OBJECTIVES:The adverse mental health effects of racism are well documented among Asian American communities, yet little is known about how internalized racism (IR) affects mental health among Asian American women, an underserved group. This study examines perceived stress and resilience as potential mechanism and moderator, respectively, in the relationship between IR and mental health outcomes (depression and anxiety). DESIGN:Using a cross-sectional design, we included a sample of 349 Asian American adult women. Mediation analyses tested whether perceived stress mediated the association between IR and mental health. Moderated mediation analyses examined whether resilience moderated the indirect effects of IR on mental health via stress. RESULTS:Perceived stress significantly mediated the relationship between IR and both depression and anxiety. The indirect effect was significant for depression (b = 1.25, Boot Standard Error (SE) = 0.44, 95% Confidence Interval [CI]: 0.44, 2.13) and anxiety (b = 1.15, Boot SE = 0.40, 95% CI: 0.40, 1.95), while direct effects were not significant. Resilience moderated the indirect effect of IR on depression (index = -0.30, 95% CI: -0.59, -0.09) and anxiety (index = -0.17, 95% CI: -0.33, -0.03), with weaker indirect effects observed at higher levels of resilience. CONCLUSION:Perceived stress is a key mechanism linking IR to depression and anxiety among Asian American women. Resilience attenuates the impact of IR on both mental health outcomes. These findings highlight the importance of culturally tailored interventions that target stress reduction to reduce mental health disparities in this underserved population.

Abstract Immigrants represent a growing segment of the United States population that needs special consideration when addressing intimate partner violence (IPV). This chapter highlights the unique experiences of diverse immigrant communities, delineating the theory and risk and protective factors that shape IPV, and promising practices to address these. Important policy, research, and practice implications should be considered to better serve the needs and strengths of immigrant communities at risk of, experiencing, and surviving IPV. This includes ensuring access to culturally and linguistically appropriate services, trauma-informed approaches that consider multiple traumas and experiences shaped by intersectional identities, and coordinated approaches that bridge health, social, and legal needs for this population.

Purpose:Chinese Americans face disproportionately higher rates of Type 2 Diabetes (T2D) and co-occurring mental health challenges. Little is known about how they perceive mental health care during their journey with diabetes. This study aimed to provide an in-depth exploration of mental health care perceptions in this population. Patients and Methods:Two focus group discussions involving 12 participants were conducted in Mandarin. Participants were purposively sampled from a previous survey of Chinese immigrants with T2D who reported co-occurring mental health challenges and were recruited through referrals from primary care practices and community-based organizations in New York City. Data were analyzed using inductive content analysis. Results:The participants in this study ranged in age from 45 to 67 years. Most were female, married, and had low educational attainment (less than a college education) and low annual household incomes (less than USD $25,000). All participants were first-generation Chinese immigrants with limited English proficiency and had health insurance. HbA1c levels ranged from 6.5% to 12.6%. Depressive symptoms and elevated stress were the most commonly reported mental health issues in this sample. Data analysis revealed five categories related to participants' perceptions of mental health care: 1) interactions between mental health and T2D, 2) barriers to accessing mental health care, 3) facilitators of accessing mental health care, 4) coping strategies for mental health challenges, and 5) preferences for mental health services. Conclusion:This study suggests the complex interactions between T2D and mental health issues among Chinese Americans. The findings indicate that seeking professional mental health services is uncommon among many individuals in this population and highlight several barriers and facilitators to access. The findings also suggest directions for future interventions to support mental health among Chinese Americans with T2D. Addressing mental health needs through effective interventions is essential for providing comprehensive care to this underserved population. Future research should explore the role of stigma in mental health-seeking behaviors, as well as design and assess the effectiveness of mental health interventions for Chinese Americans with T2D.

Women with a history of gestational diabetes mellitus (GDM) have an elevated risk for cardiometabolic diseases. Chinese American immigrants are disproportionately affected by GDM, yet their cardiometabolic risk factors are understudied. Little is known about physical activity (PA) of this understudied high-risk minority group. The purpose of this study was to describe self-reported PA and the facilitators of and barriers to PA in Chinese American immigrants with a history of GDM. We conducted an exploratory multimethod study between 2020 and 2021 among 106 Chinese American immigrant women. PA was self-reported using the International Physical Activity Questionnaire-Long form. Four domains of PA (work, transportation, housework, and leisure time) and daily sitting time were recorded. Open-ended questions were asked about the facilitators of and barriers to PA. Participants' mean age was 34.3 ± 3.7 years, and body mass index was 21.7 ± 2.6 kg/m2. Approximately 25% had low PA. Over half (N = 56, 53%) reported no leisure-time moderate-to-vigorous PA. Walking and housework were the most common types of PA. Barriers to PA included being busy with life, physical health issues (eg, sleep and postpartum health issues), low motivation or not enjoying PA, COVID-related barriers, and an unfavorable environment for PA. Strategies are needed to increase leisure-time moderate-to-vigorous PA in this population. Modifiable factors include providing convenient PA programs (eg, technology or home-based) and addressing postpartum health issues (eg, sleep). Increasing providers' awareness of barriers to PA and cardiometabolic disease risk in this hard-to-reach, high-risk group may improve assessment and referral for high-risk women. Future research is needed to further explore opportunities for PA that Chinese American immigrant women would be open to at this stage in their life.

International Asian and Latina women who are sex trafficking survivors experience a wide spectrum of gender-based violence throughout their life course and suffer from its adverse mental and physical health outcomes. However, there is limited research among this seldom heard population. This study aims to explore poly-victimization patterns of child abuse, intimate partner violence (IPV), client violence, and police violence; and to explore their associations with psychosocial factors. Using a Community-Based Participatory Research approach, survey data was collected from 95 women from 2019 to 2020. Latent class analysis was used to explore poly-victimization patterns, and chi-square tests were used to examine their bivariate associations with psychosocial factors. Mean age of the sample was 41.6 ± 9.8 years old. Most had limited English proficiency (94.6%). Majority were Asian (76.3%) and had been arrested (75.3%). The prevalence of violence was high: child abuse (62.8%), past-year IPV (10.5%), lifetime sex buyer client violence (71.3%), and lifetime police violence (17.9%). Two distinct classes of poly-victimization were observed: High violence burden class (high likelihood of child abuse, low likelihood of IPV, high likelihood of client violence, and low likelihood of police violence; 55.9%); Moderate violence burden class (low likelihood of child abuse, no likelihood of IPV, medium likelihood of client violence and lower likelihood of police violence; 44.1%). Latina women (p < .001) and those with lower tangible (p = .021) or emotional support (p = .003) were more likely to be in the high violence burden class. Post-traumatic stress disorder was associated with high violence burden class (p = .036). Our findings are among the first to highlight the heterogeneity in poly-victimization experiences within this multiply marginalized group, pointing to the importance of person-centered and trauma-informed approaches in addressing the needs of this population.

BACKGROUND:Chinese Americans with type 2 diabetes (T2D) face many linguistic, cultural, and social determinants of health-related barriers to accessing evidence-based diabetes interventions. Our team developed the culturally and linguistically tailored Chinese American Research and Education (CARE) program to provide evidence-based diabetes education and support to this group and demonstrated the feasibility, acceptability, and potential efficacy of the intervention on improving hemoglobin A1c levels. However, it remains unclear whether the CARE program also improves diabetes self-efficacy and psychosocial outcomes in the same study sample. OBJECTIVE:This is a secondary analysis to examine the potential efficacy of the CARE program on secondary outcomes, including diabetes self-efficacy, self-care activities, beliefs in diabetes self-care activities, and diabetes distress among Chinese Americans with T2D. METHODS:A 2-arm, pilot randomized controlled trial was conducted to evaluate the CARE program between March 1, 2021, and April 21, 2023. The trial included 60 Chinese Americans aged 18 to 70 years who had a diagnosis of T2D and a baseline hemoglobin A1c level of 7% or higher. Participants were recruited from various health care settings in New York City, including community health centers, private primary care providers, and NYU Langone Health and its affiliates, and were randomly assigned to either the CARE intervention group (n=30) or a waitlist control group (n=30). The intervention consisted of 2 culturally and linguistically tailored educational videos per week for 12 weeks, covering diabetes self-care topics such as healthy eating, physical activity, and medication adherence. These videos were delivered via the WeChat app. In addition, community health workers provided support calls to assist them in setting goals, problem-solving, and addressing social determinants of health barriers every 2 weeks. Secondary outcomes included patient self-reported diabetes self-efficacy, self-care activities, beliefs in diabetes self-care activities, and diabetes distress. Outcomes were assessed at baseline, 3 months, and 6 months. RESULTS:Participants had a mean age of 54.3 (SD 11.5) years and 62% (37/60) were male, 78% (47/60) were married, 58% (35/60) were employed, 70% (42/60) had a high school education or lower, and 88% (53/60) reported limited English proficiency. Intervention participants demonstrated statistically significant improvements in self-efficacy at 3 months (estimated difference in change: 8.47; 95% CI 2.44-14.5; adjusted P=.02), diabetes distress at 6 months (estimated difference in change: -0.43; 95% CI -0.71 to -0.15; adjusted P=.009), and adherence to a healthy diet at both 3 months (estimated difference in change: 1.61; 95% CI 0.46-2.75; adjusted P=.02) and 6 months (estimated difference in change: 1.64; 95% CI 0.48-2.81; adjusted P=.02). CONCLUSIONS:The culturally and linguistically tailored intervention showed promise in improving self-efficacy and diabetes self-care activities among Chinese Americans with T2D, warranting validation through a large-scale randomized controlled trial. TRIAL REGISTRATION:ClinicalTrials.gov NCT03557697; https://clinicaltrials.gov/study/NCT03557697.

Moving beyond existing research that typically focuses on a single form of violence, the current study adopts a holistic approach to examine psychosocial factors associated with intimate partner violence (IPV) and hate-motivated violence against Asian American women, as well as related mental and behavioral health outcomes. This cross-sectional study was conducted between August 2022 and June 2023 among 345 community-based adult Asian American women. Multivariable Firth logistic regression models were used to address study aims. The prevalence of violence was high: 55.1

Asian American women are an understudied population facing a substantial mental health burden, largely driven by the increasing rates of gender- and race-based violence and discrimination. Perceived safety, a key factor influencing mental health, has been underexplored. This study aimed to 1) examine the relationship between perceived safety with mental health outcomes (i.e., depression and anxiety); 2) examine the link between safety-related behavioral modifications and mental health outcomes; and 3) explore the moderating effects of loneliness and resilience on these relationships, drawing from a community sample of n = 345 Asian American women. Perceived safety was defined as feeling safe in public spaces, transportation and neighborhoods. In our study, 28.7%, 56.2% and 20.6% of women reported feeling unsafe in public spaces, transportation and neighborhoods, respectively. Feeling unsafe in public spaces was associated with higher odds of depression (aOR=2.37, 95%CI: 1.40, 4.02) and anxiety (aOR=2.61, 95%CI: 1.56, 4.37). Avoiding public spaces, leaving home or transportation were linked to increased odds of depression (aOR=2.05, 95%CI: 1.23, 3.40; aOR=2.26, 95%CI: 1.37, 3.74; aOR=2.03, 95%CI: 1.16, 3.57, respectively) while only avoiding leaving home was associated with anxiety (aOR=2.04, 95%CI: 1.24, 3.36). Loneliness moderated the association between avoiding public spaces and anxiety: avoiding public spaces was significantly associated with greater odds of anxiety among women who were not lonely (aOR = 4.77, 95% CI: 1.24-18.34), but not among those who were lonely (aOR = 0.93, 95% CI: 0.53-1.64). Resilience did not moderate these relationships (all p > .050). Our findings highlight the mental health impacts associated with reduced perceptions of safety and safety-related behavioral modifications in this group, highlighting the pervasive fear experienced by Asian American women in their day-to-day lives, and emphasizing the need for targeted interventions to address the unique safety challenges faced by Asian American women.

Background: Type 2 diabetes (T2D) contributes to significant morbidity and mortality for Chinese immigrants in the United States, exacerbated by social determinants of health (SDOH) such as language barriers, limited access to healthy foods, or low health literacy. Objective: The goal of the INtegrating CuLtUral aspects into Diabetes Education (INCLUDE) study is to test a social media-based intervention adapting the Diabetes Prevention Program (DPP) for Chinese immigrants alongside a culturally adapted community-supported agriculture (CSA) program. We report the protocol for the INCLUDE study. Methods: INCLUDE is a three-year randomized controlled trial (n=150). Participants with prediabetes or at risk for T2D are enrolled and randomized into either the control or intervention group (n=75 each). Participants from the intervention group receive 2-3 culturally tailored, in-language DPP videos weekly for 12 weeks, and biweekly phone calls from bilingual study staff to review video content, support goal setting, and to assess and address SDOH-related barriers such as food insecurity. Intervention participants will also be given produce for 10 weeks as part of the CSA program. Weight (primary outcome), self-efficacy, diet, physical activity, and food insecurity (secondary outcomes) are measured at baseline, 3-month, and 6-month intervals. Splined linear mixed models will be used to examine group differences in longitudinal weight and other secondary outcomes. The INCLUDE study was approved by the Institutional Review Board at the NYU Grossman School of Medicine. Trial registration: This study was registered at ClinicalTrials.gov (NCT05492916; registered 08/09/2022). Discussion: The INCLUDE study will serve as an innovative model for culturally adapted multi-level interventions for underserved communities previously unable to access evidence-based diabetes prevention initiatives. Aligning with several national calls for multi-level interventions, the INCLUDE intervention will provide critical data that will inform how researchers and public health professionals address SDOH barriers faced by underserved populations and prevent diabetes.

Background Type 2 diabetes (T2D) contributes to significant morbidity and mortality for Chinese immigrants in the United States, exacerbated by social determinants of health (SDOH) barriers such as language barriers, limited access to healthy foods, and low health literacy. Objective The goal of the Integrating Cultural Aspects into Diabetes Education (INCLUDE) study is to test a social media–based intervention adapting the Diabetes Prevention Program (DPP) for Chinese immigrants alongside a culturally adapted, community-supported agriculture program. Here, we report the protocol for the INCLUDE study. Methods INCLUDE is a 3-year randomized controlled trial (n=150). Participants with prediabetes or at risk for T2D are enrolled and randomized into either the control or intervention group (n=75 each). Participants from the intervention group receive 2-3 culturally tailored, in-language DPP videos weekly for 12 weeks, as well as biweekly phone calls from bilingual study staff to review video content, support goal setting, and assess and address SDOH-related barriers such as food insecurity. Intervention participants will also be given produce for 10 weeks as part of the community-supported agriculture program. Weight (primary outcome), self-efficacy, diet, physical activity, and food insecurity (secondary outcomes) are measured at baseline, 3-month, and 6-month intervals. Splined linear mixed models will be used to examine group differences in longitudinal weight and other secondary outcomes. The INCLUDE study was approved by the Institutional Review Board at the NYU Grossman School of Medicine. Results Recruitment started in May 2023, with the first cohort of 75 participants enrolled and randomized into 2 groups in July 2023. The 3-month and 6-month assessment of the first-year cohort has been completed. We have recruited 75 participants for the second cohort as of July 2024. Conclusions The INCLUDE study will serve as an innovative model for culturally adapted, multilevel interventions for underserved communities previously unable to access evidence-based diabetes prevention initiatives. Aligning with several national calls for multilevel interventions, the INCLUDE intervention will provide critical data that will inform how researchers and public health professionals address SDOH barriers faced by underserved populations and prevent diabetes. Trial Registration ClinicalTrials.gov NCT05492916; https://clinicaltrials.gov/study/NCT05492916 International Registered Report Identifier (IRRID) DERR1-10.2196/65455

The monolithic misrepresentation of Asian American (AsAm) populations has maintained assumptions that AsAm people are not burdened by health disparities and social and economic inequities. However, the story is more nuanced. We critically review AsAm health research to present knowledge of AsAm health profiles from the past two decades and present findings and opportunities across three topical domains: (a) general descriptive knowledge, (b) factors affecting health care uptake, and (c) effective interventions. Much of the literature emphasized underutilization of health care services; low knowledge and awareness among AsAms about health-related risk factors, prevention, diagnosis, and treatment; inadequate efforts by health systems to improve language access, provider-patient communication, and trust; and the critical roles of community- and faith-based organizations and leaders in health promotion initiatives. Future opportunities for AsAm health research will require adoption of and significant investment in community-engaged research infrastructure to increase representation, funding, and research innovation for AsAm communities.

Purpose: The purpose of the study was to explore the barriers to and facilitators of self-management among older adults with type 2 diabetes mellitus (T2DM). Methods: This study followed a qualitative descriptive methodology. Older adults with T2DM living in Jinan, Shandong Province, China were recruited using purposive sampling. Information saturation was used to gauge the sample size. Semistructured interviews were conducted with 23 participants. The data analysis was guided using a thematic approach. Themes were inducted from the interview data undergirded by the cumulative complexity model. Results: The key findings of this study are presented in terms of 2 themes: facilitators of T2DM self-management and barriers to T2DM self-management. Each theme has subthemes, including that having family members with diabetes, having family members who are health care professionals, and visual cues were factors for good self-management practices by older adults with T2DM. Conversely, poor health status (ie, multimorbidity and lower-limb dysfunction and pain) and intergenerational care responsibilities were identified as barriers to effective self-management. Moreover, the use of media resources, especially traditional media, was found to both assist and hinder participants in their self-management practices. Conclusion: The findings from this study can inform new research to build on existing self-management promotion programs and restructure existing services to improve the self-management of older adults with T2DM. With the increase in the number and types of media outlets, our finding implies that researchers or clinical practitioners may develop strategies to leverage media resources to enhance the self-management of diabetes among older adults with T2DM.

Latinx immigrants bear a disproportionate burden associated with intimate partner violence (IPV); however, efforts to develop evidence-based IPV prevention strategies and address health disparities have been impeded by a lack of understanding of the unique cultural (i.e., acculturation and acculturative stress) and socio-environmental (i.e., adverse childhood experiences [ACEs]) factors that contribute to IPV in this historically marginalized population. Guided by a contextual framework for IPV and a life-course perspective viewed through a gendered lens, this study aims to (a) identify relationships among acculturation, acculturative stress, ACEs, and IPV victimization and perpetration; and (b) explore whether profiles of IPV risk factors differ by gender (women vs. men) among Latinx immigrants. This cross-sectional, descriptive, correlational study was a secondary analysis of data from the baseline assessment of 331 ever-partnered Latinx immigrants aged 18 to 44 in a longitudinal study named Salud (Health), Estrés (Stress), y Resilencia (Resilency) (SER) Hispano. Logistic regressions adjusting for individual characteristics and gender subgroup analyses were used to address study aims. The majority of the participants were women (71.30%). More than half of all participants had experienced IPV victimization (57.70%) or IPV perpetration (60.73%). Latinx immigrants with higher family stress (adjusted odds ratio [aOR] = 1.16; p < .001) had an elevated risk for IPV victimization; those with more ACEs (aOR = 1.08; p = .005) had an increased risk for IPV perpetration. Women had a lower risk of IPV victimization (aOR = 0.45; p = .03) and a higher risk for IPV perpetration (aOR = 3.26; p = .001) compared to men. Although further research is warranted, the profiles of risk factors for IPV perpetration were different for women than for men. Culturally tailored preventions focused on acculturative stress and ACEs are needed to help Latinx immigrant communities minimize exposure to life-course adversities, improve positive adaptation to the US, and eliminate IPV-relevant health disparities.

Background: There is a tendency for older adults to become more physically inactive, especially older women. Physical inactivity has been exacerbated since the COVID-19 pandemic. Lockdowns and information-based preventive measures for COVID-19 increased the number of short-form video app users and short-form video exposure, including content exposure and the duration of exposure, which has demonstrated important effects on youths' health and health-related behaviors. Despite more older adults viewing short-form videos, less is known about the status of their short-form video exposure or the impacts of the exposure on their physical activity. Objective: This study aims to describe physical activity-related content exposure among older adults and to quantify its impacts along with the duration of short-form video exposure on step counts, low-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA).Methods: We analyzed a subsample (N=476) of older women who used smartphones and installed short-form video apps, using the baseline data collected from an ongoing cohort study named the Physical Activity and Health in Older Women Study (PAHIOWS) launched from March to June 2021 in Yantai, Shandong Province, China. The information on short-form video exposure was collected by unstructured questions; physical activity-related content exposure was finalized by professionals using the Q-methodology, and the duration of exposure was transformed into hours per day. Step counts, LPA, and MVPA were assessed with ActiGraph wGT3X-BT accelerometers. Multiple subjective and objective covariates were assessed. Linear regression models were used to test the effects of short-form video exposure on step counts, LPA, and MVPA. MVPA was dichotomized into less than 150 minutes per week and 150 minutes or more per week, and the binary logistic regression model was run to test the effects of short-form video exposure on the achievement of spending 150 minutes or more on MVPA.Results: Of 476 older women (mean age 64.63, SD 2.90 years), 23.7% (113/476) were exposed to physical activity-related short-form videos, and their daily exposure to short-form videos was 1.5 hours. Physical activity-related content exposure increased the minutes spent on MVPA by older women (B=4.14, 95% CI 0.13-8.15); the longer duration of short-form video exposure was associated with a reduced step count (B=-322.58, 95% CI -500.24 to -144.92) and minutes engaged in LPA (B=-6.95, 95% CI -12.19 to -1.71) and MVPA (B=-1.56, 95% CI -2.82 to -0.29). Neither content exposure nor the duration of exposure significantly increased or decreased the odds of older women engaging in MVPA for 150 minutes or more per week.Conclusions: Short-form video exposure has both positive and negative impacts on the physical activity of older adults. Efforts are needed to develop strategies to leverage the benefits while avoiding the harms of short-form videos.

Significance: The findings to date indicate that adverse childhood experiences (ACEs) increase the risk of car-diovascular disease (CVD) in later life. We demonstrate how network analysis, a statistical method that estimates complex patterns of associations between variables, can be used to model ACEs and CVD. The main goal is to explore the differential impacts of ACE components on CVD outcomes, conditioned on other ACEs and important covariates using network analysis. We also sought to determine which ACEs are most synergistically correlated and subsequently cluster together to affect CVD risk.Methods: Our analysis was based on cross-sectional data from the 2020 Behavioral Risk Factor Surveillance System, which included 31,242 adults aged 55 or older (54.6% women, 79.8% whites, mean age of 68.7 & PLUSMN; 7.85 years). CVD outcomes included angina/coronary heart disease (CHD) and stroke prevalence. Mixed graphical models were estimated using the R-package mgm, including all variables simultaneously to elucidate their one-to -one inter-relationships. Next, we conducted Walktrap cluster detection on the estimated networks using the R-package igraph. All analyses were stratified by gender to examine group differences.Results: In the network for men, the variable "household incarceration" was most strongly associated with stroke. For women, the strongest connection was between "physical abuse" and stroke, followed by "sexual abuse" and angina/CHD. For men, angina/CHD and stroke were clustered with several CVD risk factors, including depressive disorder, diabetes, obesity, physical activity, and smoking, and further clustered with components of household dysfunction (household substance abuse, household incarceration, and parental separation/divorce). No clusters emerged for women.Conclusions: Specific ACEs associated with CVDs across gender may be focal points for targeted interventions. Additionally, findings from the clustering method (especially for men) may provide researchers with valuable information on potential mechanisms linking ACEs with cardiovascular health, in which household dysfunction plays a critical role.

Intimate partner violence (IPV) is a global health challenge leading to various detrimental health outcomes. Chinese women are a vulnerable population often overlooked in IPV research. Guided by the social-ecological model, this systematic review aims to synthesize literature on the risk and protective factors for IPV among Chinese women. A comprehensive search was conducted in nine major English and Chinese databases for articles with data collected since 2006 on adult Chinese women, leading to 29 papers in the final analysis. Risk and protective factors associated with IPV identified in this review include factors at the individual level such as demographics (e.g., a younger age, unplanned pregnancy, abortion, having children, and migration), socioeconomic status (e.g., income and partners' education level), attitudinal factors (e.g., attitudes justifying IPV and traditional beliefs about gender roles), behavioral factors (e.g., alcohol use of women, partners' alcohol use and frequency, and partners' high frequency of gambling), adverse childhood experiences (e.g., witnessed violence in childhood), and other personal characteristics (e.g., chronic illness and good health status). Factors at the relationship level include conflicts, power in intimate relationships, and social capital (e.g., the size of social networks, network participation of women and their partners, and social control). Community-level factors related to geographic locations were also explored while no factors were identified at the societal level. None of the included studies examined the intersections of factors within the same level or across different levels. Recommendations for future research, practice, and policy are also discussed.

AIMS Clique percolation, one of the joint community detection algorithms in network science, is a novel and efficient approach to detecting overlapping communities in real networks. The current study illustrated how clique percolation can help to identify overlapping communities within the complex networks underlying health disparities, particularly highlighting nodes with strong associations with more than one community. DESIGN A cross-sectional study. METHODS The study used a dataset on Latinx populations (N = 1654; mean age = 43.3 years; 53.1% women) as an example to demonstrate the role of such overlapping nodes in the network of syndemic conditions and their common risk factors. Syndemic conditions in the network included HIV risk, substance abuse (smoking, heavy alcohol consumption and marijuana use) and poor mental health. Moreover, the risk factors encompassed individual (education and income) and sociostructural (adverse childhood experiences [ACEs] and access to services) factors. The network was estimated using the R-package bootnet. Clique percolation was conducted on the estimated network using the R-package CliquePercolation. RESULTS A total of three communities were detected, with HIV risk and poor mental health not being assigned to any community. In general, Community 1 was comprised of ACE categories, Community 2 included education, income and access to services and Community 3 included other syndemic conditions. Of note, two nodes were assigned to two communities: 'household dysfunction' to Communities 1 and 2 and 'smoking' to Communities 2 and 3. CONCLUSION Household dysfunction might be the key connector, among other ACEs, to individual and structural barriers. Such barriers further exposed Latinx individuals to risky behaviours, especially smoking, which further linked to marijuana use and heavy alcohol consumption. IMPACT Clique percolation facilitated our understanding of the complex systems of factors shaping health disparities. The overlapping nodes are promising intervention targets for reducing health disparities in this historically marginalized population. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.

An understanding of intimate partner violence (IPV) experiences is a crucial first step toward shaping effective responses. However, relevant knowledge among Chinese women is scant. This study described Chinese women's IPV experiences by analyzing 46 posts shared by 42 women on a public online forum. Five overarching themes were identified using conventional qualitative content analysis: being trapped in my roles, no power in the relationship, the struggles are real but I need to tolerate, I want to leave but have no help, and hope for the future. This study has important implications for future research, practice, and education.