Shared decision making (SDM) is a model of patient-provider communication. Little is known about ... more Shared decision making (SDM) is a model of patient-provider communication. Little is known about the role of SDM in health disparities among Asian American and Pacific Islander (AAPI) sexual and gender minorities (SGM). We illustrate how issues at the intersection of AAPI and SGM identities affect SDM processes and health outcomes. We discuss experiences of AAPI SGM that are affected by AAPI heterogeneity, SGM stigma, multiple minority group identities, and sources of discrimination. Recommendations for clinical practice, research, policy, community development, and education are offered.
Background: There is increasing recognition of the prominent use of sexual self-labels within the... more Background: There is increasing recognition of the prominent use of sexual self-labels within the gay male community. However, little is known about the processes that orient such labeling, and the role that sexual attraction plays. The present study examined how sexual self-labeling relates to preference for social hierarchy and race-based sexual attraction in Asian/Pacific Islander (API) men who have sex with men (MSM). Method: A total of 138 API MSM(Mage=27.26, SD=6.05) were recruited to participate in a web-based study via online social networking sites, word-of-mouth, and at community events attended by API MSM. Measures assessed participants' preference for social hierarchy, or social dominance orientation (SDO; Pratto et al., 2004); race-based attraction; and sexual self-labels indicative of their anal sex role. Results: SDO varied significantly by sexual self-label: Self-identified tops preferred social hierarchy more so than self-identified bottoms and versatiles. SDO a...
P arent-child relationships are fundamental human relationships in which specific norms govern pr... more P arent-child relationships are fundamental human relationships in which specific norms govern proper parent-child interactions. Such norms, or filial ethics, have been observed in different cultures, including in the United States and Taiwan, but important differences may exist in how filial practices are viewed across cultures. From a traditional view of power as domination over others, if filial relationships are viewed to reflect power differentials between parents and children, actors who follow filial ethics should be viewed as less powerful than actors who do not follow filial ethics for maintaining or enhancing positive parent-child relationships. Alternatively, power can be conceptualized as the ability to meet one's needs (e.g., for communal care and trust), and actors who follow filial ethics should be viewed as more powerful and trustworthy than actors who do not follow filial ethics because they have the ability to maintain or enhance positive parent-child relationships. Based on a power-trust model, we compared American and Taiwanese perceptions of actors in an experiment using vignettes describing filial behaviours. We conducted a path analysis with a sample of 112 American and 74 Taiwanese participants to test the proposed relations. Results showed that both Taiwanese and Americans rated actors more favourably (i.e., as more powerful and trustworthy) when actors behaved according to filial ethics than when they did not. Some cross-cultural differences were also observed: Taiwanese attributed trust-traits to actors who performed filial practices to a larger degree than did Americans. We discuss implications for the implicit nature of filial relationships and conceptualization of power cross-culturally.
ABSTRACT Background: Among Asian/Pacific Islander (API) men who have sex with men (MSM), an epide... more ABSTRACT Background: Among Asian/Pacific Islander (API) men who have sex with men (MSM), an epidemiological conundrum exists whereby various levels of sexual risk-taking are matched with consistently low prevalence rates. The current study highlights how dimensions of racial and sexual identity made contentious by the gay male culture and degrading stereotypes (i.e., identity concerns) place API MSM at a disadvantage to affect sexual risk-taking behavior. The study employed a "daily diary" approach to obtain a contextualized look at how factors at multiple levels interact to impact daily risk behavior. Method: Recruitment efforts targeted community-based organizations, events, media forums, and word-of-mouth. A total of 117 API MSM met eligibility criteria to participate in a three-week, online daily diary study, of whom 58 (M age = 26.90, SD = 6.09) met minimum criteria for inclusion in final multilevel analyses. Dimensions of social identity and psychosocial needs were assessed at baseline and over time, and geographical social climate indices were obtained from the ANES and linked to participant zip code, representing participant's social milieu. Results: Results demonstrated (a) significant variability in daily stress, affiliation and sexual behaviors, and their relationships; (b) that identity concerns moderated the relationship between daily social affiliation and sexual risk-taking; and (c) that the degree of societal hostility toward Asians/gays/lesbians related meaningfully to identity dimensions. Discussion: This is the first daily process study aimed to provide a contextualized understanding of HIV-vulnerability with a racial and sexual minority group. A socio-ecological model of HIV-Risk for API MSM is discussed.
HIV-related data in Asian and Pacific Islander (A&PI) populations is scarce. A cross-sectional su... more HIV-related data in Asian and Pacific Islander (A&PI) populations is scarce. A cross-sectional survey was conducted as part of an intake process at a community-based health care organization in the Tenderloin, San Francisco area targeting A&PI individuals. Elective mobile HIV testing services were provided inside of a van parked by nightlife venue entrances. Self-Administered socio-behavioral risk questionnaires were completed during the wait period for rapid test results. The survey assessed HIV, TB, and Hepatitis testing behavior and status; sexual partnerships; HIV stigma; homo-negativity; HIV information burnout; sexual communication self-efficacy; race-based sexual preferences; social network websites and apps usage; and sources of information for health. A sample of 370 participants was recruited consisting primarily of young A&PI gay men (Mage = 26.19, SD = 6.09). Over 50% of the sample was born in the U.S. While a quarter of participants reported an annual household income o...
The increasing availability of studies from many nations offers important potential insights into... more The increasing availability of studies from many nations offers important potential insights into group-based psychology and behavior, conflict, and violence. Nonetheless, to date, few cross-national or cultural comparisons of study findings have been made, representing a gap in our understanding of the historical causes and courses of inter-group conflict in current comparative approaches. Meta-analytic methods offer researchers the ability to combine data from studies with groups as well as across time. Our review of statistical methods available for comparative analyses in inter-group research found strengths and limitations for understanding group differences, conflict, and violence, and meta-analytic methods address these limitations by exploring potential structural-level moderators and by identifying how temporal and geographical variations may relate directly to group-based variables. Such methods can contribute to our understanding of broad structural effects on group-based...
Background: Asia represents a vast and diverse region of the world where alarming indications for... more Background: Asia represents a vast and diverse region of the world where alarming indications for a growing HIV/AIDS epidemic have emerged in recent years. Despite the growing need for intervention research, relatively little is known about the success of HIV/AIDS interventions in Asia, and no comprehensive review of HIV/AIDS interventions in this region exists. The purpose of this study was to summarize the efficacy of sexual risk reduction interventions for the prevention of HIV infection in developing countries in Asia and the Pacific region. Methods: Sexual risk-reduction outcomes from 19 HIV intervention studies in a developing Asian nation available by August 2006 were quantitatively synthesized. A comprehensive search identified interventions (a) with either a control group or a pre-post design, (b) that measured a sexual risk reduction marker (e.g., condom use, number of sexual partners), and (c) were conducted in a country in the Asia Pacific region. Moderator analyses were...
Why do people want power? And what IS power? We argue that to encompass all the meanings of power... more Why do people want power? And what IS power? We argue that to encompass all the meanings of power, including efficacy, agency, dominance, influence, empowerment, that constructive power should be defined as the ability to meet one's survival needs, whereas destructive power hampers this ability. Power is a joint function of the organism and its environment. Further, we argue that there are distinct survival needs, and that each of these has a concomitant type of power. The need to be whole, for example, makes health a constructive form of power and violence a destructive form of power. The reason that different forms of power are all power, and are fundamentally social, is that through social transactions, people can use one kind of power to gain or lose others. Societal and psychological control mechanisms influence how much different forms of power are fungible. We present archival, experimental game, and cultural evidence as we introduce Power Basis Theory.
International journal of conflict and violence, 2010
The increasing availability of studies from many nations offers important potential insights into... more The increasing availability of studies from many nations offers important potential insights into group-based psychology and behavior, conflict, and violence. Nonetheless, to date, few cross-national or cultural comparisons of study findings have been made, representing a gap in our understanding of the historical causes and courses of intergroup conflict in current comparative approaches. Meta-analytic methods offer researchers the ability to combine data from studies with groups as well as across time. Our review of statistical methods available for comparative analyses in intergroup research found strengths and limitations for understanding group differences, conflict, and violence, and meta-analytic methods address these limitations by exploring potential structural-level moderators and by identifying how temporal and geographical variations may relate directly to group-based variables. Such methods can contribute to our understanding of broad structural effects on group-based v...
Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 2009
To evaluate cognitive-behavioral therapy to enhance medication adherence and reduce depression (C... more To evaluate cognitive-behavioral therapy to enhance medication adherence and reduce depression (CBT-AD) in individuals with HIV. A two arm, randomized, controlled, cross-over trial comparing CBT-AD to enhanced treatment as usual only (ETAU). ETAU, which both groups received, included a single-session intervention for adherence and a letter to the patient's provider documenting her or his continued depression. The intervention group also received 10 to 12 sessions of CBT-AD. Adherence to antiretroviral therapy as assessed by Medication Event Monitoring Systems (MEMs) and depression as assessed by blinded structured evaluation. At the acute outcome assessment (3-months), those who received CBT-AD evidenced significantly greater improvements in medication adherence and depression relative to the comparison group. Those who were originally assigned to the comparison group who chose to cross over to CBT-AD showed similar improvements in both depression and adherence outcomes. Treatme...
Shared decision making (SDM) is a model of patient-provider communication. Little is known about ... more Shared decision making (SDM) is a model of patient-provider communication. Little is known about the role of SDM in health disparities among Asian American and Pacific Islander (AAPI) sexual and gender minorities (SGM). We illustrate how issues at the intersection of AAPI and SGM identities affect SDM processes and health outcomes. We discuss experiences of AAPI SGM that are affected by AAPI heterogeneity, SGM stigma, multiple minority group identities, and sources of discrimination. Recommendations for clinical practice, research, policy, community development, and education are offered.
Background: There is increasing recognition of the prominent use of sexual self-labels within the... more Background: There is increasing recognition of the prominent use of sexual self-labels within the gay male community. However, little is known about the processes that orient such labeling, and the role that sexual attraction plays. The present study examined how sexual self-labeling relates to preference for social hierarchy and race-based sexual attraction in Asian/Pacific Islander (API) men who have sex with men (MSM). Method: A total of 138 API MSM(Mage=27.26, SD=6.05) were recruited to participate in a web-based study via online social networking sites, word-of-mouth, and at community events attended by API MSM. Measures assessed participants' preference for social hierarchy, or social dominance orientation (SDO; Pratto et al., 2004); race-based attraction; and sexual self-labels indicative of their anal sex role. Results: SDO varied significantly by sexual self-label: Self-identified tops preferred social hierarchy more so than self-identified bottoms and versatiles. SDO a...
P arent-child relationships are fundamental human relationships in which specific norms govern pr... more P arent-child relationships are fundamental human relationships in which specific norms govern proper parent-child interactions. Such norms, or filial ethics, have been observed in different cultures, including in the United States and Taiwan, but important differences may exist in how filial practices are viewed across cultures. From a traditional view of power as domination over others, if filial relationships are viewed to reflect power differentials between parents and children, actors who follow filial ethics should be viewed as less powerful than actors who do not follow filial ethics for maintaining or enhancing positive parent-child relationships. Alternatively, power can be conceptualized as the ability to meet one's needs (e.g., for communal care and trust), and actors who follow filial ethics should be viewed as more powerful and trustworthy than actors who do not follow filial ethics because they have the ability to maintain or enhance positive parent-child relationships. Based on a power-trust model, we compared American and Taiwanese perceptions of actors in an experiment using vignettes describing filial behaviours. We conducted a path analysis with a sample of 112 American and 74 Taiwanese participants to test the proposed relations. Results showed that both Taiwanese and Americans rated actors more favourably (i.e., as more powerful and trustworthy) when actors behaved according to filial ethics than when they did not. Some cross-cultural differences were also observed: Taiwanese attributed trust-traits to actors who performed filial practices to a larger degree than did Americans. We discuss implications for the implicit nature of filial relationships and conceptualization of power cross-culturally.
ABSTRACT Background: Among Asian/Pacific Islander (API) men who have sex with men (MSM), an epide... more ABSTRACT Background: Among Asian/Pacific Islander (API) men who have sex with men (MSM), an epidemiological conundrum exists whereby various levels of sexual risk-taking are matched with consistently low prevalence rates. The current study highlights how dimensions of racial and sexual identity made contentious by the gay male culture and degrading stereotypes (i.e., identity concerns) place API MSM at a disadvantage to affect sexual risk-taking behavior. The study employed a "daily diary" approach to obtain a contextualized look at how factors at multiple levels interact to impact daily risk behavior. Method: Recruitment efforts targeted community-based organizations, events, media forums, and word-of-mouth. A total of 117 API MSM met eligibility criteria to participate in a three-week, online daily diary study, of whom 58 (M age = 26.90, SD = 6.09) met minimum criteria for inclusion in final multilevel analyses. Dimensions of social identity and psychosocial needs were assessed at baseline and over time, and geographical social climate indices were obtained from the ANES and linked to participant zip code, representing participant's social milieu. Results: Results demonstrated (a) significant variability in daily stress, affiliation and sexual behaviors, and their relationships; (b) that identity concerns moderated the relationship between daily social affiliation and sexual risk-taking; and (c) that the degree of societal hostility toward Asians/gays/lesbians related meaningfully to identity dimensions. Discussion: This is the first daily process study aimed to provide a contextualized understanding of HIV-vulnerability with a racial and sexual minority group. A socio-ecological model of HIV-Risk for API MSM is discussed.
HIV-related data in Asian and Pacific Islander (A&PI) populations is scarce. A cross-sectional su... more HIV-related data in Asian and Pacific Islander (A&PI) populations is scarce. A cross-sectional survey was conducted as part of an intake process at a community-based health care organization in the Tenderloin, San Francisco area targeting A&PI individuals. Elective mobile HIV testing services were provided inside of a van parked by nightlife venue entrances. Self-Administered socio-behavioral risk questionnaires were completed during the wait period for rapid test results. The survey assessed HIV, TB, and Hepatitis testing behavior and status; sexual partnerships; HIV stigma; homo-negativity; HIV information burnout; sexual communication self-efficacy; race-based sexual preferences; social network websites and apps usage; and sources of information for health. A sample of 370 participants was recruited consisting primarily of young A&PI gay men (Mage = 26.19, SD = 6.09). Over 50% of the sample was born in the U.S. While a quarter of participants reported an annual household income o...
The increasing availability of studies from many nations offers important potential insights into... more The increasing availability of studies from many nations offers important potential insights into group-based psychology and behavior, conflict, and violence. Nonetheless, to date, few cross-national or cultural comparisons of study findings have been made, representing a gap in our understanding of the historical causes and courses of inter-group conflict in current comparative approaches. Meta-analytic methods offer researchers the ability to combine data from studies with groups as well as across time. Our review of statistical methods available for comparative analyses in inter-group research found strengths and limitations for understanding group differences, conflict, and violence, and meta-analytic methods address these limitations by exploring potential structural-level moderators and by identifying how temporal and geographical variations may relate directly to group-based variables. Such methods can contribute to our understanding of broad structural effects on group-based...
Background: Asia represents a vast and diverse region of the world where alarming indications for... more Background: Asia represents a vast and diverse region of the world where alarming indications for a growing HIV/AIDS epidemic have emerged in recent years. Despite the growing need for intervention research, relatively little is known about the success of HIV/AIDS interventions in Asia, and no comprehensive review of HIV/AIDS interventions in this region exists. The purpose of this study was to summarize the efficacy of sexual risk reduction interventions for the prevention of HIV infection in developing countries in Asia and the Pacific region. Methods: Sexual risk-reduction outcomes from 19 HIV intervention studies in a developing Asian nation available by August 2006 were quantitatively synthesized. A comprehensive search identified interventions (a) with either a control group or a pre-post design, (b) that measured a sexual risk reduction marker (e.g., condom use, number of sexual partners), and (c) were conducted in a country in the Asia Pacific region. Moderator analyses were...
Why do people want power? And what IS power? We argue that to encompass all the meanings of power... more Why do people want power? And what IS power? We argue that to encompass all the meanings of power, including efficacy, agency, dominance, influence, empowerment, that constructive power should be defined as the ability to meet one's survival needs, whereas destructive power hampers this ability. Power is a joint function of the organism and its environment. Further, we argue that there are distinct survival needs, and that each of these has a concomitant type of power. The need to be whole, for example, makes health a constructive form of power and violence a destructive form of power. The reason that different forms of power are all power, and are fundamentally social, is that through social transactions, people can use one kind of power to gain or lose others. Societal and psychological control mechanisms influence how much different forms of power are fungible. We present archival, experimental game, and cultural evidence as we introduce Power Basis Theory.
International journal of conflict and violence, 2010
The increasing availability of studies from many nations offers important potential insights into... more The increasing availability of studies from many nations offers important potential insights into group-based psychology and behavior, conflict, and violence. Nonetheless, to date, few cross-national or cultural comparisons of study findings have been made, representing a gap in our understanding of the historical causes and courses of intergroup conflict in current comparative approaches. Meta-analytic methods offer researchers the ability to combine data from studies with groups as well as across time. Our review of statistical methods available for comparative analyses in intergroup research found strengths and limitations for understanding group differences, conflict, and violence, and meta-analytic methods address these limitations by exploring potential structural-level moderators and by identifying how temporal and geographical variations may relate directly to group-based variables. Such methods can contribute to our understanding of broad structural effects on group-based v...
Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 2009
To evaluate cognitive-behavioral therapy to enhance medication adherence and reduce depression (C... more To evaluate cognitive-behavioral therapy to enhance medication adherence and reduce depression (CBT-AD) in individuals with HIV. A two arm, randomized, controlled, cross-over trial comparing CBT-AD to enhanced treatment as usual only (ETAU). ETAU, which both groups received, included a single-session intervention for adherence and a letter to the patient's provider documenting her or his continued depression. The intervention group also received 10 to 12 sessions of CBT-AD. Adherence to antiretroviral therapy as assessed by Medication Event Monitoring Systems (MEMs) and depression as assessed by blinded structured evaluation. At the acute outcome assessment (3-months), those who received CBT-AD evidenced significantly greater improvements in medication adherence and depression relative to the comparison group. Those who were originally assigned to the comparison group who chose to cross over to CBT-AD showed similar improvements in both depression and adherence outcomes. Treatme...
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Papers by Judy Tan