Moving Upstream: Understanding Racism, Firearm Injury Risks, and Resiliency Among Asian Americans

摘要 2019冠状病毒病大流行期间的反亚裔情绪增加了亚裔美国人受到 种族暴力和歧视，以及结构性和个人层面长期存在的种族主义， 程度.我们提出了一项及时的研究，以响应RFA-MD-21-004-理解和解决 结构性种族主义和歧视对少数群体健康和健康差异的影响（R 01）， 初步数据显示，亚洲人购买枪支的数量急剧上升， 由于COVID-19大流行期间种族主义/歧视的经验增加，全国范围内的种族主义/歧视。种族主义，a 暴力形式及其对拥有枪支、精神痛苦症状和药物使用的影响， 使亚裔美国人面临更高的火器伤害和死亡风险，强调迫切需要了解 他们的风险和促进对种族主义的服从的因素。社会生态框架，弹性理论， 经验主义枪支研究表明，理解种族主义和枪支风险之间的联系需要 评估多层次因素和使用基于实力的方法。本研究的目的是 采用混合方法，包括焦点小组和纵向调查，结合地理 信息系统，调查多层次的风险和保护因素的火器伤害的风险，确定 邻里层面的结构性种族主义和歧视（SRD）的相关因素，并了解其机制 这些因素和枪支的结果之间的关系。我们的目标是：1）利用焦点小组来识别亚裔美国人的 社会责任感与个人、人际、社区层面的促进因素及信息调查 2）进行三波年度纵向调查，样本为1 500人 具有全国代表性的亚裔美国人，研究种族主义增加枪支风险的机制 通过增加物质使用，精神痛苦和枪支行为; 3）确定不同的个人资料， 选定的社区级SRD指标，将对亚裔美国人社区产生影响， 研究其与火器伤害风险的关系;以及4）研究累积的促进因素是否 减轻亚裔美国人种族主义的风险影响。该项目的预期成果将 包括更好地了解与火器伤害和死亡有关的背景因素， 确定可能减轻特定风险暴露负面影响的多个层面的促进因素， 亚裔美国人。调查结果将为预防艾滋病的循证干预措施提供坚实的基础。 涉及亚裔美国人的枪支伤害风险。预计该项目还将对以下方面产生积极影响： 解决由于性关系和发展以及个人经历的种族主义造成的健康差距。

Abstract Anti-Asian sentiment during the COVID-19 pandemic has elevated the risk of Asian Americans being subjected to racial violence and discrimination, in conjunction with the long-existing racism at both structural and personal levels. We proposed a timely study in response to RFA-MD-21-004– Understanding and Addressing the Impact of Structural Racism and Discrimination on Minority Health and Health Disparities (R01), as our preliminary data provided evidence that there has been a sharp rise of firearm purchases by Asian people nationwide due to increased experiences of racism/discrimination during the COVID-19 pandemic. Racism, a form of violence, and its influence on firearm possession, mental distress symptoms and substance use may put Asian Americans at elevated risk of firearm injury and mortality, stressing the urgent need to understand their risks and resilience-promotive factors against racism. The socio-ecological framework, Resilience Theory, and empirical firearm research suggest understanding the links between racism and firearm risks requires assessment of multiple-level factors and use of a strength-based approach. The objective of this study is to employ mixed methods, including focus groups and longitudinal surveys, integrated with Geographic Information System to investigate multi-level risks and protective factors of firearm injury risks, identify correlates of neighborhood-level structural racism and discrimination (SRD), and understand the mechanisms between these factors and firearm outcomes. Our goals are: 1) Use focus groups to identify Asian Americans' perspectives on SRD and individual-, interpersonal-, and community level promotive factors and inform survey instrument development; 2) Conduct three waves of annual, longitudinal surveys with a sample of 1500 nationally-representative Asian Americans to examine the mechanisms by which racism increases firearm risk through increased substance use, mental distress, and firearm behavior; 3) Identify distinct profiles with selected neighborhood-level SRD indicators that will be influential to Asian American communities and examine their associations with firearm injury risk; and 4) Examine whether cumulative promotive factors mitigate the risk effects from racism among Asian Americans. The expected outcomes of the project will include improving understanding of contextual factors associated with firearm injury and mortality and identifying multiple levels of promotive factors that may mitigate the negative effects of risk exposure specific to Asian Americans. Findings will provide a solid basis to inform evidence-based interventions that prevent firearm injury risks involving Asian Americans. The project is also expected to have a positive impact on addressing health disparities as a result of SRD and individually experienced racism.