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Addressing ACEs and its Mental Health Sequelae in AAPI College Students in NC

The Asian American (AA) population has doubled in size from 2000 to 2019 and is estimated to reach more than 46 million by 2060 in the U.S. (Budiman & Ruiz, 2021). Despite this growth, little is understood about their experiences with trauma and adverse childhood experiences (ACEs) due to the lack of data disaggregation (Yang & Dinh, n.d.). The model minority myth, a stereotype about Asian Americans’ achievements that erases the large disparities within this non-monolithic group further implicates a need for investigation and interventions for this population (Blackburn, 2019).

The prevalence of ACEs have been shown to differ among gender, race, and ethnicities; but there is very limited and oftentimes contraindicating data, with many studies excluding Asian Americans in results or including Asian Americans in “other” races (Sieben et al., 2019). For instance, a study published by the JAMA Pediatrics that combined 23 state data on ACEs collected from the Behavioral Risk Factor Surveillance system from 2011 to 2014 and that was known to be the “the largest and most diverse collection of ACE data from the BRFSS” did not include AAs as a reported race (Merrick et al., 2018).

AAs also face disparate outcomes when it comes to the mental health sequelae of ACEs. In the US, 15% of Asian Americans reported having a mental illness but only 20% received treatment, lower than 66% of the general population (Mental Health America, n.d.). In North Carolina specifically, the most recent 2021 Behavioral Risk Factor Surveillance System (BRFSS) shows that Asian Americans ranked 2nd in regards to highest rates of depression (2020).

In North Carolina, the AA population has grown by 85% from 2000 to 2010, ranking the third highest rate among all states (Asian Americans in North Carolina, n.d.). The majority of North Carolina’s AA communities are localized in these areas, with Wake County (that includes Raleigh) having the largest AA population of over 72,000 people (Asian Americans in North Carolina, n.d.). The five largest Asian ethnicities within this Triangle area include Asian Indian (42%), Chinese (21%), Vietnamese (7%), Filipino (7%), and Korean (6%) (Data & Demography, Asian American Center, n.d.).

The purpose of this intervention is to target AAPI college students in North Carolina to increase awareness of ACEs and encourage help seeking behaviors for the mental health sequelae of depression and anxiety. AAPI college students were selected as a target population due to their high risk of mental health sequelae (Leong et al., 2011) . The multilevel approach by CDC's socioecological framework is described below:

  • Individual: educational campaigns on ACEs in partnership with local Asian organizations such as North Carolina Asian Americans Together
  • Relationship: creating peer support groups on campus to promote inclusion and wellness
  • Community: provide trauma informed and cultural sensitivity training for campus health therapists
  • Social level: community leaders and organizations to speak about ACEs and impact on depression and/or anxiety to college students to decrease stigma and further encourage help seeking behavior

The potential impact on the target population is to increase awareness of ACEs, change the attitudes of seeking help for mental health sequelae like depression and anxiety, and decrease stigma around these topics. Impacts will be measured by pre and post surveys and pre and post rates of mental health care utilization in this community.

References

(2020). Cdc.gov. https://nccd.cdc.gov/BRFSSPrevalence

Asian Americans in North Carolina. (n.d.). Retrieved February 6, 2023, from https://ncaatogether.org/wp-co...final-03-10-0936.pdf

Blackburn, SS. (2019, March 21). What Is the Model Minority Myth? Learning for Justice; Southern Poverty Law Center. https://www.learningforjustice...-model-minority-myth

Budiman, A., & Ruiz, N. G. (2021, April 29). Key facts about Asian Americans, a diverse and growing population. Pew Research Center. https://www.pewresearch.org/fa...out-asian-americans/

CDC. (2022, January 18). The Social-Ecological Model: A Framework for Prevention. Centers for Disease Control and Prevention; CDC. https://www.cdc.gov/violencepr...ecologicalmodel.html

Data & Demography, Asian American Center. (n.d.). Aac.unc.edu. Retrieved February 13, 2023, from https://aac.unc.edu/data-demography/

Leong, F. T. L., Kim, H. H. W., & Gupta, A. (2011). Attitudes toward professional counseling among Asian-American college students: Acculturation, conceptions of mental illness, and loss of face. Asian American Journal of Psychology, 2(2), 140–153. https://doi.org/10.1037/a0024172

Merrick MT, Ford DC, Ports KA, Guinn AS. Prevalence of Adverse Childhood Experiences From the 2011-2014

Behavioral Risk Factor Surveillance System in 23 States. JAMA Pediatr. 2018;172(11):1038–1044.doi:10.1001/jamapediatrics.2018.2537

Mental Health America (n.d.). Asian American / Pacific Islander Communities and Mental Health [Review of Asian American / Pacific Islander Communities and Mental Health]. Mental Health America. https://www.mhanational.org/is...es-and-mental-health

Sieben, A., Lust, K., Crose, A., Renner, L. M., & Nguyen, R. H. N. (2021). Race and sex differences in adverse childhood experiences among Asian/Pacific Islander college students. Journal of American college health : J of ACH, 69(4), 353–360. https://doi.org/10.1080/07448481.2019.1677671

Yang N.I. & Dinh Q (n.d.). Intergenerational Trauma and Southeast Asian American Youth in California. Retrieved February 6, 2023, from https://www.equalmeasure.org/w...Rise_YangDinh_R1.pdf

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