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- In pressGenerational Cohort and Social Capital in AI Adoption among Native-Born and Immigrant Adults in South KoreaYoo, N., & Jang, S.H.American Behavioral Scientist
- In pressDomain-Specific Patterns of Perceived AI Usefulness among North Korean Refugees and Native Koreans: A Latent Profile AnalysisYoo, N., Lee, J., & Jang, S.H.Journal of Psychology and AI
- In pressAgentic LLM to Improve Information Access for Refugees: A Field Report from a Resource-Constrained OrganizationYoo, N., & Kim, Y.EMNLP 2026 Workshop on NLP for Positive Impact
- In pressThe AI Therapist: ChatGPT Therapy Users at the Boundary of Human Therapy, Disillusionment, and AI Companionship on RedditYoo, N., & Chen, P.EMNLP 2026 Workshop on NLP for Positive Impact
- In pressDid Generative AI Narrow the Digital Divide for Immigrants in South Korea? A Difference-in-Differences Study, 2019-2023Yoo, N., & Jang, S.H.Telematics and Informatics
- In pressNot All Language Models Are Generative: A Methods Primer on Encoder Models in Social Work ResearchPerron, B., Stoll, D., Qi, Z., Yoo, N., & Ren, C.Journal of the Society for Social Work and Research
- In pressYoo, N., Saba, S., & Goldkind, L.Journal of Social Work EducationSocial work education faces a critical gap in preparing practitioners to engage with artificial intelligence (AI) technologies that increasingly mediate mental health service delivery. This teaching note presents lessons from designing and delivering a post-master's certificate program on AI in mental health practice within a university's continuing education division. Two instructors independently developed and taught courses to licensed practitioners (n = 30), focusing on foundational AI literacy, ethical reasoning, and hands-on engagement with AI tools. The analysis draws from recorded post-course conversations between instructors, supplemented by syllabi, teaching materials, and assignments. Lessons learned include the importance of balancing technical content with accessibility through clinical case examples and tool demonstrations, the effectiveness of experiential learning activities, and students' sustained interest in ethical and social justice dimensions of AI use. Challenges included determining the appropriate technical depth for social work audiences, managing rapid changes in AI development, and addressing implementation constraints across diverse practice settings. This teaching note discusses implications for integrating AI literacy across the Council on Social Work Education (CSWE) competencies, emphasizing the need to ground technical concepts in practice contexts, teach generalizable evaluation frameworks rather than tool-specific skills, and prepare social workers as critical evaluators and advocates in AI adoption decisions.
- In pressYoo, N., Ritchie, A., & Gwadz, M.Journal of Social Work EducationThis program evaluation examined the effectiveness of the Summer Institute in Computational Social Science (SICSS-X) program in developing computational skills among social work doctoral students and early-career researchers, while examining participants' perceptions of applying computational methods in social work. A mixed-methods approach was employed, utilizing pre- and post-program surveys (n=20) based on the Technology Acceptance Model to assess changes in self-reported computational knowledge, skills, perceived ease of use, self-efficacy, and computer anxiety. Additionally, focus group interviews (n=6) provided qualitative insights into participants' experiences and perspectives on computational social work science. Significant improvements were observed in perceived ease of use (d = 0.92, p = .003), computer anxiety (d = -0.74, p = .012), technological self-efficacy (d = 0.99, p = .002), and knowledge (d = 1.43, p < .001). Participants reported significant skill gains in web scraping, API use, data cleaning, and machine learning. Qualitative findings revealed the impact of generative AI tools, ethical considerations, methodological challenges, and institutional support needs. The SICSS-X program effectively enhanced participants' computational skills and reduced psychological barriers to engagement. Findings suggest that developing computational social work scientists requires integrating social work values with technical training, addressing data access challenges, and establishing supportive institutional ecosystems.
- 2026Yoo, N., & Gill, M.Journal of Racial and Ethnic Health Disparities DOIMental health workforce research treats South Asian Americans as a single group, yet they speak many mutually unintelligible languages, and language concordance shapes whether people with limited English proficiency (LEP) reach and stay in care. We measured the availability, geographic concentration, and affordability of psychotherapists listing eight South Asian languages. We analyzed 347,464 Psychology Today directory profiles (2025), identified providers listing Hindi, Urdu, Punjabi, Gujarati, Bengali, Tamil, Telugu, or Nepali, and linked counts to American Community Survey (2019-2023) speaker and LEP populations. We computed listed providers per 100,000 speakers and per 100,000 LEP speakers, supply-need alignment, geographic concentration, and payment acceptance and session price. Of all therapists, 2,310 (0.66%) listed a South Asian language; 59.4% of them listed two or more. Listed availability per 100,000 LEP speakers ranged from 1,160 for Hindi to 22.8 for Nepali, and per 100,000 all speakers from 213.7 to 7.6; provider shares were unevenly aligned with LEP shares (index of dissimilarity, 0.41). Of Nepali LEP speakers, 43.0% lived in a state with no provider listing Nepali, against 0.9% for Hindi, and the languages with the fewest listed providers had the largest LEP shares and most recent arrivals. Providers listing a South Asian language were more often out-of-network (adjusted odds ratio, 1.58; 95% CI, 1.31-1.92) and charged $3.90 more per session (95% CI, 1.16-6.64). Language differences in listed provider availability within the South Asian population are large and invisible in aggregated data, pointing to the need for disaggregated data systems, language-specific workforce development, and affordability policy.
- 2026Closing the Urban-Rural Gap in Access to Racially and Ethnically Focused Mental Health Providers: The Role of Telehealth and Interstate Licensing CompactsYoo, N., & Weaver, A.American Journal of Public Health DOI
- 2026Provider Experiences and Preferences for Integrating an Evidence-Based Mobile Health Application in Methadone Maintenance Treatment: A Mixed-Methods StudyO’Kelly, B., Sohail, P., Yoo, N., Zimmerman, H., Miller, P., Konova, A., Murphy, S., Glimcher, P., & Tofighi, B.Drug and Alcohol Review DOI
- 2026Language Access and Written Health Communication: Readability of Medicaid Notices of Action by Primary Language, 2021-2022Yoo, N.PEC Global DOI
- 2026Yoo, N.Health Services Research DOIObjective. To estimate how often immigrant adults are asked for a Social Security number or proof of citizenship to obtain care or enroll in school, who is asked for these documents, and whether being asked relates to health care access. Study Setting and Design. Cross-sectional analysis of four pooled waves (2019-2022) of a population-based, multilingual survey of California adults. The exposure was the documentation request; outcomes were lacking a usual source of care and delaying or forgoing care. Data Sources and Analytic Sample. California Health Interview Survey public-use files were used. The documentation item is asked only of foreign-born respondents, yielding 21,133 immigrant adults (15,313 naturalized, 5820 noncitizen). Survey-weighted logistic models with jackknife variance reported average marginal effects. Principal Findings. Overall, 15.7% (95% CI: 14.9-16.5) reported being asked. After adjustment, noncitizens were 5.3 percentage points more likely than naturalized citizens (3.5-7.1) and limited-English-proficient adults 5.8 points more likely (3.5-8.1) to be asked. Being asked was associated with delaying or forgoing care (6.1 points; 4.2-8.0) but not with lacking a usual source of care (0.2 points; -1.9 to 2.3). Conclusions. Documentation requests were common, concentrated among noncitizen and limited-English-proficient immigrants, and associated with forgone care. The cross-sectional design cannot establish causation.
- 2026Yoo, N., & Jang, S.H.International Journal of Human-Computer Interaction DOIPerformance expectancy, individuals’ beliefs about the usefulness of digital transformation, could impact individuals’ intention, use, and satisfaction with technologies, yet remains an understudied topic among immigrant populations. Drawing on social capital theory, we examine how bonding and bridging social capital shape performance expectancy across different domains of digital transformation and whether these associations differ by nativity status. Using the 2022 Digital Divide Survey (N = 8,400; 7,000 native South Koreans, 700 marriage immigrants, 700 North Korean migrants), regression analyses showed that bridging social capital had positive associations with performance expectancy (b ranging from 0.43 to 0.62, p < 0.001), whereas bonding social capital was negative, particularly for networking (b = -0.09, p < 0.001) and remote work/learning (b = -0.08, p < 0.001). North Korean migrants reported the highest adjusted means of performance expectancy across all domains. Results highlight that diverse social networks generate greater perceived benefits from digital transformation.
- 2026The Role of Queer People of Colour Identity Affirmation on Psychological Flexibility amid Everyday Discrimination among Black Sexual and Gender Minority AdultsKeene, L., Maglalang, D. D., Yoo, N., & Ramos Deulofeutt, S.Psychology & Sexuality DOI
- 2026Yoo, N., Lee, J., & Jang, S.H.Journal of Ethnic and Migration Studies DOIDuring the COVID-19 pandemic, digital government platforms became a key channel for accessing health information and social support, raising questions about how refugees engage with essential resources during crises. This study examines how North Korean refugees and native-born South Koreans differed in awareness, use, and perceived usefulness of COVID-19 e-government services, and whether use was associated with subjective well-being. Using 2022 Digital Divide Survey data from South Korea (N=7,700; native-born=7,000; refugees=700), we compared outcomes for administrative application services and information services using multivariable regression and propensity score matching, adjusting for sociodemographic and digital access factors. After adjustment, refugees reported higher awareness, utilisation, and perceived usefulness of both service types. After matching, differences in awareness and overall usage change diminished, while higher utilisation of application services and higher perceived usefulness of information services (ATT=0.108) persisted. Well-being associations differed by group: among native-born Koreans, application service use was positively associated with well-being, whereas among refugees, information service use was positively associated with well-being. These findings are consistent with digital inclusion perspectives emphasising the value of informational resources for populations with limited alternative information channels and suggest that e-government returns depend on service type and user context.
- 2026Yoo, N., Kim, D., Jang, S. H., & Fong, E.International Migration Review DOIIn contemporary migration studies, online forums are common spaces where people exchange information and seek advice about international migration. This methods note introduces the Reddit community r/IWantOut as a data source for studying migration aspirations and presents a validated natural language processing (NLP) pipeline for analyzing it. The forum's community rules require posters to encode age, gender, origin, and intended destinations in a fixed title format, so users label their own migration aspirations in a semi-machine-readable form when they post. Using 156,313 submissions from 2009 to 2026 (58,892 after cleaning), we demonstrate three analytical approaches: (1) time-series analysis to identify temporal shifts in discourse volume, (2) dictionary- and rule-based extraction, together with Named Entity Recognition (NER), to recover origin-destination pairs and sociodemographic attributes from the structured titles, and (3) Large Language Model (LLM)-based zero-shot classification, used only for classifying migration motivations. Validation against human-coded labels across three LLMs (GPT-4.1, Claude-3.5-Sonnet, and DeepSeek-V3) showed that GPT-4.1 achieved the highest agreement (mean κ = 0.566), with substantial agreement on push factors, moderate agreement on pull and enabling factors, and fair agreement on constraining factors. Applying this approach to 56,242 international migration posts, we found that enabling factors (individual-level resources) appeared most frequently (77.3%), followed by constraining factors (49.3%), pull factors (37.2%), and push factors (23.6%). For each method, we provide practical guidance on implementation, data access, and validation, and reflect on methodological limitations and ethical considerations.
- 2026Yoo, N., Khor, A., Mukhija, N., Adebiyi, A., & Zilka, M.Proceedings of the Workshop on Evaluating Evaluations (EvalEval) DOIAI ethics guidelines for humanitarian settings have grown in number and scope. Whether they produce their intended outcomes depends on which deployers are expected to follow them. These guidelines respond to documented risks: surveillance, data misuse, and discriminatory outcomes affecting refugee populations. For high-risk applications such as biometric identification and asylum adjudication, the concerns they address are genuine. Many differentiate risk tiers in principle, yet the compliance expectations they establish (staff capacity, technical infrastructure, formal evaluation) reflect the organizational contexts in which they were developed. Many nonprofits providing frontline services to refugees operate with limited administrative capacity. When compliance requirements exceed what these organizations can meet, formal AI adoption stalls, while informal adoption proceeds without oversight or recourse. Current guidelines also tend to treat non-adoption as a neutral default, without accounting for the service gaps that follow when AI-assisted language access is unavailable. Drawing on collaboration with refugee-serving practitioners, we show that this gap between governance design and organizational reality has consequences for the people these guidelines are meant to protect. Evaluating AI guidelines, we argue, requires the same realist logic that evaluation research has long applied to social programs: not "does this guideline exist?" but "for which deployers, under what conditions, and does it produce its intended protective outcomes?"
- 2026Maglalang, D.D., Yoo, N., Park, M., Nicholson, H. L. Jr., de Leon, C., Okazaki, S., Chang, D.F.Journal of Racial and Ethnic Health Disparities DOIThe COVID-19 pandemic was accompanied by a surge in anti-Asian racial discrimination in the United States. To date, there has not been a study that examined the role of gender among Asian Americans (AAs) during the pandemic and its associations with racial discrimination and substance use. This study examined the relationship between COVID-19-related discrimination and substance use behaviors among AAs and investigated the moderating role of gender. We used survey data from N = 1,052 AA Chinese, Filipino/a/x, and South Asian adults (Mage = 36.58, women = 69%) collected in May 2022. COVID-19-related discrimination was measured across three dimensions: direct overt-, direct subtle-, and vicarious discrimination. Substance use outcomes included past-year frequency of alcohol, tobacco/nicotine, cannabis, and other illicit substance use. Ordinal logistic regression models examined main effects and gender interactions. Overall, COVID-19 racial discrimination was significantly associated with increased odds of all substance use: alcohol (OR = 1.72), tobacco/nicotine (OR = 1.77), cannabis (OR = 1.85), and other illicit substances (OR = 2.88). Direct overt discrimination demonstrated the strongest associations across all substances. Gender significantly moderated the discrimination-substance use relationship for alcohol and cannabis, with men showing stronger associations (alcohol interaction OR = 1.46; cannabis interaction OR = 1.68). Marginal effects revealed that men experienced consistently larger probability increases in substance use across all discrimination types compared to women. COVID-19-related racial discrimination is robustly associated with substance use among AAs, with AA men demonstrating particular vulnerability to alcohol and cannabis use following discriminatory experiences. Results underscore the need for gender-specific, culturally tailored interventions addressing discrimination-related substance use in AA populations.
- 2026Youm, S., Yoo, N., Jang, S.H., & Dorr, B.Digital Minds Workshop at ICWSM 2026 DOIStudies on intergenerational relationships between parents and children in Asian American families highlight their impact on mental health and well-being. This study investigates the role of ambivalent emotions in online narratives shared by Asian and Asian American children on the subreddit, r/Asianparentstories. By employing a BERT-based model to detect emotions at the sentence level and depressive symptoms at the post level, we examine how mixed feelings relate to depressive symptoms. First, among 28 detectable emotions, eight (realization, approval, sadness, anger, curiosity, annoyance, disappointment, disapproval) comprise over 50%; these eight emotions frequently co-occur with one another and with less common emotions. Second, we find the co-occurrence of multiple emotions, showing that individual posts contain combinations of positive and negative emotions rather than exclusively positive or negative affect. Finally, our findings indicate that emotion pairs involving at least one negative emotion (e.g., nervousness-remorse and annoyance-relief) are more strongly associated with depressive symptoms, whereas emotion pairs that do not include negative emotions show mixed associations with depressive symptoms. These findings demonstrate the value of computational emotion classification and the need to account for emotional ambivalence when studying parent-child relationship dynamics and mental health.
- 2026Yoo, N., & Jang, S.H.Computers in Human Behavior Reports DOIUse of AI for mental health support is rising faster than the clinical evidence supporting it, yet individual-level predictors of acceptance remain poorly understood. The Technology Acceptance Model's core constructs do not capture domain-specific concerns about care quality, safety, equity, and the therapeutic relationship that influence how people evaluate AI in healthcare contexts. Using nationally representative data from the Pew Research Center's American Trends Panel (N = 4,874), this study examined nativity-based differences in willingness to use an AI mental health chatbot and the extent to which perceived impact of AI in healthcare accounts for these differences. Foreign-born adults were 37% more willing than US-born adults (OR = 1.37, p = .009) after adjusting for demographics, technology experience, and survey language. Five measures of perceived impact (care quality, medical mistakes, patient-provider relationships, racial and ethnic equity, and data security)were jointly associated with willingness after adjusting for other covariates (p < .001), and their inclusion reduced the nativity coefficient to marginal significance (OR = 1.24, p = .096). Karlson-Holm-Breen decomposition indicated that approximately 34% of the sample nativity difference was associated with group variation in perceived impact, with care quality and patient-provider relationship expectations contributing to the largest shares. Among foreign-born adults, those with 11–20 years of U.S. residence were the most willing (OR = 2.04, p = .007), while those with 21+ years were comparable to US-born adults. These findings suggest that immigrant populations' greater openness is partly associated with differences in how they evaluate AI's consequences for care quality, equity, and the therapeutic relationship.
- 2026Yoo, N., Rodwin, A., Park, M., Youm, S. & Jang, S. H.JMIR Infodemiology DOIThe global rise of K-pop, particularly the influence of BTS-a South Korean boy band with over 90 million international fans known as ARMY-has shaped youth culture and online communities. Music fandoms are increasingly engaging digital platforms like YouTube not only for entertainment but also as spaces for emotional expression and mutual support. Despite growing interest in the mental health potential of music-based coping strategies, limited research has examined how fandom cultures differentially express emotional needs and supportive interactions online. This study investigates specific mental health language patterns and coping mechanisms expressed by BTS fans in online spaces, examining how different linguistic features (including self-referential language and emotional expression patterns) may reflect psychological states and mental health needs. We utilize YouTube comments of fan-curated "sad" playlists of BTS. We further included YouTube comments from a Taylor Swift "sad" playlist as a reference group. The analysis aims to identify linguistic and emotional expression patterns in BTS fan comments and examine the potential mental health implications of music engagement in digital communities. Using Natural Language Processing (NLP) and Linguistic Inquiry and Word Count (LIWC), we analyzed a total of 13,224 YouTube comments-11,772 comments on a BTS "sad playlist" video and 1,452 comments on a Taylor Swift equivalent. Statistical comparisons were conducted to evaluate differences in comment length, word count, pronoun use, and emotional valence. Representative comments were examined to contextualize the emotion classification results. BTS comments were significantly longer (M = 253.38 words) and had higher word counts (M = 38.93) compared to Taylor Swift comments (M = 89.84 words, M = 16.08), p < .001. BTS fans used more first-person singular pronouns (10.24% vs. 7.43%) and expressed greater sadness (19.8% vs. 7.0%). In contrast, Taylor Swift fans exhibited higher admiration (8.0% vs. 5.0%). Among reply comments, BTS fans demonstrated more caring (7.5% vs. 2.0%), gratitude (9.1% vs. 4.2%), and optimism (5.0% vs. 1.7%). Linguistic analysis also revealed a broader international user base for BTS, including higher proportions of Spanish (6.11%) and Portuguese (1.89%) comments. Examination of comment content showed that fans used these spaces to disclose personal struggles, express gratitude for the community, and offer peer support, with many describing the fandom as a safe space for emotional expression they could not access elsewhere. The findings underscore the significant role that music and fan communities-particularly BTS fandom-play in fostering emotional expression, mutual care, and informal mental health support online. These results suggest implications for culturally responsive, community-based, and digitally mediated mental health interventions among youth and global populations.
- 2026Yoo, N., Kang, M., Kim, E., Lee, S. Y., Woo, J., & Kim, S. Y.Journal of Religion and Health DOIAbstract Asian Americans underutilize mental health services, with particularly low rates among Korean American (KA) immigrants. Churches serve as central sources of support in this community, positioning clergy as critical mental health gatekeepers. Yet little is known about the factors shaping KA church leaders’ readiness, perceptions, and referral behaviors. This study analyzed survey data from 93 KA church leaders across the USA to explore factors associated with readiness (comfort addressing mental health), perceptions of issues and barriers, and the action of recommending professional counseling. Using multiple regressions, we found that prior mental health training was the only significant predictor of leader readiness, with trained leaders nearly three times more likely to report higher comfort levels (OR = 2.97, p < 0.05). Perceptions of church needs varied by ministry context and personal experience: Leaders with mental health training were over six times more likely to recognize depression and suicide as key concerns (OR = 6.71, p < 0.01) and more than twice as likely to identify marriage conflict (OR = 3.11, p < 0.05). In contrast, leaders who had personally received counseling were significantly less likely to report depression and suicide as a congregational issue (OR = 0.23, p < 0.05). In the integrative model, referral behavior was shaped primarily by ministry context and stigma awareness. Leaders in Korean-speaking ministries were significantly less likely to recommend counseling (OR = 0.02, p < 0.05), while those who identified stigma as a major issue were substantially more likely to make referrals (OR = 9.50, p < 0.05). These findings highlight the central role of training, bicultural ministry contexts, and stigma recognition in shaping church leaders’ engagement with mental health. The study underscores the need for culturally adapted training programs and closer collaboration between mental health professionals and immigrant churches to address persistent disparities in KA communities.
- 2026Yoo, N., Kang, M., Lee, S. Y., Na, J. Y., Woo, J., & Kim, S. Y.Pastoral Psychology DOIAbstract Korean Americans experience elevated depression and distress yet remain underserved due to structural, cultural, and linguistic barriers. Because churches are primary sources of support, church leaders often serve as critical gatekeepers but frequently lack formal training. This mixed methods study evaluated a 7-week online mental health training program tailored for Korean American church leaders. Participants ( N = 79; two cohorts) completed pre-training surveys; 48 completed post-training surveys. Fixed-effects panel regressions estimated within-person change. Outcomes included self-reported mental health knowledge (four items; α = .85), behavioral intentions/action (five items; α = .86), and confidence across topic areas (eight items; α = .94). Models showed significant gains in knowledge ( b = 0.69, p < .001), action ( b = 0.55, p < .001), and confidence ( b = 0.78, p <.001); 17 of 18 items improved. Multiple regression analysis of change scores among complete cases ( n = 46) revealed larger gains for participants with lower baseline scores ( p < .001). Serving in a medium-sized congregation (100–500 members) predicted greater improvement in action ( b = 0.36, p < .05) and knowledge ( b = 0.37, p <.05); serving in an English-speaking ministry predicted additional knowledge gains ( b = 0.35, p < .05). Qualitative analysis (56 pre-training responses, 22 post-training responses) showed a shift from general needs for foundations, tools, and referrals to specific plans for educating leadership, creating ministries/teams, formalizing referral resources, and modeling openness. The findings suggest that culturally tailored, online gatekeeper training can strengthen mental health capacity within faith communities and may be especially effective in medium-sized congregations and English ministry contexts.
- 2026Na, S., Solomon, P., & Yoo, N.Journal of Racial and Ethnic Health Disparities DOIAbstract This study examined whether the presence of Asian language-speaking mental health providers increases patient volume among Asian Americans in mental health facilities and whether this relationship is moderated by state-level Medicaid spending per capita. Data were drawn from national facility-level surveys conducted by SAMHSA between 2019 and 2023 (N = 265,395), supplemented with state-level Medicaid spending data from the Kaiser Family Foundation and demographic estimates from the American Community Survey. An instrumental variable approach was used to estimate the effect of Asian language-speaking staff on the number of Asian patients served, addressing potential endogeneity. To assess moderation by Medicaid spending, multilevel modeling with a cross-level interaction was conducted, accounting for clustering of facilities within states. Instrumental variable regression showed facilities with Asian language-speaking staff served significantly more Asian patients (B = 2.92, p < .001). The Hausman test supported IV estimation, and the Anderson-Rubin test confirmed robustness. Multilevel modeling revealed a significant interaction between Medicaid spending per capita and the presence of Asian language-speaking staff (B = 0.028, SE = 0.010, p < .01). Asian language-speaking providers play a significant role in increasing patient volume among Asian American patients. These findings underscore the importance of language-accessible mental health care in improving access for populations with limited English language proficiency. Moreover, results from the moderation analysis suggest this effect is amplified in states with greater Medicaid investment, highlighting the combined importance of workforce diversity and structural funding in reducing racial and linguistic disparities in behavioral health care for Asian American communities.
- 2026Mannan, N., Monir, A., Mishra, S., Li, S., Yoo, N., & Ahmed, N.Journal of Community Health DOISouth Asian immigrants in Southeast Queens County, New York City face healthcare, housing, and digital access challenges shaped by English proficiency. Despite community growth, data remains limited. This assessment examines English proficiency as a social determinant of health. A mixed-methods study was conducted across nine ZIP codes in Southeast Queens County, New York City. From August 1-October 31, 2023, the quantitative phase included a multilingual survey (English, Bengali, Hindi) that reached 395 South Asian participants, covering demographics, living conditions, food security, safety, mental health, and digital literacy. The qualitative phase (December 2023-March 2024), guided by IDEO's Human-Centered Design, included five interviews and a focus group. Analysis revealed significant disparities between Limited English Proficiency (LEP, n = 288) and non-LEP (n = 107) individuals. LEP respondents reported more housing issues, especially pest infestations (91.1% vs. 82.4%, p = 0.042), and lower homeownership (19.1% vs. 34.6%, p = 0.031). Computer literacy was lower among LEP individuals (50.6% vs. 80.8%, p < 0.001), though internet access was high in both groups (87.0% for LEP vs. 91.4% for non-LEP, p = 0.24). Housing instability persisted, with a greater share of LEP participants renting (70.6% vs. 56.4%, p = 0.031). This assessment highlights how language proficiency shapes social determinants of health for South Asian immigrants in Southeast Queens County, New York City. LEP individuals faced more housing, food, safety, and digital literacy challenges, underscoring the need for language-accessible, culturally tailored services.
- 2026Park, M., Jeong, E., Yoo, N., Choi, Y., Cabassa, L. J., Yasui, M., & Takeuchi, D.American Journal of Community Psychology DOIAbstract Despite the heightened mental health challenges amid rising Anti‐Asian sentiment, Asian Americans have significantly underutilized mental health services, a trend that persisted even before the COVID‐19 pandemic. Although considerable efforts have been made to understand how various factors are related to mental health service use in this population, research integrating these multiple factors in a single study, with a specific focus on ethnic disaggregation, remains limited. Using a cross‐sectional Study of Filipino and Korean American young adults ( M age = 21.37, US‐born = 65.03%), we examined the combined impact of individual, familial, and ethnic‐cultural, immigrant, and racial stereotype factors on their mental health service utilization through hierarchical logistic regressions. Depressive symptoms, being female, and less stigma associated with mental health care were significantly associated with more service use regardless of ethnicity. Notably, primarily speaking English or both English and ethnic language equally at home (as opposed to an ethnic language) was significantly associated with more service use among US‐born Filipino Americans. Conversely, the internalized model minority stereotype was significantly associated with less service use among Korean Americans. This study underscores the importance of developing effective mental health interventions tailored to both shared and unique determinants within diverse Asian American populations.
- 2026Baslock, D. & Yoo, N.The Milbank Quarterly DOIPolicy Points Single indicators such as rural population percentage can misrepresent a state's rural character, leading to flawed policy comparisons and resource allocation. This study introduces a multidimensional rurality index that combines population share, land area, and population density to create a more comprehensive ranking of US states. Policymakers and researchers can use this index to better identify and compare states with similar rural profiles (e.g., Mountain West vs. Northeast), enabling more targeted and effective rural health policies and research. Context Inadequate descriptions of rurality limit comparisons across rural areas and can lead to overgeneralizations in health policy research. Single indicators of state‐level rurality, such as rural population percentage or population density, are often used in isolation and fail to capture the multidimensional nature of rural character, obscuring important differences among states. A more holistic measure is needed to inform research on health care access, quality, and health disparities. Methods This study developed a composite state‐level rurality index for the 50 US states for three indicators: rural population percentage, rural land area percentage, and rural population density. We used Borda count and dominance count ranking methods to integrate these indicators into a final ranking. Principal component analysis (PCA) was then used to visualize the data and identify states with similar profiles. Findings Mountain West states, including Alaska, Montana, and Wyoming, ranked highest in multidimensional rurality. States traditionally considered highly rural based on a single indicator, such as Vermont and Maine (owing to high rural population share), exhibited rural profiles more similar to states such as Mississippi and Arkansas. The PCA visually distinguished between states with land‐based rurality (e.g., vast, sparsely populated areas) and those with population‐based rurality (e.g., high proportion of residents in rural towns). Conclusions This multidimensional index provides a tool for health policy research, facilitating more targeted and meaningful comparisons among rural states. It can help guide the study of health care infrastructure, workforce challenges, and health equity by moving beyond less nuanced classifications and highlighting the diverse forms of rurality across the United States.
- 2026Nicholson, H., Yoo, N., Okazaki, S., Chang, D.F., & Craig, M.Social Problems DOIAbstract Rising anti-Asian racism and the recent police killings of unarmed Black people have called attention to how Asian and Black Americans experience racism and how they perceive one another. Using data from a recent national sample of Asian (n = 1078) and Black Americans (n = 367), we explored socio-demographic (demographic, socioeconomic, political, and immigration) as well as group-relevant predictors of intergroup attitudes between Asian and Black Americans. Measures of intergroup attitudes included feelings of warmth and negative outgroup sentiment. Regression analyses showed that income, educational attainment level, employment status, immigration status, gender, age, ethnicity, political ideology, and political party affiliation were significant socio-demographic predictors of Asian Americans’ attitudes toward Black Americans. In contrast, only age and ethnicity emerged as significant socio-demographic predictors of Black Americans’ attitudes toward Asian Americans. The explanatory power of beliefs about group relations–such as endorsement of zero-sum, nationalist, and oppressed minority ideologies–as well as the degree of intergroup contact was quite strong for predicting intergroup attitudes for both groups. The findings reveal the complexity behind Asian-Black intergroup dynamics and highlight pathways and barriers toward cultivating more positive attitudes and intergroup relations.
- 2026Chang, D.F., Doucet, F., Whitney, J., Miao, I.Y., Yoo, N., Zwerger, N., Kaplan, J., Antoine, C., & Romano, L.Mindfulness DOIObjectives Racial disparities in education have driven efforts to train teachers in culturally-sustaining pedagogies (CSPs); however, implementation is often hindered by bias, emotional reactivity, and avoidance. We present the development and pilot randomized controlled trial of Mindfulness-Based Critical Consciousness Training for Teachers (MBCC-T), which integrates mindfulness to address the cognitive, emotional, and interpersonal barriers to training in critical consciousness (CC) and CSPs. Method Across two years, 108 K-5 teachers were randomized to MBCC-T or an active control: mindfulness training or CC training alone. Year 1 data from the two control groups guided the development of MBCC-T. In Year 2, we evaluated the feasibility (completion rate, practice compliance), acceptability (attitude, perceived effectiveness, self-efficacy, intervention coherence), and preliminary effectiveness (multicultural teaching competence, implicit bias, mindfulness in teaching, self-compassion) of MBCC-T relative to CC training alone. Results Completion rates were higher in MBCC-T (80.76%) compared to controls (42.31%-60.86%). MBCC-T participants practiced mindfulness ~ 3 days/week (∼50 min), with 73.68% intending to continue meditation. Acceptability ratings were high, and the MBCC-T group showed greater improvements in multicultural teaching competence compared to CC training alone, with a significant effect for the Knowledge subscale (B = 0.44, p < 0.05) in particular. No other between-group differences were observed; however, teacher race and meditator status moderated the effects of MBCC-T on study outcomes. Conclusions Results provide promising evidence of the feasibility and acceptability of MBCC-T. Additional research is needed to fully evaluate its effects on teacher attitudes, skills, and behaviors.
- 2025Yoo, N., Park, M., & Chang, D.F.Journal of the Society for Social Work and Research DOIObjective: Racial and ethnic disparities in mental health service utilization highlight the need for a social work workforce aligned with community needs, but there is limited evidence on where such mismatches occur and which populations are underserved. This study explores (a) how computational methods can be used to assess the racial, ethnic, and linguistic diversity of the U.S. clinical social work workforce; (b) the geographic distribution of clinical social workers from different racial, ethnic, and linguistic backgrounds; and (c) how this distribution aligns with population-level needs for racially/ethnically and linguistically concordant providers. Method: We leveraged the following computational methods to analyze data from 388,471 clinical social workers in the National Provider Identifier Registry and 107,050 private practice clinical social workers from Psychology Today: (a) application programming interface and web scraping to build a population-level dataset; (b) machine learning to predict race, ethnicity, and diasporic origin of social workers; and (c) geospatial analysis to explore spatial distribution of accessibility. Results: Our analyses revealed significant geographic disparities in access to diverse providers. Conclusions: Computational and geospatial methods can identify patterns related to racial and ethnic inequities in service accessibility, providing foundational evidence to inform structural reforms for creating a more inclusive and culturally diverse clinical social work profession.
- 2025Yoo, N., Hong, Y., & Choi, Y.Telemedicine Reports DOIBackground: This study examined disparities in telehealth utilization across various health care services among adults in California, with particular focus on racial, ethnic, and linguistic differences. While telehealth has emerged as a potential tool for addressing health care disparities, evidence suggests that utilization patterns may exacerbate existing inequities. Methods: Using the 2021–2022 California Health Interview Survey (n = 45,893) conducted in diverse languages, we employed descriptive statistics and nonlinear Blinder–Oaxaca decomposition to analyze disparities in telehealth utilization. The Blinder–Oaxaca method systematically partitions outcome differences between groups into explained components and unexplained components. We stratified analyses by visit purpose: mental health, primary care, acute care, chronic care, orthopedics, dermatology, and ophthalmology. Results: Compared with non-Hispanic Whites, African Americans used telehealth 4.1% more ( p < 0.01), whereas Hispanics/Latinos and Asians used it 5.9% ( p < 0.01) and 11.3% ( p < 0.01) less, respectively. For Hispanics/Latinos, approximately 14% of the disparity remained unexplained by measured covariates, while for Asians, 92% was unexplained ( p < 0.01). Individuals with limited English proficiency (LEP) were 9.6% ( p < 0.01) less likely to use telehealth overall, with 38% of this gap unexplained by measured factors ( p < 0.01). The disparity was most pronounced in mental health services, where LEP individuals utilized telehealth 4.9% points less than non-LEP individuals ( p < 0.01), with this gap entirely unexplained by sociodemographic factors. Subgroup analysis revealed telehealth utilization disparities between LEP and non-LEP individuals across all language groups, with LEP Spanish speakers using telehealth 4.3% points less than non-LEP Spanish speakers ( p < 0.01), LEP Asian language speakers using it 7.3% points less than non-LEP Asian language speakers ( p < 0.01), and LEP speakers of other languages using it 7.3% points less than their non-LEP counterparts ( p < 0.01). Discussion: Our findings reveal significant disparities in telehealth utilization associated with race/ethnicity and English proficiency levels, with linguistic barriers most evident in mental health services. The substantial unexplained components in our decomposition analyses suggest that cultural, structural, and linguistic factors beyond socioeconomic factors significantly influence telehealth utilization. These results underscore the need for efforts to develop linguistically appropriate telehealth services, particularly in mental health care. Addressing these barriers is crucial for harnessing telehealth’s potential to promote health equity rather than exacerbating existing health disparities in an increasingly digital health care environment.
- 2025Yoo, N. & Jang, S.H.Journal of Ethnicity in Substance Abuse DOISecondhand smoke is understudied among immigrants in Korea. We examined the impact of smoking rates in the parents' countries of origin on secondhand smoke exposure at home and adolescents' physical and mental health, focusing on immigrant-origin status. Further, we explored the social and environmental determinants of secondhan smoke exposure. Data from the 2021 Korea Youth Risk Behavior Web-based Survey involving 38,690 middle and high school students were used. The relationships between tobacco smoking rates in parents' countries of origin, secondhand smoke exposure, and adolescents' physical and mental health were assessed using multivariable linear regression and generalized structural equation modeling. Immigrant-origin youths reported significantly higher secondhand smoke exposure (M = 1.09, SD = 2.08) than non-immigrant youths (M = 0.85, SD = 1.89, p < 0.001), which directly correlated with their poor physical and mental health. Smoking rates in fathers' countries of origin showed significant indirect effects on physical (β=-0.326) and mental health (anxiety: β = 3.906; distress: β = 0.723, and depression: OR = 1.436) via fathers' smoking behaviors. Adolescents with low subjective socioeconomic status, low academic achievement, and residing outside the Seoul metropolitan area were more vulnerable to physical and mental health problems. Therefore, culturally informed and sex-specific interventions are required to improve the well-being of vulnerable adolescents from immigrant families.
- 2024Yoo, N., & Jang, S.H.Cyberpsychology, Behavior, and Social Networking DOIThe ability and self-efficacy to utilize the internet and technological devices has become critical during the COVID-19 pandemic. By examining the role of on- and offline social capital as a moderator in the relationship between technological self-efficacy (TSE) and subjective well-being, this study aims to contribute to the understanding of whether the social compensation or social enhancement hypotheses explain the well-being of immigrants in South Korea during the COVID-19 pandemic. We analyzed data from the 2020 Digital Divide Survey of immigrants ( n = 700) and native-born Koreans ( n = 6,910) aged ≥18 years. In the ordinary least squares regression model, subjective well-being (SWB) was the dependent variable and TSE was the independent variable. Online social capital, including bonding and bridging, was the moderating variable. Moreover, we tested the moderated moderation of nativity and on- and offline social capital. The results showed that bonding and bridging on- and offline social capital played a positive role in the SWB of both immigrants and native-born Koreans; bridging played a greater role among immigrants than among native-born Koreans. Furthermore, the interaction between TSE and online bonding social capital has a stronger association with the SWB of immigrants, as supported by the moderated moderation model. In line with the social enhancement hypothesis, immigrants with more online bonding social capital showed a stronger positive association between TSE and subjective well-being. Our results suggest that culturally adapted technological education for immigrants can be tailored to meet their unique needs and experiences.
- 2024Stanhope, V., Yoo, N., Matthews, E., Baslock, D., & Hu, Y.JMIR Medical Informatics DOIAbstract Background Collaborative documentation (CD) is a behavioral health practice involving shared writing of clinic visit notes by providers and consumers. Despite widespread dissemination of CD, research on its effectiveness or impact on person-centered care (PCC) has been limited. Principles of PCC planning, a recovery-based approach to service planning that operationalizes PCC, can inform the measurement of person-centeredness within clinical documentation. Objective This study aims to use the clinical informatics approach of natural language processing (NLP) to examine the impact of CD on person-centeredness in clinic visit notes. Using a dictionary-based approach, this study conducts a textual analysis of clinic notes from a community mental health center before and after staff were trained in CD. Methods This study used visit notes (n=1981) from 10 providers in a community mental health center 6 months before and after training in CD. LIWC-22 was used to assess all notes using the Linguistic Inquiry and Word Count (LIWC) dictionary, which categorizes over 5000 linguistic and psychological words. Twelve LIWC categories were selected and mapped onto PCC planning principles through the consensus of 3 domain experts. The LIWC-22 contextualizer was used to extract sentence fragments from notes corresponding to LIWC categories. Then, fixed-effects modeling was used to identify differences in notes before and after CD training while accounting for nesting within the provider. Results Sentence fragments identified by the contextualizing process illustrated how visit notes demonstrated PCC. The fixed effects analysis found a significant positive shift toward person-centeredness; this was observed in 6 of the selected LIWC categories post CD. Specifically, there was a notable increase in words associated with achievement (β=.774, P <.001), power (β=.831, P <.001), money (β=.204, P <.001), physical health (β=.427, P =.03), while leisure words decreased (β=−.166, P =.002). Conclusions By using a dictionary-based approach, the study identified how CD might influence the integration of PCC principles within clinical notes. Although the results were mixed, the findings highlight the potential effectiveness of CD in enhancing person-centeredness in clinic notes. By leveraging NLP techniques, this research illuminated the value of narrative clinical notes in assessing the quality of care in behavioral health contexts. These findings underscore the promise of NLP for quality assurance in health care settings and emphasize the need for refining algorithms to more accurately measure PCC.
- 2024Yoo, N., Matthews, E., Baslock, D. & Stanhope, V.Psychiatric Services DOIThis study aimed to examine differences in community mental health visit notes before and after initiation of collaborative documentation, a practice in which clinicians and consumers jointly document clinical encounters. Using a clinical informatics approach, the authors sampled visit notes (N=1,875) from nine providers in one mental health clinic. The authors compared notes from before and after the implementation of collaborative documentation by using fixed-effects regression models, controlling for therapist-level effects. Significant changes in visit note structure were found after the implementation of collaborative documentation. Most sections (N=6 of 10) contained more information (i.e., higher word and character counts) after collaborative documentation implementation, but sections describing a client's feelings were less likely to have any content (OR=0.01, p<0.001). These findings demonstrate that collaborative documentation influences clinical notes, providing much-needed research about a widely adopted practice in community mental health settings.
- 2024Yoo, N., Choi, Y. & Hong, Y.International Journal of Adolescence and Youth DOIThe COVID-19 pandemic increased the burden due to school closures and stay-at-home orders, disrupting the community energy balance. This study examines rising obesity trends among Korean adolescents during school closures, focusing on gender differences and immigrant-origin youths – those of foreign descent or with at least one foreign-born parent. We analysed data from the Korea Youth Risk Behavior Web-based Survey (KYRBS) (N = 539,187). The study aims to assess BMI trends between 2013 and 2022, examine the impact of school closures, and explore differential obesity risks among immigrant-origin youths by gender. Regression models with interaction terms were used to analyse BMI trends and pandemic effects on immigrant-origin youths compared to non-immigrant-origin youths, with gender subgroup analyses. Results show increased BMI for all adolescents, with a notable rise and higher overweight risks in immigrant-origin male adolescents during COVID-19. These findings highlight the need for gender-specific interventions in schools for immigrant-origin youths.
- 2024Yoo, N., & Jang, S.H.International Migration DOIAbstract Despite numerous studies on the economic transnational connections of immigrants, focusing mainly on remittances to their home countries, the remittance behaviours and related factors of immigrants in South Korea, a country experiencing increased racial and ethnic diversity, remain relatively understudied. Applying a resource‐dependent and reactive transnationalism framework, this study examines the associations between assimilation, human capital, and immigrants' remittance behaviours. Additionally, we investigate whether perceived unfairness moderates these relationships, reflecting reactive transnationalism. Utilizing data from a 2021 Survey on Immigrants' Living Conditions and Labor Force ( N = 7981), we delve into various remitting behaviours, including remittance frequency, the share of monthly remittances in expenditures, and the total remittance amount. The independent variables include assimilation indicators (length of stay in Korea and intention to remain), human capital factors (education and income) and perceived unfairness in the workplace. Ordinary least squares and logistic regression analyses were conducted to examine these relationships. Our findings support both linear and resource‐dependent transnationalism: assimilation and human capital levels are associated with immigrants' remittance behaviours. However, the interaction between perceived unfairness and reactive transnationalism was observed specifically for human capital, indicating that immigrants with higher human capital are more responsive to unfairness and discrimination. As a result, they may want to increase their self‐esteem by sending money back to their home country. This study not only contributes to understanding immigrant remittance behaviours in South Korea but also highlights the conceptual significance of examining remittance behaviours through reactive transnationalism, particularly the critical role of perceived unfairness among highly skilled immigrants.
- 2024Yoo, N., & Jang, S.H.Social Science & Medicine DOIThis study investigated the minority-blaming phenomenon in South Korea during the COVID-19 pandemic. The pandemic amplified fear, discrimination, and structural inequalities among minoritized groups during the COVID-19 pandemic. This study identified who was blamed for the spread of COVID-19 and the sociodemographic characteristics associated with this blame. Additionally, it examines the roles of individual and interpersonal fear and social empathy in minority blaming. We measured the fear of COVID-19 at both individual and interpersonal levels. Individual fear was assessed through personal health concerns, while the fear of transmitting the virus to others was measured as interpersonal fear. Social empathy was defined by macro perspective-taking, cognitive empathy, self-other awareness, and affective responses. The study was conducted through an online survey involving a quota sample of 1,500 South Korean participants aged 19-69 years, based on age, gender, and residential area. The response was collected in December 2020, when mass infections in specific communities received attention from mass and social media before the national spread of the COVID-19 pandemic. Analytical strategies, including OLS and hierarchical regression models, were employed to examine the roles of socioeconomic factors, individual and interpersonal fear, and social empathy in minority blaming. This study found varying correlations between sociodemographic factors and attitudes toward ethnic, religious, sexual, economic, and age-minority groups. Individual fear of contracting COVID-19 was associated with increased blame across all minority groups. In contrast, interpersonal fear was associated with increased blame only for ethnic and religious minority groups. Similarly, social empathy presented mixed associations, as it displayed a buffering role on blaming ethnic, religious, and sexual minorities when considered alongside interpersonal fear, yet mildly intensified blame for economic and age minorities. These findings provide an understanding on fear-induced minority blaming during the pandemic and the potential role of social empathy in mitigating blame.
- 2024Yoo, N., & Kapten, S. W.Transforming Careers in Mental Health for BIPOC DOIIn this chapter, a cisgender Black American woman psychologist and a cisgender female Korean international PhD student in social work share their personal experiences and nontraditional journeys into the social work and psychology fields. This chapter is organized into four sections: Financing Your Education, Choosing a University and Faculty Advisor, Centering Your Background and Your Voice, and Creating Community to Manage Isolation. Within each of these sections the authors offer narrative-based tips and strategies to consider in applying to graduate school. Because these tips and strategies are informed by the authors’ journeys into and through graduate school, they begin with describing their own positionalities and journeys. The hope is that their narratives can offer readers reassurance and confidence that it is possible to pursue your doctorate in the US even if you are entering into the mental health field with a nontraditional background.
- 2023Yoo, N., Nicholson, H., Chang, D.F., & Okazaki, S.Socius: Sociological Research for a Dynamic World DOIUsing national data from Project Implicit, the authors examine state-level variations in implicit and explicit bias against Asian Americans held by non–Asian Americans ( n = 196,678) from 2018 to 2022. The authors also explore state-level sociodemographic correlates of both types of bias. The findings reveal considerable heterogeneity in implicit and explicit bias across states. Moreover, Republican and swing states had higher levels of implicit bias against Asian Americans, and states with older median ages and greater percentages of Asian populations were associated with less explicit bias. This study underscores the importance of state-level variation in and structural factors of biases against Asian Americans as contexts for examining attitudes toward Asian Americans.
- 2023Chang, D.F., Yoo, N., Prasai, A., Lee, C.S., & Okazaki, S.Cultural Diversity & Ethnic Minority Psychology DOIIn response to increased anti-Asian discrimination and violence during the COVID-19 pandemic, this study examined pathways from discrimination experiences to own-group collective action in a diverse sample of 689 Asian Americans. Informed by theories of ethnoracial identity, critical consciousness, and collective action and utilizing structural equation modeling, we examined the associations among discrimination, psychological distress, critical awareness and motivation (CAM) to resist racism, and two types of own-group collective action: political activism and benevolent support. Multigroup invariance tests also examined whether these associations differed by ethnic subgroup, immigrant generation, and age. Results supported our integrated model in which distress mediated the relationship between discrimination and CAM, and CAM mediated the relationship between discrimination and collective action. The structural pathways from discrimination to own-group collective action generally did not differ by ethnic subgroup and immigrant generation, although path coefficients for the effect of discrimination on distress did vary by age (p < .01). Further, discrimination did not appear to have the same catalyzing effect on CAM for South and Southeast Asians compared to East Asians. While anti-Asian discrimination was associated with both distress and engagement in collective action during the COVID-19 pandemic, group differences in mediational processes highlight the importance of disaggregating analyses to explore both similarities and differences in Asian Americans' responses to discrimination. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
- 2023Yoo, N., & Jang, S.H.DIGITAL HEALTH DOIUsing digital technology to adapt to their host country is an integral part of social inclusion for migrant and refugee populations. However, researchers have not empirically examined how digital technology use may affect subjective well-being among migrant populations. This study aimed to examine the association between increased digital technology use, technological self-efficacy, and subjective well-being. Using the 2020 Digital Divide Survey in Korea, our sample consists of 6520 native South Koreans and 699 North Korean migrants aged 18 years and older. We examined the three-way interaction of technological self-efficacy and being North Korean migrants in the relationship between the increase in the use of five types of digital technology, technological self-efficacy, and subjective well-being, using hierarchical linear regressions. North Korean migrants were statistically lower than South Korean natives in all types of increased digital technology use. Moderation analysis showed that technological self-efficacy positively moderated the relationship between increased digital technology use and subjective well-being. A three-way interaction showed that this relationship was stronger in North Korean migrants for three types of utilization, networking, information sharing, and life services. A psychosocial approach needs to be taken to digital technology education for North Korean migrants, in light of the potential benefits of technological self-efficacy.
- 2023Yoo, N., Hong, Y., & Choi, Y.Journal of Affective Disorders DOIIn line with the immigrant paradox, immigrants' health advantages disappear among second-generation immigrant-origin youths, including a high prevalence of suicidal behaviors. Nevertheless, the secular trend in suicidal behaviors among immigrants in South Korea has not been examined. While Korean society was once considered homogeneous, intra-Asian migration has increased in recent decades. It is needed to explore the relationship between ethnic options and mental health outcomes among immigrant-origin youths, including suicidal behaviors. Using the nationally representative Korean Youth Risk Behavior Survey from 2011 to 2019 (600,541 non-immigrant-origin and 6,085 immigrant-origin), we examined the rates of suicidal behaviors to identify trends among youths with/without immigrant-origin and depending on the visibility of their immigrant-origin. Then, we conducted logistic regression to examine whether visibility is associated with higher suicidal behaviors among immigrant-origin youths. Overall, suicidal behaviors have declined, but immigrant-origin youths showed higher levels of suicidal behaviors than non-immigrant-origin youths. Visible minority youths showed higher suicidal behaviors than their invisible counterparts, particularly in suicidal planning and suicide attempts. Among immigrant-origin youths, visible minority status was associated with higher suicidal thoughts, plans, and attempts, controlling for socio-economic factors. Furthermore, female immigrant-origin youths show higher suicidal behaviors than their male counterparts. The results suggest that data disaggregation is needed when examining the mental health of immigrant-origin youths. Practitioners and policymakers should pay particular attention to immigrant-origin youths and recognize that their visibility may be associated with their risk of suicidal behaviors. Targeted intervention is also required for female visible minority youths.
- 2023Yoo, N., & Jang, S.H.Preventive Medicine Reports DOICOVID-19 has worsened adolescents' mental and physical health. Several studies have reported that the effect may be greater in girls; however, relevant socio-ecological factors have not been examined. This study aimed to examine the factors associated with physical and mental health status among adolescents and the moderating role of gender on the relationship between physical and mental health status and perceived household financial decline. We analyzed the cross-sectional 2020 Korea Youth Risk Behavior Web-based Survey (KYRBS) collected between August and November 2020 in South Korea. It included 54,809 adolescents (28,269 males and 26,540 females), on average aged 15.1. We conducted ordinary least squares (OLS) regressions to examine the factors associated with physical and mental health outcomes. Gender differences were observed in associated factors. Then, we tested the moderating effect of gender by including an interaction term between gender and perceived household financial decline due to the COVID-19 pandemic. Perceived household financial decline due to COVID-19 negatively affected both groups. Perceiving moderate and severe financial decline due to COVID-19 is negatively associated with self-rated health among female adolescents than male counterparts. Female adolescents were also more vulnerable to mental health outcomes (i.e., distress, anxiety, and loneliness) when they perceived severe or moderate household financial decline due to COVID-19 compared to their male peers. Our findings suggest that female adolescents are more vulnerable to household financial shocks due to COVID-19, especially in households that have experienced a severe decline. We suggest the need for gender-sensitive policy interventions for adolescent mental health.
- 2022Okazaki, S., Lee, C.S., Prasai, A., Chang, D.F., & Yoo, N.Frontiers in Public Health DOIMuch of the public discourse as well as research regarding the negative impact of COVID-19-related anti-Asian discrimination has been conducted at the broad racial group level, yet data aggregation masks critical points of diversity among Asian Americans. We conducted an online survey of 620 Asian American adults in December 2020 and examined whether there were any demographic differences–including by ethnic subgroup and Chinese street race (being Chinese or being mistaken as Chinese)–in their experiences of COVID-19-related stress, direct and vicarious discrimination, and psychological outcomes. Our analyses found that younger age was correlated with higher reports of pandemic stress, discrimination, distress, and worry. Female and U.S.-born participants reported higher levels of pandemic stress and vicarious discrimination, but there were no gender or nativity differences in levels of direct discrimination. Being uninsured was also related to higher levels of pandemic stress, discrimination, and distress. East Asian Americans reported significantly lower frequencies of direct anti-Asian discrimination than did South Asian or Southeast Asian Americans, but the ethnic subgroups did not differ in their reports of vicarious discrimination. Of note, Chinese street race was not associated with either direct or vicarious discrimination. Separate hierarchical regression analyses for East Asian, South Asian, and Southeast Asian participants revealed that, regardless of ethnicity, racial discrimination significantly contributed to psychological distress and worry beyond the effects of pandemic stress. However, the three groups varied in the demographic indicators and COVID-19 stressors that were associated with psychological outcomes. Pandemic stress was more strongly associated with negative outcomes among South Asian Americans than East Asian and Southeast Asian Americans, and neither direct nor vicarious discrimination were associated with mental health among South Asian Americans. Direct discrimination, compared to vicarious discrimination, was a particularly robust predictor of both distress and worry among East Asian Americans. For Southeast Asian Americans, direct discrimination significantly predicted higher levels of distress, whereas vicarious discrimination predicted higher levels of worry. Vicarious discrimination was not significantly related to distress across ethnic subgroups. Results suggest that practitioners and policy makers would benefit from attending to these within-group differences in Asian Americans' experiences during the pandemic.
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