Derek K. Iwamoto’s research while affiliated with University of Maryland, College Park and other places

Objectives The present study utilized an intersectional framework to examine if two forms of gendered racism, psychological emasculation and messages about Asian American men being undesirable partners, were associated with Asian American men's nicotine use. We also examined the potential mediating roles of two racial identity statuses, racial conformity and racial immersion. Methods A sample of 356 Asian American men living in the United States of America (USA) completed a cross‐sectional survey via Qualtrics containing measures assessing the aforementioned constructs of interest. The primary analysis examined separate parallel mediation models, situating psychological emasculation and undesirable partner as separate independent variables, racial conformity and racial immersion as parallel mediators, nicotine use as the outcome, and age and employment as covariates. Results In separate parallel mediation models, the links between psychological emasculation and undesirable partner on one hand, and nicotine use on the other, were completely mediated only by racial conformity, and not significantly mediated by racial immersion. Specifically, greater endorsement of gendered racism was associated with greater conformity with (and internalization of) these gendered racist beliefs, which in turn were associated with greater nicotine use. Conclusion Researchers and practitioners may consider racial conformity as an interventional target to ameliorate Asian American men's nicotine use. Future studies should continue to examine other culturally relevant and/or potentially protective constructs (e.g., on the basis of gender, race, and its intersection) that may mitigate Asian American men's nicotine use.

Intimate partners play an important role in chronic diseases. Despite the chronic disease burden in sub‐Saharan Africa, very few culturally relevant quantitative measures of intimate relationship functioning are available. We conducted an empirical investigation evaluating the psychometric properties of the South African Relationship Functioning Assessment (SARFA) assessing healthy relationship functioning in N = 150 community members (50% women; M age = 27.2 years) living in the Vulindlela area of KwaZulu‐Natal, South Africa. Item development was based on prior qualitative research from two South African communities. All assessments were conducted in isiZulu, participants' primary language. An exploratory factor analysis was conducted on the initial 39‐item measure. The best‐fitting model consisted of one factor with 22 items. The SARFA's internal consistency was α = .94. Convergent validity was observed via significant positive associations (all r s ≥ .38, p < .001) between the SARFA's total score and measures of trust, emotional intimacy, constructive communication, sexual satisfaction, and relationship control (women only). Divergent validity was observed for women only. Encouraging initial psychometric properties of a culturally relevant measure of relationship functioning in KwaZulu‐Natal may have relevance to other communities and potential to be used in research involving couples and health in chronic disease‐burdened communities.

A burgeoning body of research suggests that nuanced sociocultural factors influence college women’s health. Feminine norms, or the beliefs and expectations of what it means to be a woman, is one important factor that may help explain psychological distress. Emerging research has found that conformity to feminine norms is significantly associated with several health outcomes including substance use and eating disorder symptomatology. Guided by the gender role strain paradigm, we examined the role of conformity to feminine norms on psychological distress among college women. Data was collected from 1,700 female undergraduate women attending one university in Southern California with a mean age of 20.18. The sample consisted of 76.8% Asian American women and 23.2% white women. We conducted regression analyses to examine the association between nine feminine norms (i.e., Sweet and Nice, Relationship, Thinness, Modesty, Domestic, Care for Children, Romantic Relationship, Sexual Fidelity, and Invest in Appearance) and psychological distress. Findings revealed that the feminine norms of Modesty, Appearance and Thinness were positively associated with psychological distress, while age, Children, and Relationship decreased risk of distress. This study provides evidence of the nuanced ways in which conformity to feminine norms is associated with psychological distress. The results of this study highlight how researchers and practitioners may consider examining how specific feminine norms are associated with psychological distress instead of homogenizing all aspects of femininity.

Objective: This randomized controlled trial of the online intervention, man therapy (MT), evaluated efficacy to reduce suicidal ideation (SI) and depression among working-aged men. Method: Five-hundred and fifty-four men enrolled and 421 completed all surveys. Control Condition men explored the Healthy Men Michigan (HMM) website and Intervention Condition men explored HMM and MT. Hypotheses included men who used MT would report decreased SI and depression over time compared to Control Condition men. Results: Latent growth curve modeling revealed improvements in SI (slope = -0.23, p < 0.001, 95% CI: -0.29, -0.16) and depression (slope = -0.21, p < 0.001, 95% CI: -0.23, -0.18) over time for men in both groups; however, there was no difference in slope based on group assignment. Depression, lifetime suicide attempts, and interpersonal needs were associated with SI. Interpersonal needs and poor mental health were associated with depression. No group differences in change in risk and protective factors over time were observed. MT sub-group analyses revealed significant improvements in risk and protective factors. Conclusion: While a direct effect of MT versus HMM on SI or depression was not observed, men in both groups improved. Results suggest online screening might play a role in reducing SI and depression among men and there are potential benefits to MT related to mental health, social support, and treatment motivation.

Aims: Asian Americans are the fastest growing racial and ethnic subgroup in the USA but are underrepresented in the alcohol literature, partially due to misconceptions and racial stereotypes. We estimated any alcohol screening/discussions with providers among Asian Americans and other racial and ethnic subgroups and tested associations with alcohol treatment. Methods: Weighted prevalences of any alcohol screening or discussions with providers included US adults reporting past-year alcohol use and > =1 healthcare visit in the 2015-2019 National Survey on Drug Use and Health (n = 123,002). Multinomial logistic regressions estimated adjusted associations between alcohol use screening/discussions (ref: no screening/discussion) comparing Asian Americans to other racial and ethnic adult subgroups. Among adults with alcohol use disorder (AUD), we estimated adjusted odds of alcohol treatment and perceived treatment need by screening/discussions and racial and ethnic subgroup. Results: Among Asian American adults who reported past-year alcohol use and a healthcare visit, 24.7% reported any screening only and 51.4% discussed alcohol with providers. All racial and ethnic subgroups were more likely than Asian Americans to report alcohol screening/discussions (e.g. white adults, screening adjusted relative risk ratio [aRRR] = 1.48, 95% CI: 1.28-1.72; discussions aRRR = 1.92, 95% CI: 1.74-2.10). AUD treatment use and perceived need were about two times higher among people reporting alcohol discussions. Conclusions: Asian Americans were less likely to report discussing alcohol with providers than all other racial and ethnic subgroups. Alcohol discussions were associated with treatment use and perceived need. Efforts to increase equitable alcohol screening and discussions with clinicians are needed.

Objectives Minimal research has assessed COVID-19’s unique impact on the Native Hawaiian/Pacific Islander (NH/PI) population—an Indigenous-colonized racial group with social and health disparities that increase their risk for COVID-19 morbidity and mortality. To address this gap, we explored the scope of COVID-19 outcomes, vaccination status, and health in diverse NH/PI communities. Methods NH/PI staff at partner organizations collected survey data from April through November 2021 from 319 community-dwelling NH/PI adults in 5 states with large NH/PI populations: Arkansas, California, Oregon, Utah, and Washington. Data were analyzed with descriptive statistics, Pearson χ ² tests, independent and paired t tests, and linear and logistic regression analyses. Results During the COVID-19 pandemic, 30% of survey participants had contracted COVID-19, 16% had a close family member who died of the disease, and 64% reported COVID-19 vaccine uptake. Thirty percent reported fair/poor health, 21% currently smoked cigarettes, and 58% reported obesity. Survey participants reported heightened COVID-19–related psychosocial distress (mean score = 4.9 on 10-point scale), which was more likely when health outcomes (general health, sleep, obesity) were poor or a family member had died of COVID-19. Logistic regression indicated that age, experiencing COVID-19 distress, and past-year use of influenza vaccines were associated with higher odds of COVID-19 vaccine uptake (1.06, 1.18, and 7.58 times, respectively). Conclusions Our empirical findings highlight the acute and understudied negative impact of COVID-19 on NH/PI communities in the United States and suggest new avenues for improving NH/PI community health, vaccination, and recovery from COVID-19.

African Americans disproportionately experience homicide, and the psychological consequence of experiencing this traumatic event interferes with daily function, often in the form of post-traumatic stress disorder (PTSD). According to the Model of Coping for African American Survivors of Homicide Victims (MCAASHV), African Americans coping with the traumatic impact of homicide are influenced by: the violent nature of the death itself, racial- and cultural-bound experiences (e.g., cultural trauma, the culture of homicide including stigma, blame, shame, and lack of justice) and psychological processes including racial appraisal and coping strategies (e.g., spiritual, collective, meaning making). This study examined the direct and indirect effects racial- and cultural-bound experiences have on PTSD through coping strategies among 304 African American survivors of homicide victims across the United States using Qualtrics panels collected in March–May 2018. The path analysis model demonstrated strong model fit, and the variables in the model accounted for 34% variance in PTSD. Coping (β = −0.38, p < .001) and culture of homicide (β = −0.27, p < .001) were negatively related to PTSD. Cultural trauma (β = 0.11, p < .014), culture of homicide (β = 0.43, p < .001), reactions to homicide (β = 0.11, p < .006) and racial appraisal (β = 0.32, p < .001) were positively associated with coping (R² = 52%), and all were indirectly associated with PTSD through coping. Findings provide strong support for the MCAASHV and highlight the direct and indirect effects of racial and cultural experiences of coping that explain PTSD among African Americans chronically exposed to homicide.

People whose gender does not align with assigned sex often experience negative mental health outcomes related to cisnormative societal expectations and oppression, including familial rejection, threat of harm, and identity invalidation (e.g., misgendering). This study merged two cross-sectional data sets of trans and gender-diverse people (N = 363; Mage = 22.02) investigating how various types of distal minority stress experiences impact psychological distress. We tested the associations between three minority stressors (i.e., family rejection, threat of harm, and identity invalidation) and psychological distress using unadjusted and adjusted regression models, including gender-stratified models. In the overall unadjusted model, all three stressors were significantly, positively associated with psychological distress, with identity invalidation having the highest standardized β value. In the adjusted overall model, only identity invalidation was significantly associated with distress. Results varied in gender-stratified models. Additionally, participants who experienced any of the three stressors had predicted mean distress scores at or above the cutoff for severe psychological distress, while those who did not fell below that cutoff. Results highlight the differential impact of minority stress experiences on gender-diverse young adults and provide directions for clinical competency, interventions, and future research toward understanding mental health disparities for trans people.

While a growing body of literature has examined factors that contribute to Asian Americans’ negative body image, little research has investigated Asian Americans’ body image from a strengths-based perspective. This study thus presents the Pride in Asian American Appearance Scale (PAAAS), which was designed to measure the extent to which Asian Americans feel positively about their own racialized physical appearances as well as those of fellow Asian Americans. Items were developed through an extensive literature review, cognitive interviews, and expert feedback. Exploratory (N = 398) and confirmatory (N = 398) factor analyses suggested a bifactor model, consisting of 24 items comprising a general factor and four group factors: (a) Pride in Asian Features, (b) Preference for Asian American Appearance, (c) Asian Americans as Desirable, and (d) Action Promoting Asians’ Attractiveness. Internal consistency estimates as well as factor determinacies were high and demonstrated that the specified items adequately represented their intended factors. The PAAAS was significantly correlated in theoretically expected directions with collective self-esteem, internalized racist appearance bias, and psychological distress. Implications of these findings and suggestions for future research are discussed.