Introduction

The Mediators of Atherosclerosis in South Asians Living in America (MASALA) is the first longitudinal epidemiologic cohort study of South Asians Americans.  To understand nuances of participants’ lives that may be linked with health status, a subsample of MASALA participants with low and high risk for atherosclerotic cardiovascular disease (ASCVD) were interviewed about acculturative stress, health resources and access, and sources of support and resilience.

Methods

A total of 64 interviews were conducted with MASALA participants (19 Bangladeshis, 20 Indians, 25 Pakistanis) on their migration journey, adjusting to life in the U.S., health status, and social and family support in 2025. Interviews were conducted in Bangla, Urdu, Hindi, and English. Audio recordings of interviews were translated and transcribed to English. Modified grounded theory was used to analyze data, including an iterative process for codebook development, double coding of transcripts, and reviewing code outputs for common and unique themes. Data were analyzed using Dedoose.

Results

Preliminary findings indicated challenges associated with relocating to the U.S., adjusting to U.S. culture, and other transitions related to housing and employment. Examples of challenges included learning English and experiencing discrimination. Sources of support shared by participants included family members, friends, and neighbors in their home country and in the U.S. Other sources of support included religious beliefs and practices, and ethnic neighborhoods with shared language and culinary traditions. Despite past experiences with hardship, participants demonstrated resilience in care for themselves and their family members.

Discussion

These qualitative findings provide insight into the lived experiences of MASALA participants and their migration to and settlement in the U.S. While we are still analyzing differences between participants with low and high ASCVD risk, South Asian subgroups, and by gender, we have identified significant sources of support and resilience among participants, which are potential intervention points for improving health outcomes among South Asians.