“I Was Determined to Fulfill This Image of Myself That I Wanted of a ‘Good Asian Student’”: A Photovoice Study of Asian American College Student Mental Health

Round 1

Reviewer 1 Report

Methods: It may be helpful to your readers to summarize the larger sequential explanatory mixed methods study in which this smaller photovoice study resides and/or inform readers of where to find information about the larger study. In the photovoice study, how was informed consent obtained? Did participants agree to have their photos published? Was permission obtained from those whose likenesses are in the photos for those photos to be published? It is important to protect the privacy of everyone involved in this study (including those whose photos were taken). With regard to participants, was English their primary (native) language? A discussion about this may be helpful, as native language may play a role in qualitative data that is provided by participants. A more through discussion of this can be included in the Discussion section, too.

Findings: Throughout the findings section, it is important to clearly distinguish what are direct quotes from participants (typically by placing these in quotation marks). Some quotes appear to be placed within the regular findings paragraphs.

Discussion: A more thorough discussion about how the four themes were synthesized into the 3 domains would be helpful to the reader. How were the three domains chosen? Was there formal analysis that led to these domains? If so, that analysis can be outlined in the Findings section of the manuscript.

Implications: The authors do not weave the connection of CBT throughout the manuscript. It is appears here in the Implications section, leaving the reader to wonder about the connection of CBT to the concepts discussed throughout the manuscript. Please link CBT's role to the importance of the photovoice data/findings/results.

The manuscript would benefit from light editing.

Author Response

1) Methods: It may be helpful to your readers to summarize the larger sequential explanatory mixed methods study in which this smaller photovoice study resides and/or inform readers of where to find information about the larger study. 

AUTHOR’S RESPONSE:

We thank the reviewer for their time and efforts in reviewing our manuscript and providing feedback on how to strengthen our report. 

We have now expanded our description of the larger sequential explanatory mixed methods study:

This study analyzed Photovoice data collected during the second phase of a sequential explanatory mixed methods study which aimed to understand the link between internalized racism (IR) and education outcomes, considering the role of psychosocial well-being and critical consciousness (CC) [CITE]. The first phase of said sequential explanatory mixed methods study involved collecting quantitative data through an electronic survey. Qualtrics software was used to survey a sample of AsA undergraduate students attending a large public university in central Texas. A causal model of IR as a predictor of academic achievement and persistence, considering the role of individual psychological well-being and CC was tested in a final analytic sample of 294 AsA undergraduates. The second phase involved collecting qualitative data through semi-structured interviews and Photovoice methodology with a sub-sample (n=14) of survey respondents from May-June of 2022. The goal of the semi-structured interviews and Photovoice data was to extend understanding and provide nuance to the survey results obtained in the previous phase of the sequential explanatory mixed methods study. 

2) In the photovoice study, how was informed consent obtained? Did participants agree to have their photos published? Was permission obtained from those whose likenesses are in the photos for those photos to be published? It is important to protect the privacy of everyone involved in this study (including those whose photos were taken). 

AUTHOR’S RESPONSE:

We appreciate the reviewer’s concern for protecting participant rights. We have included the following sentence to further clarify the consent process, “The consent process included participants granting permission to have their photographs used for scholarly dissemination such as publications, community art exhibits, and presentations.” This sentence is lifted directly from the consent form that each participant signed.

3) With regard to participants, was English their primary (native) language? A discussion about this may be helpful, as native language may play a role in qualitative data that is provided by participants. A more through discussion of this can be included in the Discussion section, too.

AUTHOR’S RESPONSE: 

Eleven out of the fourteen participants were born in the U.S. Although this is not indicative of their primary language, we would invite the reviewer to reflect on this feedback. Research shows that Asian Americans contend with the perpetual foreigner stereotype which has been associated with adverse mental health outcomes. Some suggested readings:

Kim, S. Y., Wang, Y., Deng, S., Alvarez, R., & Li, J. (2011). Accent, perpetual foreigner stereotype, and perceived discrimination as indirect links between English proficiency and depressive symptoms in Chinese American adolescents. Developmental psychology, 47(1), 289.

Daley, J. S., Gallagher, N. M., & Bodenhausen, G. V. (2022). The pandemic and the “perpetual foreigner”: How threats posed by the COVID-19 pandemic relate to stereotyping of Asian Americans. Frontiers in Psychology, 13, 821891.

Ng, J. C., Lee, S. S., & Pak, Y. K. (2007). Chapter 4 contesting the model minority and perpetual foreigner stereotypes: A critical review of literature on Asian Americans in education. Review of research in education, 31(1), 95-130.

Do, K. A., Wang, C., & Atwal, K. (2019). Peer victimization and the perpetual foreigner stereotype on Sikh American adolescents’ mental health outcomes: The moderating effects of coping and behavioral enculturation. Asian American Journal of Psychology, 10(2), 131. 

4) Findings: Throughout the findings section, it is important to clearly distinguish what are direct quotes from participants (typically by placing these in quotation marks). Some quotes appear to be placed within the regular findings paragraphs.

AUTHOR’S RESPONSE: 

Direct quotes from participants are noted as follows: direct quotes that contain fewer than 40 words are included in-text demarcated with quotation marks. Direct quotations that contain 40 or more words are indicated in block form according to the APA7 style. These quotes do not include quotation marks and instead are separated from the text and aligned an additional half inch from the right margin.

Captions are not included as quotations, and are not formatted as such. 

5) Discussion: A more thorough discussion about how the four themes were synthesized into the 3 domains would be helpful to the reader. How were the three domains chosen? Was there formal analysis that led to these domains? If so, that analysis can be outlined in the Findings section of the manuscript.

AUTHOR’S RESPONSE: 

Upon further review of our analytical approach of Thematic Analysis, we decided to follow a similar approach to Byrne (2021) and developed a concept map (Figure 15) to depict how data items relate to their respective themes instead of synthesizing themes into domains which was misaligned with Thematic Analysis. We appreciate the reviewer for this feedback as it prompted us to be more intentional in our analytical approach. We have added a description of the concept map and revised the Discussion section accordingly.

6) Implications: The authors do not weave the connection of CBT throughout the manuscript. It is appears here in the Implications section, leaving the reader to wonder about the connection of CBT to the concepts discussed throughout the manuscript. Please link CBT's role to the importance of the photovoice data/findings/results.

AUTHOR’S RESPONSE: 

We appreciate this suggestion by the reviewer and have reorganized our Implications section to signal that the section on CBT is a practical recommendation. Our aim was to reach mental health clinicians/practitioners who work with Asian American youth. Drawing from prior research with Asian Americans we suggest various ways that CBT may be a suitable intervention for Asian American youth.

Reviewer 2 Report

This manuscript presents a comprehensive exploration of the stereotypes experienced by American Asian youths, shedding light on the mental and psychological stress often overlooked in academic research. The authors offer thorough background information, drawing upon insider perspectives to provide rich insights into the subject matter. One of the key strengths of this article lies in its systematic and organized structure, which guides readers seamlessly through the research design, findings, and discussions. Furthermore, the refined descriptions enhance readability and sustain reader interest.

While the manuscript excels in many aspects, there are a few minor suggestions for improvement. Firstly, considering a change in the format of references, following the reference format of the journal. Additionally, reducing picture sizes and the enlargement of figure descriptions could improve the overall professional appearance of the manuscript. Oversized pictures may give the impression of unprofessionalism, while small font sizes in figure descriptions could diminish their significance. Therefore, adjusting these elements could further enhance the manuscript's impact and reliability.

Author Response

1) This manuscript presents a comprehensive exploration of the stereotypes experienced by American Asian youths, shedding light on the mental and psychological stress often overlooked in academic research. The authors offer thorough background information, drawing upon insider perspectives to provide rich insights into the subject matter. One of the key strengths of this article lies in its systematic and organized structure, which guides readers seamlessly through the research design, findings, and discussions. Furthermore, the refined descriptions enhance readability and sustain reader interest. While the manuscript excels in many aspects, there are a few minor suggestions for improvement. 

AUTHOR’S RESPONSE: 

Thank you for taking the time to read and provide feedback on our manuscript. We also appreciate the affirmations and constructive comments.

2) Firstly, considering a change in the format of references, following the reference format of the journal. Additionally, reducing picture sizes and the enlargement of figure descriptions could improve the overall professional appearance of the manuscript. 

AUTHOR’S RESPONSE: 

Citation format has been changed to AMA to align with the requested numeric ordering. 

All photos have been sized to 1.5x2 inches for uniformity. In the case where photo orientation/axis is turned for the sake of continuity the photo was sized to 2x1.5 inches. Authors assured that the font size for photo captions is uniform with the font size of the manuscript. 

3) Oversized pictures may give the impression of unprofessionalism, while small font sizes in figure descriptions could diminish their significance. Therefore, adjusting these elements could further enhance the manuscript's impact and reliability.

AUTHOR’S RESPONSE: 

All photos have been sized to 1.5x2 inches for uniformity. In the case where photo orientation/axis is turned for the sake of continuity the photo was sized to 2x1.5 inches. Authors assured that the font size for photo captions is uniform with the font size of the manuscript.