Shahmir H. Ali

National University of Singapore | NUS · Saw Swee Hock School of Public Health

Objective The Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot (OPP) authorized the use of SNAP benefits online in Maryland in May 2020. We assessed shopping behavior and intentions associated with uptake and intended future use of online grocery shopping during and after COVID-19 among SNAP-eligible households. Design In t...

Background There is an urgent need to innovate methods of health education, which can often be resource- and time-intensive. Microinterventions have shown promise as a platform for rapid, tailored resource dissemination yet have been underexplored as a method of standardized health or dietary education; social media chatbots display unique potentia...

Family members of Asian Americans (AAs) hold enormous potential as health changemakers to help combat the growing non-communicable disease burden in the community. To inform the development of impactful family-based interventions, there is a need to disentangle the mechanisms behind family influences on health. This study aims to deconstruct how in...

Background Despite the potential for community health worker (CHW)-led programs to improve the health of people with justice involvement (PWJI), little is known about the practical implementation of such models. We explored barriers and facilitators to implementation of a municipal CHW program, the Health Justice Network (NYC HJN), led by the New Y...

Introduction Asian American populations face unique structural/social inequities contributing to poor diet quality and health disparities. The current body of literature on diet and food consumption of Asian Americans mainly focuses on the health of Filipino and East Asian Americans, or those with pre-existing non-communicable diseases. Objective...

South Asians (SAs) underutilize mental health services compared to many racial and ethnic groups in the United States (US), yet there is limited research on the experiences of SAs living with severe mental illness (SMI). This study examined psychiatric healthcare experiences of SA patients with SMI diagnoses (e.g., severe depression, bipolar disord...

Asian American (AA) young adults face a looming diet-related non-communicable disease crisis. Interactions with family members are pivotal in the lives of AA young adults and form the basis of family-based interventions; however, little is known on the role of these interactions in shared family food behaviors. Through an analysis of 2021 nationwid...

Background Type 2 diabetes disproportionately affects South Asian subgroups. Lifestyle prevention programs help prevent and manage diabetes; however, there is a need to tailor these programs for mobile health (mHealth). Objective This study examined technology access, current use, and preferences for health communication among South Asian immigran...

This chapter is highlighted upon improving digital health equity by addressing the motivation and barriers to using digital health from a broader perspective. It focuses on digital health interventions, with digital health success stories on recent advancements such as digital literacy to digital therapeutics, with overarching goal to enhancing dig...

Background The increasing annual global deaths are attributable to noncommunicable chronic diseases (NCDs). Adhering to healthy lifestyle behaviors is associated with lower NCD risk, particularly among individuals with ample movement, enough sleep, and reduced sedentariness. Nevertheless, there are only few prospective assessments on the associatio...

The relationship between family dynamics and health has been extensively studied, but the specific pathways involved are not yet fully understood. The role of intimate partner relationships in promoting and maintaining healthy lifestyle behaviors remains understudied, particularly in minority populations. This study addressed this gap by examining...

The dietary behaviors of Asian American (AA) young adults, who face a growing non-communicable disease burden, are impacted by complex socio-ecological forces. Family plays a crucial role in the lifestyle behaviors of AA young adults; however, little is known on the methods, contributors, and impact of familial dietary influence. This study aims to...

Background There has been growing attention on the role of leisure activities in older adult health outcomes. However, past health research has focused on specific, singular leisure activities, or examined a limited range of health outcomes. Methods This cross-sectional study uses data from the 2010 Sample Survey on Aged Population in Urban/Rural...

BACKGROUND Type 2 diabetes (T2D) disproportionately affects South Asian subgroups. Lifestyle prevention programs help prevent and manage diabetes, however there is a need to tailor these programs for mobile health (mHealth). OBJECTIVE This study examined We used baseline data from two clinical trials among South Asian immigrants in New York City (...

Objective Social media platforms are effective tools for promoting public health and implementing impactful health interventions. This study explored social media utilization patterns among young Asian American adults and their effect on perceived family influence on lifestyle behaviors. Methods The study analyzes data from Asian American young ad...

To date, psychosocial and interpersonal protective factors such as family connectedness have received little attention in studies of eating behaviors among sexual minority Asian Americans. Therefore, we investigated associations of family connectedness and two types of eating behavior regulation motives and the moderating role of individualism in t...

Foreign-born (first-generation) South Asians face a growing diet-related chronic disease burden. Little is known about whether the adult US-born (second-generation) children of South Asian immigrants can provide unique insights as changemakers in their parents' dietary behaviors. This study aims to assess how second-generation South Asians describe...

BACKGROUND There is an urgent need to innovate methods of health education, which can often be resource- and time-intensive. Microinterventions have shown promise as a platform for rapid, tailored resource dissemination yet have been underexplored as a method of standardized health or dietary education; social media chatbots display unique potentia...

Context Public reactions to health policies are vital to understand policy sustainability and impact but have been elusively difficult to dynamically measure. The 2021 launch of the Twitter Academic Application Programming Interface (API), allowing for historical tweet analyses, represents a potentially powerful tool for complex, comprehensive poli...

Background Social connectivity and support can reduce depressive symptoms. Few studies have examined urban–rural differences in the relationship between social support and depressive symptoms in the context of urbanization for Chinese older adults. The overall aim of this study is to examine urban–rural differences in the relationship between famil...

Community-clinical linkage models (CCLM) have the potential to reduce health disparities, especially in underserved communities; however, the COVID-19 pandemic drastically impacted their implementation. This paper explores the impact of the pandemic on the implementation of CCLM intervention led by community health workers (CHWs) to address diabete...

Background: Type 2 diabetes (T2D) disproportionately affects South Asians in the United States (US). Living with T2D can be challenging due to the distress it can create for an individual. Distress associated with diabetes, commonly known as diabetes distress (DD), may lead to complications and challenges with the management of diabetes. This study...

BACKGROUND The increasing annual global deaths are attributable to noncommunicable chronic diseases (NCDs). Adhering to healthy lifestyle behaviors is associated with lower NCD risk, particularly among individuals with ample movement, enough sleep, and reduced sedentariness. Nevertheless, there are only few prospective assessments on the associatio...

Background: Blood pressure (BP) control is suboptimal in minority communities, including Asian populations. We evaluate the feasibility, adoption, and effectiveness of an integrated CHW-led health coaching and practice-level intervention to improve hypertension control among South Asian patients in New York City, Project IMPACT (Integrating Millio...

Background: Asian Americans (AA) young adults face a growing non-communicable disease burden linked with poor dietary behaviors. Family plays a significant role in shaping the diet of AA young adults, although little is known on the specific types of family structures most associated with different dietary behaviors. Aim: This analysis explores the...

Family members play a crucial role in the health of Asian American communities, and their involvement in health interventions can be pivotal in optimizing impact and implementation. To explore how family members can be effectively involved in Asian American health interventions and develop a conceptual framework of methods of involvement at the sta...

How online grocery shopping behaviors differ among Asian American (AA) ethnic subgroups and acculturation level is unknown. From June 9-15, 2020, we administered an online survey to a nationally-derived nonprobability sample of 2,895 AA adults, including 1,737 East, 570 South, and 587 Southeast Asian adults, assessing online grocery shopping (yes/n...

By the end of this chapter, readers will be able to: ■ Identify types of intervention study designs used to conduct research in Asian American communities and considerations for selecting particular study designs to meet the cultural, social, and health needs of different Asian American populations. ■ Using multiple theoretical lenses, describe the...

The objective of this study was to evaluate the impact of a multi-modal pilot intervention on the stocking and acquisition of healthy foods in urban food pantries. An intervention that consisted of three 8-week phases, each focused on promotion of one food group: (1) lean & low-sodium proteins; (2) fruits & vegetables; and (3) healthy carbohydrates...

Background Tackling infodemics with flooding misinformation is key to managing the COVID-19 pandemic. Yet only a few studies have attempted to understand the characteristics of the people who believe in misinformation. Methods Data was used from an online survey that was administered in April 2020 to 6518 English-speaking adult participants in the...

Objective To explore barriers and facilitators of online grocery shopping and identify community-driven strategies to promote equity in online food access. Design This qualitative study used a purposive recruitment strategy to conduct 11 focus groups and 5 in-depth interviews between November 2020 and March 2021. Setting Data collection was condu...

Understanding the views of families from low-income backgrounds about inequities in healthy food access and grocery purchase is critical to food access policies. This study explored perspectives of families eligible for the Supplemental Nutrition Assistance Program (SNAP) on healthy food access in physical and online grocery environments. The quali...

Family is uniquely influential in the health of young Asian Americans (AAs), yet little is known on the impact of specific shared family activities. This study explores different types and frequencies of AA young adult shared family activities on perceived familial influence on the ability to maintain a healthy lifestyle (diet, physical activity, s...

Aim Given the need for data to inform public health messaging to mitigate the COVID-19 pandemic, this national survey sought to assess the state of COVID-19-related knowledge, beliefs, mental health, substance use changes, and behaviors among a sample of U.S. adults. Subject and methods In the period March 20–30, 2020, we collected data on COVID-1...

In the United States, Black communities face a complex mental health burden, with growing attention on addressing these disparities through the lens of holistic wellbeing. Given the dearth of research on faith-based interventions focused on mental health through the lens of holistic wellbeing, this study evaluates the impact of a spirituality-based...

Objectives The Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot (OPP) authorized the use of SNAP benefits online in Maryland in May 2020 and expanded rapidly across the US due to the COVID-19 pandemic. We assessed sociodemographic factors associated with online grocery service uptake and current and intended future use durin...

Objectives Online grocery services hold potential to reduce physical barriers to equitable healthy food procurement, particularly among low-income families who often live far from groceries stores. During COVID-19, the USDA authorized the use of the Supplemental Nutrition Assistance Program (SNAP) benefits online in some retailers across the US. We...

Objectives Asian Americans (AAs) experience a complex and growing non-communicable disease burden linked with dietary behaviors. Dietary norms, which significantly contribute to eating behaviors, face a complex set of Western and Asian socio-ecological influences in AA communities. However, little is known of how dietary norms (such as definitions...

Objectives Online grocery shopping has grown in popularity among low-income households. Yet, few studies have explored how this service can equitably promote healthy food access and reduce food insecurity and nutritional inequities. Thus, this study explores community-identified recommendations for enhancing online grocery shopping to promote equit...

Objectives South Asians comprise most of the United Arab Emirates (UAE) population and face a complex non-communicable disease (NCD) burden linked with dietary behaviors. While past research has focused on disease risk factors of first-generation migrant workers, little is known on the dietary behaviors of the South Asians born or socialized within...

Background Sexual violence is a growing issue faced across diverse South Asian American communities under the backdrop of a distinct religious and cultural environment that intersects with the ability to prevent and manage this public health crisis. There is also growing attention on sexual violence experienced by younger or second-generation South...

Objective: China faces a growing non-communicable disease (NCD) burden linked with diet. The link between attitudes towards healthy diets and specific eating behaviors has been underexplored in Chinese settings. The aim of this study is to evaluate disparities in personal healthy eating prioritization among Chinese adults and its association with s...

Background The COVID-19 pandemic has disproportionately impacted economically-disadvantaged populations in the United States (US). Precarious employment conditions may contribute to these disparities by impeding workers in such conditions from adopting COVID-19 mitigation measures to reduce infection risk. This study investigated the relationship b...

Introduction: Research suggests that individualism has profound implications in health promotion, yet little is known on the impact of individualism on the life- style behaviors of Asian Americans (AA). Methods: This study analyses data of AA young adults (aged 18-35) participating in an online survey in March 2021. Horizontal individualism was ass...

Background: Stress has emerged as a pressing public health crisis among young adults in the US, including Asian Americans (AA), and has been associated with an array of negative physical and mental health outcomes. Given the significant role of family dynamics in the health of Asian Americans, family members may play a key role in mitigating and/or...

Objectives: The COVID-19 pandemic and its resulting social distancing measures significantly disrupted community-level and family-level interaction patterns. Family dynamics play a pivotal role in the health experiences of Asian Americans (AAs), yet understanding of the impact of COVID-19 on AA family interaction patterns has been limited by minima...

Young adults (18-35), particularly Asian Americans (AAs), face deficiencies in the length and quality of sleep. Given the unique role family plays in the health experience of AAs, exploring this role in healthy sleep behavior promotion is warranted. This study analyses 933 unique family interaction patterns reported by 489 AAs participating in an o...

Asian Americans (AAs), particularly those with higher acculturation such as young adults, experience a significant diet-related non-communicable disease burden in the United States, however specific motivational factors involved in the regulation of eating behaviors among AAs remain unclear. This study analyses data from AA young adults (aged 18-35...

Background: South Asians are the fastest growing ethnic subgroup of Americans, and first-generation South Asian American (SAA) adults face a complex non- communicable disease (NCD) burden linked to poor dietary behaviors (including hypertension, diabetes). While past research has explored self-identified drivers behind SAA dietary behaviors, little...

Family members play an interconnected and highly significant role throughout the lives of Asian Americans (AAs) and, particularly for young AAs, serve as a foundational influence on socialization experiences. However, little is quantita- tively known on specific ways family members may influence the ability of young AAs to socialize and form relati...

Background: Young and second-generation Asian Americans (AAs) face a growing non-communicable disease (NCD) burden linked with poor dietary be- haviors, yet understanding the complex socio-economic determinants driving these disparities reflects an emerging area of research. While family members, mostly parents, have been identified as a major cont...

Objective: Mobile health programs are rapidly growing, yet such interventions remain untested in underserved low-income immigrant populations. This study aimed to examine technology ownership, current use, and preferences for health communication in primarily low-income South Asian immigrants with prediabetes or diabetes. Methods: Technology use an...

The Asian American, Native Hawaiian, and Pacific Islander (AANHPI) population is rapidly growing in the United States. Despite sexual violence being a persistent and significant public health issue, research on this topic among AANHPIs is lacking. The study objective is to conduct a systematic scoping review on the published literature on non-partn...

Background COVID-19 mitigation strategies have had an untold effect on food retail stores and restaurants. Early evidence from New York City (NYC) indicated that these strategies, among decreased travel from China and increased fears of viral transmission and xenophobia, were leading to mass closures of businesses in Manhattan’s Chinatown. The cons...

Background Ultra-processed food (UPF) consumption is linked to adverse health outcomes, including cardiovascular disease and all-cause mortality. Asian Americans (AAs) are the fastest growing ethnic group in the United States (US), yet their dietary patterns have seldom been described. Objectives To characterize UPF consumption among AAs and deter...

A recent policy in the U.S. authorized monthly benefits from a nutrition assistance program - Supplemental Nutrition Assistance Program (SNAP) - to be used online to increase grocery access and promote healthy eating. This study examined online grocery attitudes and purchasing behaviors among low-income SNAP-eligible households with young children...

This study explores a novel, mixed qualitative method to deconstruct the diet of second-generation South Asian Americans (SAAs). Online interviews of 32 second-generation SAAs were conducted usingintegrated free-listing and mind-mapping. Ranked free-lists were aggregated to identify salient drivers, while connections made within mind-maps were anal...

Background: Tackling infodemics with flooding misinformation is key to managing the COVID-19 pandemic. Yet only a few studies have attempted to understand the characteristics of the people who believe in and adhere to misinformation. Methods: Data was used from an online survey that was administered in April 2020 to 6,518 English-speaking adult par...

Introduction: Ultra-processed food (UPF) consumption is linked to adverse health outcomes, including cardiovascular disease and all-cause mortality. Asian Americans (AAs) are the fastest growing ethnic group in the United States (US), yet their dietary patterns have seldom been described. Objectives: To characterize UPF consumption among AAs and de...

Lesbian, gay, bisexual, and other sexual minority (LGB+) South Asian Americans represent a disproportionately underserved and often invisible community in the United States. While issues of sexual violence have been documented in the South Asian American community, little is known on its impact among LGB+ individuals. This study explores the experi...

The COVID-19 pandemic has disproportionately impacted the physical and mental health, and the economic stability, of specific population subgroups in different ways, deepening existing disparities. Essential workers have faced the greatest risk of exposure to COVID-19; women have been burdened by caretaking responsibilities; and rural residents hav...

We examined whether dietary intake differs across household and child food security (FS) status, and Supplemental Nutrition Assistance Program (SNAP) participation among Black children (ages 9–15) in a low-income urban setting. This cross-sectional survey used the USDA 18-item Household Food Security Survey, which includes the 8-item Child Module,...

A systematic assessment of the effect of COVID-19 on the food retail environment—an important determinant of health—has not been conducted. Our objective was to assess the impact of COVID-19 on closures of restaurants, food retail stores, and fresh produce vendors in New York City (NYC). We conducted a cross-sectional study following the peak of CO...

Context: Online grocery services are an emerging component of the food system with the potential to address disparities in access to healthy food. Objective: We assessed the barriers and facilitators of equitable access to healthy foods in the online grocery environment, and the psychosocial, purchasing, and dietary behaviors related to its use...

Social media has been crucial for seeking and communicating COVID-19 information. However, social media has also promulgated misinformation, which is particularly concerning among Asian Americans who may rely on in-language information and utilize social media platforms to connect to Asia-based networks. There is limited literature examining social...

Introduction Little is known on the independent effects of generational status and acculturation on the consumption of specific foods among disaggregated Asian American (AA) populations. This study explores the associations of generational status and acculturation with dietary behaviors of a nationwide non-probability sample of 3018 AAs (58.6% East...

The COVID‐19 pandemic has disrupted the social, economic, and health care systems in the United States and shined a spotlight on the burden of disease associated with social determinants of health (SDOH). Addressing SDOH, while a challenge, provides important opportunities to mitigate cardiovascular disease incidence, morbidity, and mortality. We p...

There is a growing need to better capture comprehensive, nuanced, and multi-faceted qualitative data while also better engaging with participants in data collection, especially in virtual environments. This study describes the development of a novel 3-step approach to virtual mind-mapping that involves (1) ranked free-listing, (2) respondent-driven...

This study assessed the modifying role of primary source of COVID-19 information in the association between knowledge and protective behaviors related to COVID-19 among adults living in the United States (US). Data was collected from 6,518 US adults through an online cross-sectional self-administered survey via social media platforms in April 2020....

The COVID-19 pandemic has resulted in social isolation and reports of insomnia. However, reports of changes in sleep duration and associated factors are few. To determine the impact of COVID-19 on changes in sleep behavior, data were analyzed from an online survey of adults recruited via social media that included questions asking whether the respo...

Research Objective To assess the moderating effects of primary sources of COVID-19 information on the association between knowledge and protective behaviors against COVID-19. Study Design This is a secondary analysis of data from a cross-sectional online COVID-19 survey conducted among US adults in April 2020 using advertisement-based recruitment...

Background In the United States, approximately 11% of households were food insecure prior to the COVID-19 pandemic. The present study aims to describe the prevalence of food insecurity among adults and households with children living in the United States during the pandemic. Methods This study utilized social media as a recruitment platform to adm...

There is a lack of quantitative research examining how the pandemic has affected individuals at different income levels. The Asian American population has the highest level of income inequality and serves as an excellent case study for examining differences in experience between income groups. A non-probability sample of 3,084 Asian American adults...

BACKGROUND: The COVID-19 pandemic has limited the ability of community health workers (CHWs) and other front-line health professionals to delivery in-person health education and coaching, necessitating the transition of evidence-based interventions to virtual formats. This study used a mixed-methods approach to assess the impact of the COVID-19 pan...

This study aimed to evaluate the association of the overall nutritional quality and the weight share of specific types of foods received by food pantry clients with food pantry size and distribution method. Data on healthy food weights using the gross weight share (GWS) of select foods and the validated Food Assortment Score Tool (FAST) were collec...

Objectives The COVID-19 pandemic has catalyzed both a health and economic crisis in the US, with growing concerns on how eating behaviors and food security (risk factors of non-communicable disease) have changed. This study examines changes in food insecurity and eating behaviors during the early months of the pandemic among US adults. Methods A n...

Objectives The USDA is partnering with retailers to authorize online EBT card use to increase grocery store access and promote healthy eating. We examined online grocery shopping behaviors among households with children (< age 8), including SNAP recipients and SNAP-eligible non-recipients (income < 130% of federal poverty level). Methods Mixed-met...

Objectives South Asian Americans (SAAs) face a growing non-communicable disease burden, however the behavioral contributors to health disparities experienced by second-generation South Asians remain under-explored. The aim of this study was to identify major drivers of the foods typically eaten by second-generation SAAs. Methods Between October-No...