Hello.
I'm Rear Admiral Richardae Araojo, the Associate Commissioner for Minority Health and Director
of FDA's Office of Minority Health and Health Equity.
Welcome to the Health Equity Lecture Series.
For today's lecture, we have invited Dr. Wei Sun to discuss health disparities impacting
Asian-American, Native Hawaiian and Pacific Islander communities before and during the
COVID 19 pandemic.
Dr. Sun is an associate professor and Associate Dean for Research and Academic Affairs at
the Kathy Hughes School of Communications at Howard University.
She is also a Fulbright Specialist in Communications and Journalism and an elected first Vice Chair
for the International and Intercultural Communication Division of the National Communication Association.
She has taught various doctoral seminars and published on international and intercultural
communication, community and public health, global health communication, race, culture
and social justice and, new media studies.
Dr. Sun's most recent research has focused on COVID-19 health disparities.
Dr. Sun, it's a pleasure to welcome you to the Health Equity Lecture Series.
I'll turn it over to you.
Thank you, Rear Admiral Araojo, for the introduction.
Today, I'm going to talk about Advancing Health Equity for Asian and Pacific Islander communities.
So here is a disclaimer on the funding statement.
You can read.
And today's agenda, I'm going to introduce my background and Asian health disparities
during the pandemic and bridging gaps recruiting African and Asian American participants in
clinical trials and creating culturally competent messages.
My Research specialties are intercultural communication, new media studies and health
communication.
My interest to combine the three started in 2011 when I was writing an article about how
Chinese cancer patients formed their own social support group on social media.
Before I move on to the discussion, I want to introduce three important concepts.
According to World Health Organization, health is a state of complete physical, mental and
the social well-being, and the not merely the absence of disease or infirmity.
Health communication are actions to influence and empower individuals, populations, and
the communities to make healthier choices.
Effective health communication is critical to health and the wellbeing.
Healthy People 2030 focuses on improving health communication so that people can easily understand
and act on health information.
According to CDC, health disparities are preventable, differences in the burden of disease, injury,
violence, or opportunities to achieve optimal health that are experienced the by socially
disadvantaged populations.
And next, I'm going to discuss Asian health disparities during the pandemic.
Health disparities are gaps in the quality of health and health care, that mirror differences
in socioeconomic status, racial and ethnic background, and education level.
Nearly 17.3 million Asian Americans and the Pacific Islanders, reside in the United States,
and about 64% of them are employed and have job related health insurance coverage.
57% of Asians were born in the foreign country.
CDC foundation funded the research projects refocus phase one.
It was led by my coworker, Dr. Monica Ponder, Assistant Professor at Howard University and
the Senior Investigator for this project.
One area of the project examined the five minority groups social stigma during COVID-19.
These five minority groups include African American, Asian, Hispanic, undocumented immigrant
and LGBTQ communities.
It has been well documented that Asian Americans have experienced increased social stigmatization
related to COVID-19.
Stigma has negative social and health impacts on minority communities such as labelling,
avoiding, shame, disgust, and social exclusion.
The health impacts include both physical and mental illness and the acceleration of health
disparities.
This study seeks to understand their life experiences and the subsequent coping strategies.
The findings reveal that a stigmatized behavior and the attitudes of others did not stop Asian
Americans from following the COVID-19 related health guidelines.
Because perceived health risks were high, consumer behaviors of Asian Americans also
changed dramatically towards buying almost everything online during the pandemic.
For the sake of the pandemic itself and the personal safety.
This behavior decisioning provides insights into the complex motivations for adopting
health behaviors.
And in this case, social distancing was preferred not only to avoid people, but also due to
the fear of becoming victims of stigmatization in public areas.
During the pandemic.
Historically underrepresented and ethnic minority communities have been disproportionately impacted
by the COVID-19, according to an AAPI research.
In 2020, there is a 35% increase in deaths, or, 13,620 more Asian Americans died during
the first year of the pandemic compared to the previous five years average.
According to CDC statistics, recently, Asian, non-Hispanic, COVID-19 cases, hospitalization
and death rates are 0.7 and 0.8 times more than white Americans.
It is important to raise awareness, empower the AAPI community for reducing and closing
the health disparity gap.
Next, I'm going to discuss bridging gaps, recruiting African and Asian-American participants
in clinical trials, and creating culturally competent messages.
Bridging gaps, recruiting African and Asian-American participants in clinical trials and creating
cultural, culturally competent messages.
This is an ongoing project in collaboration with FDA Office of Minority Health and Health
Equity.
The Howard University team, includes myself, Dr. Monica Ponder, Dr. Shoaa Almalki and the
two Doctoral students Bryan Jenkins, and Kapriatta Jenkins.
And we collaborated with Communication and Culture Consulting LLC.
Other team members include Dr. Donna Oti, Dr. Eleana Lazarus and the Dr. Tracy Chong.
The research background for this project is clinical trials with homogeneous participants
limit researchers ability to generalize findings to heterogeneous populations.
Participants in clinical trials should be a reflection of the US and individuals who
may one day need to rely on these drugs, vaccines or devices to manage chronic, life-threatening
illnesses.
Throughout the COVID-19 pandemic, underserved populations such as racial and ethnic minorities,
were disproportionately impacted by illness, death, and devastation.
Ensuring people from diverse backgrounds have the ability to participate in clinical trials
is key to advancing health equity.
The objective for Asian-American clinical trials participation includes investigate
Asian-American perceptions of clinical trials and the barriers participation and the test
of strategies to increase knowledge and encourage participation in clinical trials and designing
effective communication messages to increase participation in clinical trials.
And we have conducted five focus groups n Asian Americans, there are 36 participants
participated in five focus groups study.
The demographics of this group include 20 Asian women and 16 Asian men, and they are
from 13 different Asian ethnic communities.
The level of education of this group has a very high educational level.
About 83% of participants have at least a college degree.
The household income, at least 80% of them have eight- 800- $80,000 household income.
The primary findings from the first of five focus groups.
Number one is clinical trials knowledge.
Participants in the five focus groups expressed having some familiarity with clinical trials.
However, there are doubts about how medicine and the science work.
For example, a young Asian man in his twenties heard about the clinical trials because he
used to take care of his late grandfather.
He said the primary care provider suggested that if he wants, he could get into one of
the trials.
But it doesn't guarantee anything since, as she mentioned in his trial, it is not proven
yet.
So that was the first time I heard it.
An Asian woman in her late twenties shared her concerns regarding clinical trials and
questioned the risks associated with it.
She said to me when I heard clinical trials, it is risky.
To me it is like it didn't pass FDA fully and it is in the trial period.
So, I need to consent by agreement to get the trial and then I take all the risk.
Another participant believed clinical trials help the community at large, but because it
is new, it could be risky to participate in a clinical trial.
The second finding regarding clinical trials attitudes participants displayed a mixed feelings
regarding perceived benefit, perceived barriers to all threats, and the misconception about
COVID-19 clinical trials.
Some participants presented anti-vaccines and anti-science attitude.
Others expressed concerns related to racial disparities as obstacles for their hesitancy.
For example, misconceptions and the perceived threats.
Participants showed concerns over the short time it took to develop the COVID-19 vaccine
and the process of clinical trials.
There was a clear lack of knowledge about clinical trials and that what they entail
motivators and the perceived benefit.
For example, for some participants expressed a willingness to participate in clinical trials.
Motivators included advice from credible sources, protecting elderly members of their families,
and increasing their ethnic groups representation in clinical trials.
The third, finding.
00:13:47:01 - 00:14:25:17 Perceived barriers and threats.
The fear of side effect was the most prominent theme across all focus groups.
Lack of knowledge has also played a role in what participants believe about clinical trials
and the misconceptions they have about the process.
For example, a married man said if he was still single, he would not hesitate to participate
in a clinical trial, even knowing it is risky.
But since he has family, he will put his family first before taking a potential risk of participating
in a clinical trial.
There are concerns about legal issues if the trial failed, or privacy protection.
Overall, the major observations include Asian population believe they are socially responsible
and self-reliant.
Messages that emphasize social responsibility and the ability to help others resonate.
Perception of low impact on Asian American Community conflicts with the data.
The best result of recruiting more Asian Americans participate in clinical trials could be that
could be received by targeting second and a third generation of Asian Americans.
Under this group.
The focus groups have highly educated participants.
For example, there is a physician spouse enrolled their children in COVID-19 vaccine trials.
There are distinct differences between the highly and the less educated participants
in terms of perceptions of Western medicine.
And also, there are several scientists in focus group they may have more information
than the rest of the participants.
So, in conclusion, to advance health equity.
It required the collective actions from individuals, community leaders, researchers, agitators,
medical professionals, and the governmental agencies.
The selected references are listed here.
Thank you so much, Dr. Sun, for that very informative presentation.
And we have a couple of pre submitted questions that I want to spend some time talking about.
The first question is, can you describe how information from the focus groups may be used
to create key messages?
This is our second stage pass and as I said, this is a primary finding.
We intend to recruit 25 Asian American participants to the study and through the, for example,
the major observation, we already have some idea that the credible information come from
the scientist, or the national leader, or the community leaders.
They are very important for the Asian Americans to like actually they will be encouraged to
participate in the clinical trials.
Great.
Thank you.
And another question related to the focus groups.
Was there anything that surprised you from the focus group findings?
Yes.
And when we know that the national data showed that Asian Americans, many of them died, or
have these positive cases and the hospitalization, the rate, but that the whole group said, okay,
that has less impact on Asian-American community and that they rely on themselves to have keep
all these information and protect themselves.
So that's the part that really surprised me.
Thank you, Dr. Sun.
And another question that we received.
Do you think that the Asian community perspectives towards clinical trials may be different depending
on the disease state, for example, for COVID clinical trials compared to diabetes clinical
trials?
Yeah, I think because COVID-19 clinical trials, as some of the participants expressed it,
is a very new and that people are still suspecting the scientific the process and that if they
are safe, are not.
So, I think probably if it is a well-studied area like cancer or diabetes, when people
are in need, they are more likely to participate.
Dr. Sun, thank you so much again for that very informative presentation on Asian-American,
Native Hawaiian and Pacific Islander health disparities.
We really appreciate your time today and thank you, everyone, who joined us for the lecture
series.
Thank you.