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Asian American Center on Disparities Research

Research

Major Research Programs

Clinical Effectiveness

    Project Leader: Gordon Hall
    Co-investigators: Nolan Zane and Janie Hong
    Project Coordinator:
    Research Assistant: Mimi Wong

Dr. Gordon Hall directs the Clinical Effectiveness Research Program that (a) tests the effectiveness of an empirically supported intervention by conducting a randomized effectiveness trial of combined Cognitive Therapy and pharmacotherapy vs. pharmacotherapy in the treatment of Asian American patients with major depression and (b) determines if certain culturally based variables such as somatization and loss of face and shame moderate the effects of these treatments. The study is the first to actually test the effects of an empirically supported intervention with Asian American patients. The study also involves one of the most comprehensive assessments of culturally based variables ever made on mental health clients to date, so that sociocultural effects can be effectively examined within the context of treatment. Asian American culturally-based tendencies toward somatization might result in expectations of treatments that directly address somatic symptoms, such as pharmacotherapy. Disclosures in psychotherapy could result in perceived loss of face not only for the individual, but also for significant others.

Medication Adherence

    Project Leader: Tonya Fancher
    Co-investigators: Ladson Hinton, Anthony Jerant, and Debora Paterniti
    Project Coordinator:

Major advances have occurred in medication treatment for mental health disorders. However, the odds of a good outcome if the patient is adherent are almost three times higher than the odds of a good outcome if the patient is non-adherent. Non-adherence occurs for a variety of reasons, and many of these can be linked to sociocultural variables such as the lack of help and support from family members and peers, the patientsí identity and self-image, as well as the meaning of the medication. Dr. Tonya Fancher directs the Medication Adherence Research Program that tests the effectiveness of a family-based approach to improving medication adherence among Southeast Asian patients. The underlying assumption of the approach is that family matters very much for adherence in Southeast Asian psychiatric outpatients and that key decision-makers within the family are often unavailable to clinicians, compromising attempts to improve compliance. The research is conducted in two phases. In the initial phase, qualitative methods are used to refine and improve the intervention model that has been developed for Hmong and Vietnamese patients. This is followed by an experimental study that compares the culturally targeted, family-based psychosocial intervention with a standard attention-control group.

Therapist Factors

    Project Leader: Wei-Chin Hwang
    Co-investigator: Stanley Sue
    Project Coordinator:

No study has investigated whether therapists considered to be more culturally competent by some criteria actually are more effective in treating ethnic minority clients than less culturally competent therapists. There also is virtually no knowledge of the extent to which evidence-based treatments are practiced in mental health systems. Dr. Wei-Chin Hwang leads the Therapist Factors Research Program, which conducts the first of these empirical tests. Using a prospective design, the research determines if therapist factors or characteristics associated with cultural competence and the use of evidence-based practices interact or independently affect treatment outcomes for mental health outpatient clients. This study will make major contributions to disparities research in several ways. First, it will determine if certain types of therapist characteristics, presumed to be cultural competent in nature, are actually predictive of treatment outcomes. Second, the research determines if therapist cultural competence contributes to treatment outcomes above and beyond the effects of other therapist factors. Third, the research may also yield some important interactions between therapist factors and the use of evidence-based treatments in predicting treatment outcomes.

Vietnamese Youth Stress and Coping Study (Adolescents Coping with Everyday Stress, ACES)

    Project Leader: Nolan Zane
    Project Coordinator:

This is a multi-site collaboration of Vanderbilt University, UCLA, and UC Davis. This project longitudinally follows a sample of adolescents in Southern California, Northern California, and Vietnam. The overall aim is to increase our understanding of how culture and cultural factors are related to human behavioral and emotional functioning, with a particular focus on the "stress - coping - symptom manifestation" system, with an ultimate goal of identifying cultural factors that could be useful for informing culturally specific interventions.

Other Studies