Asian American Pacific Islander Representation in Outcomes Research: NSQIP Scoping Review

Chao, Grace F.; Emlaw, Jonel; Chiu, Alexander S.; Yang, Jie; Thumma, Jyothi R.; Brackett, Alexandria; Pei, Kevin Y.

doi:10.1016/j.jamcollsurg.2021.01.015

Cited by 13 publications

(10 citation statements)

References 35 publications

(28 reference statements)

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“…A total of 549 (47.86%) participants reported their race as White, 306 (26.68%) as Asian/Pacific Islander or mixed Asian, 133 (11.60%) as Latinx, 109 (9.50%) as Black, 11 (0.96%) as Indigenous, and 33 (2.88%) as mixed (not Asian). Asian American and Pacific Islander participants were combined for analysis because these groups have historically been studied in tandem [ 93 ] and have been shown to experience similar increases in instances of discrimination during the COVID-19 pandemic [ 51 , 53 ]. Additional demographic information is provided in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

The Impacts of Social Media Use and Online Racial Discrimination on Asian American Mental Health: Cross-sectional Survey in the United States During COVID-19

Layug¹,

Krishnamurthy²,

McKenzie³

et al. 2022

JMIR Form Res

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Background During the COVID-19 pandemic, increased social media usage has led to worsened mental health outcomes for many people. Moreover, due to the sociopolitical climate during the pandemic, the prevalence of online racial discrimination has contributed to worsening psychological well-being. With increases in anti-Asian hate, Asian and Asian American social media users may experience the negative effects of online racial discrimination in addition to the reduced psychological well-being resulting from exposure to online COVID-19 content. Objective This study aims to investigate the impact of COVID-19–related social media use and exposure to online racial discrimination during the pandemic on the mental health outcomes (ie, anxiety, depression, and secondary traumatic stress [STS]) of Asian Americans compared with those of non-Asian Americans. In addition, this study explores the mediating role of negative affect and the moderating role of racial/ethnic identification. Methods An online survey was conducted through Amazon Mechanical Turk and a university-wide research portal from March 3 to March 15, 2021. A total of 1147 participants took the survey. Participants’ social media usage related to COVID-19 and exposure to 2 online forms of racial discrimination (individual and vicarious), mental health outcomes (anxiety, depression, and STS), racial/ethnic identification, negative affect, and demographics were assessed. Results Our results showed that COVID-19–related social media use, individual discrimination, and vicarious discrimination were predictors of negative mental health outcomes (anxiety, depression, and STS). Asian Americans reported higher vicarious discrimination than Latinx and White Americans, but Asian Americans’ mental health outcomes did not differ substantially from those of the other racial/ethnic groups. Racial/ethnic identification moderated the relationship between both types of discrimination and STS, and negative affect served as a mediator between both types of discrimination and all 3 mental health outcomes. Conclusions These results suggest that social media exposure continues to have a dire effect on mental health during the COVID-19 pandemic. This study helps to contextualize the rise of anti-Asian American hate and its impact on mental health outcomes in the United States.

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Section: Resultsmentioning

confidence: 99%

The Impacts of Social Media Use and Online Racial Discrimination on Asian American Mental Health: Cross-sectional Survey in the United States During COVID-19

Layug¹,

Krishnamurthy²,

McKenzie³

et al. 2022

JMIR Form Res

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“…26 The omission of Asian American data in medical school curricula may reflect these stereotypes and the general invisibility of Asian American data in research. 8,29 Omitting data on Asian American populations fails to educate physicians-in-training on the implications of both health care disparities and risk for disease among omitted groups 7 -discussing cardiovascular disorders, for example, without reference to Asian American populations despite cardiovascular disorders being the leading cause of mortality among nearly all Asian American subgroups. 9 Although aggregation of Asian American populations by panethnic terms could be a powerful signature of political alliance as seen during the US Civil Rights movement, it can also lead to imprecise statistics and racial and ethnic erasure without proper intentionality and framework.…”

Section: Discussionmentioning

confidence: 99%

“…These stereotypes influence societal narratives of Asian American populations and affect their representation or lack thereof in research and higher education . The omission of Asian American data in medical school curricula may reflect these stereotypes and the general invisibility of Asian American data in research . Omitting data on Asian American populations fails to educate physicians-in-training on the implications of both health care disparities and risk for disease among omitted groups—discussing cardiovascular disorders, for example, without reference to Asian American populations despite cardiovascular disorders being the leading cause of mortality among nearly all Asian American subgroups …”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Despite their growth and heterogeneity, Asian American populations and their subgroups remain underrepresented in health research, rendered invisible in health policies and discussion. [5][6][7][8] Moreover, small sample sizes, inadequate questionnaire design, and data aggregation contribute to misrepresentation of Asian American populations and their subgroups even when they are included. 3,9 These challenges limit our ability to identify and address inequities in health and health care for Asian American populations.…”

Section: Introductionmentioning

confidence: 99%

“…The Asian American population is one of the fastest growing racial and ethnic populations in the US, composed of more than 20 diverse subgroups with different historical backgrounds, socioeconomic characteristics, languages, cultures, and values . Despite their growth and heterogeneity, Asian American populations and their subgroups remain underrepresented in health research, rendered invisible in health policies and discussion . Moreover, small sample sizes, inadequate questionnaire design, and data aggregation contribute to misrepresentation of Asian American populations and their subgroups even when they are included .…”

Section: Introductionmentioning

confidence: 99%

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Representation of Asian American Populations in Medical School Curricula

et al. 2022

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ImportanceDespite being one of the fastest-growing populations in the US, the Asian American population is often misrepresented in and omitted from health research and policy debate. There is a current lack of understanding of how Asian American populations are portrayed in medical school curricula.ObjectiveTo assess how Asian American populations and their subgroups are represented in medical school curricula.Design, Setting, and ParticipantsIn this qualitative study, the content of 632 lectures from all 19 courses of the preclinical curriculum at a single US institution from the academic year 2020 to 2021 was analyzed to identify and characterize unique mentions of race and ethnicity as well as granular ethnicity. Among the 632 lectures, we identified 256 nonrepetitive, unique mentions of race and ethnicity or granular ethnicity. These unique mentions were coded and analyzed for emerging patterns of use.Main Outcomes and MeasuresStudy outcomes included (1) the frequency of specific racial and ethnic categories mentioned in the curriculum, (2) the relative proportion of mentions of race and ethnicity that involved or included Asian American data by courses and context, and (3) key themes representing emerging patterns found from qualitative analysis of curriculum content for mentions of Asian American populations or lack thereof.ResultsAmong the 632 lectures, 256 nonrepetitive mentions of race and ethnicity or granular ethnicity were identified; of these, Asian American populations and/or their subgroups were mentioned in 79 of the instances (30.9%). The most common terms used to denote Asian American populations were Asian, with 36 mentions (45.6%); followed by Japanese, with 10 mentions (12.7%); and Chinese, with 8 mentions (10.1%). Overall, there were 26 mentions (10.2%) of American Indian or Alaska Native populations, 12 mentions (4.7%) of Asian and Pacific Islander or Asian American and Pacific Islander populations, 67 mentions (26.2%) of Asian or Asian American populations, 143 mentions (55.9%) of Black or African American populations, 62 mentions (24.2%) of Hispanic or Latino populations, 4 mentions (1.6%) of Native Hawaiian or Pacific Islander populations, and 154 mentions (60.2%) of White populations. During the analysis of the curriculum for representation of Asian American populations, the following 5 key themes emerged from the data: (1) omission, (2) aggregation, (3) inconsistent categorization, (4) misidentification of granular ethnicity, and (5) association of race and ethnicity with disease.Conclusions and RelevanceThis qualitative study suggests that the curriculum from a single US medical school largely mirrors the inappropriate use of race and ethnicity found in published health literature and clinical guidelines. Solutions with long-term results will require collaboration among diverse groups of interest to adopt inclusive research programs and design. Such solutions could better equip students in combating race-based medicine and could promote community outreach programs built based on trust.

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The Reporting of Race and Ethnicity in Surgery Literature

et al. 2021

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nequities affecting underserved racial and ethnic groups continue to be identified across the spectrum of medical research. [1][2][3][4] From the disproportionate number of Black and Hispanic persons who have been hospitalized or died because of COVID-19 in 2020 [5][6][7][8] to discrimination against Asian American persons 9 and the comparatively poor perioperative outcomes even among low-risk racial and ethnic minority patients, 10,11 attentiveness to race and ethnicity has illuminated inequities and disparities throughout our health care systems. Recognition of health disparities through research has led to recent significant victories, such as the Henrietta Lacks Enhancing Cancer Research Act of 2019, 12 which became public law in January 2021, requiring officials to examine barriers to government-funded clinical trials for traditionally underrepresented groups. Unfortunately, race and ethnicity continue to be infrequently reported in the medical literature to describe study participants, and when race is described, the quality of the reporting is variable. [1][2][3][4][13][14][15][16] In 1978 (updated in 2019), the International Committee of Medical Journal Editors (ICMJE) developed recommendations for uniformity in manuscript submissions and promoting increased frequency and quality reporting of race. Current recommendations are that "[a]uthors should define how they determined race or ethnicity and justify their relevance," 17 and that a study "should aim for inclusion of representative populations into all study types and at a minimum provide descriptive data for these and other relevant demographic variables." [17][18][19] Despite these recommendations, studies examining the reporting of race continue to show infrequent use of race to desc ribe study partic ipants in sc ientific publications. [13][14][15][16] A 2020 article by Moore 14 revealed that in the ophthalmology literature, most articles (88%) reported baseline demographic information on study participants; however, only 43% of articles included data on race and ethnicity, and an even smaller fraction described how the information was determined. IMPORTANCEThe reporting of race provides transparency to the representativeness of data and helps inform health care disparities. The International Committee of Medical Journal Editors (ICMJE) developed recommendations to promote quality reporting of race; however, the frequency of reporting continues to be low among most medical journals.OBJECTIVE To assess the frequency as well as quality of race reporting among publications from high-ranking broad-focused surgical research journals. DESIGN, SETTING, AND PARTICIPANTSA literature review and bibliometric analysis was performed examining all human-based primary research articles

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Asian American Pacific Islander Representation in Outcomes Research: NSQIP Scoping Review

Cited by 13 publications

References 35 publications

The Impacts of Social Media Use and Online Racial Discrimination on Asian American Mental Health: Cross-sectional Survey in the United States During COVID-19

The Impacts of Social Media Use and Online Racial Discrimination on Asian American Mental Health: Cross-sectional Survey in the United States During COVID-19

Representation of Asian American Populations in Medical School Curricula

The Reporting of Race and Ethnicity in Surgery Literature

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