Multiethnic Families Research Articles

Interracial and Interethnic Marriages: Given Recent History, Have Things Been Getting Better?

Abstract Interracial and interethnic marriages have been increasing in the United States, growing from 7.4 percent in 2000 to 10.2 percent by 2016. Given the growing number of such marriages, more research is needed to inform social work practice, policy, and programming to effectively serve these couples, and their multiracial families. The current research reports on findings from a 2022 survey of 413 partners in interracial or interethnic marriages. Respondents were asked whether over the past five years they felt things have been getting better, about the same, or worse for intermarried couples in our society. Predictive of feeling things had been getting better included reporting support from extended family, living in a community with a number of multiracial and/or multiethnic families, intentionally seeking out social groups or settings with other interracial/interethnic couples, and having children. A few variables predicted feeling things have been about the same or getting worse. These included being male, the couple discussing recent racially related traumatic events such as the murder of George Floyd, and reporting being more frequently consciously aware of the interracial or interethnic nature of their marriage. Implications for practice with interracial and interethnic couples are discussed.

The construction of dual ethnic identity among multi-ethnic adolescents

This article examines the relationship between intermarriage and integration in a novel context, centering on Israeli adolescents with ethnic origins from both Europe and Middle Eastern and North African countries. Current analyses explore this relationship mainly through the self-identification of multi-ethnic individuals. One line of studies shows that intermarriage enlarges social networks and lowers social differences thereby weakening ethnic identification among multi-ethnic adolescents; another line points to the continuation of ethnic boundaries within multi-ethnic families and close environments that lead adolescents to identify themselves as ethnic. In contrast to these lines of research, that examine the relationship between intermarriage and integration among different ethnic groups, this article analyses this relationship between two subgroups – Middle Eastern and North African and European Jews – from the same ethnic group: Israeli Jews. Interviews with Israeli multi-ethnic adolescents show that they develop a dual ethnic identity that comprised two opposing elements. The first is a ‘thin’ identity, which enables them to choose and switch between ethnicities, thus blurring ethnic boundaries; the other, a ‘strong’ identity, creates an inner experience of two opposing ethnicities, thereby maintaining a hierarchy between the groups. This article demonstrates that in specific structural conditions, intermarriage does not influence integration in one direction only, but facilitates and impedes this process simultaneously in both directions.

The Doses of Post-Transplantation Cyclophosphamide in Haploidentical Stem Cell Allografts Can be Reduced

Background Allogeneic hematopoietic cell transplantation (HSCT) remains the most important curative modality for several hematologic malignancies, but an HLA-matched sibling or unrelated donor is not always available, particularly for ethnic minorities and multiethnic families. Haploidentical HSCT (Haplo-HSCT) is a solution and, since it can be safely conducted on an outpatient basis, the costs can be substantially reduced; toxicity, however, remains a major problem. Material and methods All patients given a Haplo-HSCT in the Centro de Hematología y Medicina Interna in Puebla, México and Hospital Universitario de Nuevo León, Nuevo León, México employing the “Mexican” method to conduct Haplo-HSCT on an outpatient basis were included. The employed protocol is as follows: Fludarabine dose of 50 mg/m2 IV daily from Day -6 to Day -4 (total dose received 150 mg/m2), Pre-HSCT Cyclophosphamide dose of 500mg/m2 IV daily from Day -7 to Day -4 (total dose received 2000 mg/m2). Post-HSCT Cyclophosphamide daily from Days +3 to +4, conventional dose: 50 mg/kg IV; reduced dose 25-30mg/kg IV. The employed protocol is registered in www.clinicalTrials.gov, identifier NCT05780554. Between March 2013 and July 2016, the transplants were done using the conventional doses (CD) of PTCy (50 mg/Kg) on d 3 and 4, whereas after July 2016, the allografts were done using reduced doses (RD-PTCy) 25-30 mg/Kg, d 3 and 4. Twenty-one patients received the CD, whereas 14 were given RD. All grafts were started as outpatients and could be completed as outpatients in 71% and 60% of cases respectively, for the groups of CD and RD. Results According to the statistical analysis, the two comparative groups (CD-PTCy versus RD-PTCy) had no significant differences in terms of age, sex and hematological recovery. Cytokine release syndrome and hematological toxicity were less frequent in the group of persons given RD-PTCy, whereas the prevalence of both acute and chronic graft versus host disease was similar in the two groups (Table 1). The median OS for the group CD-PTCy is 5.7 months meanwhile for the RD-PTCy is 15.67 months. The figure 1 depicts the Kaplan-Meier OS plots for the two subsets of patients, which were not statistically different. The RFS were better in the patients grafted with RD-PTCy (2.13 mo vs 5.13 mo). There are no differences between PTCy 25mg/kg and 30mg/kg. The median follow up for entire group is 4.53 months (IQR: 1.1 - 18.9 mo). Conclusion These results indicate that the doses of PTCy can be significantly reduced without compromising the effectiveness of the Haplo-HSCT conducted in an outpatient basis and employing the “Mexican” reduced intensity method. This preliminary observation may be considered as an idea to conduct prospective randomized studies to explore the possibility of significantly reducing the doses of PTCy in the setting of Haplo-HSCT.

PEMAHAMAN KESUKUAN DALAM KELUARGA MULTI-SUKU DI PONTIANAK

In general, this research is motivated by the problem of the condition of knowledge in one of the multi-ethnic families in the komplek BLKI, Pontianak Tenggara, who still do not fully know about the ethnic they belong to. This was revealed after observing daily habits that do not describe the ethnic group used as the identity. The purpose of this study is to find out about: (1) The application of culture to multi-ethnic families in everyday life. (2) Knowledge of each member of a multi-ethnic family about the tribe they belong to. (3) General material about ethnic groups belonging to multi-ethnic families. (4) Factors influencing ethnic knowledge in multi-ethnic families. This research used qualitative methods in the form of observation and online interview. The data source for this research is one of the multi-ethnic families who live in the komplek BLKI, Pontianak Tenggara. As a result, the condition of ethnic knowledge in the family is not good. The discussion is that family members apply some of the tribal culture in everyday life, knowledge about the ethnicity that is owned is not much, the tribes that are owned are Malay and Bugis, the factors that influence knowledge in the multi-ethnic family are individual factors, heredity, and environmental factors. It can be concluded that the condition of ethnic knowledge in multi-ethnic families in the komplek BLKI, Pontianak Tenggara is still limited.

Can doses of post-transplantation cyclophosphamide in haploidentical stem cell allografts be reduced?

ABSTRACTObjectives: Allogeneic hematopoietic stem cell transplantation (HSCT) remains the most important curative modality for several hematologic malignancies, but an HLA-matched sibling or unrelated donor is not always available, particularly for ethnic minorities and multiethnic families. We have shown that Haplo-HSCT can be conducted safely on an outpatient basis, using peripheral blood stem cells; this leading into substantial decreases in the costs. Methods: In this study twenty-one patients prospectively received the conventional dose of post-transplantation cyclophosphamide (PTCy): (50 mg/Kg on days 3 and 4), whereas 10 were given reduced doses of the drug (25 mg/Kg on days 3 and 4). Results: According to the statistical analysis, the two comparative groups (PTCy 50 mg/kg vs PTCy 25 mg/kg) had no significant difference in terms of age, sex, hematological recovery, and type of conditioning regimen. The median OS for the group PTCy 50 mg/kg is 5.7 months meanwhile for the group PTCy 25 mg/kg the median is 6.4 months. The median follow up for entire group is 4.5 months (IQR: 1.1–18.9 mo). Conclusion: These results could indicate that the Cy-dependent hematological toxicity can be reduced without compromising its effectivity. This preliminary observation may be considered as an idea to conduct prospective randomized studies to explore the possibility of significantly reducing the doses of PT-Cy in the setting of Haplo-HSCT.Trial registration: ClinicalTrials.gov identifier: NCT05780554.

Developmental trajectories of Korean and heritage language proficiencies and their association with maladjustment among Korean multicultural adolescents.

This study identified changes in Korean and heritage language proficiencies across five waves (2011-2015) and examined the association between linguistic acculturation trajectories and adjustment (2016) among Korean adolescents with immigrant family backgrounds (N=1441; 51.21% female; Mage(baseline) =9.97). All adolescents were from multiethnic families with 91.65% comprising a non-Korean Asian mother (e.g., Japan, Philippines, China, Thailand) and Korean father. Parallel process latent class growth modeling and multivariate regression analysis were conducted to estimate the trajectories of linguistic acculturation and their effects on adolescents' future adjustment. Linguistic acculturation trajectories were classified into three latent groups. Bilingual adolescents demonstrated better adjustment over adolescents in other trajectories. Findings highlight the importance of considering patterns of change in linguistic acculturation for understanding Korean multicultural adolescents' adjustment.

“You Will Be Missed You Know, but This Is No Place for You to Grow”: A Critical Metaphor Study of Pre-Adoption Narratives

This article discusses (pre-)adoption narratives by investigating a selection of children’s picture books featuring multi-ethnic families. The research examines both textual and pictorial resources, focusing specifically on the use of metaphors as a tool of cognition which may help an audience of young readers understand and become acquainted with unfamiliar notions connected to the process of interracial adoption. Attention is also devoted to the identification, interpretation, and explanation of recurring metaphors in the books as a means of framing (pre-)adoption experiences, i.e. foregrounding certain aspects of the target domains and backgrounding others. The analysis has revealed an almost ubiquitous presence of the journey metaphor in the sample of books.

THE PHENOMENON OF GENERATIONS IN THE FAMILIES OF ETHNIC MINORITIES: A SOCIO-PSYCHOLOGICAL ANALYSIS

The article sheds light on the results of a theoretical study of the problem of the generational phenomenon in the families of ethnic minorities: sociopsychological analysis. The author of the article sheds light on the psychological characteristics of people of different nationalities in multi-ethnic families, and considers such concepts as the phenomenon of generations and the concept of generational change within the framework of a socio-psychological approach, namely, in the family, the foundations of the individual’s relations with representatives of other ethnic communities are laid, and from what these relations will be, which depends on the life of a person and society as a whole. Concepts are revealed: multi-ethnic family, concept of family of ethnic minorities. The socio-psychological characteristics and features of relationships are analyzed, which allow us to identify such psychological conditions for the harmonization of relationships in the families of ethnic minorities as the commonality of family values, respect for the older generation, the consistency of the child-rearing model, and the spiritual level of compatibility of spouses. The concept of a generation as a socio-age group of people, equally distant in terms of kinship from common ancestors (parents, children, grandchildren), forming in relation to them the same degree of kinship in a direct line, as well as the offspring of spouses by the level of kinship, is considered. It reveals the presence of intergenerational transmission of culture from the older generation to the younger and back, how the youth’s interpretation of the current situation and cultural heritage affects the older generation – parents and forefathers. The article emphasizes that in the course of historical development, significant changes occur in relations between different generations of people. The main results of the theoretical study of the problem of the generational phenomenon in the families of ethnic minorities are the conclusions that in modern society, which is developing at a rapid pace, with completely changed living conditions of people, circumstances and laws – the situation in families is also changing. Meanwhile, in the families of ethnic minorities, their own national traditions and customs are revived, preserved and passed down from generation to generation, the native language is used, national cuisine is used, and national culture is valued.

Sleep and parenting in ethnically diverse Pacific families in southern New Zealand: A qualitative exploration

ObjectivesChildren's sleep has been shown to vary by ethnicity, but little is known about children's sleep in multiethnic households. In New Zealand, Pacific families are increasingly ethnically diverse, due to intermarriage and to people identifying as more than 1 ethnicity. Thus, the objective of this work was to explore children's sleep habits, and sleep-related parenting practices, in ethnically diverse Pacific families (EDPF). DesignTen qualitative interviews with adult members of EDPF were undertaken. Open-ended questioning was used. SettingInformal, conversational interviews conducted in homes and workplaces in southern New Zealand. ParticipantsFifteen adults from 10 EDPF. MeasurementsInterviews were recorded and transcribed. Thematic open coding was used to analyze transcripts and identify themes. ResultsSleep practices such as bedtime routines and preferred sleep environments varied both within and between EDPF. The EDPF in this sample responded to the context in which they lived, and the demands of everyday life in New Zealand, when managing children's sleep. Respectful communication between parents was key to navigating cultural differences and resolving areas of tension. The families in this study aspired to instill strong multi-cultural knowledge and identities in their children. Some families had sought out resources to help with this, but they were often either difficult to find, or expensive. ConclusionsA variety of sleep habits and related parenting practices were observed in this small sample of EDPF, who recognized that raising children in multi-ethnic families was associated with distinct opportunities as well as challenges.

«Native among foreigners, foreign among natives»: on the issue of linguistic identity

The article regards the problem of the linguistic identity of Kazakh youth from interethnic Kazakh-Russian families. A survey of respondents aged 18–21 shows the difficulties in linguistic self-determination of the individual. Nevertheless, a significant part of respondents identifies themselves with the linguistic correlation of the father due to the traditional dominant role of the father in the Kazakh family, a slightly smaller number of respondents chooses the nationality of the mother. Anthropological characteristics and language are important factors in choosing ethnic identity. Most students from multi-ethnic families are bilingual, they are equally fluent in two languages. The study highlights the types of relationship between linguistic and ethnic identity of bilingual personality. The correlation between linguistic and ethnic identity is identical in 56/62.9 % of respondents, not coinciding in 33/37 % of respondents.

The role of CDHR3 in susceptibility to otitis media.

Otitis media (OM) is common in young children and can cause hearing loss and speech, language, and developmental delays. OM has high heritability; however, little is known about OM-related molecular and genetic processes. CDHR3 was previously identified as a locus for OM susceptibility, but to date, studies have focused on how the CDHR3 p.Cys529Tyr variant increases epithelial binding of rhinovirus-C and risk for lung or sinus pathology. In order to further delineate a role for CDHR3 in OM, we performed the following: exome sequencing using DNA samples from OM-affected individuals from 257 multi-ethnic families; Sanger sequencing, logistic regression and transmission disequilibrium tests for 407 US trios or probands with OM; 16S rRNA sequencing and analysis for middle ear and nasopharyngeal samples; and single-cell RNA sequencing and differential expression analyses for mouse middle ear. From exome sequence data, we identified a novel pathogenic CDHR3 splice variant that co-segregates with OM in US and Finnish families. Additionally, a frameshift and six missense rare or low-frequency variants were identified in Finnish probands. In US probands, the CDHR3 p.Cys529Tyr variant was associated with the absence of middle ear fluid at surgery and also with increased relative abundance of Lysobacter in the nasopharynx and Streptomyces in the middle ear. Consistent with published data on airway epithelial cells and our RNA-sequence data from human middle ear tissues, Cdhr3 expression is restricted to ciliated epithelial cells of the middle ear and is downregulated after acute OM. Overall, these findings suggest a critical role for CDHR3 in OM susceptibility. KEY MESSAGES: • Novel rare or low-frequency CDHR3 variants putatively confer risk for otitis media. • Pathogenic variant CDHR3 c.1653 + 3G > A was found in nine families with otitis media. • CDHR3 p.Cys529Tyr was associated with lack of effusion and bacterial otopathogens. • Cdhr3 expression was limited to ciliated epithelial cells in mouse middle ear. • Cdhr3 was downregulated 3h after infection of mouse middle ear.

Greater Focus on Strengths is Associated with Successful Discharge in Youth Public Mental Health Treatment.

The positive psychology literature suggests focusing on strengths in mental health treatment improves well-being, reduces symptomology, and is linked to positive outcomes.However, there is little research on the use of strengths in treatment and their association with outcomes in youth clinical populations. The present study used multi-level modeling to examine the association between the proportional targeting of strengths and treatment outcomes for 1,841 youth ages 3-19 receiving intensive in-home services through a public mental health system. A greater percentage of targets endorsed during treatment that were strength-focused was associated with increased likelihood of successful treatment discharge, even after accounting for other predictors, including episode length, youth age, and level of impairment at treatment start. Specifically, as the percentage of strengths targeted increased from 46 to 64% of total targets endorsed, the odds of successful discharge increased by 21%. Such practice-based findings derived from aggregated data regarding services to multiethnic low-income families extend the strength-based intervention literature to include youth with significant life challenges. Study findings point to the need to develop structured interventions suitable for examination via clinical efficacy and effectiveness trials.Clinical practice, dissemination, implementation, and future research implications are discussed.

РЕЛИГИОЗНАЯ ИДЕНТИЧНОСТЬ И ПРИОБЩЕНИЕ ДЕТЕЙ К РЕЛИГИИ В МЕЖНАЦИОНАЛЬНЫХ СЕМЬЯХ (НА ПРИМЕРЕ РЕСПУБЛИКИ БАШКОРТОСТАН)

The article reveals some results of a sociological study on the features of religious identity of spouses and social practices of children's inclusion in interethnic families (on the example of the Republic of Bashkortostan). This topic is most relevant for multi-ethnic regions, where interfaith marriages are quite common, despite the presence of isolationist attitudes among a part of the population. Marriages between representatives of various religious movements lead to the formation of a special cross-cultural environment of interaction, which requires the spouses to make many decisions, including on the confessional affiliation of children, on the choice of mechanisms for the formation of religious identity. Based on the author's research, the article analyses the state of religious identity of a resident of a multi-ethnic region in a dynamic aspect. Special attention is paid to spouses who are in an interethnic marriage. The author studies variants of religious communications, among which the dominant one is the co-existence of religions in variations from "common / unified religion" to "equality". Most of the families studied are classified as egalitarian and democratic in terms of their power structure and upbringing model. The article provides data on the state of religious identity of children raised in multi-ethnic families. The authors call traditional, psychological and educational motives for introducing children to religion the predominant ones. Based on the presented material, the authors come to the conclusion that there are two most common models of introducing children to religion in interethnic families: passive (indirect) and active religious socialization. The first model is the most popular among residents of large cities, while traditional families choose the second one.

‘A Drumbeat Underneath the Child’: Asian Indian Mothers’ Perceptions of Their Multiethnic Children’s Lived Experiences

There has been an increase in the number of multiethnic families and children across the world. Within the research addressing the realities and needs of multiethnic children, there has been little inclusion of children of Asian Indian heritage and their mixed heritage families. This phenomenological study includes interviews with eight Asian Indian mothers raising multiethnic children with their non-Asian Indian spouses in the Northeastern United States. Four primary themes emerged through analysis: navigating multiple cultures, effects of pervasive racism, strengths of multiethnic children, and recommendations for professionals.

Otitis media susceptibility and shifts in the head and neck microbiome due to SPINK5 variants

BackgroundOtitis media (OM) susceptibility has significant heritability; however, the role of rare variants in OM is mostly unknown. Our goal is to identify novel rare variants that confer OM susceptibility.MethodsWe...

Problem Gambling Risk Among Older Francophones in Ontario Canada: Surprising Results that Contradict Previous Findings of Gambling in Minority Groups.

Gambling is a popular activity among older adults. Despite this increase in popularity little research has examined gambling among this group. This is especially true for minority older adults, like Francophones in Ontario. The purpose of this study was to better understand gambling in a sample of older Francophones from North-Eastern Ontario, the first study to do so. A sample of 181 older (over 55years) Francophones from Northeastern Ontario (M age = 68.7, SD 7.6) was recruited. This sample was compared to a sample of older adults with English as their native language that had been previously collected (Norris and Tindale in The meaning of gambling among Ontario seniors in small and rural communities, Final report to the Ontario Problem Gambling Research Centre, 2006; Tindale and Norris in Gambling among intergenerational and multi-ethnic families, Final report to the Ontario Problem Gambling Research Centre, 2012). In addition to demographic measures the participants filled out a questionnaire that included measures of gambling behaviours and attitudes the Windsor Screen, The Problem Gambling Severity Index of the Canadian Problem Gambling Inventory, The Center for Epidemiologic Studies Depression Scale and the CAGE Alcohol Screen. Contrary to expectations, the Francophone sample had lower scores on the problem gambling measures with a smaller proportion of the sample in the categories indicating a high risk for problem gambling. This surprising result might be due to the protective effect of a positive ethnolinguistic identity. However, more research will need to be done to better understand these unanticipated results. The findings of this study help us better understand gambling among older adults in a minority group.

Not a level playing field: A qualitative study exploring structural, community and individual determinants of greenspace use amongst low-income multi-ethnic families.

Greenspace is important for physical and mental health. Low-income, multi-ethnic populations in deprived urban areas experience several barriers to using greenspace. This may exacerbate health inequalities. The current study explored structural and individual determinants of greenspace use amongst parents of young children in an urban, deprived, multi-cultural area situated in the North of England, UK. Semi-structured in-depth interviews and focus group discussions were conducted with 30 parents of children aged 0-3 between December 2016 and May 2017 from a range of ethnic groups. Thematic analyses were informed by the Human Health Habitat Map and the Theoretical Domains Framework. The results show that whilst all families recognised the benefits of greenspaces, use was bounded by a variety of structural, community, and individual determinants. Individual determinants preventing use included lack of knowledge about where to go, or how to get there and confidence in managing young children whilst outdoors. Fear of crime, antisocial behaviour and accidents were the overriding barriers to use, even in high quality spaces. Social and community influences both positively encouraged use (for example, positive social interactions, and practical support by others) and prevented use (antisocial or inappropriate behaviours experienced in greenspace). The built environment was a key barrier to use. Problems related to unsuitable or unsafe playgrounds, no gardens or safe areas for children's play, poor accessibility, and lack of toilets were identified. However, the value that parents and children placed on natural blue and green features was an enabler to use. Contextual influences included external time pressures, difficulties of transporting and caring for young children and poor weather. Multi-sectoral efforts are needed to tackle the uneven playing field experienced by multi-ethnic, urban, deprived communities. Initiatives to increase use should tackle structural quality issues, addressing fears about safety, whilst simultaneously encouraging communities to reclaim their local greenspaces.

Multicultural Education for Young Children through Information Books

This study aims to determine the impact of information book-based multicultural education for young children in terms of their knowledge and attitudes towards other cultures and their positive feelings towards other countries. Fifty-nine five-year-old children were placed into three groups: an information book-based multicultural education group, photograph-based multicultural education group, and control group. To implement multicultural education for the information book-based group, information books were produced on the top five countries of origin of parents of students from multiethnic families in Korea. For the photograph-based group, photographs from the same five countries were used to implement multicultural education. The study found that, compared to the other two groups, the young children from the group that used illustrated information books had greater positive changes with respect to knowledge and attitude towards other cultures and positive feelings towards other countries.

Motivation of Parents Towards Reading Multilingual eBooks To Pre-School Children

<span class="TextRun SCXW153678227" lang="EN-US" xml:lang="EN-US">The use of mobile devices for language learning, under the Mobile Assisted Language Learning (MALL) has been found to motivate children to read digital print. However, parents need to be convinced of the benefits of this new technology-assisted learning method within a multilingual learning context. A case study was conducted to propose a MALL framework in which educators and parents created a shared meaningful learning environment to develop the children’s emergent multilingual literacy skills, using mobile devices installed with interactive multilingual </span><span class="TextRun SCXW153678227" lang="EN-US" xml:lang="EN-US">eB</span><span class="TextRun SCXW153678227" lang="EN-US" xml:lang="EN-US">ooks. This paper reports the findings, specifically on the parents’ attitude and motivation towards reading multilingual </span><span class="TextRun SCXW153678227" lang="EN-US" xml:lang="EN-US">eBooks</span><span class="TextRun SCXW153678227" lang="EN-US" xml:lang="EN-US"> with their children. A group of 25 multi-ethnic families, together with their 5-year-old children participated in this study. A mixed-method explanatory research design obtained parent's attitude and motivation from a questionnaire, interview, and feedback form. The results show a high level of parents’ acceptance toward reading eBook with their children. Parents attributed their positive attitude and motivation towards MALL to the use of the multimedia, multilingual, and mobile platform. The MALL framework was also found to encourage parents and other adults to scaffold the children’s multilingual skills development. However, there were also setbacks toward the use of eBook as some parents expressed a stronger preference for printed books and were concerned with health issues associated with the children’s eBook use. Areas for improvements and future research are also made in this paper.</span>

FUT2 Variants Confer Susceptibility to Familial Otitis Media

Non-secretor status due to homozygosity for the common FUT2 variant c.461G>A (p.Trp154∗) is associated with either risk for autoimmune diseases or protection against viral diarrhea and HIV. We determined the role of FUT2 in otitis media susceptibility by obtaining DNA samples from 609 multi-ethnic families and simplex case subjects with otitis media. Exome and Sanger sequencing, linkage analysis, and Fisher exact and transmission disequilibrium tests (TDT) were performed. The common FUT2 c.604C>T (p.Arg202∗) variant co-segregates with otitis media in a Filipino pedigree (LOD = 4.0). Additionally, a rare variant, c.412C>T (p.Arg138Cys), is associated with recurrent/chronic otitis media in European-American children (p = 1.2× 10-5) and US trios (TDT p = 0.01). The c.461G>A (p.Trp154∗) variant was also over-transmitted in US trios (TDT p = 0.01) and was associated with shifts in middle ear microbiota composition (PERMANOVA p < 10-7) and increased biodiversity. When all missense and nonsense variants identified in multi-ethnic US trios with CADD > 20 were combined, FUT2 variants were over-transmitted in trios (TDT p = 0.001). Fut2 is transiently upregulated in mouse middle ear after inoculation with non-typeable Haemophilus influenzae. Four FUT2 variants-namely p.Ala104Val, p.Arg138Cys, p.Trp154∗, and p.Arg202∗-reduced A antigen in mutant-transfected COS-7 cells, while the nonsense variants also reduced FUT2 protein levels. Common and rare FUT2 variants confer susceptibility to otitis media, likely by modifying the middle ear microbiome through regulation of A antigen levels in epithelial cells. Our families demonstrate marked intra-familial genetic heterogeneity, suggesting that multiple combinations of common and rare variants plus environmental factors influence the individual otitis media phenotype as a complex trait.