating informed decision-making and implementing preventive measures against gastric cancer. Citation Format: Zhiqing E. Liu, Jerry Kai-Chun Fu, Wenyue Lu, Phuong Do, Kathy Zhou, Ellen Kim, Yin Tan, Lin Zhu, Grace X. Ma. Patient-provider trust and immigration experiences and h. pylori knowledge among Asian Americans [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A064.

Abstract A066: Unmasking differences in adolescent HPV vaccine uptake in six Asian American subgroups: data from the national immunization survey-teen (2015-2019)

Abstract Introduction: The HPV vaccination rates among Asian American adolescents were found to be below optimal levels. Understanding the high-risk demographics and the various factors influencing HPV vaccine acceptance is essential for addressing disparities and enhancing vaccination rates in this population. This study aimed to investigate HPV vaccine uptake in adolescents aged 13 to 17 across six major Asian American ethnic groups using nationally representative data. Methods: The study analyzed data from the National Immunization Survey- Teen (2015-2019), comprising 3,968 Asian American adolescents from Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese backgrounds. Provider and practice characteristics were examined alongside HPV vaccine initiation and completion rates within each subgroup. Results: Findings revealed that while the overall initiation rate among Asian American adolescents was 66.65%, significant variations existed among subgroups, ranging from 57.3% in Asian Indians to 71.22% in Chinese adolescents. Similarly, completion rates ranged from 30.89% in Asian Indians to 48.14% in Chinese adolescents, with an aggregated completion rate of 40.37% for the total Asian American sample. Household survey data generally showed lower initiation and completion rates compared to provider-reported data but still reflected subgroup disparities. Conclusion: Across all ethnic groups, a common barrier to HPV vaccination was the lack of physician recommendation. However, slight variations in this barrier were observed among subgroups. These findings underscore the importance of considering socioeconomic, cultural, and acculturation-related factors in designing effective public health and clinical interventions to promote HPV vaccination among Asian American adolescents. Citation Format: Lin Zhu, Elaine Z. Liu, Philip Siu, Chun Pan, Grace X. Ma. Unmasking differences in adolescent HPV vaccine uptake in six Asian American subgroups: data from the national immunization survey-teen (2015-2019) [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A066.

Abstract B178: Examining ovarian cancer survival by Asian American ethnic subgroup: An analysis of California Cancer Registry data

Abstract Background: Ovarian cancer is the leading cause of death among gynecologic malignancies. However, outcomes are not the same for all women with studies showing Asian Americans having the highest survival across all major racial groups. Since the Asian American population is heterogeneous, we examined ovarian cancer survival by Asian ethnic subgroup using data from the California Cancer Registry. Most ovarian cancer survival studies evaluate Asian Americans as a single aggregated group, which may mask important ethnic-specific disparities. Methods: A total of 31,230 ovarian cancers diagnosed among non-Hispanic Whites and Asian/Pacific Islanders between 1996 and 2020 were included in the analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to evaluate the risk of dying from ovarian cancer comparing the Asian ethnic subgroups to non-Hispanic Whites using Cox proportional hazards models. The survival analyses also considered demographic, tumor, socioeconomic, and treatment characteristics. Results: For most Asian ethnic subgroups, risk of dying from ovarian cancer was comparable to non-Hispanic Whites with the only exception being Other Asians who showed a statistically significant 15% decreased risk of ovarian cancer death (HR=0.85, 95% CI 0.73-0.97, p-value=0.02). Another notable finding was the increased risk of death observed among Pacific Islander ovarian cancer patients when compared to non-Hispanic White patients (HR=1.27, 95% CI 0.99-1.62, p-value=0.06). Conclusion: Although most studies show Asian Americans having the highest ovarian cancer survival, our analyses indicate that only Other Asians have better survival and Pacific Islanders may have poorer survival relative to non-Hispanic Whites, highlighting the importance of disaggregation in future studies. These ethnic-specific disparities that were observed even after accounting for relevant survival-related characteristics should be further explored as it may inform important biological and behavioral factors associated with survival, which are not captured in cancer registry data. Citation Format: Alice W. Lee, Jenny Chang, Sannia Siddiqui, Argyrios Ziogas, Robert E. Bristow. Examining ovarian cancer survival by Asian American ethnic subgroup: An analysis of California Cancer Registry data [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B178.

Abstract A103: Feasibility of using data from the All of Us Research Program to better understand Asian American breast cancer risk

Abstract Asian Americans (AAs) are the only racial/ethnic group in the United States for whom cancer is the leading cause of death. In AA women, the rate of breast cancer (BC) has significantly increased in the past two decades. However, the reasons behind the observed increase in risk are not well understood. The All of Us (AoU) Research Program aims to enroll one million participants nationwide, focusing on including individuals from diverse backgrounds, to advance precision health research. The goal of this pilot study was to evaluate the feasibility of using AoU data to analyze factors potentially associated with breast cancer risk in AAs and to develop enhanced breast cancer prediction models. There were 3,433 self-reported AA women with available genomic data. In addition to the genomic data, data was available from surveys, participants’ electronic health records (EHRs), and physical measurements taken at the time of their study visit. BC cases were identified by self-report on surveys (n=38), EHR diagnosis data (n=104), or both survey and EHR (n=59), totaling 201 cases identified. Of these, only 17 were incident cases. Of the 163 cases detected in the EHR, 96.3% were invasive BCs, and the median age at diagnosis was 54.2 (±12.6) years. Among the 38 survey-only-identified cases, age at diagnosis was unclear due to the large age ranges (e.g.18-64 years) in the categories presented in the survey. For purposes of the case-control analysis, five AA women with no BC diagnosis were matched to each BC case by age group and geographic region. Body mass index, annual household income, marital status, history of alcohol consumption, and history of cigarette smoking and vaping were not statistically significantly different between cases and controls (a=0.05). One third (34.3%) of cases were born in the U.S. and 65.2% were born in another country vs. 25.0% and 74.0% of controls, respectively (p= 0.01). Employment status was also different, with 50.8% of cases being unemployed vs. 42.0% of controls (p=0.02). There appeared to be a difference in first-degree family history of BC (reported in 8% of cases vs. 5% of controls) although the results were not statistically significant (p=0.08). However, family history of BC data was not available for 43.3% and 51.0% of the cases and controls, respectively. Gynecologic factors, such as ages at menarche and menopause, and hormone use, were not asked in the surveys and were not widely captured in the EHR data. In our analysis of nine BC- associated genes (BRCA1, BRCA2, ATM, TP53, PTEN, CHEK2, CDH1, PALB2, STK11), pathogenic variants were identified in 1.0% of cases and 0.7% of controls. In summary, the AoU data set enables the study of a diverse national cohort with rich genomic data. However, the low representation of AAs, small numbers of incident cases, limited data on personal gynecologic history, cancer family history and social determinants of health, and broad categorization of age at diagnosis present challenges to using this data to build accurate and effective risk prediction models for BC risk in AAs. Citation Format: Catalina Haas Garcia, Wen-Pin Chen, Danni Liu, Alice W Lee, Min Zhang, Argyrios Ziogas, Sora Tanjasiri, Hannah Lui Park. Feasibility of using data from the All of Us Research Program to better understand Asian American breast cancer risk [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A103.