Search Results (24)

Background/Objectives: Filipino Americans are one of the least likely Asian American subgroups to use formal mental health services, even when mental health needs are present. This study used the Capability–Opportunity–Motivation–Behavior (COM-B) framework to examine mental health symptomatology, perceived social support, help-seeking intentions, and perceived barriers to mental health treatment among Filipino American older adults residing in the United States. Methods: We used a cross-sectional descriptive correlational design. A sample of 100 Filipino American older adults completed the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, an 8-item subset of the Multidimensional Scale of Perceived Social Support, the Mental Health Seeking Intention Scale, and the Perceived Barriers to Psychological Treatment scale. We performed descriptive statistics and correlation analyses using Pearson’s and Spearman’s coefficients. Results: Participants experienced low levels of depressive symptoms (M = 2.73, SD = 4.80) and anxiety symptoms (M = 2.56, SD = 4.11), high perceived social support (M = 5.32, SD = 1.83), moderate help-seeking intentions (M = 4.90, SD = 2.18), low overall perceived barriers to care (M = 1.67, SD = 0.90), and nearly universal health insurance coverage. Of the barrier domains, stigma/interpersonal barriers had the highest mean scores. Greater depressive and anxiety symptom severity was associated with higher overall perceived barriers to mental health care (r = 0.45–0.47) and with higher structural, motivational, and stigma/interpersonal barriers (r = 0.41–0.46). Conclusions: Despite high healthcare access and strong perceived social support, Filipino American older adults expressed only moderate intentions to seek professional mental health care. Culturally mediated factors may shape mental health help-seeking beyond structural barriers to access. The COM-B framework offers a useful lens for understanding help-seeking behavior and guiding culturally responsive interventions with Filipino American older adults. Full article

Background/Objectives: Routine depression screening is recommended in primary care, yet depression may remain underdetected among Filipino American patients. Provider-level factors, including culturally responsive preparation, communication challenges, workflow constraints, and attitudes toward mental health screening, may influence opportunities for early identification and referral. This exploratory cross-sectional study examined provider perspectives on barriers to depression screening and mental health discussions with Filipino American patients using the Capability, Opportunity, Motivation, and Behavior (COM-B) framework as an implementation-informed organizing lens. Methods: A cross-sectional survey was conducted among healthcare providers (N = 81) with experience caring for Filipino American patients in the United States. Survey items assessed provider confidence, perceived adequacy of mental health training, cultural and communication barriers, perceived stigma-related concerns, comfort discussing mental health, and interest in additional culturally responsive resources. Items from the adapted Attitudes Toward Assisting Filipino American Patients with Mental Health Symptoms (ATFA) scale and one item from the Mental Illness Clinicians’ Attitudes scale were conceptually mapped to the COM-B domains. Descriptive statistics, internal consistency estimates, and nonparametric tests were used to summarize findings and explore differences by provider characteristics. Results: Most providers recognized that Filipino cultural beliefs and customs may influence mental health help-seeking and symptom expression. Although many providers reported confidence identifying mental health symptoms, fewer reported adequate training to assess mental health concerns among Filipino American patients. Communication barriers, stigma-related concerns, and interest in additional culturally tailored resources were commonly reported. COM-B domain scores were not significantly associated with provider role or years of clinical experience. Providers who identified as Filipino reported greater perceived capability and opportunity related to initiating mental health discussions compared with non-Filipino providers. Conclusions: Findings suggest that provider motivation to address mental health concerns may be present, while capability- and opportunity-related barriers, including culturally responsive training, communication support, workflow integration, and referral resources, may remain important targets for future implementation efforts. Because this exploratory study used a modest convenience sample and an adapted measure that requires further psychometric validation, the findings should be interpreted with caution. Larger studies using validated instruments are needed to examine further provider-level determinants of culturally responsive depression screening among Filipino American patients. Full article

Perceptions of group typicality can shape how resources, such as scholarships, are distributed among group members. Across two studies, we predicted that East Asian applicants (e.g., Chinese) would be perceived as more typical of Asian Americans and thus more likely to be seen as worthy of an Asian American scholarship than their South Asian (e.g., Indian) and Southeast Asian (e.g., Filipino) counterparts. In Study 1, Chinese applicants were rated as more worthy of an Asian American scholarship than both Indian and Filipino applicants. Moreover, perceptions of Asian typicality predicted greater scholarship worthiness. In Study 2, we added a general scholarship condition that did not specify ethnicity to test whether Asian typicality influenced scholarship worthiness when the award was not designated for Asian Americans. However, we did not find the expected interaction between applicant ethnicity and scholarship type. Instead, we found only that the Chinese applicant was rated as more worthy of scholarships, regardless of scholarship type. Overall, perceptions of Asian typicality may guide judgements of scholarship worthiness in contexts where Asian identity is relevant. Full article

Background: Despite a decline in lung cancer in the U.S., lung cancer among never-smoking Asian American (AsA) women is rising, and subgroup aggregation obscures heterogeneity. We compared primary lung cancer prevalence across disaggregated AsA subgroups and examined factors associated with prevalence such as personal- and family-cancer histories versus Non-Hispanic Whites (NHWs). Methods: This cross-sectional study analyzed electronic health records of AsA women (≥18) in a large Northern California health system (2010–2022). Lung cancer cases were obtained from the hospital registry and categorized by smoking status and self-reported ethnicity. Adjusted prevalence ratios (aPRs) were estimated using targeted maximum likelihood estimation, accounting for sociodemographic, smoking, and clinical covariates. Results: Among 1,843,119 women, 8651 had primary lung cancer; 2429 were never-smokers. In AsA never-smokers, aPRs and 95% confidence intervals versus age-matched NHW were: Chinese (3.36, [3.20–3.53]), Filipino (2.68, [2.55–2.82]), Vietnamese (2.07, [1.96–2.18]), Japanese (1.99, [1.89–2.10]), Korean (1.90, [1.80–2.00]), and Other Asian (0.35, [0.33–0.37]). Personal cancer-history reflected an increase in prevalence among Korean patients (2.91, [2.76–3.06]) while family cancer-history demonstrated increased prevalence among Chinese patients (1.51, [1.42–1.60]). Among women with uterine cancer, Chinese patients had higher lung-cancer prevalence than NHW (1.91, [1.58–2.31]). Conclusions: Never-smoking disaggregated AsA women show heterogeneous lung cancer prevalence, with higher prevalence in Korean women with personal cancer-history and in Chinese women with family cancer-history compared with NHW, supporting history-informed and ethnic-specific lung cancer screenings. Full article

Background/Objectives: Socio-cultural adversities and health disparities across Asian American origin groups remain understudied, particularly in early childhood. This limits the development of culturally responsive prevention and intervention strategies. A family-based Asian American epidemiologic study is essential to address these gaps and to inform tailored solutions. As an initial pilot effort, this pilot study was designed primarily to assess feasibility and generate preliminary data to inform future hypothesis-driven, large-scale epidemiologic research. The study objectives were to evaluate the feasibility of a remote study protocol and to collect preliminary data on child development and parental factors among Asian Indian, Filipino, and Korean American families with young children. Methods: A remote pilot study was conducted in 2024–25 among 48 mother–father–child (age 1–4 years) triads residing in Illinois, including 18 Asian Indian, 12 Filipino, and 18 Korean American mothers. Parents completed an online survey, and children wore an ActiGraph accelerometer on their hips. Analyses were conducted to describe child development, parental experiences, and parenting practices among the three ethnic groups. Results: Of the 48 mothers, 29 (60%) were US-born, and all but 1 had at least a bachelor’s degree. All parent pairs completed the survey, whereas only 34 children (71%) provided valid accelerometer data. Disaggregated data showed that, compared to children of Asian Indian mothers, children of Filipino mothers had higher daily screen time (p < 0.10) and higher sleep problem scores (p < 0.05), and children of Korean mothers had higher child–caregiver interaction scores (p < 0.05). Across all three groups, more favorable parenting practices were associated with lower sleep problem scores, higher wellbeing scores, and higher child–caregiver interaction scores (p < 0.01). Conclusions: The remote study protocol was generally feasible; however, child compliance with hip accelerometer wear was suboptimal. Preliminary data revealed differences in children’s physical behaviors and social-emotional development across Asian ethnic groups. A full-scale study should enhance the engagement of socioeconomically diverse families and refine wearable data collection methods to improve data representativeness and completeness. Full article

Despite the growing acceptance of the varieties of English, standard language ideology continues to cause some to be valorized and denigrated. This paper examines the attitudes of Filipino-Americans within an inner-circle English variety zone towards Philippine English (PhE), focusing on its status, development, lexicon, intelligibility, and acceptability. The study surveyed 113 Filipino-American speakers of American English (AmE) who were familiar with Philippine culture and PhE. Studies show that some first-language English speakers exhibit negative attitudes towards new English varieties. Contrary to this trend, our findings reveal positive attitudes among AmE speakers towards PhE. However, although it is commonly understood, these positive attitudes do not guarantee the full acceptability of PhE. Notably, there is a growing trend towards the acceptability of PhE neologisms, especially in formal and scientific contexts, indicating a shift in previous perceptions. Additionally, the findings of the study highlight that word-formation processes significantly influence the acceptability of new terms across different speech domains, a novel finding that merits further investigation. Acceptability plays a vital role in the dissemination of local expressions and in shaping the status of a language variety. This research may contribute to understanding the evolving dynamics of the acceptability of PhE and its status in local and international contexts. The positive attitudes towards PhE among American English speakers indicate a shift in perceptions. Language teaching can build on this trend by fostering an environment where students are encouraged to appreciate and respect different English varieties. This can be achieved through exposure to diverse linguistic inputs and discussions on language attitudes. Full article

This paper examines the separation of church and state in the Philippines during the early American colonial period, contextualizing it within the process of American overseas expansion and considering it as one of the projects of imperial hegemony construction. After the Spanish–American War, the United States substituted Spain as the new colonial ruler of the Philippines, legitimizing its regime as the spread of ‘civilization’ to the Filipinos. On this basis, the Americans enacted laws guaranteeing religious freedom and introduced an American-style institution dealing with church–state relations. Beyond the legal and administrative initiatives, the new regime also constructed an official narrative of the transformation of political–religious relations in the Philippine that emphasized the absolute ‘difference’ between the American human rights principle, which guaranteed freedom of worship, and the Spanish theocracy, which was dedicated to the consolidation of privileges. By legislating the separation of church and state, buying up church properties, recognizing the equality of denominations, and constructing the official imperial narrative of church–state relations, the Americans hoped to ‘teach’ Filipinos that the ‘true’ belief was rooted in the inner convictions of individual Christians, not in the authority and coercion of the hierarchical church. By disciplining the construction of ‘difference’ under tutelary colonialism, the separation of church and state movement initiated by the American colonial government in the Philippines became an important source of imperial self-endowed legitimacy. Full article

This study used longitudinal survey data of Filipino American and Korean American youth in the Chicago Metropolitan area (N = 786, M_AGE = 15.00, SD = 1.91 at Wave 1 in 2014) to examine whether and how a set of organized predictors (i.e., universal predictors of youth outcomes and cultural orientations) independently and collectively explains internalizing and externalizing problems and academic performance. The results were that universal predictors such as youth antisocial beliefs, peer antisocial behaviors, and the quality of parent–child relations, were extensively predictive of youth outcomes in the expected directions. The magnitudes of universal predictors were largely unchanged when bilinear and multidimensional cultural orientation variables were accounted for together. The magnitudes of cultural orientation variables were slightly attenuated in full models but showed independent associations with youth outcomes. Specifically, English and heritage language proficiencies were protective of externalizing and internalizing problems. Behavioral practices in respective cultures increased youth problems. In addition, ethnic identity, although beneficial to mental health, can increase externalizing problems. The findings of this study provide insights into understanding the mixed outcomes among Asian Americans and important empirical evidence that can inform intervention programs to prevent youth problems, ultimately toward a pathway to positive youth development among Asian American youth. Full article

Guided by the theory of planned behavior, this study aimed to determine the influence of Physical Education (PE) teachers’ attitudes, their perceived behavioral control, and the influence of subjective norms on their intention and constraints (intrapersonal, interpersonal, and structural) to offer a high-quality class based on best practices to deliver PE lessons online during the COVID-19 pandemic. This cross-sectional, multi-country survey study recruited PE teachers from five countries (China, Malaysia, the Philippines, Turkey, and the United States). A total of 928 online questionnaires were used in the analysis. In terms of the overall intention to teach online, our findings showed that American and Filipino teachers had higher levels of intention to continue teaching online. In contrast, Turkish, Malaysian, and Chinese teachers showed a lower interest. Moreover, Malaysian teachers had more intrapersonal constraints while the teachers in the other four countries were not as restrained intrapersonally. The results highlight the significant influence of perceived behavioral control and attitudes on PE teachers’ intention to deliver online courses. Constraints to online teaching had a considerably large negative impact on attitudes, subjective norms, and perceived behavioral control. Based on the results, the proposed extension to the theory of planned behavior was an appropriate framework for understanding the behavioral intent of PE teachers. Full article

Objective: The US 5-year survival rate after thyroid cancer (TC) diagnosis is over 95%. Our aim was to investigate survival differences by sex and race and ethnicity in a multiethnic US population. Design: In the Multiethnic Cohort (MEC) study, a total of 605 incident TC cases were identified by linkage to HI and CA statewide cancer registries. Cox models were performed to compare the risk of all-cause mortality among TC cases by sex and race and ethnicity, with adjustment for age, first course of treatment, baseline body mass index, smoking status, alcohol intake, and neighborhood socioeconomic status. Survival among cases was also compared to matched MEC controls with no thyroid cancer. Results: After a mean follow-up of 10.1 years, 250 deaths occurred among TC cases, including 63 deaths attributed to thyroid cancer. The median survival was 14.7 years, and the 5-year age-adjusted overall survival was 84.4% for female cases and 68.7% for male cases (p < 0.0001, HR 2.28 (95% CI: 1.72, 3.01)). Age-adjusted survival was lower among African American, Native Hawaiian, and Filipino cases, compared to Japanese American cases, with Whites and Latinos being intermediate. Men and Filipinos were found to have excess mortality due to thyroid cancer compared to controls (adjusted HR 1.39, 95% CI: 1.11, 1.74; HR 1.62, 95% CI: 1.04, 2.53, respectively). Conclusions: Sex and racial and ethnic disparities in survival among TC cases were similar to those found in the general population. However, cases with TC had an excess risk of death among males and for Filipinos. Full article

Current characteristics of early onset colorectal cancer (EOCRC) in the United States have been mainly studied in Whites, African Americans, and Hispanics, but little is known in regard to EOCRC in Asians and Native Hawaiians in the US. EOCRC was examined in Hawaii’s multiethnic population. Data from the Hawaii Tumor Registry was used to analyze colorectal cancer (CRC) cases diagnosed in Hawaii from 2000–2019 by subsite, age, gender, ethnicity, and stage. Ethnicity analyses were limited to 3524 CRC cases, diagnosed between 2015–2019. Average annual 5-year age-adjusted incidence and mortality rates, average annual percent change over time, and 5-year survival were evaluated. Group comparisons utilized Chi-square and binomial proportion tests. Overall CRC incidence and mortality declined and were more pronounced for colon than rectal/rectosigmoid junction cancers. Colon cancer incidence rates significantly increased 1.46-fold for cases diagnosed under 45 years of age and rectal/rectosigmoid cancers significantly increased 1.54-fold for cases 45–54 years of age. CRC incidence increased sharply for females aged 45–54 years from 2000–2009 to 2010–2019, and increases in colon and rectal/rectosigmoid cancer among individuals aged 45–54 were higher for females. Among both sexes, the increase in rectal/rectosigmoid cancer incidence for individuals under 55 years was highest for stage I cancers. Overall, the mean (SD) age of CRC diagnosis was 5–10 years earlier for Native Hawaiians (60.6 [13.3] years) compared with Japanese, Chinese, Filipinos, Whites, and Other Asians (p < 0.001). Native Hawaiians constituted a greater proportion of CRC diagnosed under age 55 years and, conversely, a smaller proportion of cases 55 years and older compared with Japanese, Chinese, Filipinos, Whites, and Other Asians. Native Hawaiians had a significantly higher CRC-related mortality rate (14.5 per 100,000 [95% CI: 12.4, 16.8]) compared with Japanese (10.7 per 100,000 [95% CI: 9.3, 12.3]) and a significantly lower CRC survival rate (62.2% [95% CI: 59.1, 65.2]) compared with Japanese (71.9% [95% CI: 69.9, 73.8]), Filipinos (71.9% [95% CI: 69.2, 74.4]), Chinese (70.2% [95% CI: 65.5, 74.4]), Whites (69.3% [95% CI: 67.1, 71.4]), and Other Asians (71.7% [95% CI: 66.2, 76.5]). In our diverse US population, Native Hawaiians contribute disproportionately to EOCRC and present 5–10 years earlier than Whites, Japanese, Chinese, and Filipinos. EOCRCs are increasing faster in females than males in Hawaii, which differs from trends in the general US population. Emerging ethnic disparities in EOCRC in the US speak to the need for studies on targeted interventions and ethnic-specific risk factors for EOCRC. Full article

This study examined the health disparities in primary cesarean delivery (PCD) use among Asian American (AA) women and within AA subgroups. We examined 22 years of birth registry data from one diverse northeastern state in the United States, including singleton vertex live births between 24 and 44 weeks of gestation without congenital abnormalities. Multivariate logistic regression was used to test the association between PCD and race and ethnicity groups adjusting for maternal demographic and health behaviors, infant gender and birth weight, gestational age, initiation of prenatal care, and other risk factors. Among the eligible sample, 8.3% were AA. AAs had the highest rate of PCD (18%) among all racial and ethnic groups. However, extensive heterogeneity was found among the AA subgroups. After controlling for confounding variables, compared to non-Hispanic White women, Filipino, Asian Indian, and Other Asian subgroups had a higher risk for PCD (Adj OR = 1.40, 1.37, and 1.21, p < 0.001), while Japanese, Chinese, and Korean had a lower risk (Adj OR = 0.57, 0.83, and 0.90, p < 0.001), and Vietnamese had no significant difference in PCD use. Although AA as a single racial and ethnic group had higher prevalence of PCD, more studies are warrantied to address the disproportional distribution of health disparities in PCD use within AA subgroups. Full article

Health outcomes for Asian American subgroups are often aggregated, masking unique experiences and disparities exacerbated by the COVID-19 pandemic, specifically among Filipino Americans (FilAms). The FILLED (Filipino Lived Experiences during COVID-19) Project launched a cross-sectional online survey between April-August 2021 among FilAm adults in Southern California to document community issues and outcomes during the pandemic. Among 223 participants, 47.5% were immigrants, 50.9% identified as essential workers, and 40.6% had a pre-existing health condition before the pandemic. Despite high rates of health insurance (93.3%), 24.4% of the sample did not have a regular health care provider. During the pandemic, 32.7% needed mental health help but did not get it and 44.2% did not know where to get such services. Most respondents felt that the COVID-19 vaccination was a personal responsibility to others (76.9%) and the majority had received at least one dose of a COVID-19 vaccine (82.4%). Regarding COVID-19 impact, participants reported moderate-severe changes in their daily routines (73.5%), access to extended social support (38.9%), housing issues (15.4%), and access to medical care (11.6%). To our knowledge, this study is the first community-driven effort highlighting FilAm community experiences in Southern California, where the highest proportion of FilAms in the United States reside, specifically after the COVID-19 vaccine was made widely available. The observational findings may help community leaders, policy makers, and public health researchers in the design, development, and implementation of post-pandemic intervention strategies used by community-partnered projects that address FilAm and sub-Asian group health disparities at grassroots to societal levels. Full article

Filipino Americans show higher thyroid cancer recurrence rates compared to European Americans. Although they are likely to die of this malignancy, the molecular mechanism has not yet been determined. Recent studies demonstrated that small non-coding RNAs could be utilized to assess thyroid cancer prognosis in tumor models. The goal of this study is to determine whether microRNA (miRNA) signatures are differentially expressed in thyroid cancer in two different ethnic groups. We also determined whether these miRNA signatures are related to cancer staging. This is a retrospective study of archival samples from patients with thyroid cancer (both sexes) in the pathology division from the last ten years at Loma Linda University School of Medicine, California. Deidentified patient demographics were extracted from the patient chart. Discarded formalin-fixed paraffin-embedded tissues were collected post-surgeries. We determined the differential expressions of microRNA in archival samples from Filipino Americans compared to European Americans using the state-of-the-art technique, HiSeq4000. By ingenuity pathway analysis, we determined miRNA targets and the pathways that those targets are involved in. We validated their expressions by real-time quantitative PCR and correlated them with the clinicopathological status in a larger cohort of miRNA samples from both ethnicities. We identified the differentially upregulated/downregulated miRNA clusters in Filipino Americans compared to European Americans. Some of these miRNA clusters are known to target genes that are linked to cancer invasion and metastasis. In univariate analysis, ethnicity and tumor staging were significant factors predicting miR-4633-5p upregulation. When including these factors in a multivariate logistic regression model, ethnicity and tumor staging remained significant independent predictors of miRNA upregulation, whereas the interaction of ethnicity and tumor staging was not significant. In contrast, ethnicity remained an independent predictor of significantly downregulated miR-491-5p and let-7 family. We provide evidence that Filipino Americans showed differentially expressed tumor-tissue-derived microRNA clusters. The functional implications of these miRNAs are under investigation. Full article

Historically, the language of Protestant congregational song in the Philippines was English, which was tied to that nation’s twentieth-century colonial history with the United States. The development of Filipino songs since the 1970s is linked to this legacy, but church musicians have found ways to localize their congregational singing through processes of translation and hybridization. Because translation of hymn texts from English has proven difficult for linguistic reasons, Papuri, a music group that produces original Tagalog-language worship music, bypasses these difficulties while relying heavily on American pop music styles. Word for the World is a Pentecostal congregation that embraces English-language songs as a part of their theology of presence, obviating the need for translation by singing in the original language. Day by Day Ministries, the third case study, is a congregation that translates beyond language texts, preparing indigenous Filipino cultural expressions for urban audiences by composing hybridized songs that merge pre-Hispanic and contemporary forms. Full article