Latino Respondents Research Articles

The Double-Edged Sword of Online Learning for Ethnoracial Differences in Adolescent Mental Health During Late Period of the COVID-19 Pandemic in the United States: National Survey.

Despite several theories suggesting online learning during the COVID-19 pandemic would aggravate ethnoracial disparities in mental health among adolescents, extant findings suggest no ethnoracial differences in mental health or that those from minoritized ethnoracial groups reported better mental health than their White counterparts. This study aimed to identify why findings from prior studies appear to not support that ethnoracial disparities in mental health were aggravated by testing 2 pathways. In pathway 1 pathway, online learning was associated with reporting fewer confidants, which in turn was associated with poorer mental health. In pathway 2, online learning was associated with reporting better sleep, which in turn was associated with better mental health. We analyzed survey data from a US sample (N=540) of 13- to 17-year-olds to estimate how school modality was associated with mental health via the 2 pathways. The sample was recruited from the AmeriSpeak Teen Panel during spring of 2021, with an oversample of Black and Latino respondents. Ethnoracial categories were Black, Latino, White, and other. Mental health was measured with the 4-item Patient Health Questionnaire, which assesses self-reported frequency of experiencing symptoms consistent with anxiety and depression. School modality was recorded as either fully online or with some in-person component (fully in-person or hybrid). We recorded self-reports of the number of confidants and quality of sleep. Covariates included additional demographics and access to high-speed internet. We estimated bivariate associations between ethnoracial group membership and both school modality and mental health. To test the pathways, we estimated a path model. Black and Latino respondents were more likely to report being in fully online learning than their White counterparts (P<.001). Respondents in fully online learning reported fewer confidants than those with any in-person learning component (β=-.403; P=.001), and reporting fewer confidants was associated with an increased likelihood of reporting symptoms consistent with anxiety (β=-.121; P=.01) and depression (β=-.197; P<.001). Fully online learning respondents also reported fewer concerns of insufficient sleep than their in-person learning counterparts (β=-.162; P=.006), and reporting fewer concerns was associated with a decreased likelihood of reporting symptoms consistent with anxiety (β=.601; P<.001) and depression (β=.588; P<.001). Because of these countervailing pathways, the total effect of membership in a minoritized ethnoracial group on mental health was nonsignificant. The findings compel more nuanced discussions about the consequences of online learning and theorizing about the pandemic's impact on minoritized ethnoracial groups. While online learning may be a detriment to social connections, it appears to benefit sleep. Interventions should foster social connections in online learning and improve sleep, such as implementing policies to enable later start times for classes. Future research should incorporate administrative data about school modality, rather than relying on self-reports.

School modality, race and ethnicity, and mental health of U.S. adolescents during the COVID-19 pandemic

BackgroundWhile minoritized ethnoracial groups were most likely to be in online learning during the COVID-19 pandemic, the impact of these ethnoracial disparities on adolescent mental health is unclear. Since past studies do not directly examine whether the association between school modality and self-reported mental health outcomes varied by race and ethnicity among U.S. adolescents during the COVID-19 pandemic, this study addresses the gap.MethodsAdolescents aged 13 to 17 years old (n = 510) were surveyed for self-reports of anxiety and depression symptoms using the 4-item Patient Health Questionnaire during Spring 2021. Seemingly unrelated regressions were used to estimate the differential association between school modality and mental health by respondents’ race and ethnicity.ResultsEstimates without interaction between school modality and race and ethnicity suggested that Latino respondents reported a significantly higher frequency of depressive symptoms than their White counterparts (b = 0.459; p < 0.05). Similarly, the estimates without the interaction suggested respondents reporting hybrid learning had a higher frequency of depressive symptoms than in-person learning (b = 0.504; p < 0.05). Estimates with interaction between school modality and race and ethnicity suggested fully online learning was associated with poorer mental health only among White respondents and better mental health among Black respondents. Among adolescents attending school fully online, Black adolescents reported fewer mental health symptoms than their White counterparts (anxiety, b =– 1.364; p < 0.05, and depression, b =– 1.647; p < 0.05).ConclusionsFully online learning may have benefitted the mental health of Black adolescents during the COVID-19 pandemic, perhaps because it buffered racial discrimination and social anxiety in schools. Additional interventions should be explored to promote in-person school environments that better support the mental health of Black adolescents. Moreover, prioritizing equitable access to broadband internet will provide better access to online learning and ensure positive mental health, particularly for adolescents from minoritized ethnoracial groups during instances of future pandemics. Future research should continue to consider the race and ethnicity of adolescents to promote mental well-being in schools across learning modalities.

Opinion Instability and Measurement Errors: A G-Theory Analysis of College Students

ABSTRACT This study examines opinion instability among individuals from different ethnic groups (White, Latino, and Asian Americans) by analyzing measurement errors in survey measures. Using a multi-wave panel dataset of college students and employing generalizability theory, the study uncovers significant patterns. The results reveal that White students exhibit higher attitude reliability, characterized by larger variances in true opinions and smaller measurement errors. In contrast, Latino and Asian American students display lower attitude stability, with lower variances in true opinions and higher variances in both item-specific and measurement errors. Disparities in political socialization and issue concerns contribute to the observed attitude instability among Latino and Asian American students. Moreover, Asian American and Latino respondents require a greater number of survey items to mitigate measurement error compared to their White counterparts. However, the impact of multiple waves of surveys on improving reliability is limited for Latino and Asian American students compared to White students. These findings deepen our understanding of attitude stability across ethnic groups and underscore the importance of further research in this area.

Prevalence of Positive Childhood Experiences Among Adults - Behavioral Risk Factor Surveillance System, Four States, 2015-2021.

Positive childhood experiences (PCEs) promote optimal health and mitigate the effects of adverse childhood experiences, but PCE prevalence in the United States is not well-known. Using Behavioral Risk Factor Surveillance System data, this study describes the prevalence of individual and cumulative PCEs among adults residing in four states: Kansas (2020), Montana (2019), South Carolina (2020), and Wisconsin (2015). Cumulative PCE scores were calculated by summing affirmative responses to seven questions. Subscores were created for family-related (three questions) and community-related (four questions) PCEs. The prevalence of individual PCEs varied from 59.5% (enjoyed participating in community traditions) to 90.5% (adult in respondents' household made them feel safe), and differed significantly by race and ethnicity, age, and sexual orientation. Fewer non-Hispanic Black or African American (49.2%), non-Hispanic Alaska Native or American Indian (37.7%), and Hispanic or Latino respondents (38.9%) reported 6-7 PCEs than did non-Hispanic White respondents (55.2%). Gay or lesbian, and bisexual respondents were less likely than were straight respondents to report 6-7 PCEs (38.1% and 27.4% versus 54.7%, respectively). A PCE score of 6-7 was more frequent among persons with higher income and education. Improved understanding of the relationship of PCEs to adult health and well-being and variation among population subgroups might help reduce health inequities.

National Benchmarks to Understand How Doctor of Physical Therapy Learners From Minoritized Race and Ethnicity Groups Perceive Their Physical Therapist Education Program.

The demographic homogeneity of the physical therapist workforce and its educational pathway may undermine the profession's potential to improve the health of society. Building academic environments that support the development of all learners is fundamental to building a workforce to meet societal health care needs. The Benchmarking in Physical Therapy Education study uses the Physical Therapy Graduation Questionnaire to comprehensively assess learner perceptions of the physical therapist academic environment. The present report examined whether racial and ethnic minoritized (REM) physical therapist learners perceive their doctor of physical therapy education differently from their non-REM peers. Five thousand and eighty graduating doctor of physical therapy learners in 89 institutions provided demographic data and perceptions of a range of learning environment domains. Analyses included REM versus non-REM comparisons as well as comparisons among individual race and ethnicity groups. Compared with their non-minoritized peers, REM respondents expressed less satisfaction with their education and lower confidence in their preparedness for entry-level practice. REM respondents observed more faculty professionalism disconnects and demonstrated less agreement that their program had fostered their overall psychological well-being. REM respondents experienced higher rates of mistreatment than their peers and reported higher rates of exhaustion and disengagement, the 2 axes of academic burnout. Black/African American and Hispanic/Latino/a/x (Hispanic, Latino, Latina, and/or Latinx) respondents incurred significantly more educational debt than Asian and White respondents. REM respondents reported greater empathy and greater interest in working in underserved communities. REM respondents perceived the physical therapist learning environment more negatively than their non-minoritized peers but expressed strong interest in serving people from underserved communities. These national benchmarks offer academic institutions the opportunity to self-assess their own environment and to work to improve the quality of the educational experience for all learners. In a nationwide benchmarking study, learners from minoritized race and ethnicity backgrounds reported more negative experiences and outcomes during physical therapist education than their non-minoritized peers. These same learners demonstrated high empathy and interest in serving people from underserved (under-resourced) communities. Learning environments that permit all individuals to thrive may be an essential avenue to improve the health of a rapidly diversifying society.

Factors Associated with Condom Use among Community College Students

The incidence and prevalence of sexually transmitted infections (STIs) have increased over the past decade, with half of all new diagnoses occurring in young people ages 15-24 years. Despite the risk, college students report low rates of condom use during sex. This study investigated factors associated with condom use in college students with the intent to inform health education strategies. In this cross-sectional study, a 40-item survey was administered to a random sample of classes at a community college in Central California. A total of 883 students participated. A multivariate logistic regression model identified factors associated with condom use, controlling for demographics, knowledge, and perceptions about sexually transmitted infections (STIs) and condoms.Hispanic/Latino respondents had higher rates of condom use compared to non-Hispanic/Latinos, as did non-White respondents compared to White respondents, non-females, and individuals who were not in a relationship. Regression results revealed that assertive negotiation (i.e., directly requesting to use condoms) was the most significant influencer of condom use. STI knowledge was not associated with condom use, nor was perceived seriousness or susceptibility to STIs.While traditional health promotion programs focus on knowledge and access to condoms, these results suggest that additional factors influence condom use, including the ability to directly request condom use with partners. In addition to topics such as STIs, contraception, and pregnancy, comprehensive sexual health education should also include communication and negotiation strategies between partners, through a lens that includes all sexualities and gender identities.

Is Love (Skin Color) Blind?: Skin Color and Interdating across Ethnoracial Groups1

The role skin color plays in shaping cross‐ethnoracial relationships is not well understood despite its implications for the trajectory of U.S. ethnoracial relations. Using the National Longitudinal Study of Freshmen, I investigate two questions: Among ethnoracial minorities, how does a person's skin color relate to the likelihood of dating individuals from another ethnoracial group? Does this relationship vary by the combination of ethnoracial backgrounds of the individuals who are dating? The results indicate that the influence of skin color on interdating may depend on the status levels of partners' ethnoracial groups. A person from a lower status group with a darker skin color—relative to other similar group members with lighter skin color—is less likely to date someone from a higher status group, but darker skin color is associated with a greater likelihood of interdating when a darker‐skinned member of a higher status group dates a member of a lower status group. Further, the results point to a complex relationship between two intermediate groups, Asians and Latinos, which seems dependent on Latino respondents' gender.

Why Culture and Context Matters: Examining Differences in Mental Health Stigma and Social Distance Between Latino Individuals in the United States and Mexico.

This study examines the influence of cultural context on social distance and perceptions of stigma towards mental health conditions among Latino populations in Houston, TX, USA and Mexico City, Mexico. We employed a community-based experimental vignette survey to assess perceptions towards individuals experiencing symptoms of alcohol misuse, depression, and psychosis. Participants (n = 513) from Houston and Mexico City were asked about their willingness to accept community members experiencing mental health symptoms in various social roles, their perceptions of stigma related to these symptoms, anticipated danger, possible positive outcomes, and the community member's ability to change. Findings demonstrate significant differences in stigma perceptions between Latino respondents in the US and in Mexico. Houston participants reported lower public stigma and perceived dangerousness of someone with mental health concerns compared to respondents in Mexico City. Furthermore, the cultural context may influence the association between various dimensions of stigma, with some inverse relationships occurring based on location of data collection. Findings illuminate the complex interplay between cultural context, mental health symptoms, and stigma, and underscores the need for culturally nuanced interventions to reduce mental health stigma and promote service utilization in Latino communities.

What Makes a Citizen? Contemporary Immigration and the Boundaries of Citizenry

Abstract How do native-born Americans evaluate citizenship claims made by immigrant groups? Prior research identifies three broad patterns: respondents (1) make judgments based on immigrants’ willingness to adhere to national norms and civic values, (2) rely on ethnoracial cues, and (3) rely on economic cues. Using a conjoint survey experiment, this is the first study to examine how these patterns hold across two distinct dimensions of citizenship—legal membership (being considered a citizen of the state) and cultural membership (being perceived as a fellow American). The results reveal that legal status and age of arrival are powerful determinants for attitudes toward legal membership. By contrast, ethnoracial boundaries have a more significant impact on cultural membership, even after accounting for key predictors, such as legal status and English proficiency. Moreover, we show that evaluations of citizenship claims differ for White and non-White Americans in meaningful ways. Compared to White respondents, Black and Latino respondents express higher levels of ingroup preference for legal membership, and Latinos are significantly more likely to use an inclusive definition of cultural membership. In tandem, these results highlight the importance of measuring citizenship as a multidimensional concept and the limitations of focusing on the dominant group to understand immigration attitudes in contemporary diverse societies.

Resident Willingness to Participate in Digital Contact Tracing in a COVID-19 Hotspot: Findings From a Detroit Panel Study.

Digital surveillance tools and health informatics show promise in counteracting diseases but have limited uptake. A notable illustration of the limits of such tools is the general failure of digital contact tracing in the United States in response to COVID-19. We investigated the associations between individual characteristics and the willingness to use app-based contact tracing in Detroit, a majority-minority city that experienced multiple waves of COVID-19 outbreaks and deaths since the start of the pandemic. The aim of this study was to examine variations among residents in the willingness to download a contact tracing app on their phones to provide public health officials with information about close COVID-19 contact during summer 2020. To examine residents' willingness to participate in digital contact tracing, we analyzed data from 2 waves of the Detroit Metro Area Communities Study, a population-based survey of Detroit, Michigan residents. The data captured 1873 responses from 991 Detroit residents collected in June and July 2020. We estimated a series of multilevel logit models to gain insights into differences in the willingness to participate in digital contact tracing across a variety of individual attributes, including race/ethnicity, degree of trust in the government, and level of education, as well as interactions among these variables. Our results reflected widespread reluctance to participate in digital contact tracing in response to COVID-19, as less than half (826/1873, 44.1%) of the respondents said they would be willing to participate in app-based contact tracing. Compared to White respondents, Black (odds ratio [OR] 0.45, 95% CI 0.23-0.86) and Latino (OR 0.32, 95% CI 0.11-0.99) respondents were significantly less willing to participate in digital contact tracing. Trust in the government was positively associated with the willingness to participate in digital contact tracing (OR 1.17, 95% CI 1.07-1.27), but this effect was the strongest for White residents (OR 2.14, 95% CI 1.55-2.93). We found similarly divergent patterns of the effects of education by race. While there were no significant differences among noncollege-educated residents, White college-educated residents showed greater willingness to use app-based contact tracing (OR 6.12, 95% CI 1.86-20.15) and Black college-educated residents showed less willingness (OR 0.46, 95% CI 0.26-0.81). Trust in the government and education contribute to Detroit residents' wariness of digital contact tracing, reflecting concerns about surveillance that cut across race but likely arise from different sources. These findings point to the importance of a culturally informed understanding of health hesitancy for future efforts hoping to leverage digital contact tracing. Though contact tracing technologies have the potential to advance public health, unequal uptake may exacerbate disparate impacts of health crises.

Self-rated health of both US citizens and noncitizens is associated with state-level immigrant criminalization policies

Evidence shows that state-level restrictive immigrant policies are associated with health disparities between noncitizens and citizens. Most research has focused on Latinos and there is limited knowledge of the relationship between restrictive policies and citizenship status among other groups, particularly Asian and Pacific Islanders (API). We examined whether state-level criminalization policy contexts (e.g., law enforcement collaboration with immigration authorities, E-Verify employment authorization) were associated with self-rated health (SRH) by citizenship, with a focus on Latinos and APIs. We expected that criminalization policies would be associated with worse health for noncitizens and citizens, but with a more negative influence for noncitizens; and that this pattern would be the same for Latinos and APIs. We merged a state-level immigrant criminalization policy database with a multi-racial/ethnic sample from 2014 to 2015 National Health Interview Survey (NHIS, n = 70,335). We tested the association between SRH and the number of state-level criminalization policies and generated predicted probabilities of noncitizens and citizens reporting excellent health in states with the most and fewest criminalization policies for the full sample, Latino, and API respondents. In states with the most criminalization policies, all noncitizens had a higher and all US-born citizens had a lower probability of excellent health. In states with the fewest criminalization policies there were no differences by citizenship status. Findings provide new evidence that state-level immigrant policies may harm the health of US-born citizens. As immigrant policymaking at the state level continues, understanding the relationship between state-level immigrant policies and health inequities across citizenship statuses will continue to be critical to improving population health.

Factors associated with COVID-19 vaccine intent among Latino SNAP participants in Southern California

BackgroundCOVID-19 is significantly impacting the health and well-being of the country, particularly for ethnic minority populations and low-income groups. Our goal was to determine COVID-19 vaccination intent in a low-income, Latino population receiving aid from the Supplemental Nutrition Assistance Program (SNAP) in Southern California, and identify contributing factors and concerns.MethodsA cross-sectional, mixed-methods survey was conducted among participants in the Southern California Nutrition Incentives Program (¡Más Fresco! More Fresh). Only Latino respondents were included in this analysis. Primary outcome was vaccine intent trichotomized into: “definitely/likely yes”, “not sure/don’t know”, and “definitely/likely not.”ResultsThe majority of participants (n = 486) were female (93%), Spanish speaking (74%), with a median age of 40 years (IQR = 13). Approximately half (48%) reported they would get a COVID-19 vaccine, 39% were unsure, and 13% reported “definitely/likely not”. In the multivariable multinomial logistic regression model, participants with a household member with a COVID-19 health risk factor were more likely to be unsure about getting the vaccine. Participants who were primarily English speaking, did not receive the influenza vaccine last season, and reported not reading or talking about COVID-19 were more likely to report not intending to receive the vaccine. Many respondents were concerned about “side effects and ingredients”, and did not trust the vaccine development process, particularly with how fast it happened.ConclusionLow-income Latinos in Southern California were generally hesitant to get a COVID-19 vaccine. Culturally sensitive vaccine promotion campaigns need to address the concerns of minority populations who experience increased morbidity and mortality from COVID-19.

Trajectories of cognitive functioning in later life: Disparities by race/ethnicity, educational attainment, sex, and multimorbidity combinations

Evaluating multimorbidity combinations, racial/ethnic background, educational attainment, and sex associations with age-related cognitive changes is critical to clarifying the health, sociodemographic, and socioeconomic mechanisms associated with cognitive function in later life. Data from the 2011–2018 National Health and Aging Trends Study for respondents aged 65 years and older (N = 10,548, mean age = 77.5) were analyzed using linear mixed effect models. Racial/ethnic differences (mutually-exclusive groups: non-Latino White, non-Latino Black, and Latino) in cognitive trajectories and significant interactions with sex and education (<high school, high school, some college, and ≥ college degree) were evaluated. Models included sex, education, ever covered by Medicaid, coupled status, waist-height ratio, study cohort, and chronic disease category (no diseases; one disease; advanced cardiovascular multimorbidity; metabolic multimorbidity; advanced cardiovascular-metabolic multimorbidity; and neither advanced cardiovascular nor metabolic multimorbidity). In covariate-adjusted models, Black (b = −1.31, 95% CI: 1.74,-0.89) and Latino (b = −0.83, 95% CI: 1.58,-0.07) respondents had lower cognitive scores at age 65 and steeper declines with age (b = −0.08, 95% CI: −0.15,-0.01; b = −0.20, 95% CI: 0.34,-0.05, respectively) compared with White respondents. Cognitive scores were lower among respondents with advanced cardiovascular (b = −0.28, 95% CI: 0.54,-0.01) and advanced cardiovascular-metabolic (b = −0.56, 95% CI: 0.86,-0.27) multimorbidity compared with respondents with none of the chronic diseases of interest. In interaction models, protective associations by female sex and higher education were not observed among minority racial/ethnic groups. It is important to develop interventions to postpone cognitive decline among older Black and Latino adults.

Communication about vaccine efficacy and COVID-19 vaccine choice: Evidence from a survey experiment in the United States.

While mass vaccination campaigns against COVID-19 have inoculated almost 200 million Americans and billions more worldwide, significant pockets of vaccine hesitancy remain. Research has firmly established that vaccine efficacy is an important driver of public vaccine acceptance and choice. However, current vaccines offer widely varying levels of protection against different adverse health outcomes of COVID-19. This study employs an experiment embedded on a survey of 1,194 US adults in June 2021 to examine how communications about vaccine efficacy affect vaccine choice. The experiment manipulated how vaccine efficacy was defined across four treatments: (1) protection against symptomatic infection; (2) protection against severe illness; (3) protection against hospitalization/death; (4) efficacy data on all three metrics. The control group received no efficacy information. Subjects were asked to choose between a pair of vaccines—a one-dose viral vector vaccine or two-dose mRNA vaccine—whose efficacy data varied across the four experimental treatment groups. Efficacy data for each vaccine on each dimension were adapted from clinical trial data on the Johnson & Johnson/Janssen and Pfizer/BioNTech vaccines. Among all respondents, only modest preference gaps between the two vaccines emerged in the control group and when the two vaccines’ roughly equivalent efficacy data against hospitalization and death were reported. Strong preferences for a two-dose mRNA vaccine emerged in treatments where its higher efficacy against symptomatic or severe illness was reported, as well as in the treatment where data on all three efficacy criteria were reported. Unvaccinated respondents preferred a one-dose viral vector vaccine when only efficacy data against hospitalization or death was presented. Black and Latino respondents were significantly more likely to choose the one-shot viral vector vaccine in the combined efficacy treatment than were whites. Results speak to the importance of understanding how communications about vaccine efficacy affect public preferences in an era of increasing uncertainty about efficacy against variants.

Tailoring recruitment message content to reach diverse communities for AD research participation

AbstractBackgroundCOVID19 forced cessation of in‐person recruitment accelerating reliance on social media and other communication strategies. New strategies are needed to reach healthy controls who are typically recruited outside of clinical settings. Engaging diverse communities is also a priority given the disproportionate burden of AD and related dementias. Understanding the general and differential appeal of recruitment messaging to diverse groups will facilitate more effectively tailored messaging.MethodsThe Voices Heard Survey designed to identify factors associated with willingness to participate in biomedical research requesting biospecimens was administered to a diverse sample of 406 Wisconsin residents. Respondents include White (n=100), African American (n=105), Latino (n=100) and American Indian (n=101) adults. The 96 item survey assessed trust in medical research, along the continuum of study complexity and invasiveness relevant to AD studies, factors positively or negatively affecting willingness to participate in biomedical studies and clinical trials. Response frequencies indicated likelihood of participation were calculated for the full sample and by racial/ethnic group. Chi‐Square analyses were computed to determine significant differences across groups.ResultsSample characteristics are presented in Table 1. The factors most highly associated with willingness to volunteer for a study for the total sample were: Invited to Participate (85%), Research Goal (83%), Family Member with Disease (74%) and factors less likely to promote participation were: Share Results (48%), Paid for Participation (35%) and Transportation (34%) (see Figure 1). Significant differences were observed between the White and minority groups for the following factors: Black, Latino and American Indian respondents were: Significantly more likely to volunteer if asked by a a person of the same race (p&lt;.0001), and more concerned than Whites about Disruption of work and family responsibilities (p&lt; .001),Availability of transportation(p&lt;.01), and If the results are used to help others (p&lt;.01), and Childcare (p&lt;.02). Remuneration for participation (p&lt;.06) and sharing results with community (p&lt;.07) approached significance. Specific priorities by racial and ethnic group will be presented.ConclusionAD study recruitment requires strategic communication and innovative methods of reaching groups traditionally underrepresented in biomedical research. We identified information opportunities for tailored messaging designed to increase awareness of the value and opportunities afforded of research participation.

Racial/ethnic disparities in intent to obtain a COVID-19 vaccine: A nationally representative United States survey

Black, Latino, Pacific Islander, and American Indian/Alaska Native adults are more likely than White adults to experience SARS-CoV-2-related infections, hospitalizations, and mortality. We assessed intent to be vaccinated and concerns among 7 U.S. racial/ethnic groups (1,000 Black/African American, 500 American Indian/Alaska Native, 1,000 Asian, 1,000 Latino (500 English- and 500 Spanish-speaking), 500 Pacific Islander, 500 multiracial, and 1,000 White adults) in a cross-sectional online survey conducted December 2020-February 2021, weighted to be nationally representative within groups. Intent to be vaccinated was ascertained with: “If a COVID-19 vaccine becomes available, how likely are you to get vaccinated?” (not at all/slightly/moderately/very/extremely likely). Respondents identified which concerns would keep them from being vaccinated: cost, not knowing where, safety, effectiveness, side-effects, and other. Multinomial logistic regression models assessed associations of race/ethnicity with odds of being extremely/very/moderately, slightly likely to be vaccinated (ref = not at all), controlling for demographics and health. Overall, 30% were extremely likely, 22% not at all likely, and 48% unsure. Compared to White respondents, American Indian/Alaska Native (Adjusted Odds Ratio (AOR) = 0.66, 95% CI, 0.47–0.92) and Black/African American (AOR = 0.54, 95% CI, 0.41–0.72) respondents were less likely, and Asian (AOR = 2.21, 95% CI, 1.61–3.02) and Spanish-speaking Latino respondents (AOR = 3.74, 95% CI, 2.51–5.55) were more likely to report being extremely likely to be vaccinated. Side-effects (52%) and safety (45%) were overriding concerns. Intent and vaccination rates are changing rapidly; these results constitute a comprehensive baseline for ongoing vaccination efforts among U.S. racial and ethnic groups.

Has Pandemic Threat Stoked Xenophobia? How COVID-19 Influences California Voters' Attitudes toward Diversity and Immigration.

Sociological theory and historical precedent suggest that pandemics engender scapegoating of outgroups, but fail to specify how the ethnoracial boundaries defining outgroups are drawn. Using a survey experiment that primed half of the respondents (California registered voters) with questions about COVID‐19 during April 2020, we ask how the pandemic influenced attitudes toward immigration, diversity and affect toward Asian Americans. In the aggregate, the COVID prime did not affect attitudes toward immigrants, but did reduce support for policies opening a pathway to citizenship for undocumented immigrants and reduced appreciation of California’s diversity. Respondents reported rarely feeling anger or fear toward Asian Americans, and rates were unaffected by the COVID prime. A non‐experimental comparison between attitudes toward immigrants in September 2019 and April 2020 found a positive change, driven by change among Asian‐American and Latino respondents. The results provide selective support for the proposition that pandemics engender xenophobia. At least in April 2020 in California, increased bias crimes against Asian Americans more likely reflected politicians’ authorization of scapegoating than broad‐based racial antagonism.

If you build it, will they come? Social, economic, and psychological determinants of COVID-19 testing decisions.

BackgroundThe efficacy of testing and tracing programs to reduce COVID-19 transmission hinges not only on widespread access to testing, but also on the public’s willingness to participate in them. To the extent that testing intentions are patterned by social determinants of health, this constitutes an understudied mechanism of disparities in COVID-19 morbidity and mortality.DesignUsing data from a representative household probability sample, the Person to Person Health Interview Study (n = 935), sociodemographic, economic, and psychological determinants of testing considerations were evaluated across six domains: treatment affordability, ability to work if positive, hospital effectiveness, symptom severity, proximity to infected, and risk of transmitting to others.ResultsFindings demonstrated significant differences in testing motivations across race/ethnicity, education level, socioeconomic status, and worry about self and loved ones. Notably, Black (p<0.01) and Latino (p<0.05) respondents and those experiencing financial strain (p<0.001) were disproportionately likely to indicate that resource factors would influence their decision to get tested. Desire to reduce transmission and concern about proximity to the infected were reported among those who expressed COVID-19 worries (p<0.001).ConclusionPublic health efforts to combat the COVID-19 pandemic must address social, economic, and psychological factors that enable and constrain individual behavior. Increasing access to preventative interventions and technologies, including vaccines, is unlikely to markedly reduce morbidity and mortality without effective messaging and economic support to improve uptake in vulnerable populations.

Prevalence of SARS-CoV-2 Antibodies in New York City Adults, June-October 2020: A Population-Based Survey.

BackgroundSerosurveys are important to ascertain burden of infection. Prior SARS-CoV-2 serosurveys in New York City (NYC) have used nonrandom samples. During June–October 2020, the NYC Health Department conducted a population-based survey to estimate SARS-CoV-2 antibody prevalence in NYC adults.MethodsParticipants were recruited from the NYC 2020 Community Health Survey. We estimated citywide and stratified antibody prevalence using a hybrid design: serum tested at the NYC Health Department using the DiaSorin LIAISON ® SARS-CoV-2 S1/S2 IgG assay and self-reported antibody test results were used together. Prevalence was estimated using univariate frequencies and 95% confidence intervals (CI), accounting for complex survey design. Two-sided P-values ≤0.05 were statistically significant.ResultsThere were 1074 respondents overall; 497 provided blood and 577 provided only a self-reported antibody test result. Weighted prevalence was 24.3% overall (95% CI: 20.7–28.3). Latino (30.7%, 95% CI: 24.1–38.2, p<0.01) and Black (30.7%, 95% CI: 21.9–41.2, p=0.02) respondents had a higher weighted prevalence compared with White respondents (17.4%, 95% CI: 12.5–23.7).ConclusionsBy October 2020, nearly 1 in 3 Black and 1 in 3 Latino NYC adults had SARS-CoV-2 antibodies, highlighting unequal impacts of the COVID-19 pandemic on Black and Latino adults in NYC.

Increasing access to individualized medicine: a matched-cohort study examining Latino participant experiences of genomic screening

PurposeMultiple efforts are underway to increase the inclusion of racial minority participants in genomic research and new forms of individualized medicine. These efforts should include studies that characterize how individuals from minority communities experience genomic medicine in diverse health-care settings and how they integrate genetic knowledge into their understandings of health-care needs. MethodsAs part of a large, multisite genomic sequencing study, we surveyed individuals to assess their decision to pursue genomic risk evaluation. Participants included Latino patients recruited at Mountain Park Health Center, a Federally Qualified Health Center in Phoenix, Arizona, and non-Latino patients recruited at a large academic medical center (Mayo Clinic in Rochester, MN). Both groups agreed to receive individualized genomic risk assessments. ResultsComparisons between cohorts showed that Latino respondents had lower levels of decisional conflict about pursuing genomic screening but generally scored lower on genetic knowledge. Latino respondents were also more likely to have concerns about the misuse of genomic information, despite both groups having similar views about the value of genomic risk evaluation. ConclusionOur results highlight the importance of evaluating sociocultural factors that influence minority patient engagement with genomic medicine in diverse health-care settings.