This study investigates the relationship between COVID-19 preventive behaviors and health insurance coverage in populations residing in Arizona border towns, a transnational geographical area with limited research focus. The literature highlights the impact of healthcare policies on immigrant communities, suggesting that restricted access to healthcare exacerbates vulnerability to COVID-19. This secondary data analysis study is based on data collected from 2022 to 2023. The data revealed that being uninsured (b = -0.04, p = 0.44) or having public health insurance (b = -0.02, p = 0.72) did not predict stronger masking attitudes. The lack of a significant association between health insurance and preventive behaviors could be explained by the widespread dissemination of knowledge and adherence to established public health guidelines at that point in the pandemic. Additionally, culturally adaptive information and training for healthcare professionals was necessary to address migrants' health needs. Access to health services is crucial for all populations, including immigrants, to improve public health despite the loss of health insurance caused by the end of the COVID-19 public health emergency.

Bridging social capital describes the diffusion of information across networks built between individuals of different social identities. This project aims to understand if the bridging ties of economic connectedness (EC), measured by data from Facebook friends and calculated as the average share of high socioeconomic status friends that an individual from a low socioeconomic status has, can be a predictor of variations in COVID-19 infection risk across Arizona ZIP code tabulation areas (ZCTAs). Economic connectedness values across Arizona ZCTAs was examined in addition to the correlation of EC to various social and demographic factors such as age, sex, race and ethnicity, educational background, income, and health insurance coverage. A multiple linear regression model was conducted to examine the association of EC to biweekly COVID-19 growth rate from October 2020 to November 2021, and to examine the longitudinal trends in the association between these two factors. The study found that the bridging ties of economic connectedness has a significant effect size comparable to that of other demographic features, and has implications in being used to identify vulnerabilities and health disparities in communities during the pandemic.

Descendants of Vietnamese, Laotian, and Cambodian refugees have been impacted by intergenerational trauma as a result of their parent’s trauma from being refugees from the Vietnam War, Secret War, and the Khmer Rouge in the 1970s and 1980s. There are limited studies evaluating the impacts of intergenerational trauma on adult descendants in Southeast Asian (SEA) refugee families. To address this research gap, a quantitative survey was conducted with adult descendants who are 18 years old or older to examine if intergenerational trauma is associated with depressive symptoms among adult Vietnamese, Laotian, and Cambodian Americans whose parents came to the United States as refugees. To recruit participants, both purposive and snowball sampling was used. A total of 66 participants responded to the online survey. The survey consisted of multiple measures that analyzed the relationship between intergenerational trauma and depressive symptoms, including perceived parental trauma, intergenerational/intercultural conflict, acculturation, social support, and demographic characteristics. Statistical analysis was conducted through descriptive statistics and bivariate correlation analysis. Results indicated that intergenerational trauma was not associated with depressive symptoms. However, depressive symptoms were associated with intergenerational/intercultural conflict (r = 0.421, p < .01) and social support (r = -0.383, p < .01). It is possible that acculturation differences between descendants and parents are connected to intergenerational/intercultural conflict and depressive symptoms while social support allows the descendants to feel connected with others, which can reduce depressive symptoms. Culturally adapted family interventions, education, culturally sensitive therapy, and community spaces are possible solutions to addressing depressive symptoms among SEA adult descendants.

Tenants of publicly subsidized housing (PSH) as well as the general population may choose from one of many existing diabetes education programs, such as the national Diabetes Prevention Program or choose from a smaller, more community-based program. The purpose of this study is to explore experiences of tenants of PSH who participated in a community-based Diabetes Empowerment Education Program (DEEP). This program aims to increase health literacy regarding public health concepts, such as the social determinants of health, gives participants the skills and resources for better diabetes management. From the literature review, a research gap was identified in two areas: studies evaluating participant’s experiences in diabetes education and studies using tenants of PSH for diabetes education. This study was designed using both qualitative and quantitative approaches to address the research gap. First, 5 participants were recruited and two surveys were conducted during the first and last sessions of the six-week DEEP class. The survey was created based upon the Diabetes Knowledge Questionnaire and the Summary of Diabetes Self-Care Activities Measure. From the surveys, a coding guide was created and data was coded according to the guide. In addition, the means and standard deviations of categories from within the survey were calculated. Second, to better understand lived experiences during the DEEP intervention, semi-structured interviews were conducted with 2 class participants and the class educator to gain a deeper understanding of their experiences in the class. Diabetes knowledge increased between the first and second surveys. The rate of correct replies to 26 questions on the Diabetes Knowledge Questionnaire increased from 52.8 % to 73.1% prior to and following the DEEP intervention. Overall, there was a 38.4% increase in diabetes knowledge before and after the DEEP classes. Regarding the findings from the individual interviews, social networks improved diabetics overall experience in the DEEP class and managing their diabetes. Additionally, barriers such as COVID-19, comorbidities, and cultural norms were discovered in participant’s experiences. Participants shared similar facilitators to diabetes management, such as time with diabetes increasing success at diabetes management. COVID-19 significantly limited enrollment in the DEEP classes, leading to a very small sample size which is a major limitation of this study. A critical implication of this study is highlighting the necessity of free community health education programs, such as this one, especially in publicly subsidized housing communities, to promote health equity for all.

Young adults with type one diabetes mellitus (T1DM) face unique challenges in managing their chronic disease. While simultaneously navigating major life transitions and becoming fully responsible for their diabetes-self management behaviors (DSMB), social support can be an integral part of disease management. Many young adults enroll in college where student organizations are prevalent including diabetes related social groups on some campuses, which provide a rich source of social support for students with diabetes as they transition to greater independence in diabetes management. This study used descriptive analysis and personal network analysis (PNA) to investigate which aspects of being a part of a diabetes related social group and personal networks, in general, are pertinent to successful diabetes management, measured by a Diabetes Self-Management Questionnaire (DSMQ) among 52 young adults with T1DM. The majority of respondents indicated that since being a part of College Diabetes Network (CDN) or another diabetes-related social group, they increased time spent paying attention to, and felt more empowered to make changes to their diabetes management routine, and they were able to generally take better care of their diabetes. Half of respondents noticed their health improved since joining, and over half felt less burdened by their diabetes. Though no personal network measures were highly correlated with higher Diabetes Self-Management Scores, the degree to which health matters were discussed within their personal network was the most associated personal network measure. Our findings help contextualize the ways in which young adults’ DSMB are influenced by participation in diabetes- related social groups, as well as introduce the use of personal network analysis in gauging important aspects of social capital and support in young adults with chronic disease.

Young adults with type one diabetes mellitus (T1DM) face unique challenges in managing their chronic disease. While simultaneously navigating major life transitions and becoming fully responsible for their diabetes-self management behaviors (DSMB), social support can be an integral part of disease management. Many young adults enroll in college where student organizations are prevalent including diabetes related social groups on some campuses, which provide a rich source of social support for students with diabetes as they transition to greater independence in diabetes management. This study used descriptive analysis and personal network analysis (PNA) to investigate which aspects of being a part of a diabetes related social group and personal networks, in general, are pertinent to successful diabetes management, measured by a Diabetes Self-Management Questionnaire (DSMQ) among 52 young adults with T1DM. The majority of respondents indicated that since being a part of College Diabetes Network (CDN) or another diabetes-related social group, they increased time spent paying attention to, and felt more empowered to make changes to their diabetes management routine, and they were able to generally take better care of their diabetes. Half of respondents noticed their health improved since joining, and over half felt less burdened by their diabetes. Though no personal network measures were highly correlated with higher Diabetes Self-Management Scores, the degree to which health matters were discussed within their personal network was the most associated personal network measure. Our findings help contextualize the ways in which young adults’ DSMB are influenced by participation in diabetes- related social groups, as well as introduce the use of personal network analysis in gauging important aspects of social capital and support in young adults with chronic disease.

COVID-19 has shocked the bedrock of society, impacting both human life and the economy. Accompanying this shock has been the psychological distress inflicted onto the general population as a result of the emotion strain stemming from isolation/quarantine policies, being sick with COVID-19, dealing with COVID-19 losses, and post-COVID syndrome and its effect on quality of life. The psychological distress has been experienced by the general population, but compared to middle age (30-50) and older adults (>50 years of age), it has been young adults (18-30 years old) who have been more psychologically affected (Glowacz & Schmits, 2020). Psychological distress, specifically anxiety and depression, has been exacerbated by feelings of uncertainty, fear of illness, losing loved ones, and fear of post-COVID syndrome. Post-COVID syndrome, as with other post-viral syndromes such as post viral SARS involve lingering symptoms such as myalgic encephalomyelitis or Chronic Fatigue Syndrome (CFS), and loss of motivation (Underhill, 2015). In addition to these symptoms, patients suffering from post-COVID syndrome have also presented brain inflammation and damaged brain blood vessels (Meinhardt et al., 2021), Endotheliitis (Varga et al., 2020), CV abnormalities and changes in glucose metabolism (Williams et al., 2020). CV abnormalities and changes in glucose metabolism are connected to chronic illnesses like diabetes and heart disease respectively. These chronic illnesses are then associated with higher risk for depression as a result of the stress induced by the symptoms and their impact on quality of life (NIMH, 2021). Further monitoring, and research will be important to gauge ultimate physiological and psychological impact of COVID-19.