School of Public Health
Permanent URI for this communityhttp://hdl.handle.net/1903/1633
The collections in this community comprise faculty research works, as well as graduate theses and dissertations.
Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.
Browse
2 results
Search Results
Item Understanding the informal help-seeking process of Korean emerging adults living in the U.S.: Influence of the family context(2022) Yoo, Jee Hun; Curbow, Barbara; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Korean Americans are a major Asian subgroup in the U.S., and epidemiological data demonstrate that rates of mental health symptoms are higher among Korean American emerging adults compared to other Asian American counterparts. Seeking and receiving appropriate support are important ways to cope with mental health burden, but there is a dearth of literature on how Asian Americans seek help from friends and family members. Available studies suggest that various sociocultural factors influence the informal help-seeking process among Asian Americans. As family context has a significant impact on children’s sociocultural development, examining such contextual factors can help understand some of the mechanisms and correlates of informal help-seeking. In this dissertation study, I explored the characteristics and associations among family communication patterns, relevant sociocultural factors (i.e., perceived parental support, emotional self-control, relational concerns, face loss concerns), and informal help-seeking intentions using a sample of 201 Korean American emerging adults (ages 18 – 29) drawn from an online survey. In paper 1, factor analysis showed that different help sources can be grouped into three domains (i.e., formal sources, family members, and partner and friends), with intention to seek help being the highest towards partner and friends, followed by family members and formal sources. Characteristics of higher acculturation were positively associated with help-seeking intention towards partner and friends. In paper 2, mediation analyses revealed that participants with parents fostering unrestrained communications perceived receiving more informational support from parents, which in turn was associated with higher intention to seek parental support. Participants with parents emphasizing conformity in beliefs and values perceived receiving less emotional and implicit support from parents, which in turn was associated with lower intention to seek parental support. The negative association between conformity orientation and perceived emotional support was only significant among participants identifying as American or bi-cultural. In paper 3, bivariate analyses showed that conversation orientation was positively associated with informal help-seeking intention, while conformity orientation, emotional self-control, relational concerns, and face loss concerns were negatively associated. Mediation analyses indicated that participants with parents stressing conformity in beliefs and values were more likely to endorse suppression of emotional expression and be concerned with potential loss of face from help-seeking, which in turn were associated with lower intention to seek help from family and friends. Findings from this dissertation study point to the utility of examining family contextual factors to better understand the informal help-seeking process among Korean American emerging adults. More studies on Asian Americans’ informal help-seeking are needed to find more culturally appropriate ways to address the mental health needs of this population.Item Self-reported discrimination among Asian Americans: An examination of its measurement and relationship with health-related quality of life(2019) Jung, Mary; Lee, Sunmin; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Labeled as a “model minority,” Asian Americans have often been excluded from the dialogue on discrimination. Previous studies frequently used discrimination measures that were initially developed for African Americans and lack items related to language and nativity. Although discrimination adversely affects mental and physical health, its relationship to health-related quality of life (HRQOL) has been understudied in this population. This dissertation evaluated self-reported discrimination among Asian Americans by examining its measurement and relationship with HRQOL. Manuscript 1 assessed the psychometric properties of everyday (ERDS) and major racial discrimination scales (MRDS) that were developed for Asian Americans. In a sample of 569 Asian American immigrant adults, reliability was excellent for ERDS but moderate for MRDS (Cronbach’s α=0.94 and 0.60). The latter is likely low given that MRDS is an inventory of events. For construct validity, weak positive linear correlations with perceived stress and depressive symptoms were observed (r=0.22 and 0.28 for ERDS and r=0.11 and 0.14 for MRDS; p<0.001). Factor analysis confirmed the unidimensionality of both measures. Manuscript 2 cross-sectionally examined the association between the racial discrimination measures from Manuscript 1 and HRQOL among 524 foreign-born Asian American adults. Multivariable logistic regression and negative binomial regression were performed to examine self-rated health (poor vs. good) and days of poor physical health, mental health, and activity limitation. ERDS (IRR range: 1.04-1.08) and MRDS scores (IRR range: 1.19-1.61) were significantly and positively associated with worse HRQOL for all measures, except for self-rated health. Manuscript 3 examined discrimination trajectories and assessed their relationship with self-rated health in a longitudinal, multi-ethnic sample of 2,004 middle-aged women in the Study of Women’s Health Across the Nation (SWAN). Group-based trajectory analysis identified three distinct discrimination groups. The “high and decreasing” but not “moderate and decreasing” group was significantly associated with poor self-rated health compared to the “low and decreasing” group (OR=1.61; 95% CI: 1.12-2.31). This dissertation provides insight into discrimination measures and their relationships with HRQOL among Asian Americans. Proper measurement and health impact assessment of discrimination in this population can contribute to better monitoring and provide improved accountability and support for interventions and public policies.