DOI: 10.60773/50dx-sm74
title: Southeast Asians in the US: Health Equity and Research to Understand COVID-19 Stories (SEA US, HEAR US)

description: Unlike other ethnic minority groups, data on the impacts of COVID-19 on Southeast Asian Americans (SEAAs) are limited, oftentimes aggregated with other Asian American groups, thus limiting targeted assistance efforts. Without adequate data to inform best practices around testing and vaccination, many SEAAs become invisible Americans who have difficulties navigating a health care system that inadvertently excludes them. SEAAs have large disparities gap due to a combination of historical trauma, discrimination, harsh immigrant policies, and language barriers. Many are undocumented, hold low wage jobs, and less likely to attend college. Social isolation, anxiety, and financial hardships resulting from COVID-19 have intensified existing health and mental health issues. Lack of disaggregated data and under-reporting of race/ethnicity data, potentially masks the true impacts of COVID-19 on SEAAs and thus exemplifies systemic barriers and structural racism that keep them invisible and hinder targeted assistance. The goal of this project, "Southeast Asians in the U.S.: Health Equity And Research to Understand COVID-19 Stories (SEA US, HEAR US)" was to understand and address multi-level social, ethical, and behavioral implications of COVID-19 testing, vaccination, and its sequelae among Cambodians, Filipinos, Thais, and Vietnamese Americans in Greater Los Angeles through a community-based approach. The central hypothesis was that provision of data-informed and community-informed best practices/guidelines will improve evidence-based COVID-19 testing, vaccination, and its sequelae among their communities. Aim 1: Conduct multi-level formative research using a mixed-methods approach to validate, refine, and tailor existing SEBI measures and potentially develop new, more culturally-relevant, measures for SEAAs. Focus groups with community members (N=30) and key informant interviews with community leaders (N=6) were conducted to confirm cultural relevancy, comprehension, and potential refinement of the existing RADx-UP Common Data Elements (CDEs) and the Social Determinants of Health (SDOH), COVID-19 research findings, and other relevant measures present in the PhenX Toolkit. Aim 2: Collect individual-level data about social, ethical, and behavioral implications (SEBI) of COVID-19 testing, vaccination, and its sequelae among Southeast Asian Americans in the Greater Los Angeles area through a prospective longitudinal study. Spanning 12 months (BL, 3, 6, and 12 months), the survey allowed a better understanding of critical areas in COVID-19 testing and vaccination such as structural, cultural, and intrapersonal barriers and assets in SEAA communities (N=1000). The study isolated barriers that hinder or facilitate testing and vaccination over time, such as lack of accessibility, health literacy, language barriers, self-efficacy, stigma, or lack of social capital. Findings identified areas for potential programs and interventions and/or better access points to underserved groups. Aim 3: Conduct in-depth interviews with community leaders and stakeholders (community-based and faith-based organizations) within SEAA communities to understand their capacity, perceptions, attitudes, beliefs, and intentions towards COVID-19 testing and vaccination. This approach provided insight into organizational infrastructure, community-level, and societal-level factors for COVID-19 testing and vaccinations from the perspectives of community leaders (N=60). The study was able to identify common potential gaps or assets in service delivery and navigation, and areas of resiliency between groups. SEA US, HEAR US studied Cambodians, Filipinos, Thais, and Vietnamese Americans at a time when health equity is a challenge and issues of structural discrimination and anti-Asian hate is at its peak. SEAAs are invisible Americans who will continue to experience health disparities and be structurally discriminated against in the absence of culturally targeted, relevant assistance. SEBISEAA gathered community-driven, culturally-sensitive data to inform existing and future COVID-19 programs and policies that improve necessary resources and support for these sub-ethnic AA communities.