Chinese American Immigrants Research Articles

Older Chinese and Filipino American Immigrants with Type 2 Diabetes and their Adult Child: A Qualitative Dyadic Exploration of Family Support.

Type 2 Diabetes (T2D) among older Asian American immigrants (AA) is a growing concern. Asian Americans represent 9% of diagnosed diabetes. Very little is known on how older Asian American immigrants with T2D navigate diabetes management, in particular the role of family support. This qualitative study examines Chinese and Filipino Americans, the two largest Asian subgroups in the US (4.2 million, and 3.6 million, respectively), and family support dynamics among adult children and their parents diagnosed with T2D. Ten dyads (n = 20) made up of adult children and aging parents participated in in-depth and dyadic interviews. Results indicate that family support occurs in a trajectory of stages. The following thematic patterns emerged in these dyads around support: independence, transitions, partnership, and stepping in. The findings point to various supportive stages that Asian American adult children and aging parents with T2D experience and the importance of developing supportive interventions for both adult children and aging parents at these various stages.

Study Recruitment, Retention, and Adherence Among Chinese American Immigrants During the COVID-19 Pandemic.

Chinese American immigrants have been underrepresented in health research partly due to challenges in recruitment. This study aims to describe recruitment and retention strategies and report adherence in a 7-day observational physical activity study of Chinese American immigrants with prior gestational diabetes during the COVID-19 pandemic. Foreign-born Chinese women aged 18-45 years, with a gestational diabetes index pregnancy of 0.5-5 years, who were not pregnant and had no current diabetes diagnosis were recruited. They wore an accelerometer for 7 consecutive days and completed an online survey. Multiple recruitment strategies were used: (a) culturally and linguistically tailored flyers, (b) social media platforms (e.g., WeChat [a popular Chinese platform] and Facebook), (c) near-peer recruitment and snowball sampling, and (d) a study website. Retention strategies included flexible scheduling and accommodation, rapid communications, and incentives. Adherence strategies included a paper diary and/or automated daily text reminders with a daily log for device wearing, daily email reminders for the online survey, close monitoring, and timely problem-solving. Participants were recruited from 17 states; 108 were enrolled from August 2020 to August 2021. There were 2,479 visits to the study webpage, 194 screening entries, and 149 inquiries about the study. Their mean age was 34.3 years, and the mean length of U.S. stay was 9.2 years. Despite community outreach, participants were mainly recruited from social media (e.g., WeChat). The majority were recruited via near-peer recruitment and snowball sampling. The retention rate was 96.3%; about 99% had valid actigraphy data, and 81.7% wore the device for 7 days. The majority of devices were successfully returned, and the majority completed the online survey on time. We demonstrated the feasibility of recruiting and retaining a geographically diverse sample of Chinese American immigrants with prior gestational diabetes during the COVID-19 pandemic. Recruiting Chinese immigrants via social media (e.g., WeChat) is a viable approach. Nonetheless, more inclusive recruitment strategies are needed to ensure broad representation from diverse socioeconomic groups of immigrants.

Abstract C105: Addressing stomach cancer disparities in low-income New York City Chinese American immigrants: A randomized controlled trial

Abstract Background Stomach cancer is the most common infection-related cancer worldwide. In the United States, Chinese Americans, especially recent immigrants, experience a disproportionate burden of stomach cancer incidence and mortality. Infection with the bacterium Helicobacter pylori (H. Pylori) is the strongest risk factor for stomach cancer. However, adherence to the complex H. pylori treatment regimen is challenging for Chinese New Yorkers with limited English proficiency (LEP) and low health literacy. By linking bilingual/bicultural community health workers (CHWs) to Chinese-speaking patients in clinical settings – the first intervention of its kind that targets this at-risk population – we aim to help participants facilitate H. pylori eradication and stomach cancer prevention. Objective We seek to implement and assess the efficacy of a patient-centered, culturally-adapted and in-language intervention to reduce stomach cancer risk factors for at-risk Chinese American immigrants in NYC. Methods We conducted a multiyear, 2-arm RCT (n=135). Participants randomized to the intervention group were paired with a bilingual/bicultural CHW for 6 months and received a standardized protocol consisting of culturally and linguistically-adapted educational sessions, goal-setting and action planning. Data collection methods include: 1) Baseline, 2-month and 6-month surveys; 2) interviews with intervention group participants; and 3) encounter reports. Clinical outcomes were confirmed through chart review. Results Participants in the RCT were predominantly LEP, low-income Chinese immigrants with low health literacy and limited knowledge of H. pylori and stomach cancer risk factors. We will share the primary and secondary study outcomes of H. pylori eradication, medication adherence, self-efficacy, and health literacy. Our results will be supplemented with qualitative findings from the encounter reports detailing participant barriers and facilitators to medication adherence, goal-setting and behavior change. Citation Format: Simona Kwon, Yi-Ling Tan, Suzanne Vang, Angel Mui, Janet Pan, Stella Chong, Laura Wyatt, Qiuqu Zhao, Renee Williams, Patrick Xiao, Anju Malieckal, Zoi Gamagaris, Chau Trinh-Shevrin. Addressing stomach cancer disparities in low-income New York City Chinese American immigrants: A randomized controlled trial [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C105.

Chinese Diplomacy in the 1950s: A Study of Dag Hammarskjlds Visit to China

After the Korean Armistice Agreement in 1953, the direct war between the Peoples Republic of China (PRC) and United States was temporarily halted. But the subsequent issues relating to the prisons of war, China students studied at US and the collusion between US and Taiwan, made the tensions between the PRC and US government. In order to resolve the American spy case, the United States manipulated the UN General Assembly (UNGA) to pass a resolution which Dag Hammarskjld, Secretary-General of the United Nations(UNSG), was mandated to visit China to solve this issue. This incident offered the PRC government a rare opportunity to engage with the UN and participate in global affairs. Zhou Enlai, the Chinese Foreign Minister, successfully defended Chinas sovereignty. This engagement helped to highlight the newly established PRCs position in the international affairs during Cold War while alleviate the tense atmosphere between China and the United States. This event also provided crucial groundwork for the resolution of issues concerning Chinese-American immigrants.

Exploring the Racial Discrimination against Chinese American Immigrants: Analysis of Celeste Ng’s Little Fires Everywhere in the Backdrop of Critical Race Theory

This article aims at the exploration of the novel Little Fires Everywhere by Celeste Ng as a reproduction of the racial discrimination and marginalization experienced by a Chinese immigrant woman, Bebe Chow who is unable to get the custody of her biological daughter May Ling Chow from a White American family of McCulloughs through a legal battle. Drawing insight from the certain concepts of Critical Race Theory inferred from the work of Delgado and Stefancic, the study ascertains that Bebe Chow offers a strong resistance against the injustice by kidnapping her daughter and leaving America for China. The findings of this study reveal that the Asian immigrants in America often face various oppressions embedded in the societal structure and legal system due to their marginalized status in the society. The study also encourages the immigrant women to offer resistance against their persecution on the basis of colour and race.

Constructing Identity among Chinese American through Jean Kwok Novels Mambo in Chinatown: Postcolonial Study

This study aims to see how Chinese American people as immigrants in America construct their identity while facing two different cultures in society. This research is a descriptive qualitative study and using postcolonial approach. This study used novel by Mambo in Chinatown by Jean Kwok as the main data. Another document, journal, and author’s interview as the secondary data. Ambivalence by Homi K. Bhabha will used as the main theory of this research. The main data collected after the researcher goes through close reading of the novel. The result of this study show that ambivalence occur through this novel. This study also highlights that the struggle of the character in the novel reflect the reality life of Chinese American immigrant in America. Seen from their arrival in America and how the first-generation immigrant transferring Chinese culture and value to their children as the second-generation in America.

The temporal trend of women's cancer in Changle, China and a migrant epidemiological study.

Although the etiology of women's cancer has been extensively studied in the last few decades, there is still little evidence comparing the temporal pattern of these cancers among different populations. Cancer incidence and mortality data from 1988 to 2015 were extracted from the Changle Cancer Register in China, and cancer incidence data for Los Angeles were extracted from Cancer Incidence in Five Continents plus database. A Joinpoint regression model was used to analyze the temporal trends of incidence and mortality for breast, cervical, corpus uteri and ovarian cancers. The standardized incidence ratios were applied to compare the cancer risk across populations. An increasing trend of incidence rate for breast, cervical, corpus uteri and ovarian cancer was observed in Changle, although the rate leveled off for breast and cervical cancer after 2010, although not statistically significant. The mortality rate of breast and ovarian cancer was slightly increased during this period, while we found a decreased mortality of cervical cancer from 2010. The mortality of corpus uteri cancer showed a decreasing and then increasing trend. The incidence of breast, corpus uteri and ovarian cancer in Chinese American immigrants in Los Angeles was significantly higher than indigenous Changle Chinese and lower than Los Angeles whites. However, the incidence of cervical cancer in Chinese American immigrants shifted from significantly exceeding to lower than Changle Chinese. The incidence and mortality of women's cancers in Changle were generally on the rise, and this study concluded that environmental changes were important factors affecting the occurrence of these cancers. Appropriate preventive measures should be taken to control the occurrence of women's cancers by addressing different influencing factors.

Abstract P611: A Multi-Sector, Collaborative Approach to Improve Diet in Mexican and Chinese American Immigrant Families

Introduction: Latinx and Asian American communities in the U.S. face unique yet similar structural barriers to maintaining adequate diet quality, contributing to an increased burden of diabetes and non-alcoholic fatty liver disease in these groups. These inequities have been exacerbated in recent years due to overt anti-immigrant and anti-Asian sentiment during the COVID-19 pandemic, invoking fear and cultural shame for these groups, and amplifying challenges towards accessing food and economic stability. Hypothesis: Herein we describe a community-centered, multi-level approach aligned with the National Institute of Minority Health and Health Disparities Framework. We hypothesize our study will result in increased fruit and vegetable intake (self-report, measured via skin carotenoids), social cohesion and ethnic pride at the individual level and improved socioeconomic outcomes at the neighborhood level. Methods: Working collaboratively with 8 community-based and farm partners, the goal of the Building Access to Food through Systems and Solidarity (BASIS) Study is to improve diet and economic stability in Sunset Park—a neighborhood of Mexican and Chinese American families in Brooklyn, NY. This neighborhood has been hard-hit during the COVID-19 pandemic and lagged in economic recovery, and its residents are disconnected from government support. BASIS addresses food access, nutrition education, policy change, and hands-on learning (e.g., gardening, cooking) incorporating culturally appropriate values, foods, and taste preferences throughout each of these activities. Results: To date, we have held four group model-building workshops with partners to identify common priorities/goals towards improving nutrition in immigrant communities; co-developed Mexican and Chinese American-specific nutrition education materials; held eight virtual and in-person sessions with community members (n=291); conducted qualitative interviews (n=19) and quantitative data collection (n=175) amongst community residents to inform program development; and implemented a subsidized, community-supported agriculture pilot program for 20 weeks in 2022 (n=38). BASIS resources have been well-received by community members, with high engagement (90% attend weekly produce box pick-up events) and acceptance (100% indicated they would recommend the program to others). Conclusions: Planned evaluation will include mixed methods and administrative data analyses for assessment of multi-level outcomes. BASIS will expand to more participants (n=150), and will include additional program components (e.g., food policy assessment; workforce development; small business owner education). BASIS presents a powerful model to improve diet in immigrant communities applying systems thinking and community-centered best practices, lessons which may be gleaned for other immigrant communities.

Risk of Sleep Apnea Is Associated with Abdominal Obesity Among Asian Americans: Comparing Waist-to-Hip Ratio and Body Mass Index.

This study examines associations between the risk of sleep apnea and abdominal obesity (assessed by waist-to-hip ratio (WHR)) and general obesity (assessed by body mass index (BMI)) in a sample of Chinese and Korean American immigrants. The dataset included Chinese and Korean participants aged 50-75 who were recruited from primary care physicians' clinics from April 2018 to June 2020 in the Baltimore-Washington D.C. Metropolitan area (n = 394). Abdominal obesity was determined if WHR ≥ 0.9 in men and WHR ≥ 0.85 in women. General obesity was determined if BMI ≥ 30. The risk of sleep apnea was determined by using the Berlin questionnaire. Poisson regression models examined associations between sleep apnea risk and obesity. Models controlled for socio-demographic risk factors. Twelve percent of the study participants were classified as a high risk for sleep apnea, and 75% had abdominal obesity whereas 6.4% had general obesity. High risk of sleep apnea was positively associated with abdominal obesity (PR = 1.31, 95% CI: 1.17-1.47) and general obesity (PR = 2.19, 95% CI: 0.90-5.32), marginally significant at p < 0.1). Chinese and Korean immigrants living in the USA who are at high risk of sleep apnea have higher abdominal obesity, even after accounting for sociodemographic characteristics. Abdominal obesity may be a better indicator than general obesity when examining the risk of sleep apnea among Asian Americans. Name: Screening To Prevent ColoRectal Cancer (STOP CRC) among At-Risk Asian American Primary Care Patients NCT Number: NCT03481296; Date of registration: March 29, 2018 URL: https://clinicaltrials.gov/ct2/show/NCT03481296?term=Sunmin+Lee&draw=2&rank=1.

Tracing roots of attitudes toward race and affirmative action among immigrant Chinese Americans: Learning from undergraduate international students.

Tracing roots of attitudes toward race and affirmative action among immigrant Chinese Americans: Learning from undergraduate international students.

A Pilot Study of the Gut Microbiota Associated With Depressive Symptoms and Sleep Disturbance Among Chinese and Korean Immigrants in the United States.

Depression is prevalent among Asian Americans (AsA) during the COVID-19 pandemic, and depression often leads to sleep disturbance in this population. The gut microbiota (GM) plays a critical role in mental health and sleep quality, and the composition of the GM is largely unknown among AsA. Examine associations of the GM with depressive symptoms and sleep disturbance among Chinese and Korean American immigrants. Depressive symptoms (PROMIS Short Form-Depression) and sleep quality (Pittsburgh Sleep Quality Index [PSQI]) were collected via surveys. PROMIS measure T-score > 55 indicates positive depressive symptoms, and a total PSQI score > 5 indicates sleep disturbance. 16S rRNA V3-V4 gene regions were sequenced from fecal specimens to measure GM. Permutational multivariate analysis of variance and linear discriminant analysis effect size were applied to examine associations of the GM with symptoms. Among 20 participants, 55% (n = 11) reported depressive symptoms and 35% (n = 7) reported sleep disturbance. A higher α-diversity was marginally associated with lower depressive symptoms: Chao1 (r = -0.39, p = 0.09) and Shannon index (r = -0.41, p = 0.08); β-diversity distinguished participants between categories of depressive symptoms (weighted UniFrac, p=0.04) or sleep disturbance (Jaccard, p=0.05). Those with depressive symptoms showed a higher abundance of Actinobacteria, while those without depressive symptoms had a higher abundance of Bacteroidetes. No significant taxa were identified for sleep disturbance. Gut microbial diversity showed promising associations with depressive symptoms and sleep disturbance among Chinese and Korean immigrants. Specific taxa were identified as associated with depressive symptoms. Future studies with a larger sample size are warranted to confirm our findings.

Kinship, Migration, and the Chinese American Immigrant Family Narrative

AbstractThe Asian American immigrant family narrative has been extensively discussed in relation to white domesticity and assimilation by critics who emphasize the unique conditions of Asian racialization in North America. Departing from this approach, this essay considers how the immigrant family narrative depicts kinship structures that were instrumental in sustaining the lifeworld of Chinese migrants during and in the aftermath of the exclusion period (1882–1943). Drawing on theories of racial capitalism, I argue that the appropriation of pre-existing kinship structures played a crucial role in the exploitation of Chinese migrants by sustaining a transnational remittance economy that tied migrants to their locations of origin. Through an extended reading of the opening chapter of Maxine Hong Kingston’s The Woman Warrior (1975), I trace how the text depicts the communal and intimate consequences of this social structure. Kingston’s detailed knowledge of migrant kinship relations stands in contrast with her professed confusion about Chinese culture and identity, a tension that underscores the text’s combination of speculative narrative and historical realism.… the immigrant family narrative conveys the global operations of capital even if, or more precisely because, it subordinates depictions of recognizably “economic” tropes—labor, wages, remittances, and so on—to the ostensibly private realm of family relations.

Haunted by Cultural Memory: Analysing Spectral Presence in Select Novels of Amy Tan

This article depicts how Tan, following several writers of contemporary American literature, widely uses recollected cultural memories to construct ethnic ghost narratives in her novels that address the predicaments of Chinese immigrants in the US. In her novels, Tan reconstitutes cultural memories as cultural hauntings representing immigrants’ loss of identity and the repressed trauma of relocating to a new territory. Further, the notion of a matrilineal continuum in Tan’s fiction is intrinsically related to her fictional representation of cultural hauntings. Focusing on Tan’s use of ghost narratives in her novels The Joy Luck Club, The Hundred Secret Senses and The Bonesetter’s Daughter as a supernatural terrain constituted partly through collective cultural history and partly through personal memories of ancestors, this article demonstrates how such memories in being part of the Chinese American cultural unconscious assists Chinese immigrants to find a balance between their heritage and American lifestyles.

Correlates of Undiagnosed Hypertension Among Chinese and Korean American Immigrants.

Asian Americans are more likely to be unaware that they have hypertension compared to non-Hispanic white Americans, despite having higher risk of hypertension at lower body-mass indices. Furthermore, immigrants are more likely than their United States (U.S.)-born counterparts to have undiagnosed hypertension, placing them at greater risk of subsequent morbidity and mortality. This study examines the social determinants of undiagnosed hypertension among Asian American immigrants. Using a study of foreign-born Chinese and Korean Americans between the ages of 50–75 years-old recruited from physicians’ clinics in the Baltimore-Washington DC Metropolitan Area (n = 355), we used blood pressure readings measured by trained staff members, self-reported diagnosis by a medical professional, and self-reported hypertension medication use to determine hypertension status—whether patients were non-hypertensive, had diagnosed hypertension, or had undiagnosed hypertension. Using multinomial logistic regression, we examined how demographic, socioeconomic, and immigration-related factors were associated with hypertension status. Results indicated that older age, male gender, Korean subgroup, and marital status were associated with having diagnosed hypertension compared to being non-hypertensive. Lack of health insurance was the strongest predictor of having undiagnosed hypertension compared to being non-hypertensive. Acculturation variables had no strong associations with hypertension status. We then explored correlates of health insurance status for Chinese and Korean American immigrants. Those without health insurance were more likely to have lower income and to be not currently employed. Our findings point to the importance of increasing health insurance access for Asian American immigrant groups to ensure that hypertension is not left undiagnosed and untreated.

Organizing an “organizationless” protest campaign in the WeChatsphere

The introduction of digital technologies in collective actions seems to have transformed the dynamics of movement organizing and enabled divergent forms of protest organizing. While some studies emphasize “organizationless” organizing in which traditional organizational forms—social movements organizations and formal-bureaucratic structures—have been pushed into the margins, other studies showcase how traditional forms have assumed alternative features, for example, connective leadership and organizations with fluid boundaries. While existing research correctly points out the evolving organizing dynamics and forms in digital activism, few studies have accounted for why digitally enabled protests take certain organizing forms over others among multiple modes of interaction between protesters and digital technologies. Using a case study of a protest campaign organized by Chinese American immigrants, this study illustrates why immigrant activists struggled to keep the campaign “organizationless” on WeChat, a China-based digital platform that afforded other forms of organizing over such an organizing mode. Building on the mechanism-based approach in social movement studies, the findings show that immigrant activists’ emotional–cognitive responses to the changing digital environments became the driving force behind the relational choices to maintain the protest “organizationless.” The study, therefore, may not only inform future studies to explore why certain structures of protest networks emerge and develop but also contribute to the mechanism-based approach by foregrounding emotional–cognitive mechanisms, which mediate environmental and relational mechanisms.

“At the Western Palace”: The Dehumanization of Whiteness, Americanness, and Chinese-Americanness in Maxine Hong Kingston’s The Woman Warrior

The dehumanization of whiteness in Maxine Hong Kingston’s The Woman Warrior (1976) inheres in the overarching ghosthood metaphor. While first generation Chinese American immigrants in The Woman Warrior attribute the power of transforming people into ghosts to the United States of America as a country, the questioning of a person’s humanity by calling them a “ghost” is not reserved for white people alone. Chinese American immigrants also run the risk of losing their humanity and becoming ghosts if they renounce their relatives and their heritage. The husband of the first-person narrator’s Chinese aunt, Moon Orchid, is an example of a Chinese American man, who turns into a ghost on account of swapping his Chinese wife for a much younger American one. The clinic in which Moon Orchid’s husband works, a chrome and glass Los Angeles skyscraper, becomes a vehicle for the metaphoric representation of the United States as the Western Palace – also the title of the fourth of the five chapters of The Woman Warrior, exemplifying narrative techniques employed by Kingston in order to render the above mentioned dehumanization.

Chinese American Immigrant Parents' Socialization of Emotions in Bilingual Bicultural Preschool Children.

The purpose of this study was to examine Cantonese-speaking Chinese American immigrant parents' socialization of emotions in bilingual bicultural preschool children, using a combination of a parent questionnaire and parent language samples from emotion-elicited storytelling tasks. Sixteen Cantonese-speaking parents and their children participated in this study. Children were sequential bilinguals who were exposed to Cantonese (L1) at home since birth, and then learned English (L2) at school. The Chinese parent questionnaire examined parents' emotion talk in the home, as well as the child's dual language background and language distribution. Parents' language samples in Cantonese were collected from three parent-child storytelling tasks that each elicited a different type of negative emotion (sad, angry, scared). Results from the parent questionnaire and the parent language samples were analyzed using quantitative and qualitative methods. In the parent questionnaire, correlation analysis revealed that parents' use of guilt emotions was not associated with any of the other emotion words, suggesting that parents may not talk about guilt as frequently as the other emotions. Results from the parents' language samples showed no significant differences between parents' number of emotion words and emotion explanations across the storytelling tasks, suggesting that parents used negative emotion words similarly across all three books. Further qualitative analysis between the parent questionnaire and the language samples revealed patterns in the way parents use Chinese emotion words with their children. Findings illustrate how the combined use of a parent questionnaire and parent language samples offer complementary information to provide a more comprehensive understanding about Chinese American immigrant parents' socialization of emotions.

The central role of social support in the health of Chinese and Korean American immigrants

Prior research contends that social support positively influences health by optimizing individuals’ psychological processes such as appraisals, emotions, and sense of control—known as stress-buffering effects. This study tests this theoretical concept by examining whether the association between social support and health can be explained by the psychological processes of perceived stress and distress among Chinese and Korean American immigrants. Furthermore, we examine what predicts social support in this population, with a particular focus on factors related to immigration. Using a total sample of 400 Chinese and Korean American immigrants, we examine the association between social support and self-rated health (SRH), accounting for demographic factors, socioeconomic status, perceived stress, and perceived distress using multivariable logistic regression models. We conducted a mediation analysis using the Karlson, Holm, and Breen (KHB) method to determine whether perceived stress and distress partly explained the association between social support and SRH. Findings showed a strong total effect of higher social support on better SRH. Furthermore, mediation was detected, with perceived stress and distress explaining 42.98% of the total effect of social support on SRH. Multivariable linear regression models revealed that social support among Chinese and Korean American immigrants was associated with marital status, employment, ethnic identity, and acculturative stress. This study highlights the centrality of social support for Chinese and Korean American immigrants, which lowers perceived stress and distress, leading to better overall health. By confirming these stress-buffering effects, our findings suggest that bolstering social support among vulnerable Chinese and Korean American immigrant populations can have a positive effect on health by optimizing stress appraisals.

The importance of community and culture for the recruitment, engagement, and retention of Chinese American immigrants in health interventions.

Chinese Americans experience cancer health disparities throughout the entire cancer continuum. Yet, they remain underrepresented in health research in part due to barriers in recruitment, engagement, and retention. This paper describes the strategies that we devised, by drawing upon our experiences with conducting two culturally sensitive cancer intervention studies, to help researchers improve their recruitment and retention rates of Chinese Americans in health research and address the gap in knowledge on intervention research with this population. The first study assessed the efficacy, adoption, and impact of an intervention, delivered by community health workers, to improve adherence to recommended stomach cancer prevention guidelines for at-risk Chinese Americans. The second study evaluated the feasibility and preliminary efficacy of a culturally adapted version of the Expressive Helping intervention for Chinese American cancer patients and survivors. Our main recruitment strategies revolved around building community relationships, developing culturally sensitive materials, and establishing good first impressions with participants. Our main engagement and retention strategies focused on attending to cultural sensitivity, fostering relationships, and using technology. Harnessing the community's inherent strengths and prioritizing cultural understanding is crucial for culturally sensitive health research with Chinese Americans.

Prevalence of Psychological Symptoms in Community-Dwelling Chinese American Patients with Chronic Cancer Pain.

Cancer is common among older Chinese American immigrants. Psychological distress may be associated with cancer pain, yet prior studies have not examined this relationship. We conducted a secondary analysis of 514 Chinese Americans with cancer-related pain. Patients completed validated questionnaires, including the Chinese Health Questionnaire-12 (CHQ-12). Analyses evaluated associations among sociodemographics, acculturation, psychological distress, and pain variables. Most patients had low acculturation and socioeconomic levels. Overall, 51.9% of patients reported moderate-severe psychological distress, 35.8% reported worst pain intensity ≥7/10 over the previous week and 41.2% had high pain-related distress. Higher CHQ-12 scores were associated with younger age (β = -0.13); lower educational level (β = -0.12); birthplace in China (β = -0.18); lack of a caregiver (β = -0.10); higher worst pain intensity (β = 0.15); and higher pain-related distress (β = 0.28; all p < 0.05; R2= 0.23). Chinese American cancer patients with chronic pain experience high psychological distress, which is associated with pain characteristics and other social factors.