Chinese-speaking Immigrants Research Articles

“We have to lie low … that sort of poisons me more and more”: A qualitative study of violent political rhetoric and health implications for Spanish and Chinese speaking immigrants

BackgroundIn recent years, the historical legacy of anti-immigrant sentiment in the US has resurfaced, fueled by a new wave of anti-immigrant political rhetoric. Violent political rhetoric, defined as either explicit or metaphorically targeted language to dehumanize targeted groups, can incite discriminatory treatment of immigrants at both interpersonal and institutional levels, shaping their health and healthcare experiences. This qualitative study explores and compares how Spanish- and Chinese-speaking immigrant populations in Chicago make sense of violent political rhetoric against their racial and ethnic identities, utilize coping strategies to maintain their sense of belonging, and experience downstream health consequences. MethodsIn 2019, 14 semi-structured focus groups were conducted among immigrants to the U.S. (n = 79). Participants were recruited from four community sites in either Hispanic/Latino or Chinese neighborhoods in Chicago. Focus groups were conducted by racially- and linguistically concordant interviewers in Spanish, Mandarin, or Cantonese. The research team developed a codebook iteratively and analyzed transcripts using grounded theory and the constant comparison method. ResultsParticipants included Chinese (61%) and Spanish-speaking immigrants (39%), with an average age of 61.4 years (sd = 13); the majority were female (62%), unemployed (68%), and attained less than a high school diploma (53%). Self-reported stress due to political rhetoric was more pronounced among Spanish-speaking participants (93%) than Chinese participants (39.6%). Immigrants responded to manifestations of violent political rhetoric in numerous ways including mobilizing the model minority myth with internalized racism, anticipatory stress, and “high effort” coping mechanisms (John Henryism), all with downstream health effects. ConclusionViolent political rhetoric is one of the mechanisms by which racism and xenophobia exacerbate a toll on the health of racialized immigrant groups. These processes have implications for both interpersonal and institutional experiences, as well as health and healthcare interactions. We propose a conceptual model that outlines these mechanisms and points to potential areas of intervention to ameliorate immigrant health inequities.

Chinese Immigrants’ Health Beliefs and Practices of Traditional Chinese Medicine in British Columbia of Canada

Objective: This study is to address the health beliefs and health behavior of Chinese immigrants residing in the Greater Vancouver area of British Columbia (BC) Province in Canada. This article discussed Chinese immigrants’ traditional Chinese medicine (TCM) use, health beliefs, and health behaviors. Methods: Information used in this study is based on data collected in the Chinese-speaking community in the Greater Vancouver area of BC in 2020–2022. Quantitative and qualitative methods were applied to this study. The first stage recruited 314 participants for the quantitative study to cross-validate an instrument tool, followed by the 2nd stage of 20 stratified random sampling out of the 314 participants for TCM-related in-depth qualitative interviews. This study focuses on the second stage of TCM qualitative interviews. Results: Results indicated that TCM health beliefs have cultural and spiritual meanings tied to the Chinese-speaking participants. There are barriers for the Chinese-speaking population to access the existing healthcare services due to their TCM health beliefs and other health needs, for example, family doctors, integrated medicine for better health outcomes, and mental health services especially during the coronavirus disease 2019 (COVID-19) pandemic. Conclusion: Integrating TCM health beliefs and behaviors of Chinese-speaking immigrants into existing Canadian mainstream health services are strongly recommended.

A Study of the TOMM and DCT in Chinese-Speaking Immigrants with Limited English Proficiency in the United States

The accuracy of performance validity tests (PVTs) with culturally diverse populations has increasingly been questioned. High false positive rates have been found in some PVTs in culturally and linguistically diverse individuals within the U.S. and internationally. No study to date has investigated the accuracy of PVTs with Chinese-speaking immigrants (CSI) in the U.S. The current study aimed to evaluate two PVTs, the Test of Memory Malingering (TOMM) and Dot Counting Test (DCT), to determine their accuracy in a community sample of CSI with limited English proficiency. These two measures were used in a simulation design, contrasting 52 participants who were instructed to respond honestly to 22 participants instructed to feign incompetency to stand trial. Results demonstrated the scores of TOMM Trial 1 and Trial 2 were effective in classifying honest responders from simulators, whereas the DCT E-score did not differentiate the groups better than chance. However, false positive rates for the TOMM Trial 1, Trial 2, and the DCT E-score were relatively low. Only one honest responder (1.9%) was classified as exerting insufficient effort in TOMM Trial 1 and DCT E-score, and the TOMM Trial 2 did not misclassify any honest responders. Implications and cautionary statements are provided and discussed.

Evaluating the Beijing Version of Montreal Cognitive Assessment for Identification of Cognitive Impairment in Monolingual Chinese American Older Adults.

Objective: This study aims to evaluate the performance of a Chinese version of the Montreal Cognitive Assessment (MoCA) as a screener to detect mild cognitive impairment (MCI) and dementia from normal cognition in the monolingual Chinese-speaking immigrant population. Method: A cohort of 176 Chinese-speaking older adults from the National Alzheimer's Coordinating Center Uniform Data Set is used for analysis. We explore the impact of demographic variables on MoCA performance and calculate the optimal cutoffs for the detection of MCI and dementia from normal cognition with appropriate demographic adjustment. Results: MoCA performance is predicted by age and education independent of clinical diagnoses, but not by sex, years of living in the U.S., or primary Chinese dialect spoken (i.e., Mandarin vs. Cantonese). With adjustment and stratification for education and age, we identify optimal cutoff scores to detect MCI and dementia, respectively, in this population. These optimal cutoff scores are different from the established scores for non-Chinese-speaking populations residing in the U.S. Conclusions: Our findings suggest that the Chinese version of MoCA is a valid screener to detect cognitive decline in older Chinese-speaking immigrants in the U.S. They also highlight the need for population-based cutoff scores with appropriate considerations for demographic variables.

A validated translation of a survey for measuring incontinence knowledge in Chinese-speaking American immigrants.

Urinary incontinence is common amongst Chinese immigrants. These women are a rapidly growing population in the USA who require unique assessment tools due to language barriers. Presently, there are no Chinese language surveys to assess knowledge of urinary incontinence. Our goal was to translate and validate a urinary incontinence knowledge survey from English into Chinese. The English language Urinary Incontinence Quiz (UIQ) developed and validated by Branch et al. for the Educational Demonstration of Urinary Continence Assessment and Treatment for the Elderly program assesses general knowledge of urinary incontinence as a disease entity. We translated it into Chinese using the forward translation/back translation technique. The Chinese and English versions were then administered to bilingual volunteers in a nonrandomized order during a single encounter. Their responses were analyzed using Cohen's kappa coefficient to establish the validity of the translated knowledge survey. Minimal reconciliation was needed in construction of the Chinese survey. Minor English grammatical corrections were made to the back-translated English survey. One question testing two knowledge concepts was separated into two questions to allow clear testing of both concepts individually. Twenty-one bilingual participants performed the validity testing. Over 50% (8 out of 15) of the questions showed nearly perfect agreement with a kappa coefficient >0.80, 5 out of the 15 questions showed substantial agreement with kappa coefficients between 0.61 and 0.8 and two questions showed moderate agreement with kappa coefficients between 0.4 and 0.6. We validated a translation of the UIQ for assessment of urinary incontinence knowledge in Chinese-speaking immigrants to the USA.

Naturalization and ESL learning: A case study of an ESL naturalization program

Why do older adult Chinese-speaking immigrants want to naturalize? How do they prepare for the naturalization test in English? This qualitative research tries to answer both questions by observing classes, interviewing older adult students, volunteer teachers and analyzing documents of an ESL/naturalization program at PCCC in the Northwest. This paper focuses on the experience of both student and teacher participants. First, the author presents an overview of the naturalization program at PCCC. Secondly, the author examines their preparation for the naturalization exam in English, following the experiences of the immigrants and the reasons they want to naturalize. In the end, the author argues that student participants’ decisions to learn English and naturalize are related to their identities, such as nationality, financial and family situations.

Alcohol consumption change of English, French and Chinese speaking immigrants in Ottawa and Gatineau, Canada

Aim The multicultural study aimed at examining alcohol consumption change or drinking change of English, French and Chinese speaking immigrants in Ottawa and Gatineau, Canada, and identifying demographic factors that impact the change.

Mood Change of English, French and Chinese Immigrants in Ottawa-Gatineau Region, Canada

This multicultural study aimed at examining moodchange of English, French and Chinese speaking immigrants in Ottawa-Gatineau Region, Canada, and identifying demographic factors that impact the change. 810 immigrants of English, French and Chinese speaking sub-groupswere recruited by purposive-sampling. Using self-reports, respondents answered questions regarding moodchange (moodstatus change and mood belief change) and demography in Multicultural Lifestyle Change Questionnaire of English, French or Chinese version. Data were analyzed statistically for the different immigrant sub-groups. Immigrants of different gender, language and category sub-groups exhibited different Mood Change Rates, Mood Improving Rates,Mood Declining Rates and MoodBelief Change Rates. There was no statistical difference between the ratesof immigrant sub-groups.Mood Change (MoodStatus Change + MoodBelief Change) was correlated positively with Mother Tongue and negatively with Speaking Languages. Mood Status Change was negatively correlated with Marital Status and Highest Level of Education. Mother Tongue, Speaking Languages and Highest Level of Education significantly impacted MoodChange (Mood Status Change + Mood Belief Change). Marital Status and Highest Level of Education significantly influenced Mood Status Change. Immigrants of different sub-groups in Canada experienceddifferentmoodchanges. Marital Status and Highest Level of Educationwerethe main factors impacting Mood Status Change. Mother Tongue and Speaking Languages werethe principal factors influencing Mood Belief Change. Culture was an important factor contributing Mood Change. Acculturation could impact Mood Status Change and Mood Belief Change. Data of immigrant mood change can provide evidence for health policy-making and policy-revising in Canada.

Mood Change of English, French and Chinese Immigrants in Ottawa-Gatineau Region, Canada

This multicultural study aimed at examining moodchange of English, French and Chinese speaking immigrants in Ottawa-Gatineau Region, Canada, and identifying demographic factors that impact the change. 810 immigrants of English, French and Chinese speaking sub-groupswere recruited by purposive-sampling. Using self-reports, respondents answered questions regarding moodchange (moodstatus change and mood belief change) and demography in Multicultural Lifestyle Change Questionnaire of English, French or Chinese version. Data were analyzed statistically for the different immigrant sub-groups. Immigrants of different gender, language and category sub-groups exhibited different Mood Change Rates, Mood Improving Rates,Mood Declining Rates and MoodBelief Change Rates. There was no statistical difference between the ratesof immigrant sub-groups.Mood Change (MoodStatus Change + MoodBelief Change) was correlated positively with Mother Tongue and negatively with Speaking Languages. Mood Status Change was negatively correlated with Marital Status and Highest Level of Education. Mother Tongue, Speaking Languages and Highest Level of Education significantly impacted MoodChange (Mood Status Change + Mood Belief Change). Marital Status and Highest Level of Education significantly influenced Mood Status Change. Immigrants of different sub-groups in Canada experienceddifferentmoodchanges. Marital Status and Highest Level of Educationwerethe main factors impacting Mood Status Change. Mother Tongue and Speaking Languages werethe principal factors influencing Mood Belief Change. Culture was an important factor contributing Mood Change. Acculturation could impact Mood Status Change and Mood Belief Change. Data of immigrant mood change can provide evidence for health policy-making and policy-revising in Canada.

Physical Activity Change of English, French and Chinese Speaking Immigrants in Ottawa and Gatineau, Canada

OBJECTIVES: The multicultural study aims at examining Physical Activity Change of English, French and Chinese speaking immigrants in Ottawa and Gatineau, Canada, and identifying demographic factors that correlate with the change and impact the change. METHODS: 810 immigrants of three language sub-groups were recruited by purposive-sampling. Using self-reports, respondents answered questions regarding Physical Activity Change and Demography in Multicultural Lifestyle Change Questionnaire of English, French or Chinese version. Data were analyzed statistically in percentage, correlation, regression and factor analysis. RESULTS: Immigrants of different gender, language and category sub-groups exhibited different rates in Physical Activity Change, and different language sub-groups displayed different Physical Exercise Items rates after immigration, but no statistical difference between the rates. Physical Activity Change (Physical Activity Behavior Change + Physical Activity Belief Change) was negatively correlated with Gender, Category of Immigration, Employment Status and Primary Occupation. Physical Activity Behavior Change was negatively correlated with Age, Gender, Category of Immigration, Employment Status and Primary Occupation. Age, Gender, Category of Immigration and Employment Status significantly impacted Physical Activity Change. Mother Tongue, Age, Gender, Category of Immigration and Employment Status significantly impacted Physical Activity Behavior Change. Two factors (factor one: physical activity behavior change factor and factor two: physical activity belief change factor) influenced significantly Physical Activity Change. Factor one exposed more significant effect than factor two. CONCLUSIONS: Different immigrant sub-groups experienced different Physical Activity Change and three language sub-groups presented different physical activity patterns after immigration. Age, Gender, Category of Immigration, Employment Status and Primary Occupation were main factors impacting significantly Physical Activity Change. Mother Tongue was an important factor influencing significantly Physical Activity Behavior Change. Culture and acculturation were relating contributing factors. Data may provide evidence and implication for physical exercising policy-making and policy-revising in Canada.

Smoking change of English-, French-, and Chinese speaking immigrants in Ottawa and Gatineau, Canada

Background: Immigrant smoking change is of particular interest to multicultural health researchers and policymakers. Objective: To examine the smoking change of the English-, French-, and Chinese-speaking immigrants in Ottawa and Gatineau, Canada, and identify the demographic factors that correlate with the change and impact the change. Materials and Methods: In total, 810 immigrants of the three language subgroups were recruited by purposive-sampling method. Using self-reports, the participants answered questions regarding smoking change and demography in multicultural lifestyle change questionnaire of English, French, or Chinese version. Percentage, significance, and multivariate (correlation and regression) analysis methods were used in data analysis for the different subgroups. Result: Immigrants of different gender, language, and category subgroups exhibited values for different smoking rates, smoking rates before and after immigration, smoking change rates, and smoking belief change rates but no statistical difference between the rates. Smoking change (smoking behavior change + smoking belief change) correlated positively with age and duration of residence in Canada and negatively with gender and category of immigration. Smoking behavior change correlated positively with age and duration of residence in Canada and negatively with mother tongue and gender. Age and gender significantly impacted smoking change (smoking behavior change and smoking belief change). The duration of residence in Canada significantly impacted smoking belief change. Conclusion: The immigrants in Canada experienced different smoking changes. Age, gender, and duration of residence were the main impacting factors. Culture and acculturation were the relating contributing factors. Data of immigrant smoking change may provide an evidence for smoking control policymaking and policy-revising in Canada.

Parent Training With High-Risk Immigrant Chinese Families: A Pilot Group Randomized Trial Yielding Practice-Based Evidence

We studied the efficacy and implementation outcomes of a culturally responsive parent training (PT) program. Fifty-four Chinese American parents participated in a wait-list controlled group randomized trial (32 immediate treatment, 22 delayed treatment) of a 14-week intervention designed to address the needs of high-risk immigrant families. Parents were eligible for intervention if they were Chinese-speaking immigrants referred from schools, community clinics, or child protective services with concerns about parenting or child behavior problems. Retention and engagement were high with 83% of families attending 10 or more sessions. Results revealed that the treatment was efficacious in reducing negative discipline, increasing positive parenting, and decreasing child externalizing and internalizing problems. Treatment effects were larger among families with higher levels of baseline behavior problems and lower levels of parenting stress. Further augmentation of PT to address immigrant parent stress may be warranted. Qualitative impressions from group leaders suggested that slower pacing and increased rehearsal of skills may improve efficacy for immigrant parents unfamiliar with skills introduced in PT.

Perceptions of unmet healthcare needs: what do Punjabi and Chinese-speaking immigrants think? A qualitative study

BackgroundUnmet healthcare needs - the difference between healthcare services deemed necessary to deal with a particular health problem and the actual services received - is commonly measured by the question, "During the past 12 months, was there ever a time when you felt that you needed healthcare, but you didn't receive it?" In 2003, unmet needs were reported by 10% of immigrants in Canada, yet, little is known specifically about Chinese- or Punjabi-speaking immigrants' perceptions and reporting of unmet needs. Our study examined: 1) How are unmet healthcare needs conceptualized among Chinese- and Punjabi-speaking immigrants? 2) Are their primary healthcare experiences related to their unmet healthcare needs?MethodsTwelve focus groups (6 Chinese, 6 Punjabi; n = 78) were conducted in Chinese or Punjabi and socio-demographic and health data were collected. Thematic analysis of focus group data examined the perceptions of unmet needs and any relationship to primary healthcare experiences.ResultsOur analysis revealed two overarching themes: 1) defining an unmet healthcare need and 2) identifying an unmet need. Participants had unmet healthcare needs in relation to barriers to accessing care, their lack of health system literacy, and when the health system was less responsive than their expectations.ConclusionsAsking whether someone ever had a time when they needed healthcare but did not receive it can either underestimate or overestimate unmet need. Measuring unmet need using single items is likely insufficient since more detail in a revised set of questions could begin to clarify whether the reporting of an unmet need was based on an expectation or a clinical need. Who defines what an unmet healthcare need is depends on the context (insured versus uninsured health services, experience in two or more healthcare systems versus experience in one healthcare system) and who is defining it (provider, patient, insurer).

Testing the “Epidemiologic Paradox” of Birth Outcomes Among Asian Immigrant Women in Hsin-Chu County, Taiwan

Taiwan saw an increase in immigration during the last decade. This retrospective study investigated whether immigrant status confers a protective effect on birth outcomes and whether this effect varies across racial/ethnic subgroups in Hsin-Chu County, Taiwan. A total of 30,770 singleton birth certificates from January 1, 2002 to July 31, 2007 were analyzed using ANOVA and logistic regression. Outcomes included low birth weight (LBW, < 2500 g), high birth weight (HBW, > 4000 g), preterm birth (< 37 weeks) and stillbirth. Covariates included maternal age, year of delivery, mode of delivery, medical care institution, infant sex and congenital birth defects. Five models were designed for various analyses. The reference categories included non-immigrant, non-aboriginal Taiwanese and non-Chinese-speaking immigrants. Preterm rate ranged from 6.3% among mainland Chinese to 13.5% among aboriginal Taiwanese. LBW rate ranged from 4.3% among mainland Chinese to 17.3% among aboriginal Taiwanese. HBW rate ranged from 1.2% among aboriginal Taiwanese to 3.4% among mainland Chinese. Stillbirth rate ranged from 0.2% among Indonesians to 0.7% among aboriginal Taiwanese. Adjusted odds ratio (OR) was lower among mainland Chinese (preterm OR, 0.77; LBW OR, 0.62) but higher among aboriginal Taiwanese (preterm OR, 1.79; LBW OR, 2.68; stillbirth OR, 2.92). HBW rate was significantly higher (OR, 1.84) among mainland Chinese. Chinese-speaking immigrants showed significant differences in LBW (OR, 0.57) and HBW (OR, 1.62) compared with non-Chinese-speaking immigrants. An epidemiologic paradox and heterogeneity of birth outcomes were observed among immigrants in this study. However, aboriginal Taiwanese constituted the subgroup with the highest risk. Further research is needed to identify the determinants of birth outcomes.

Translations and Transformations: Thai Texts for Children in the USA

Very few Thai-language works have been published in the US. While English-language works by Thai American authors are limited to cookbooks of Thai cuisine and the occasional book on Thai kick-boxing, Thai-language works are limited for the most part to newspapers (for example, the Los Angeles-based Saereechai and Madhichon), magazines (including Siam Media and Inter Thai), and newsletters produced by religious or social organizations (including Wat Thai in Los Angeles). A few texts on Buddhism include Pra Prayudh Payutto's Buddhadhamma: Natural Laws and Values for Life by G.A. Olson and published by the State University of New York as part of its series in Buddhist Studies, and A. Sujata's Beginning to See. Yet very few Thai books have been published in the US because of the technological difficulties presented by a non-Roman alphabet and by the limitations of a small, widely-dispersed immigrant group. Adapted in the late thirteenth century from a Khmer script derived from the Indian Devanagari script, Thai uses an alphabet of 44 consonants, 32 vowels, four tone marks, and various other symbols for punctuation and numbers. Even with widespread personal computing technology, Thai remains a difficult script to render, and software packages designed for the Thai language, although produced in the United States, are typically available only in Thailand. Indeed, software packages alone are insufficient without a Thai-character keyboard. The technological obstacles to printing Thai, however, do not provide a sufficient explanation for the small number of Thai-language works produced in the US. Ideographic languages such as Chinese, for example, are potentially more difficult to produce than a phonetic language such as Thai, and Chinese-language texts were produced in the United States as early as the 1870s. An obvious explanation for the relative abundance of Chinese-language texts as compared to Thai-language texts is the smaller number of Thai-speakers in the United States. The 1990 census counted about 90,000 Thai immigrants in the US, 1.3% of the Asian American population, or .05% of the total population. In contrast, the 1990 census found 1.6 million Chinese-speaking immigrants, almost twenty times larger than the Thai group. Spanish-speaking immigrants comprise an even greater portion of the US population at 11.1%, or 29.7 million people (1990 Census, US Census Bureau). German Americans represented a similarly large immigrant group, with over five million German Americans in the US in 1914. Moreover, Thai immigrants are not concentrated in one central geographic location, but are spread throughout the US. The Thai-American population is also very small compared to the population of Thailand, estimated at 53 million. Although books such as Loy Kratong (1981) and I am a Thai (1983) that describe different Thai cultural traditions are published in Thailand, they are written to be easily accessible to both Thai-and American-born children. Works of American origin, like A Guide to Learning the Thai Language (1988), (1) tend to focus more on language instruction but also include cultural elements. Yet regardless of their Asian or American origins, Thai children's texts offer evidence for an alternative theory explaining the small size of the body of Thai American literature. What becomes apparent in these texts is an ambivalent relationship to language, one in which language can and does exist independently of social identity or culture. Unlike early German American works, which insisted upon a learning of the German language, and unlike Spanish-language works, which explicitly state their goals of teaching Spanish, Thai-language works lack a clear conviction that teaching Thai is essential to maintaining a Thai identity. Instead, Thai-language children's literature exhibits a strikingly unusual resignation to the difficulties of teaching Thai, and also a tacit understanding that teaching the Thai language is subordinate to a larger goal of preserving Thai culture. …

Measuring Need to Achieve by n Ach-n Aff Scale—A Forced-Choice Questionnaire

To measure the need to achieve (n Ach), a questionnaire was constructed which required the subject to make a forced choice on each of 30 pairs of adjectives. Half the adjectives were based on the Need for Achievement scale and the other half on the Need for Affiliation scale of Gough's Adjective Check List. When the questionnaire was scored in the n Ach direction, differences between sex and age groupings of college students were negligible and nonsignificant, but scores for males were positively and significantly correlated with grades on midterms and GPA, whereas correlations for female students were low, positive, and significant only at the 10% level. Bank tellers' n Ach scores correlated positively with supervisors' ratings and were significantly lower than those of college students. Expectant mothers were the lowest scoring group on n Ach, while male Chinese-speaking immigrants under 30 scored the highest. Results were considered to be consistent with previous research and with expectations based on common sense and everyday impressions.