Pilot Randomized Controlled Trial Protocol Evaluating an Evidence-based Parenting Intervention among Filipino Parents (Preprint)

BACKGROUND Filipino Americans underutilize mental health and preventive care services even though studies have indicated that Filipino youth experience high rates of suicidal ideation, substance abuse and teen pregnancy, while adults experience immigration stress, discrimination, and depression. Evidence-based parenting interventions provided in early childhood have proven to be effective in preventing the onset and escalation of child mental health disorders. In a pilot randomized controlled trial, we found that participation in the Incredible Years® (IY) Parent Training Program improved parenting stress and positive parenting practices and decreased child internalizing and externalizing symptoms among Filipino families. A fully powered trial is needed to determine the efficacy of IY as a prevention program among Filipino families. OBJECTIVE The aims of this manuscript are to 1) describe the design and rationale of a randomized controlled trial evaluating the effects of the on-line IY program among parents recruited from multiple community-based settings and its impact on parenting practices, parenting stress, and child problem behavior among Filipino Americans and 2) describe the impact of COVID-19 on our study protocols. METHODS This study uses a randomized controlled two-arm individually randomized group treatment pretest posttest design for 180 parent-child dyads. Individuals are eligible if they are 18 years or older, live in California, and have at least one Filipino child aged 8-12 years old. Consenting participants are randomly allocated to receive: (1) the 12-week Incredible Years parenting intervention (intervention arm), or (2) American Academy of Pediatrics’ Bright Future handouts and placed on a waitlist to receive IY post-trial (waitlist control arm). Primary outcomes include the Parent Practices Interview (PPI) and Parenting Stress Index (PSI). Secondary outcomes will be measured by the Child Behavior Checklist (CBCL, completed by Parent and Child) and will include child externalizing and externalizing behaviors, and total problems. Data is collected at baseline, 3-month and 6-month follow-ups. RESULTS Recruitment is currently ongoing. Changes made to the protocol due to COVID-19 include administration of surveys remotely and implementation of the intervention online. The pandemic has provided an opportunity to evaluate the effectiveness of an online version of IY that may improve access and increase use of the intervention. Recruitment and data collection procedures are still ongoing and are expected to be completed in one year. CONCLUSIONS Our research will determine whether IY promotes positive parenting practices and prevents child internalizing and externalizing behaviors among Filipino families with children ages 8-12 years old. It will also uplift cultural narratives and add to the evidence based supporting online parenting programs and their implementation in real-world settings. If found efficacious, IY has the potential to prevent behavioral health disparities in this understudied and high-risk Filipino population and can be scaled, adapted, and implemented in other at-risk ethnic minority communities. CLINICALTRIAL ClinicalTrials.gov NCT04031170; https://clinicaltrials.gov/ct2/show/NCT04031170

Differential Expression of Non-Coding RNA Signatures in Thyroid Cancer between Two Ethnic Groups

Filipino Americans show higher thyroid cancer recurrence rates compared to European Americans. Although they are likely to die of this malignancy, the molecular mechanism has not yet been determined. Recent studies demonstrated that small non-coding RNAs could be utilized to assess thyroid cancer prognosis in tumor models. The goal of this study is to determine whether microRNA (miRNA) signatures are differentially expressed in thyroid cancer in two different ethnic groups. We also determined whether these miRNA signatures are related to cancer staging. This is a retrospective study of archival samples from patients with thyroid cancer (both sexes) in the pathology division from the last ten years at Loma Linda University School of Medicine, California. Deidentified patient demographics were extracted from the patient chart. Discarded formalin-fixed paraffin-embedded tissues were collected post-surgeries. We determined the differential expressions of microRNA in archival samples from Filipino Americans compared to European Americans using the state-of-the-art technique, HiSeq4000. By ingenuity pathway analysis, we determined miRNA targets and the pathways that those targets are involved in. We validated their expressions by real-time quantitative PCR and correlated them with the clinicopathological status in a larger cohort of miRNA samples from both ethnicities. We identified the differentially upregulated/downregulated miRNA clusters in Filipino Americans compared to European Americans. Some of these miRNA clusters are known to target genes that are linked to cancer invasion and metastasis. In univariate analysis, ethnicity and tumor staging were significant factors predicting miR-4633-5p upregulation. When including these factors in a multivariate logistic regression model, ethnicity and tumor staging remained significant independent predictors of miRNA upregulation, whereas the interaction of ethnicity and tumor staging was not significant. In contrast, ethnicity remained an independent predictor of significantly downregulated miR-491-5p and let-7 family. We provide evidence that Filipino Americans showed differentially expressed tumor-tissue-derived microRNA clusters. The functional implications of these miRNAs are under investigation.

Filipino Festivals in Southern California

Filipino festivals (also “Philippine festivals”) in southern California are lively, dynamic events that draw multigenerational and multicultural crowds to enjoy food, partake in traditional games and crafts, buy Filipino pride gear, and watch a variety of acts that showcase the talent and creativity of Filipino Americans. Inclusive of those who identify as immigrant, U.S.-born, and transnational, Filipinos from across the region convene to express pride and promote visibility as an overlooked and marginalized ethnic group in the United States. The first public performances by Filipinos in the United States were in exhibits curated by colonial officials at the St. Louis World’s Fair in 1904 to justify colonization of the Philippines. Presented as an uncivilized people in need of American tutelage, this stereotyping of Filipinos as primitives motivated pensionados or students from the Philippines to represent themselves; they organized Rizal Day starting in 1905, which valorized national Philippine hero José Rizal, in order to highlight their identity as modern, educated people. New immigrants, who were mostly rural, single men from the northern Philippines, arrived in the 1930s and frequented taxi dance halls in which Filipino jazz musicians and dancers flourished. Yet the established Filipino community criticized these venues as places of vice that were lacking in family and traditional cultural values. Philippine folk dances were not prevalent among Filipino Americans until after the Philippine Bayanihan Folk Dance Company appeared on the Ed Sullivan Show in 1958. Due to their influence, Filipino American folk dance troupes were established across the nation, presenting Philippine cultures through stylistically diverse dances such as the Indigenous or Tribal suite, the Muslim or “Moro” suite, and the Maria Clara or Spanish-influenced suite. Folk dance performance became a hallmark of festivals such as the Philippine Folk Festival, which has been held annually in San Diego since 1979 (renamed the Philippine Cultural Arts Festival in 1996). In Los Angeles, the Festival of Philippine Arts and Culture began in 1992, attracting thousands from around the region. These large-scale public Filipino festivals in southern California offer opportunities to gain insight into the variety of ways in which Filipino Americans creatively express a range of experiences, interests, and concerns. While folk dance troupes and traditional music ensembles such as Spanish-influenced rondalla (plucked string instruments) are most visibly tied to representations of Philippine traditions, rappers, DJs, spoken word artists, hip-hop dance crews, R&B singers, and rock bands demonstrate Filipinos’ mastery of American popular forms. With origins in community celebrations since the early 1900s, Filipino festivals of the early 21st century reflect changes and continuities in California’s Filipino communities, which have adapted to internal dynamics, larger societal forces, and engagement with the homeland of the Philippines.

Not all Asians End up on Third Base

Scholars generally treat Asians as a homogenous, high-performing population. However, for Filipino Americans, this is not always the case. The analysis of why Filipino Americans are less likely than those in other large hyper-selected Asian groups to get to “third base” demonstrates the need to avoid treating Asians as a homogenous group.

Evaluating psychosocial and physical activity outcomes following an intervention among Filipino Americans

Background: Physical activity (PA) is a strong contributor to enhancing a healthy lifestyle and preventing numerous chronic diseases. As ethnic minorities engage in low levels of PA, psychosocial and activity-based interventions for sustaining PA are crucial. Methods: The 6-month intervention incorporated culturally tailored educational workshops and weekly PA classes at a community center. Educational workshops were led by six trained community health workers (CHWs). Participants (n=37) completed pre- and post-intervention questionnaires regarding PA related self-efficacy, outcome expectations, social support, enjoyment, self-regulation, goal setting, and overall PA. Results: Following the intervention, study participants exhibited increases in weekly PA levels. Wilcoxon Signed-Rank test revealed higher median scores for Exercise Self-Efficacy Scale (ESES), Identified Regulation, and Intrinsic Motivation. Positive changes were observed for Physical Outcome Expectations, Social Outcome Expectations, Self-Evaluative Outcome Expectations, Physical Activity Enjoyment, Social Support for Exercise Scale – Family, Social Support for Exercise – Friends, and Exercise Goal-Setting. Conclusion: Community-based PA interventions may provide potential benefits to Filipino Americans, an ethnic Asian minority group, in identifying exercise benefits, developing proper exercise goals, increasing motivation, promoting PA behavior, and facilitating long-term PA adherence.

"It's the Filipino Way": Remittance Practices of Filipino American Families

Remittances, money, or products sent to relatives at a distance is a common practice Filipino Americans use to retain ties and assist their family members living in the Philippines. This study investigated first-generation Filipino Americans' remittance practices and secondgeneration's intention to remit, to better understand the dynamics around remittance and generational differences. Qualitative interviews revealed complex motivations and reasons for remitting money and balikbayan boxes to the Philippines, and they shed light on the multifaceted cultural identity of both generations, including the tradition of remitting, giving back, and the family pressure to do so. Secondgeneration respondents felt less pressure to remit and reported weaker ties to their heritage and to the Philippines itself. FCS professionals are called to investigate and understand the minority experience of remittance and how it can shape family values.

Diasporic Performativity in the Practice of Karaoke

This study explores how karaoke serves as a spatializing practice for Filipino Americans in Chicago from which a new poetics of diaspora life is performed. Space, as argued by Lefebvre, is essentially empty but becomes occupied through visual cues animated by the gestures and actions of those who inhabit it. The spatializing potential of karaoke places everyday life as a site of discourse where music and childhood memories serve not only as objects of the past but also as cultural imaginaries that live and breathe in the present. Drawing from interviews of and engaging in participant observation with Filipino Americans in Chicago from various occupational backgrounds, this study argues that karaoke as a cultural practice is informed by a logic of diasporic performativity that locates active engagement with media as an expression of human agency. The spaces of interaction that it creates embody a reconstruction of home, identity, and community, the discursive potential of which can be as political as it is poetic. Through karaoke, perceived dichotomies between performer and spectator, immigrant and American-born, homeland and hostland are untangled creating social and emotional bonds that offer possibilities of social critique.