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Priddle T, Crawford T, Power T. The inclusion and representation of LGBTIQ+ content in undergraduate nurse education: A scoping review. NURSE EDUCATION TODAY 2023; 124:105771. [PMID: 36889046 DOI: 10.1016/j.nedt.2023.105771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/11/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES The aim of this review was to gain an overview of existing empirical literature examining LGBTIQ+ content in undergraduate nursing curricula. DESIGN An international scoping review was conducted using librarian assisted search strategies. DATA SOURCES The databases CINAHL, SCOPUS and ERIC were searched. A total of 30 studies meeting the eligibility criteria were included in this review. REVIEW METHODS Following a quality appraisal, thematic analysis was conducted to identify six key themes. RESULTS 30 studies spanning 8 countries, across 5 continents were included in this review. 6 themes emerged 1) Level of Knowledge Regarding LGBTIQ+ People and Their Specific Health Needs, 2) Comfort and Preparedness in the Provision of Care to LGBTIQ+ People, 3) Attitudes Toward LGBTIQ+ People, 4) Inclusion of LGBTIQ+ Educational Content, 5) Framing of LGBTIQ+ Educational Content, 6) Pedagogical Strategies to Incorporate LGBTIQ+ Content. CONCLUSIONS Nurse education is dominated by heteronormativity, deficit discourses, stereotypes, binary ideologies and western cultural perspectives. The body of literature surrounding LGBTIQ+ content in nurse education is largely quantitative, insular and contributes to the erasure of unique identities under the LGBTIQ+ umbrella.
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Affiliation(s)
- Tyler Priddle
- Level 8, D18 - Susan Wakil Health Building, The University of Sydney, Gadigal Country, Camperdown, NSW, 2006, Australia.
| | - Tonia Crawford
- Level 8, D18 - Susan Wakil Health Building, The University of Sydney, Gadigal Country, Camperdown, NSW, 2006, Australia.
| | - Tamara Power
- Level 8, D18 - Susan Wakil Health Building, The University of Sydney, Gadigal Country, Camperdown, NSW, 2006, Australia.
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152
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Roman CS. A Personal Reflection on the Concept of Cultural Safety. Holist Nurs Pract 2023; 37:E51-E52. [PMID: 37070844 DOI: 10.1097/hnp.0000000000000579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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153
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Hamzehpour H, Ashktorab T, Esmaeili M. Safe acceptance in the nurses' cultural care of medical tourists in Iran: a qualitative study. BMC Health Serv Res 2023; 23:399. [PMID: 37098493 PMCID: PMC10127161 DOI: 10.1186/s12913-023-09378-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 04/07/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Medical tourism is traveling to another country to promote, restore and maintain health, recreation, and pleasure. There are different types of health tourism, including medical tourism, recovery tourism, and preventive tourism. This study aimed to explain safe acceptance in the nurses' cultural care of medical tourists in Iran. METHODS In this qualitative study, 18 semi-structured interviews were conducted with nurses, patients, and patients' relatives, who had been selected by purposeful sampling in 2021-2022. The interviews were recorded, transcribed, and then analyzed by conventional content analysis. RESULTS The statistical analysis revealed that the main theme of this study was safe acceptance which included the five categories of trust building, safety, maintaining comfort and peace, stress control, and identifying patients' expectations. CONCLUSIONS The present study demonstrated that safe acceptance of cultural care was essential to medical tourism. Iranian nurses were aware of the factors that affected cultural care and the safe acceptance of medical tourists. Moreover, they carried out the necessary measures to achieve safe acceptance. In this regard, solutions such as developing a comprehensive and mandatory national qualification program and evaluating its periodic performance in this field are suggested.
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Affiliation(s)
- Hero Hamzehpour
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences Islamic Azad University, Tehran, Iran
| | - Tahereh Ashktorab
- Department of Management, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, 00 98 912 236 1149, Iran.
| | - Maryam Esmaeili
- Nursing and Midwifery Care Research Center, Critical Care Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Nash K, Macniven R, Clague L, Coates H, Fitzpatrick M, Gunasekera H, Gwynne K, Halvorsen L, Harkus S, Holt L, Lumby N, Neal K, Orr N, Pellicano E, Rambaldini B, McMahon C. Ear and hearing care programs for First Nations children: a scoping review. BMC Health Serv Res 2023; 23:380. [PMID: 37076841 PMCID: PMC10116763 DOI: 10.1186/s12913-023-09338-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/24/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Ear and hearing care programs are critical to early detection and management of otitis media (or middle ear disease). Otitis media and associated hearing loss disproportionately impacts First Nations children. This affects speech and language development, social and cognitive development and, in turn, education and life outcomes. This scoping review aimed to better understand how ear and hearing care programs for First Nations children in high-income colonial-settler countries aimed to reduce the burden of otitis media and increase equitable access to care. Specifically, the review aimed to chart program strategies, map the focus of each program against 4 parts of a care pathway (prevention, detection, diagnosis/management, rehabilitation), and to identify the factors that indicated the longer-term sustainability and success of programs. METHOD A database search was conducted in March 2021 using Medline, Embase, Global Health, APA PsycInfo, CINAHL, Web of Science Core Collection, Scopus, and Academic Search Premier. Programs were eligible or inclusion if they had either been developed or run at any time between January 2010 to March 2021. Search terms encompassed terms such as First Nations children, ear and hearing care, and health programs, initiatives, campaigns, and services. RESULTS Twenty-seven articles met the criteria to be included in the review and described a total of twenty-one ear and hearing care programs. Programs employed strategies to: (i) connect patients to specialist services, (ii) improve cultural safety of services, and (iii) increase access to ear and hearing care services. However, program evaluation measures were limited to outputs or the evaluation of service-level outcome, rather than patient-based outcomes. Factors which contributed to program sustainability included funding and community involvement although these were limited in many cases. CONCLUSION The result of this study highlighted that programs primarily operate at two points along the care pathway-detection and diagnosis/management, presumably where the greatest need lies. Targeted strategies were used to address these, some which were limited in their approach. The success of many programs are evaluated as outputs, and many programs rely on funding sources which can potentially limit longer-term sustainability. Finally, the involvement of First Nations people and communities typically only occurred during implementation rather than across the development of the program. Future programs should be embedded within a connected system of care and tied to existing policies and funding streams to ensure long term viability. Programs should be governed and evaluated by First Nations communities to further ensure programs are sustainable and are designed to meet community needs.
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Affiliation(s)
- Kai Nash
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia.
| | - Rona Macniven
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Liesa Clague
- Thurru Indigenous Unit, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Harvey Coates
- The University of Western Australia, Perth, Australia
| | | | | | - Kylie Gwynne
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | - Luke Halvorsen
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | | | - Leanne Holt
- Department of Indigenous Studies, Macquarie University, Sydney, Australia
| | - Noeleen Lumby
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | | | - Neil Orr
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | | | - Boe Rambaldini
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
| | - Catherine McMahon
- The Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Sydney, Australia
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155
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Marchand T, Daodu O, MacRobie A, Green-Dowden S, Brindle M. Examining Indigenous emergency care equity projects: a scoping review protocol. BMJ Open 2023; 13:e068618. [PMID: 37015788 PMCID: PMC10083800 DOI: 10.1136/bmjopen-2022-068618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
INTRODUCTION Indigenous peoples across the globe face inequitable access to high-quality care. Emergency departments are the first point of access for many Indigenous peoples and are the interface between the individual and the healthcare system. There is a reliance on emergency services due to a lack of primary healthcare, a history of mistreatment from providers and increased disease complexity. As such, a potential place for health equity reform is within these departments and other acute care settings. It is the purpose of this review to determine what projects have occurred that address emergency care inequities in four countries such as Australia, Canada, New Zealand and the USA and explore their successes and failures. METHODS AND ANALYSIS Using search strategies developed with a research librarian, publications will be identified from indexed databases including Medline, Embase, Web of Science, Cochrane Central, CINAHL and Scopus. Grey literature will also be searched and scanned for inclusion. To be included in the review, articles must describe interventions developed to address Indigenous health equity occurring within emergency care settings. Articles will include both programme descriptions and programme evaluations and be quality appraised by analysing study design and Indigenous research methodologies. ETHICS AND DISSEMINATION This review does not require ethics approval. This protocol describes a review that attempts to map Indigenous health equity interventions taking place within emergency care settings. It will contribute to Indigenous health scholarship and equity research. Results will be made available in multiple dissemination methods to ensure accessibility by researchers and community members.
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Affiliation(s)
- Tyara Marchand
- University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Surgery, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | | | - Ali MacRobie
- Surgery, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | | | - Mary Brindle
- Surgery, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Ariadne Labs, Boston, Massachusetts, USA
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156
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Sar BK. Refugee Family Health Brokers' (FHBs') Experiences with Health Care Providers: A Thematic Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5381. [PMID: 37047995 PMCID: PMC10094286 DOI: 10.3390/ijerph20075381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/24/2023] [Accepted: 03/23/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The resettlement and post-resettlement quality of life of refugees is often marred by chronic health/mental health conditions. To adequately care for refugees suffering these conditions, a promising strategy is the use of refugee Family Health Brokers (FHBs). FHBs are safe and trusted family members functioning as intermediaries between one's family and health care providers. Although FHBs are known to positively influence health care utilization in their families, little is known about them and this aspect of their family caregiving role and experiences, particularly with health care providers, necessitating further research. METHODS Fourteen Bhutanese and three Bosnian refugee FHBs participated in a 2-hr focus group discussing their experiences with health care providers after being surveyed about their FHB role. RESULTS Thematic analysis yielded five themes centered around perceptions, knowledge, communication, behavior, and responsibilities reflective of FHBs' experiences, which can be understood as symptoms of existing structural inequalities. CONCLUSIONS FHBs primarily conveyed problems, struggles, and dilemmas they experienced more so than rewarding aspects of being an FHB. Suggestions are provided on how to avert these negative experiences from occurring and becoming barriers to developing allyship with FHBs in the context of existing structural inequalities.
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Affiliation(s)
- Bibhuti K Sar
- Kent School of Social Work and Family Science, University of Louisville, Louisville, KY 40208, USA
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157
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Perkins S, Nishimura H, Olatunde PF, Kalbarczyk A. Educational approaches to teach students to address colonialism in global health: a scoping review. BMJ Glob Health 2023; 8:bmjgh-2022-011610. [PMID: 37055173 PMCID: PMC10106004 DOI: 10.1136/bmjgh-2022-011610] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/18/2023] [Indexed: 04/15/2023] Open
Abstract
INTRODUCTION The enduring legacy of colonisation on global health education, research and practice is receiving increased attention and has led to calls for the 'decolonisation of global health'. There is little evidence on effective educational approaches to teach students to critically examine and dismantle structures that perpetuate colonial legacies and neocolonialist control that influence in global health. METHODS We conducted a scoping review of the published literature to provide a synthesis of guidelines for, and evaluations of educational approaches focused on anticolonial education in global health. We searched five databases using terms generated to capture three concepts, 'global health', 'education' and 'colonialism'. Pairs of study team members conducted each step of the review, following Preferred Reporting Items for Systematic reviews and Meta-Analyse guidelines; any conflicts were resolved by a third reviewer. RESULTS This search retrieved 1153 unique references; 28 articles were included in the final analysis. The articles centred North American students; their training, their evaluations of educational experiences, their individual awareness and their experiential learning. Few references discussed pedagogical approaches or education theory in guidelines and descriptions of educational approaches. There was limited emphasis on alternative ways of knowing, prioritisation of partners' experiences, and affecting systemic change. CONCLUSION Explicit incorporation of anticolonial curricula in global health education, informed by antioppressive pedagogy and meaningful collaboration with Indigenous and low-income and middle-income country partners, is needed in both classroom and global health learning experiences.
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Affiliation(s)
- Sylvie Perkins
- Center for Indigenous Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Holly Nishimura
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Praise F Olatunde
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anna Kalbarczyk
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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158
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Jones LL, Costello BD, Danks E, Jolly K, Cross-Sudworth F, Byrne A, Fassam-Wright M, Latthe P, Clarke J, Adbi A, Abdi H, Abdi H, Taylor J. Preferences for deinfibulation (opening) surgery and female genital mutilation service provision: A qualitative study. BJOG 2023; 130:531-540. [PMID: 36572653 DOI: 10.1111/1471-0528.17358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/27/2022] [Accepted: 11/08/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To explore the views of female genital mutilation (FGM) survivors, men and healthcare professionals (HCPs) on the timing of deinfibulation surgery and NHS service provision. DESIGN Qualitative study informed by the sound of silence framework. SETTING Survivors and men were recruited from three FGM prevalent areas of England. HCPs and stakeholders were from across the UK. SAMPLE Forty-four survivors, 13 men and 44 HCPs. Ten participants at two community workshops and 30 stakeholders at a national workshop. METHODS Hybrid framework analysis of 101 interviews and three workshops. RESULTS There was no consensus across groups on the optimal timing of deinfibulation for survivors who wished to be deinfibulated. Within group, survivors expressed a preference for deinfibulation pre-pregnancy and HCPs antenatal deinfibulation. There was no consensus for men. Participants reported that deinfibulation should take place in a hospital setting and be undertaken by a suitable HCP. Decision making around deinfibulation was complex but for those who underwent surgery it helped to mitigate FGM impacts. Although there were examples of good practice, in general, FGM service provision was suboptimal. CONCLUSION Deinfibulation services need to be widely advertised. Information should highlight that the procedure can be carried out at different time points, according to preference, and in a hospital by suitable HCPs. Future services should ideally be developed with survivors, to ensure that they are clinically and culturally appropriate. Guidelines would benefit from being updated to reflect the needs of survivors and to ensure consistency in provision.
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Affiliation(s)
- Laura L Jones
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Emma Danks
- Faculty of Education Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Alison Byrne
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Pallavi Latthe
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.,Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Joanne Clarke
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Ayan Adbi
- Patient Representative and Collaborator
| | - Hodo Abdi
- Patient Representative and Collaborator
| | | | - Julie Taylor
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.,School of Nursing, University of Birmingham, Birmingham, UK
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159
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Hikaka J, Haua R, Parore N, McIntosh B, Anderson A, Pewhairangi K, Brown R. Designing for health equity: A mixed method study exploring community experiences and perceptions of pharmacists' role in minor ailment care. Res Social Adm Pharm 2023; 19:643-652. [PMID: 36639337 DOI: 10.1016/j.sapharm.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/22/2022] [Accepted: 12/29/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Minor ailments are self-limiting, easily diagnosable and treatable conditions. Funded pharmacist minor ailments services (PMAS) have been posited to improve medicines access equity and, despite ethnic minorities across the globe experiencing reduced access to medicines and health care, PMAS internationally have not explicitly centered ethnic equity in service design or outcome measurement. OBJECTIVE To explore Māori experiences of minor ailments care and perceptions of the pharmacists' role. METHODS This mixed methods study collected data through facilitated wānanga (collaborative knowledge-sharing group discussions). Eligible participants (Māori, 18 years plus, obtained medicine from pharmacy in last 3 years) were recruited through local pharmacist networks using convenience sampling. Wānanga included qualitative data collection through discussion using a topic guide and a quantitative questionnaire. Indigenous theory was applied within a general inductive approach to thematic development to analyze qualitative data. Quantitative data was reported using simple descriptive statistics. RESULTS Thirteen wānanga (3 in-person, 10 online) were conducted from September 2021-February 2022 with 62 participants from seven New Zealand regions. The minor ailments that participants were most likely to seek treatment from pharmacy first, instead of a doctor, were eczema (87.2%), coughs and colds (85.7%), headlice (85.7%), insect bites (83.9%), and hayfever (83.9%). Four themes were generated from the qualitative data: designing the right environment for minor ailment care; clinically and culturally safe care; moving from stigmatizing to strengths-based services; the benefits of PMAS. Participant-informed ideas for PMAS service development centered on Māori aspirations included: developing clinically and culturally safe pharmacy environments, enabling medicine supply outside of the physical pharmacy setting, avoiding stigmatizing language when promoting PMAS availability, and collaborative practice with other health providers. CONCLUSION This study provides important recommendations when developing PMAS to increase the likelihood of delivering equitable care, and has international application across multiple pharmacy and health service settings.
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Affiliation(s)
- Joanna Hikaka
- Ngā Kaitiaki o Te Puna Rongoā o Aotearoa- the Māori Pharmacists' Association, PO Box 42013, Acacia Bay Post Shop, Taupō, 3330, New Zealand.
| | - Robert Haua
- Ngā Kaitiaki o Te Puna Rongoā o Aotearoa- the Māori Pharmacists' Association, PO Box 42013, Acacia Bay Post Shop, Taupō, 3330, New Zealand
| | - Nora Parore
- Ngā Kaitiaki o Te Puna Rongoā o Aotearoa- the Māori Pharmacists' Association, PO Box 42013, Acacia Bay Post Shop, Taupō, 3330, New Zealand
| | - Brendon McIntosh
- Ngā Kaitiaki o Te Puna Rongoā o Aotearoa- the Māori Pharmacists' Association, PO Box 42013, Acacia Bay Post Shop, Taupō, 3330, New Zealand
| | | | - Kevin Pewhairangi
- Ngā Kaitiaki o Te Puna Rongoā o Aotearoa- the Māori Pharmacists' Association, PO Box 42013, Acacia Bay Post Shop, Taupō, 3330, New Zealand
| | - Rachel Brown
- The National Hauora Coalition, Auckland, New Zealand
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160
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Lokugamage AU, Rix EL, Fleming T, Khetan T, Meredith A, Hastie CR. Translating Cultural Safety to the UK. JOURNAL OF MEDICAL ETHICS 2023; 49:244-251. [PMID: 34282043 DOI: 10.1136/medethics-2020-107017] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 06/24/2021] [Indexed: 06/13/2023]
Abstract
Disproportional morbidity and mortality experienced by ethnic minorities in the UK have been highlighted by the COVID-19 pandemic. The 'Black Lives Matter' movement has exposed structural racism's contribution to these health inequities. 'Cultural Safety', an antiracist, decolonising and educational innovation originating in New Zealand, has been adopted in Australia. Cultural Safety aims to dismantle barriers faced by colonised Indigenous peoples in mainstream healthcare by addressing systemic racism.This paper explores what it means to be 'culturally safe'. The ways in which New Zealand and Australia are incorporating Cultural Safety into educating healthcare professionals and in day-to-day practice in medicine are highlighted. We consider the 'nuts and bolts' of translating Cultural Safety into the UK to reduce racism within healthcare. Listening to the voices of black, Asian and minority ethnic National Health Service (NHS) consumers, education in reflexivity, both personal and organisational within the NHS are key. By listening to Indigenous colonised peoples, the ex-Empire may find solutions to health inequity. A decolonising feedback loop is required; however, we should take care not to culturally appropriate this valuable reverse innovation.
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Affiliation(s)
- Amali U Lokugamage
- Department of Clinical and Professional Practice, University College London Medical School, London, UK
- Department of Women's Health, Whittington Health NHS Trust, London, UK
| | - Elizabeth Liz Rix
- Faculty of Health, Southern Cross University, Gold Coast Campus, Bilinga, Queensland, Australia
| | - Tania Fleming
- School of Midwifery, Auckland University of Technology, Auckland, New Zealand
| | - Tanvi Khetan
- University College London Medical School Alumni, University College London, London, UK
| | - Alice Meredith
- University College London Medical School Alumni, University College London, London, UK
| | - Carolyn Ruth Hastie
- Department of Nursing and Midwifery, Griffith University Faculty of Health, Gold Coast, Queensland, Australia
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161
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Fialkowski MK, Sandlin MR, Kai J, Ng-Osorio J, Custodio RC, Odom SK, Boyd JK, Medina C, Takahashi D, Esquivel MK. An Exploratory Mixed Method Cross-Sectional Study to Identify Opportunities to Increase Enrollment and Retention of Native Hawaiian Students in an Undergraduate Dietetic Program. J Acad Nutr Diet 2023; 123:577-592.e5. [PMID: 36002112 DOI: 10.1016/j.jand.2022.08.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 08/05/2022] [Accepted: 08/18/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Native Hawaiians (NH) are underrepresented in dietetics, contributing to less than 1% of the profession nationally. Increasing the number of NH Registered Dietitian Nutritionists (RDN) is one mechanism to facilitate improved health outcomes in disparate populations. OBJECTIVES 1) Identify and summarize NH student interests in the field of nutrition and dietetics; 2) Identify and contextualize factors that support and prohibit achievement of academic goals and aspirations; 3) Identify NH students' responsibility to the community; 4) Explore the context around NH alumni enrollment in nutrition and dietetics and their perceived impact of RDNs in the community; 5) Identify and describe supporting agencies that foster academic and professional success. DESIGN This exploratory mixed-methods cross-sectional study surveyed all levels of NH nutrition and dietetics students in the University of Hawai'i (UH) System. In addition, in-depth interviews were conducted with NH students, NH alumni, and supporting agencies to identify supports and barriers, explore the context of NH enrollment in nutrition and dietetics, and the contribution of dietetics to the NH community. PARTICIPANTS/SETTING Eighty-one NH students enrolled in a nutrition course across the UH system were surveyed. Nine of the 81 NH students surveyed, eight NH alumni, and persons from 15 identified supporting agencies were interviewed. ANALYSIS Survey responses were descriptively analyzed. Open-ended survey questions and interviews were analyzed through content analysis. To ensure findings were guided by NH perspective, data were triangulated by researchers and a NH dietetics advisory council. RESULTS Food and chronic disease prevention and management were topics that drew NH students to the field. Bridge/scholarship programs supported NH academic achievement. Education-related cost was a perceived barrier. Alumni and students shared varying degrees of responsibility to serve the NH community. Increasing the connection between NH values and the nutrition and dietetics curriculum are an identified need. CONCLUSION Findings illuminate opportunities to drive future programmatic efforts. The framework used in this study should be adaptable to other programs to support overall dietetics diversity initiatives.
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162
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Makanjee CR, Allen M, Lee J, Gyawali J, Hayre C, Lewis S. Diagnostic radiography students' perspectives on cultural competence and safety. Radiography (Lond) 2023; 29 Suppl 1:S96-S102. [PMID: 36935246 DOI: 10.1016/j.radi.2023.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/22/2023] [Accepted: 03/02/2023] [Indexed: 03/19/2023]
Abstract
INTRODUCTION Cultural competency and safety are essential components to consider in the provision of person-centred equitable healthcare. Therefore, student radiographers' learning should include the necessary knowledge, skill sets and competence to recognise the patient's unique characteristics to enable culturally competent and safe medical imaging services. Therefore, this study explored undergraduate and postgraduate diagnostic radiography students' perspectives on cultural competency and safety. METHODS A qualitative phenomenological design with a hermeneutic phenomenological approach was followed to explore student perspectives. Student radiographers (second and third-year undergraduate and first and second-year postgraduate) from the study site were purposively and conveniently recruited to participate in focus group interviews. Fifteen focus group interviews were conducted, recorded and transcribed verbatim before undergoing thematic analysis. RESULTS Thematic analysis identified two themes. Theme one centred around the cultural competence and safety learnt by student radiographers at university and the second theme cultural competence and safety learnt in workplace learning. CONCLUSION This study demonstrated the importance of cultural competence and safe practice in examining patients of different cultures. It highlights the importance of creating awareness among students of their own abilities and capabilities of cultural sensitivity and safe practice as part of their learning. Future health professionals should be empowered to address and respond to patients' unique needs in a competent, safe and professional manner to reduce health disparities. IMPLICATIONS FOR PRACTICE Cultural competence and safety are integral to person-centred care. Including these concepts in radiography education is therefore vital to ensure optimal patient outcomes.
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Affiliation(s)
- C R Makanjee
- Department of Medical Radiation Science, University of Canberra, University Drive, Bruce, ACT 2617, Australia.
| | - M Allen
- Department of Medical Radiation Science, University of Canberra, University Drive, Bruce, ACT 2617, Australia.
| | - J Lee
- Department of Medical Radiation Science, University of Canberra, University Drive, Bruce, ACT 2617, Australia.
| | - J Gyawali
- Department of Medical Radiation Science, University of Canberra, University Drive, Bruce, ACT 2617, Australia.
| | - C Hayre
- Department of Health and Care Professions, University of Exeter, College of Medicine and Health, Room 1.32, South Cloisters, UK.
| | - S Lewis
- Department of Medical Imaging and Radiation Sciences, Faculty of Health Sciences, University of Johannesburg, South Africa; University of Johannesburg, DFC Campus, JOB 6306a, Doornfontein, Johannesburg, South Africa.
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163
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Yıldız M, Yildirim MS, Elkoca A, Varol E, Aydin MA, Dege G. Investigation of the Relationship Between Xenophobic Attitude and Intercultural Sensitivity Level in Health Education Students. J Transcult Nurs 2023; 34:238-246. [PMID: 36927307 DOI: 10.1177/10436596231158136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Intercultural sensitivity and xenophobia levels of health education students can affect the care they give to the patient. It is important to know the level of intercultural sensitivity and xenophobia of students receiving health education and to determine the relationship between them. The purpose of the study was to examine the relationship between xenophobic attitudes and intercultural sensitivity among university students. METHODS This quantitative cross-sectional research was conducted in between January and June 2022 with health education students. The study conducted with health education students at Gumushane University and Agri Ibrahim Cecen University. Child Development, Nursing, Emergency Management Services/Technicians, Nutrition and Dietetics, Elderly care, Social services, Medical Laboratory Techniques, and Disabled Care studying at these universities were included in the study. Students who received health education and wanted to participate voluntarily in the study were included. Students aged 18 and over, studying in the health education department of the university, studying in the 1, 2, 3, 4th classes and volunteering to participate in the study were included in the study. The Introductory Information Form, the Xenophobia Scale, and the Intercultural Sensitivity Scale were used to collect the research data. RESULTS This study was conducted with 789 students. According to our study, a significant negative correlation was found between the students' xenophobia scale and the intercultural sensitivity scale total score means (p < .05). Intercultural sensitivity has a negative and significant effect on the level of xenophobia (β = -0.116; t (787) = -3.283, p = .001). A significant difference was found between the students' Xenophobia Scale total score mean and gender, department, and grade (p < .05) as was the case between Intercultural Sensitivity Scale total score mean and gender, department, grade, immigrant acquaintance, and foreign language knowledge (English language) level (p < .05). DISCUSSION Intercultural sensitivity has a negative and significant effect on the level of xenophobia. It can negatively affect the level of caregiving of students receiving health education. It is thought that intercultural sensitivity will be developed by including course content in the curriculum to increase students' intercultural effectiveness and awareness levels and to reduce xenophobic prejudices.
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Affiliation(s)
| | | | - Ayşe Elkoca
- Gaziantep Islamic Science and Technology University, Turkey
| | - Ela Varol
- Agri Ibrahim Cecen University, Turkey
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Ramke J, Zhao J, Wilson O, Lee A, Dakin S, Watene R, Cunningham W, Harwood M, Black J. Geographic access to eye health services in Aotearoa New Zealand: which communities are being left behind? Clin Exp Optom 2023; 106:158-164. [PMID: 35917587 DOI: 10.1080/08164622.2022.2102410] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
CLINICAL RELEVANCE Efforts to provide accessible eye care must consider the extent to which travel-distance may be a barrier for some communities. BACKGROUND This study aimed to determine the distribution of - and geographic access to - eye health services in Aotearoa New Zealand. We further sought to identify communities who might benefit from provision of eye health services that were more geographically accessible. METHODS We obtained addresses of optometry and ophthalmology clinics from regulatory bodies and augmented this with online searches. Address locators were created using a Land Information dataset and geocoded using ArcGIS 10.6. A national population was derived using Statistics New Zealand's Integrated Data Infrastructure. We generated population-weighted centroids of each of New Zealand's 50,938 meshblocks and calculated the travel distance along the road network between each clinic and population (meshblock centroid). The proportion of the population living >50 km from each clinic type was calculated; as was the median, inter-quartile range and maximum distance across area-level deprivation quintiles in each district. RESULTS A national population of 4.88 million was identified, as were addresses for 344 optometry, 46 public ophthalmology and 90 private ophthalmology clinics. Nationally and within each district, travel distance to optometry was shorter than to either type of ophthalmology clinic. The region of Northland - with a high proportion of the population Māori and in the highest quintile of area-level deprivation - had the furthest average distance to travel to optometry and public ophthalmology, while the West Coast region on the South Island had the farthest to travel to private ophthalmology. Several communities were identified where longer distances intersected with higher area-level deprivation. CONCLUSION Most New Zealanders live within 10 km of eye health services. However, to achieve equitable eye health, strategies are required that make affordable eye health services accessible to communities for whom large travel distances intersect with high deprivation.
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Affiliation(s)
- Jacqueline Ramke
- School of Optometry & Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jinfeng Zhao
- School of Population Health, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Oliver Wilson
- School of Population Health, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Arier Lee
- School of Population Health, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Steven Dakin
- School of Optometry & Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Renata Watene
- School of Optometry & Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - William Cunningham
- Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand
| | - Matire Harwood
- School of Population Health, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Joanna Black
- School of Optometry & Vision Science, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand
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165
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Anstice NS, Alam K, Armitage JA, Biles B, Black JM, Boon MY, Carlson T, Chinnery HR, Collins AV, Cochrane A, Duthie D, Hopkins S, Fitzpatrick G, Keay L, Watene R, Yashadhana A, Bentley SA. Developing culturally safe education practices in optometry schools across Australia and Aotearoa New Zealand. Clin Exp Optom 2023; 106:110-118. [PMID: 36336833 DOI: 10.1080/08164622.2022.2136514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Access to culturally safe health services is a basic human right, however through the lasting effects of colonisation, oppression, and systemic racism, the individual and community health of Indigenous peoples in Australia and Aotearoa New Zealand have been severely impacted. The Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy of the Australian Health Practitioners Regulation Agency, and the Standards of Cultural Competence and Cultural Safety of the Optometrists and Dispensing Opticians Board of New Zealand, recognise the importance of access to safe health care for Aboriginal, Torres Strait Islander and Māori patients, which encompasses both clinical competency and cultural safety. Universities have an ongoing responsibility to ensure their learning and teaching activities result in graduates being able to provide culturally safe practice. This article highlights the emergence of culturally safe practices in the Australian and Aotearoa New Zealand optometry curricula over the last five years incorporating Indigenous ways of knowing, being and doing into the curricula, understanding the local Indigenous histories and contexts, the adoption of online cultural education modules, and clinical placement partnerships with local Indigenous communities. Whilst there is still much work to do to achieve the goal of graduating culturally safe optometrists, this paper focuses on features that enable or impede progress in the development of culturally safe practices within the optometry programmes to improve eye health equity for Indigenous recognise the diversity of Indigenous cultures across Australia and NZ.
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Affiliation(s)
- Nicola S Anstice
- Optometry and Vision Science, Flinders University, Adelaide, Australia
| | - Khyber Alam
- Division of Optometry, University of Western Australia, Perth, Australia
| | - James A Armitage
- School of Medicine (Optometry), Deakin University, Geelong, Australia
| | - Brett Biles
- Office of Medical Education, University of New South Wales, Sydney, Australia
| | - Joanna M Black
- School of Optometry and Vision Science, The University of Auckland, Aotearoa New Zealand
| | - Mei Ying Boon
- Optometry and Vision Science, University of Canberra, Bruce, Australia
| | - Teah Carlson
- College of Health, Massey University, Aotearoa, New Zealand
| | - Holly R Chinnery
- Department of Optometry and Vision Science, The University of Melbourne, Melbourne, Australia
| | - Andrew V Collins
- School of Optometry and Vision Science, The University of Auckland, Aotearoa New Zealand
| | - Anthea Cochrane
- Department of Optometry and Vision Science, The University of Melbourne, Melbourne, Australia
| | - Debbie Duthie
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Shelley Hopkins
- School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Australia
| | - Gary Fitzpatrick
- Division of Optometry, University of Western Australia, Perth, Australia
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Renata Watene
- School of Optometry and Vision Science, The University of Auckland, Aotearoa New Zealand
| | - Aryati Yashadhana
- Office of Medical Education, University of New South Wales, Sydney, Australia
| | - Sharon A Bentley
- School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Australia
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166
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Ladha R, Neiterman E. Shades of care: Understanding the needs of racially and ethnically
diverse paediatric patients, their families, and health care providers in North
America. J Child Health Care 2023; 27:18-34. [PMID: 34461757 PMCID: PMC9932619 DOI: 10.1177/13674935211041863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While race and ethnicity have been acknowledged as determinants of health, there remain gaps regarding their effects on experiences of paediatric care. This scoping review examines empirical literature regarding the state and experience of paediatric care provided to racially and ethnically diverse families in North America. We seek to clarify the needs of care administrators and recipients, as well as to conceptualize what paediatric care must look like to enable equitable practices and optimal health outcomes. Utilizing Arksey and O'Malley's framework, we reviewed literature published between 2005 and 2020, most of which was written within an American context. The literature reviewed featured quantitative, qualitative and mixed methods studies. Paediatric care administrators and recipients collectively identified the following as domains requiring an increased focus: (1) knowledge (awareness or training), (2) alignment of views and values, (3) resources and (4) communication. Findings suggest overall that despite there being merit in the cultural competency efforts underway, more patient-centric approaches are vital. This review concludes by encouraging the sustained development of cultural safety initiatives in paediatric care to ultimately promote patient comfort and provider-patient collaboration.
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Affiliation(s)
- Raisa Ladha
- School of Public Health and Health
Systems, Faculty of Applied Health Sciences, University of
Waterloo, Waterloo, ON, Canada,Raisa Ladha, School of Public Health and
Health Systems, Faculty of Applied Health Sciences, University of Waterloo, 200
University Avenue West, Waterloo, ON N2L 3G1, Canada.
| | - Elena Neiterman
- School of Public Health and Health
Systems, Faculty of Applied Health Sciences, University of
Waterloo, Waterloo, ON, Canada
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167
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Macfarlane E, Stitely M, Paterson H. What skills do New Zealand clinicians have to provide first trimester abortion in primary care and are they willing? SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 35:100810. [PMID: 36706712 DOI: 10.1016/j.srhc.2022.100810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/15/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To determine the skills and intentions of health practitioners in New Zealand to provide first trimester abortion care.New Zealand achieved abortion law reform in 2020, changing how abortion could be delivered and experienced by pregnant people. However, little has changed in the way abortion care is provided. STUDY DESIGN This survey, which was deployed to a range of health practitioners via regulatory bodies and professional groups, used an online free text and tick box survey. Questions included demographics, scope of practice, abortion care experience, philosophical perspective on abortion, and skills transferable to abortion care. Data was analysed using descriptive statistics and deductive and inductive thematic analysis. RESULTS 128 respondents included doctors, nurses, midwives, counsellors, and social workers from a range of practice settings, the majority from primary health (51%). Most respondents indicated competency or proficiency in clinical skills relevant to provision of early medical abortion. However, practitioners were more likely to indicate "I do not have this skill" or "support required" for: calculating gestational age by bimanual examination (42%), LARC (implant and IUC) insertion (36%), undertake a pregnancy related consultation using tikanga best practice guidelines (19%).Analysis of qualitative data showed three main themes; (1) support for abortion access and for abortion provision in primary care (2) levels of intention to provide abortion (3) critical components for an action plan for abortion in primary care. CONCLUSION Abortion care in the community has support from health practitioners. They identified needs including development of clinical skills, funding, and wider sector support.
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Affiliation(s)
- E Macfarlane
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin 9054, Dunedin, New Zealand.
| | - M Stitely
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, New Zealand
| | - H Paterson
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, New Zealand
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168
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Watene R, Davies SL, Bandler LG, Murray D, Anstice N, Hopkins S, Collins A, Anjou MD, Baldwin K, Kelly SL. Working towards a culturally safe optometry workforce for first nations peoples in Australia and Aotearoa New Zealand. Clin Exp Optom 2023; 106:211-214. [PMID: 35883243 DOI: 10.1080/08164622.2022.2097859] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Affiliation(s)
- Renata Watene
- Kaiāwhina, University of Auckland, Auckland, Aotearoa/New Zealand
| | | | - Lilon G Bandler
- Leaders in Indigenous Medical Education (LIME) Network, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Donna Murray
- Indigenous Allied Health Australia, Canberra, Australian Capital Territory, Australia
| | - Nicola Anstice
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Shelley Hopkins
- School of Optometry & Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Andrew Collins
- School of Optometry and Vision Science, Faculty of Medical & Health Sciences, The University of Auckland, Auckland, Aotearoa/New Zealand
| | - Mitchell D Anjou
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Kelley Baldwin
- Optometry Council of Australia and New Zealand, Melbourne, Australia
| | - Susan L Kelly
- Optometry Council of Australia and New Zealand, Melbourne, Australia
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Mistry M, Boyle L, Taylor E, Campbell D. Development and validation of a national perioperative mortality risk model for pediatric surgery: The New Zealand pediatric surgical risk tool (NZRISK-pediatric): NZRISK-Pediatric. J Pediatr Surg 2023; 58:524-531. [PMID: 35970677 DOI: 10.1016/j.jpedsurg.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Risk prediction models are well established as an adjunct to perioperative decision making, but few exist for pediatric surgical outcomes. The majority of risk tools do not feature Australasian data and do not estimate mortality risk beyond 30-days. Our aim was to develop and validate a model for mortality risk prediction in children (age <18yrs) at 30-days, 90-days and 1 year following all types of surgery using a national database. METHODS AND RESULTS The New Zealand Ministry of Health National Minimum Dataset was accessed to obtain clinical and demographic data for all children having surgery between June 1st 2011 and July 1st 2016. Three quarters of the data were used to derive 3 models to predict 30-day, 90-day and 1-year mortality risk, and the remaining data used for validation. We constructed 3 models using data from 135 217 patients, validating a total of 11 covariates for risk prediction. Included were neonate, prematurity, ASA-PS status, heart and lung disease, active malignancy, sepsis, surgical type, surgical severity score, surgical urgency, ethnicity and socioeconomic deprivation. All models showed excellent discrimination (area under the receiver operating characteristic curve (AUROC) values of 0.947, 0.933 and 0.908 respectively) and calibration statistics (calibration slopes of 0.778, 1.125, 1.153, Brier scores of 0.001, 0.002, 0.003 respectively). CONCLUSION Combining objective data with severity indices, NZRISK-Paed presents a risk stratification model which is intuitive and practical. Application of 30-day, 90-day and 1-year percentage mortality risk aids in longer-term planning, shared decision-making and allocation of resource to the individual and to high needs populations. Risk prediction tools add an objective measure to pre-operative assessment but few exist for pediatric surgery and none predict mortality beyond 30-days.
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Affiliation(s)
- Manisha Mistry
- Pediatric Anesthesia Fellow, Starship Children's Health, 2 Park Road, Grafton, Auckland 1023, New Zealand.
| | - Luke Boyle
- PhD Candidate, Department of Statistics, The University of Auckland, Auckland 1023, New Zealand
| | - Elsa Taylor
- Specialist Pediatric Anesthetist, Department of Pediatric Anesthesia, Starship Children's Health, 2 Park Rd, Grafton, Auckland 1023, New zealand
| | - Douglas Campbell
- Specialist Anesthetist, Department of Anesthesia and Perioperative Medicine, Auckland City Hospital, 2 Park Road, Grafton, Auckland 1023, New Zealand
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170
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Whitehead J, Blattner K, Miller R, Crengle S, Ram S, Walker X, Nixon G. Defining catchment boundaries and their populations for Aotearoa New Zealand's rural hospitals. J Prim Health Care 2023; 15:14-23. [PMID: 37000550 DOI: 10.1071/hc22133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/03/2023] [Indexed: 04/01/2023] Open
Abstract
Introduction There is considerable variation in the structure and resources of New Zealand (NZ) rural hospitals; however, these have not been recently quantified and their effects on healthcare outcomes are poorly understood. Importantly, there is no standardised description of each rural hospital's catchment boundary and the characteristics of the population living within this area. Aim To define and describe a catchment population for each of New Zealand's rural hospitals. Methods An exploratory approach to developing catchments was employed. Geographic Information Systems were used to develop drive-time-based geographic catchments, and administrative health data (National Minimum Data Set and Primary Health Organisation Data Set) informed service utilisation-based catchments. Catchments were defined at both the Statistical Area 2 (SA2) and domicile levels, and linked to census-based population data, the Geographic Classification for Health, and the area-level New Zealand Index of Socioeconomic Deprivation (NZDep2018). Results Our results highlight considerable heterogeneity in the size (max: 57 564, min: 5226) and characteristics of populations served by rural hospitals. Substantial differences in the age structure, ethnic composition, socio-economic profile, 'remoteness' and projected future populations, are noted. Discussion In providing a standardised description of each rural hospital's catchment boundary and its population characteristics, the considerable heterogeneity of the communities served by rural hospitals, both in size, rurality and socio-demographic characteristics, is highlighted. The findings provide a platform on which to build further research regarding NZ's rural hospitals and inform the delivery of high-quality, cost-effective and equitable health care for people living in rural NZ.
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Affiliation(s)
- Jesse Whitehead
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
| | - Katharina Blattner
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand; and Rawene Hospital, Hauora Hokianga, Northland, New Zealand
| | - Rory Miller
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand; and Thames Hospital, Te Whatu Ora Health New Zealand - Waikato, Hauraki, New Zealand
| | - Sue Crengle
- (Kai Tahu, Kati Mamoe, Waitaha) Ngai Tahu Maori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Stephen Ram
- Tokoroa Hospital, Te Whatu Ora Health New Zealand, Waikato District, Tokoroa, New Zealand
| | - Xaviour Walker
- Department of Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand; and Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Garry Nixon
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand; and Dunstan Hospital, Central Otago Health Services, Clyde, New Zealand
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171
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Samuels I, Pirere J, Muntz A, Craig JP. Ngā whakāro hauora Māori o te karu: Māori thoughts and considerations surrounding eye health. Clin Exp Optom 2023; 106:133-139. [PMID: 36509093 DOI: 10.1080/08164622.2022.2136513] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
CLINICAL RELEVANCE Research highlighting Indigenous patient perspectives is essential in the pursuit of understanding and addressing longstanding health inequities. BACKGROUND Evidence indicates that disparities in ocular health outcomes between Māori and non-Māori are pervasive in the New Zealand health system. Evidence shows the cause of these inequities is often multifactorial; due to factors such as colonisation, ongoing marginalisation, racism, socioeconomic status, poverty and culturally unsafe practice between health professionals and Māori patients. METHODS This project used kaupapa Māori methodology to identify the perceptions of Māori surrounding ocular healthcare within a Māori context in Aotearoa New Zealand. Three focus groups with Māori community members and three individual interviews with Māori eyecare practitioners were conducted. Participants discussed sub-topics relating to Māori health, ocular health consultations, ocular examination and access to ocular health services in Aotearoa New Zealand. Reflexive thematic analysis was undertaken using NVivo qualitative research software. RESULTS Five key themes were derived from the data: (1) the importance of effective clinician-patient communication; (2) historical experiences of patients inform their health attitudes; (3) barriers to access are systemic; (4) Māori health is important to Māori and (5) Te Ao Māori, Tikanga and Tapu are significant cultural concepts for Māori. Overall, Māori patients recognise the value of ocular healthcare and the importance of acknowledging Māori models of health within services. CONCLUSION The key issues Māori patients face within ocular health services resonate strongly with wider concepts intrinsically important to Māori. These are the right to cultural safety within clinical settings, the right to accurate and pertinent communication of information between clinician and patient and the respect of cultural beliefs and acknowledgement of power imbalances within the wider healthcare system. Participant discussions and suggestions raise possible pathways to begin addressing ocular ethnic disparities in healthcare delivery.
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Affiliation(s)
- Isaac Samuels
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Julie Pirere
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.,School of Nursing (Māori), Manukau Institute of Technology, Auckland, New Zealand
| | - Alex Muntz
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
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Barnabe C, Osei-Tutu K, Maniate JM, Razack S, Wong BM, Thoma B, Duchesne N. Equity, diversity, inclusion, and social justice in CanMEDS 2025. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:27-32. [PMID: 36998498 PMCID: PMC10042795 DOI: 10.36834/cmej.75845] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
| | | | | | | | | | - Brent Thoma
- University of Saskatchewan, Saskatchewan, Canada
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173
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Black JM, Collins AV, Ramke J, Phillips G, Giurgiu A, Morar V, Watene R, Dakin SC. Vision Bus Aotearoa: a platform for strengthening eye health teaching, research and community partnership. Clin Exp Optom 2023; 106:165-170. [PMID: 36403253 DOI: 10.1080/08164622.2022.2146483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
CLINICAL RELEVANCE Vision Bus Aotearoa is a fully equipped mobile eye health clinic designed to provide a novel platform for undergraduate optometry clinical training, community eye health research and deliver services to underserved communities. BACKGROUND Aotearoa New Zealand has inequitable access to eye health care. Vision Bus Aotearoa aims to work in partnership with communities to provide comprehensive mobile primary eye health care services while training optometry students, and integrating community eye health research. METHODS A description is provided of the governance model which has been involved throughout the project. RESULTS The process of vehicle manufacture, clinical set-up, funding models and service delivery are described. The aims of the project are detailed in terms of optometry teaching, clinical services in partnership with communities, and research integration and implementation. CONCLUSION Vision Bus Aotearoa represents a valuable opportunity to deliver mobile eye health care to historically underserved communities, enhance undergraduate optometry teaching and to provide a unique platform for community eye health research.
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Affiliation(s)
- Joanna M Black
- School of Optometry & Vision Science, The University of Auckland, Auckland, New Zealand
| | - Andrew V Collins
- School of Optometry & Vision Science, The University of Auckland, Auckland, New Zealand
| | - Jacqueline Ramke
- School of Optometry & Vision Science, The University of Auckland, Auckland, New Zealand
| | - Geraint Phillips
- School of Optometry & Vision Science, The University of Auckland, Auckland, New Zealand
| | - Adina Giurgiu
- School of Optometry & Vision Science, The University of Auckland, Auckland, New Zealand
| | - Veeran Morar
- School of Optometry & Vision Science, The University of Auckland, Auckland, New Zealand
| | - Renata Watene
- School of Optometry & Vision Science, The University of Auckland, Auckland, New Zealand
| | - Steven C Dakin
- School of Optometry & Vision Science, The University of Auckland, Auckland, New Zealand
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174
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Christian LW, Brawdy M, Wohlgemuth E, Hutchings N, Spafford MM. Teaching cultural safety principles: optometry student perceptions. Clin Exp Optom 2023; 106:150-157. [PMID: 36600583 DOI: 10.1080/08164622.2022.2151871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
CLINICAL RELEVANCE Providing optometry learners with cultural safety training can improve patient safety and health outcomes among Indigenous Peoples. BACKGROUND Healthcare practitioners require cultural safety training to provide safe eye care to Indigenous Peoples in Canada. Culturally safe care requires optometrists to critically reflect upon their unconscious biases and power differences that impact patient care. Informed by the cultural safety literature and working directly with learners, revisions were made to first and second-year optometry clinic experience courses in a Canadian Doctor of Optometry program. This descriptive study examined student feedback on curricular changes, focused on enhancing cultural safety. METHODS An 8-item, anonymous, online survey was offered to all learners (n = 178) enrolled in clinic experience courses at in fall 2021 and winter 2022. The survey addressed student understanding of cultural safety, comfort with self-reflective activities, and course effectiveness in teaching patient-centred care. Six items used a 5-point Likert response scale. Descriptive statistics were analyzed (Wilcoxon and Wilcoxon-Pratt). Two open-ended items were analysed using content analysis for themes. RESULTS Thirty-three surveys were completed. Overall respondents found the clinic experience courses provided effective training in cultural safety and were of professional value. Comfort engaging in self-reflective activities increased (before: mean response 4.0; after: 4.4), and students made connections with societal problems (overall mean 3.5) and with bias/power differential (overall mean 4.0). Suggested changes to support the learning objectives included increased clinic observation, scaffolding these topics in additional courses, and adding relevant literature (e.g. anti-racism) and guest speakers with Indigenous knowledge and experience. CONCLUSION Optometry learners were favourable about the inclusion of cultural safety concepts in their clinic experience courses. Their feedback points to areas for improvement including deepening course content, and collaborating with Indigenous Peoples in content, course design, and cross-curricular scaffolding.
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Affiliation(s)
- Lisa Wt Christian
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Molly Brawdy
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Ethan Wohlgemuth
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Natalie Hutchings
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Marlee M Spafford
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
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Naidoo T, Chamunyonga C, Burbery J, Rutledge P. Identifying methods to best integrate indigenous knowledge and perspectives within the radiation therapy undergraduate curriculum. J Med Radiat Sci 2023. [PMID: 36781205 DOI: 10.1002/jmrs.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/24/2023] [Indexed: 02/15/2023] Open
Abstract
The Australian healthcare system continues to work towards close the gap to improve and achieve equality in health and life expectancy for Aboriginal and Torres Strait Islander peoples. When culturally safe practice is forefront, it may be the driving force in improving Indigenous Australian healthcare outcomes. For students and practitioners to be equipped with the industry-required cultural safety skills, we believe Indigenous Australian knowledge and perspectives must be effectively integrated into undergraduate education. A scoping review of the literature was conducted to identify the most effective teaching and learning methods and assessment tools to best integrate Indigenous knowledge and perspectives into undergraduate radiation therapy curriculum at Queensland University of Technology (QUT). Embase, CINAHL, Scopus and PubMed-Medline were searched to access peer-reviewed studies published between 2017 and 2022. A total of 591 articles were identified with 39 full-text articles meeting the inclusion criteria. Methods of teaching and learning and independent assessment tools that promote cultural capability in undergraduate education were identified. Findings included intensive patient-specific workshops, which were reported to provide students with an immersive learning experience, better preparing them for clinical placements and future practice. Additionally, other allied healthcare professions have utilised tools such as the Cultural Capability Management Tool (CCMT) and Trans-Cultural Self-Efficacy Tool (TSET) to quantitatively assess positive shifts and highlight developmental needs. These findings will inform current educational endeavours to promote cultural safety and the cultural capability continuum in the undergraduate radiation therapy curriculum.
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Affiliation(s)
- Thashmira Naidoo
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Radiation Oncology Princess Alexandra Hospital Raymond Terrace, South Brisbane, Queensland, Australia
| | - Crispen Chamunyonga
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Julie Burbery
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Peta Rutledge
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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176
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Sadusky A, Yared H, Patrick P, Berger E. A systematic review of client’s perspectives on the cultural and racial awareness and responsiveness of mental health practitioners. CULTURE & PSYCHOLOGY 2023. [DOI: 10.1177/1354067x231156600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Culturally and racially responsive practice continues to be a common challenge among Mental Health Practitioners (MHPs). To the authors’ knowledge, this systematic review was the first to collate and synthesize clients’ perspectives of MHPs’ cultural and racial awareness and responsiveness from around the world. Original studies that were published between 2010 and 2021 reporting on qualitative data about clients’ perspectives regarding MHPs’ cultural-racial awareness and responsiveness were included in the review. The studies’ key findings that addressed this review’s question were synthesized and analyzed using reflexive thematic analysis. This review found 48 papers that met inclusion criteria, which represented the views of 652 clients across 10 countries. Three major themes and eight subthemes were established that concerned characteristics of the MHP, the client, and the therapeutic alliance. The results of this review indicate individual and systemic factors that influence mental health access for people from culturally and racially marginalized groups. Ongoing training of MHPs, increased racial and cultural representation among MHPs, inclusive physical settings, and reduced discrimination by MHPs are among the key findings and directions based on the results of this review.
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Affiliation(s)
- A Sadusky
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Australia
| | - H Yared
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Australia
| | - P Patrick
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Australia
| | - E Berger
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Australia
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177
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Morton Ninomiya ME, Almomani Y, Dunbar Winsor K, Burns N, Harding KD, Ropson M, Chaves D, Wolfson L. Supporting pregnant and parenting women who use alcohol during pregnancy: A scoping review of trauma-informed approaches. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057221148304. [PMID: 36744547 PMCID: PMC9905036 DOI: 10.1177/17455057221148304] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Alcohol is legalized and used for a variety of reasons, including socially or as self-medication for trauma in the absence of accessible and safe supports. Trauma-informed approaches can help address the root causes of alcohol use, as well as the stigma around women's alcohol use during pregnancy. However, it is unclear how these approaches are used in contexts where pregnant and/or parenting women access care. Our objective was to synthesize existing literature and identify promising trauma-informed approaches to working with pregnant and/or parenting women who use alcohol. A multidisciplinary team of scholars with complementary expertise worked collaboratively to conduct a rigorous scoping review. All screening, extraction, and analysis was independently conducted by at least two authors before any differences were discussed and resolved through team consensus. The Joanna Briggs Institute method was used to map existing evidence from peer-reviewed articles found in PubMed, CINAHL, PsycINFO, Social Work Abstracts, and Web of Science. Data were extracted to describe study demographics, articulate trauma-informed principles in practice, and gather practice recommendations. Thirty-six studies, mostly from the United States and Canada, were included for analysis. Studies reported on findings of trauma-informed practice in different models of care, including live-in treatment centers, case coordination/management, integrated and wraparound supports, and outreach-for pregnant women, mothers, or both. We report on how the following four principles of trauma-informed practices were applied and articulated in the included studies: (1) trauma awareness; (2) safety and trustworthiness; (3) choice, collaboration, and connection; and (4) strengths-based approach and skill building. This review advances and highlights the importance of understanding trauma and applying trauma-informed practice and principles to better support women who use alcohol to reduce the risk of alcohol-exposed pregnancies. Relationships and trust are central to trauma-informed care. Moreover, when applying trauma-informed practices with pregnant and parenting women who use alcohol, we must consider the unique stigma attached to alcohol use.
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Affiliation(s)
- Melody E Morton Ninomiya
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, ON, Canada,School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada,Melody E Morton Ninomiya, Department of Health Sciences, Wilfrid Laurier University, Rm. BA0546, 75 University Avenue West, Waterloo, ON N2L 3C5, Canada.
| | - Yasmeen Almomani
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | | | - Nicole Burns
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Kelly D Harding
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada,School of Liberal Arts, Laurentian University, Sudbury, ON, Canada
| | - Megan Ropson
- Memorial University, St. John’s, NL, Canada,Labrador-Grenfell Health, Happy Valley-Goose Bay, NL, Canada
| | - Debbie Chaves
- Library, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Lindsay Wolfson
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC, Canada,Centre of Excellence for Women’s Health, Vancouver, BC, Canada
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178
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Rasul TF, Morgan O, Elkhadem A, Henderson A. Soft tissue infection and follow-up for an unsheltered patient: the role of Street Medicine providers in bridging gaps in care. BMJ Case Rep 2023; 16:e251082. [PMID: 36737066 PMCID: PMC9899995 DOI: 10.1136/bcr-2022-251082] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Street Medicine is a volunteer-run initiative for low-resource healthcare settings. Formed to bridge gaps in care for persons experiencing homelessness, these organisations work to provide preventative medicine through maintenance care and follow-up. However, there are limits to what Street Medicine can accomplish given the geographical radius covered, lack of available transportation options and vulnerable sleeping locations night to night for the patients served. The subject of this case report is a middle-aged Spanish-speaking unsheltered man who began his care with a Street Medicine team. He was unable to attend medical appointments due to relocation, complicating his disease course and resulting in hospital intervention for cellulitis. Post-discharge, he stayed within radius and was treated by the street team. Increased emphasis on the effects of housing insecurity and addressing social determinants of health could prevent deterioration of manageable diseases and should be an area of active interest for Street Medicine team expansion.
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Affiliation(s)
- Taha Faiz Rasul
- Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Orly Morgan
- Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Adam Elkhadem
- College of Arts and Sciences, Columbia University, New York City, New York, USA
| | - Armen Henderson
- Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA
- Internal Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
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179
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McCalman P, McLardie-Hore F, Newton M, McLachlan H, Forster D. Trust, privacy, community, and culture: Important elements of maternity care for Aboriginal and Torres Strait Islander women giving birth in Victoria. Women Birth 2023; 36:e150-e160. [PMID: 35803869 DOI: 10.1016/j.wombi.2022.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/10/2022] [Accepted: 06/06/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The Australian maternity system must enhance its capacity to meet the needs of Aboriginal and Torres Strait Islander (First Nations) mothers and babies, however evidence regarding what is important to women is limited. AIMS The aim of this study was to explore what women having a First Nations baby rate as important for their maternity care as well as what life stressors they may be experiencing. METHODS Women having a First Nations baby who booked for care at one of three urban Victorian maternity services were invited to complete a questionnaire. RESULTS 343 women from 76 different language groups across Australia. Almost one third of women reported high levels of psychological distress, mental illness and/or were dealing with serious illness or death of relatives or friends. Almost one quarter reported three or more coinciding life stressors. Factors rated as most important were privacy and confidentiality (98 %), feeling that staff were trustworthy (97 %), unrestricted access to support people during pregnancy appointments, (87 %) birth (66 %) and postnatally (75 %), midwife home visits (78 %), female carers (66 %), culturally appropriate artwork, brochures (68 %) and access to Elders (65 %). CONCLUSIONS This study provides important information about what matters to women who are having a First Nations baby in Victoria, Australia, bringing to the forefront social and cultural complexities experienced by many women that need to be considered in programme planning. It is paramount that maternity services partner with First Nations communities to implement culturally secure programmes that respond to the needs of local communities.
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Affiliation(s)
- P McCalman
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3052 Australia.
| | - F McLardie-Hore
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; The Royal Women's Hospital, Parkville, Victoria 3052 Australia
| | - M Newton
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3052 Australia
| | - H McLachlan
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3052 Australia
| | - D Forster
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; The Royal Women's Hospital, Parkville, Victoria 3052 Australia
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180
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Salins A, Nash K, Macniven R, Halvorsen L, Lumby N, McMahon C. Culturally safe speech-language supports for First Nations children: Achieving Sustainable Development Goals 3, 4, 8 and 10. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:152-156. [PMID: 36412077 DOI: 10.1080/17549507.2022.2143565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
PURPOSE Self-determination is foundational to health and well-being for First Nations people. Colonisation has undermined self-determination and widespread effects are observed as disparities in health and well-being. Chronic middle ear disease is more highly prevalent in First Nations children, is associated with delays in speech and language and lower levels of educational readiness. However, there is a paucity of culturally and linguistically sensitive speech-language assessments and habilitation services globally. Focussing on high-income colonial-settler countries (including United States, Canada, Australia and New Zealand), where health disparities are significant, we aim to discuss the importance of and the challenges in providing culturally safe care to First Nations children with communication disabilities. RESULT To be effective, both cultural and linguistic diversity and cultural safety must be considered in all aspects of assessment and intervention. Furthermore, speech-language pathologists must be equipped to work with First Nations children with communication disorders. CONCLUSION To optimally support First Nations' children with communication disabilities, services need to be culturally safe, family-centred and strengths-based. This commentary focuses on the United Nations Sustainable Development Goals (SDGs)3, 4, 8 and 10.
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Affiliation(s)
- Andrea Salins
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Macquarie University Centre for Reading, Sydney, Australia
| | - Kai Nash
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Rona Macniven
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia, and
| | - Luke Halvorsen
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Noeleen Lumby
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Catherine McMahon
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- HEAR Centre, Macquarie University, Sydney, Australia
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181
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Maina G, Mousavian G, Sherstobitoff J, Kamrul R, Twum-Antwi B, Lewis K, Malonga F, Herzog T, Maroof R, Okinyo-Owiti D. Process and Outcome of Community Engagement Event on Substance Use and Addiction Risks Facing Their Immigrant Communities in Regina, Saskatchewan. Subst Abuse 2023; 17:11782218221150109. [PMID: 36712575 PMCID: PMC9880570 DOI: 10.1177/11782218221150109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/20/2022] [Indexed: 01/24/2023]
Abstract
Canada is a significant destination for immigrants who are drawn from different ethnic and cultural backgrounds some of whom have a hidden risk for substance use disorders due to acculturation stress and are not screened for risks of substance use or addiction when considering medical admissibility. Not surprisingly, healthcare providers in Regina are reporting a noticeable increase in substance use among immigrants. These immigrants experience barriers in seeking substance use prevention and treatment services due to diverse challenges: stigma, shame, and lack of knowledge of existing services. Considering the discussed challenges and risks of substance use disorders in immigrant communities, creating a safe space for discussing these topics is urgent. To understand and address these challenges, a connection grant from the Saskatchewan Health Research Foundation (SHRF) to mobilize immigrant communities in Regina to explore substance use issues and their impact on the community was sought and received. Subsequently, a Zoom knowledge-sharing event brought settlement agency stakeholders together to deliberate issues on substance use and addiction faced by immigrants in Regina, Saskatchewan. The Zoom session included presentations on immigrants and substance use from the clinical, community, and lived experience perspectives of immigrants. Because of the challenges and risks, this community consultation process revealed that acculturation stress and the ease of obtaining socially acceptable substances fuel substance use and addiction among immigrants in Regina; this is further exacerbated by the lack of programming available to prevent and reduce the risks of substance use in this population. A team of knowledge keepers with lived experiences, service providers, and researchers was assembled to explore substance use and addiction among immigrants. This manuscript reports the process of community engagement to identify solutions to this budding issue. The strengths, challenges, and lessons learned are identified.
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Affiliation(s)
- Geoffrey Maina
- College of Medicine, University of Saskatchewan,
Regina Campus, SK, Canada,Geoffrey Maina, College of Nursing, University of
Saskatchewan, #173 130-1061 Central Avenue, Prince Albert, SK S6V 4V4, Canada.
| | - Ghazal Mousavian
- InterDisciplinary Studies, University of
Saskatchewan, Prince Albert, SK, Canada
| | | | - Rejina Kamrul
- College of Medicine, University of Saskatchewan,
Regina Campus, SK, Canada
| | - Barbara Twum-Antwi
- College of Medicine, University of Saskatchewan,
Regina Campus, SK, Canada
| | - Kennedy Lewis
- College of Medicine, University of Saskatchewan,
Regina Campus, SK, Canada
| | - Francia Malonga
- College of Medicine, University of Saskatchewan,
Regina Campus, SK, Canada
| | - Thea Herzog
- College of Medicine, University of Saskatchewan,
Regina Campus, SK, Canada
| | - Razawa Maroof
- College of Medicine, University of Saskatchewan,
Regina Campus, SK, Canada
| | - Denis Okinyo-Owiti
- College of Medicine, University of Saskatchewan,
Regina Campus, SK, Canada
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182
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Milroy H, Kashyap S, Collova JR, Platell M, Gee G, Ohan JL. Identifying the key characteristics of a culturally safe mental health service for Aboriginal and Torres Strait Islander peoples: A qualitative systematic review protocol. PLoS One 2023; 18:e0280213. [PMID: 36634056 PMCID: PMC9836303 DOI: 10.1371/journal.pone.0280213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Mental health inequities between Indigenous and non-Indigenous populations are well documented. There is growing recognition of the role that culturally safety plays in achieving equitable outcomes. However, a clear understanding of the key characteristics of culturally safe mental health care is currently lacking. This protocol outlines a qualitative systematic review that aims to identify the key characteristics of culturally safe mental health care for Aboriginal and Torres Strait Islander peoples, at the individual, service, and systems level. This knowledge will improve the cultural safety of mental health care provided to Indigenous peoples, with a focus on Aboriginal and Torres Strait Islander peoples in Australia. METHODS AND EXPECTED OUTPUTS Through a review of academic, grey, and cultural literature, we will identify the key characteristics of culturally safe mental health care for Aboriginal and Torres Strait Islander peoples in Australia. We will consider the characteristics of culturally safe care at the individual practitioner, service, and systems levels. PROSPERO REGISTRATION NUMBER CRD42021258724.
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Affiliation(s)
- Helen Milroy
- UWA Medical School, University of Western Australia, Perth, Western Australia, Australia
- Bilya Marlee School of Indigenous Studies, University of Western Australia, Perth, Western Australia, Australia
| | - Shraddha Kashyap
- Bilya Marlee School of Indigenous Studies, University of Western Australia, Perth, Western Australia, Australia
| | - Jemma R. Collova
- Bilya Marlee School of Indigenous Studies, University of Western Australia, Perth, Western Australia, Australia
| | - Monique Platell
- School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
| | - Graham Gee
- Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, Victoria, Australia
- Mebourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Jeneva L. Ohan
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
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183
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Haruta J, Ando T, Fujishima S. How do medical students learn in an online community diagnostics program? BMC MEDICAL EDUCATION 2023; 23:15. [PMID: 36627667 PMCID: PMC9830126 DOI: 10.1186/s12909-023-04007-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND The need to engage medical students in understanding the social and environmental determinants of health in disparate communities is increasing. However, previous reviews have noted the limited community diagnosis programs and program evaluation. Given the feasibility of the programs, it is expected to be widely available online. Therefore, this study used a realist approach to identify learning patterns through an online community diagnosis program, namely context (C), mechanism (M), and outcomes (O) patterns. METHODS A 2-week general medicine clinical practice program was conducted for 4th- and 5th-year medical students at a medical university in Japan. The program included a one-hour zoom-based lecture, feedback for students on their presentations on community diagnosis, and a structural report on community diagnosis. We developed the program based on variation theory, which views discernment and variation in situations having time, space, and social dimensions as core learning. The students' reflections on their learning through the program were thematically analyzed through CMO perspectives. The realist approach used in the online diagnosis program evaluation allows us to explore, test, and refine what mechanisms work under what conditions (context) and with what interventions (including opportunities and resources), from which we can describe iteratively explainable results. RESULTS First, the medical students, who spent most of their time in the limited residential areas they lived in, discovered the characteristics of their own community by discovery learning and comparison among peers. Second, they increased their intrinsic interest in the community by discerning specific issues in their familiar community through community diagnosis. Third, they valued community diagnosis by identifying relationships between local data on health issues under their learning responsibility. Fourth, they become more flexible in their thinking and created new knowledge that would fit the local community, and their reflection on themselves was encouraged. CONCLUSION In this online community diagnosis program, medical students learned about the community through four types of learning patterns. Medical students may develop an understanding of community with interest using variation theory as a program development perspective and cognitive flexibility theory surrounding the essential ambiguity and abstraction of community.
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Affiliation(s)
- Junji Haruta
- Medical Education Center, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
| | - Takayuki Ando
- Center for General Medicine Education, School of Medicine, Keio University, Tokyo, Japan
| | - Seitaro Fujishima
- Center for General Medicine Education, School of Medicine, Keio University, Tokyo, Japan
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Tutone S, Fuimaono-Asafo A, Wilson A, Harwood M, Love R, Rahiri JL. The Surgical Sisterhood - The Experiences of wāhine Māori and Pasifika Aspiring Surgeons. QUALITATIVE HEALTH RESEARCH 2023; 33:106-116. [PMID: 36538013 DOI: 10.1177/10497323221144929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The establishment of a culturally diverse surgical workforce, largely on the basis of gender, has been highly promoted in Australasia in the last decade. Despite this, discussions of gender diversity in surgery have largely excluded Indigenous women. This study presents the experiences of wāhine Māori and Pasifika doctors in Aotearoa, who formed a surgical sisterhood to support them towards applying for advanced surgical training. Utilising mana wāhine and Masi methodologies, semi-structured interpersonal interviews were undertaken with five wāhine who formed the surgical sisterhood. Following transcription and analysis of all interviews, four key themes were identified. These were mana wāhine, unity, our why and change on the horizon. These themes illustrate the complex and varied experiences of wāhine Māori and Pasifika and how they have navigated their surgical pathways amidst multiple layers of discrimination towards being in a position to apply for advanced surgical training.
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Affiliation(s)
- Senitila Tutone
- Department of Surgery, 1406Waitematā District Health Board, Auckland, New Zealand
| | | | - Ailsa Wilson
- Department of Orthopaedics, 8458Capital and Coast District Health Board
| | - Matire Harwood
- Department of General Practice and Primary Health Care, 1415the University of Auckland, Auckland, New Zealand
| | - Rachelle Love
- Department of Otorhinolaryngology, 63588Canterbury District Health Board, Christchurch, New Zealand
| | - Jamie-Lee Rahiri
- Department of Surgery, 89490Taranaki Base Hospital, New Plymouth, New Zealand
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185
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Capper TS, Williamson M, Chee R. How is cultural safety understood and translated into midwifery practice? A scoping review and thematic analysis. Nurse Educ Pract 2023; 66:103507. [PMID: 36410133 DOI: 10.1016/j.nepr.2022.103507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022]
Abstract
AIM To identify and understand the scope of the literature published since January 2008 that explored Australian midwives understanding of cultural safety and how this is translated into their practice when caring for First Nations women and families. BACKGROUND Recognition and understanding of First Nations peoples history and culture and the impact this has on the health and wellbeing of women and their families is essential if the midwife is to promote culturally safe and respectful maternity care. The role and responsibilities of the midwife in ensuring that their practice is culturally safe are now reflected in the Australian professional midwifery codes and standards. Whilst midwifery academics' awareness of cultural safety and how it is taught within midwifery education programs have previously been explored, at present, little is known about midwives' understanding of cultural safety, and how this translates into their clinical practice. METHODS A Scoping Review was undertaken following Arksey and O'Malley's five step process. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta Analyses - Scoping Review extension checklist. Twelve studies met the criteria for inclusion. Thematic analysis was used to analyse the data and organise the results. RESULTS Thematic analysis, guided by two predetermined review questions led to the identification of six overarching themes: 'Awareness of deficiencies', 'The importance of meeting women's diverse needs', 'Understanding relationships as a foundation for culturally safe care', 'Working in partnership with others', 'Providing individualised care' and 'Fostering effective relationships and communication'. One sub-theme of the first theme was identified, this was named 'Seeking an understanding of culture'. CONCLUSION Australian midwives' level of understanding of cultural safety and how it is translated into their midwifery practice when caring for First Nations women and their families differ widely. Midwives across Australia require increased and equitable access to appropriate opportunities to improve their knowledge and understanding of cultural safety. Whilst theoretical learning on cultural safety has a place in all midwives annual mandatory training requirements, this should ideally be supplemented, where possible, with opportunities for immersive practice in communities. Immersion was considered the optimal way to gain rich knowledge and understanding to strengthen culturally safe midwifery practice. Continuity models of midwifery care which incorporate the principles of cultural safety should be consistently implemented across Australia. These models enable midwives, women, families, communities, and Aboriginal Support Workers to work in collaboration towards achieving optimal outcomes for mothers and babies. STUDY REGISTRATION N/A.
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Affiliation(s)
- Tanya S Capper
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, Level 20, 160 Ann Street, Brisbane, Queensland 4000, Australia.
| | - Moira Williamson
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, Level 21, 160 Ann Street, Brisbane, Queensland 4000, Australia.
| | - Rachelle Chee
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 160 Ann Street, Brisbane, Queensland 4000, Australia.
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186
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Edelman NL. Trauma and resilience informed research principles and practice: A framework to improve the inclusion and experience of disadvantaged populations in health and social care research. J Health Serv Res Policy 2023; 28:66-75. [PMID: 36326603 PMCID: PMC9850377 DOI: 10.1177/13558196221124740] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Trauma, socio-economic, cultural and structural issues are associated with poor outcomes for most health conditions and may also make research participation difficult and onerous, perpetuating intervention-generated inequalities by generating evidence from those least in need. Trauma-informed and resilience-informed approaches to care may help address these concerns across health and social care research. These approaches take an empowerment-based response to adversity, and are suitable for integration and extension as Trauma and Resilience Informed Research Principles and Practice (TRIRPP) for studies beyond the topics of resilience and trauma. Four TRIRPP aims were identified: addressing the adversity context that may underpin the lives of research participants and the phenomenon under study; improving study accessibility and acceptability for individuals and populations facing adversity; recognising and addressing traumatisation in potential participants; and recognising and promoting resilience. Recommendations include interview participant control of recording devices, over-sampling of under-represented populations in population surveys, and actively seeking to engage disenfranchised individuals in patient and public involvement from design to dissemination. The practice of research has the power to address adversity and trauma or to perpetuate it at both an individual and a societal level. It is feasible and worthwhile to integrate trauma-informed and resilience-informed approaches across research topics and designs. Further work should extend the TRIRPP recommendations and evaluate their use.
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Affiliation(s)
- Natalie L Edelman
- Principal Research Fellow in
Applied Sexual & Reproductive Health, School of Sport & Health Sciences,
University
of Brighton, UK,Honorary Research Fellow,
Department of Primary Care & Public Health, Brighton & Sussex Medical
School, UK,Natalie L Edelman, University of Brighton,
Westlain House, Village Way, Brighton BN2 4AT, UK.
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187
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Jenkin RA, Garrett SA, Keay KA. Altruism in death: Attitudes to body and organ donation in Australian students. ANATOMICAL SCIENCES EDUCATION 2023; 16:27-46. [PMID: 35344291 PMCID: PMC10084255 DOI: 10.1002/ase.2180] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 05/25/2023]
Abstract
Health education, research, and training rely on the altruistic act of body donation for the supply of cadavers. Organ transplantation and research rely on donated organs. Supply of both is limited, with further restrictions in Australia due to requirements for a next-of-kin agreement to donation, irrespective of the deceased's pre-death consent. Research suggests health workers are less likely to support the donation of their own bodies and/or organs, despite recognizing the public good of donation, and that exposure to gross anatomy teaching may negatively affect support for donation. Attitudes to body and organ donation were examined in Australian students studying anatomy. Support for self-body donation (26.5%) was much lower than support for self-organ donation (82.5%). Ten percent of participants would not support the election of a family member or member of the public to donate their body, and just over 4% would not support the election of a family member to donate their organs, with one-to-two percent not supporting this election by a member of the public. Exposure to gross anatomy teaching was associated with an increased likelihood of consideration of issues about body and organ donation, whether for self, family, or the public, and registration as an organ donor. Exposure decreased participants' willingness to donate their own body, with those who practiced a religion least likely to support body donation. Gross anatomy courses provide an opportunity to inform future healthcare workers about altruistic donation, albeit with a recognition that religious or cultural beliefs may affect willingness to donate.
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Affiliation(s)
- Rebekah A. Jenkin
- Anatomy and Histology, School of Medical Sciences, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
| | - Samuel A. Garrett
- Anatomy and Histology, School of Medical Sciences, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
- University of SydneyCamperdownNew South WalesAustralia
| | - Kevin A. Keay
- Anatomy and Histology, School of Medical Sciences, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
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188
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Olaniyan FV, Hayes G. Just ethnic matching? Racial and ethnic minority students and culturally appropriate mental health provision at British universities. Int J Qual Stud Health Well-being 2022; 17:2117444. [PMID: 36052439 PMCID: PMC9448376 DOI: 10.1080/17482631.2022.2117444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
| | - Graeme Hayes
- Department of Sociology and Policy, Aston University, Birmingham, UK
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189
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de Jager E, Gunnarsson R, Ho YH. Self-discharge as a marker of surgical cultural competency and cultural safety for Aboriginal and/or Torres Strait Islander patients. ANZ J Surg 2022; 93:807-809. [PMID: 36582020 DOI: 10.1111/ans.18238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 12/15/2022] [Accepted: 12/18/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Elzerie de Jager
- College of Medicine and Dentistry, The James Cook University, Townsville, Queensland, Australia
| | - Ronny Gunnarsson
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden.,Research, Education, Development & Innovation, Primary Health Care, Västra Götaland Region, Sweden.,Primary Health Care Center for Homeless People, Närhälsan, Västra Götaland Region, Sweden
| | - Yik-Hong Ho
- College of Medicine and Dentistry, The James Cook University, Townsville, Queensland, Australia.,Townsville Clinical School, The Townsville Hospital, Townsville, Queensland, Australia
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190
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Yogarajan V, Dobbie G, Leitch S, Keegan TT, Bensemann J, Witbrock M, Asrani V, Reith D. Data and model bias in artificial intelligence for healthcare applications in New Zealand. FRONTIERS IN COMPUTER SCIENCE 2022. [DOI: 10.3389/fcomp.2022.1070493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IntroductionDevelopments in Artificial Intelligence (AI) are adopted widely in healthcare. However, the introduction and use of AI may come with biases and disparities, resulting in concerns about healthcare access and outcomes for underrepresented indigenous populations. In New Zealand, Māori experience significant inequities in health compared to the non-Indigenous population. This research explores equity concepts and fairness measures concerning AI for healthcare in New Zealand.MethodsThis research considers data and model bias in NZ-based electronic health records (EHRs). Two very distinct NZ datasets are used in this research, one obtained from one hospital and another from multiple GP practices, where clinicians obtain both datasets. To ensure research equality and fair inclusion of Māori, we combine expertise in Artificial Intelligence (AI), New Zealand clinical context, and te ao Māori. The mitigation of inequity needs to be addressed in data collection, model development, and model deployment. In this paper, we analyze data and algorithmic bias concerning data collection and model development, training and testing using health data collected by experts. We use fairness measures such as disparate impact scores, equal opportunities and equalized odds to analyze tabular data. Furthermore, token frequencies, statistical significance testing and fairness measures for word embeddings, such as WEAT and WEFE frameworks, are used to analyze bias in free-form medical text. The AI model predictions are also explained using SHAP and LIME.ResultsThis research analyzed fairness metrics for NZ EHRs while considering data and algorithmic bias. We show evidence of bias due to the changes made in algorithmic design. Furthermore, we observe unintentional bias due to the underlying pre-trained models used to represent text data. This research addresses some vital issues while opening up the need and opportunity for future research.DiscussionsThis research takes early steps toward developing a model of socially responsible and fair AI for New Zealand's population. We provided an overview of reproducible concepts that can be adopted toward any NZ population data. Furthermore, we discuss the gaps and future research avenues that will enable more focused development of fairness measures suitable for the New Zealand population's needs and social structure. One of the primary focuses of this research was ensuring fair inclusions. As such, we combine expertise in AI, clinical knowledge, and the representation of indigenous populations. This inclusion of experts will be vital moving forward, proving a stepping stone toward the integration of AI for better outcomes in healthcare.
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Lee GY, Robotham J, Song YJC, Occhipinti JA, Troy J, Hirvonen T, Feirer D, Iannelli O, Loblay V, Freebairn L, Agung-Igusti R, Chang EP, Dudgeon P, Hickie IB. Partnering with Aboriginal and Torres Strait Islander Peoples: An Evaluation Study Protocol to Strengthen a Comprehensive Multi-Scale Evaluation Framework for Participatory Systems Modelling through Indigenous Paradigms and Methodologies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:53. [PMID: 36612375 PMCID: PMC9819653 DOI: 10.3390/ijerph20010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
The social and emotional wellbeing of young Aboriginal and Torres Strait Islander peoples should be supported through an Indigenous-led and community empowering approach. Applying systems thinking via participatory approaches is aligned with Aboriginal and Torres Strait Islander research paradigms and can be an effective method to deliver a decision support tool for mental health systems planning for Indigenous communities. Evaluations are necessary to understand the effectiveness and value of such methods, uncover protective and healing factors of social and emotional wellbeing, as well as to promote Aboriginal and Torres Strait Islander self-determination over allocation of funding and resources. This paper presents modifications to a published evaluation protocol for participatory systems modelling to align with critical Aboriginal and Torres Strait Islander guidelines and recommendations to support the social and emotional wellbeing of young people. This paper also presents a culturally relevant participatory systems modelling evaluation framework. Recognizing the reciprocity, strengths, and expertise Aboriginal and Torres Strait Islander methodologies can offer to broader research and evaluation practices, the amended framework presented in this paper facilitates empowering evaluation practices that should be adopted when working with Aboriginal and Torres Strait Islander peoples as well as when working with other diverse, non-Indigenous communities.
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Affiliation(s)
- Grace Yeeun Lee
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Julie Robotham
- Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, School of Indigenous Studies, University of Western Australia, Perth, WA 6009, Australia
| | - Yun Ju C. Song
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Jo-An Occhipinti
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
- Computer Simulation & Advanced Research Technologies (CSART), Sydney, NSW 2021, Australia
| | - Jakelin Troy
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Tanja Hirvonen
- Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, School of Indigenous Studies, University of Western Australia, Perth, WA 6009, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
| | - Dakota Feirer
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Olivia Iannelli
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Victoria Loblay
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Louise Freebairn
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT 2601, Australia
| | - Rama Agung-Igusti
- Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, School of Indigenous Studies, University of Western Australia, Perth, WA 6009, Australia
| | - Ee Pin Chang
- Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, School of Indigenous Studies, University of Western Australia, Perth, WA 6009, Australia
| | - Pat Dudgeon
- Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, School of Indigenous Studies, University of Western Australia, Perth, WA 6009, Australia
| | - Ian Bernard Hickie
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
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192
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Saunders P, Doyle AK. Cultural Proficiency in First Nations Health Research: A Mixed-Methods, Cross-Cultural Evaluation of a Novel Resource. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:39. [PMID: 36612362 PMCID: PMC9819740 DOI: 10.3390/ijerph20010039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Recent efforts have illustrated the efficacy of culturally proficient approaches to research, underpinned by robust partnerships between researchers and First Nations peoples and communities. This article seeks to determine differences in approaches to First Nations research engagement perceptions between First Nations and non-First Nations researchers, as well as whether participation in a cultural proficiency workshop improved the perceived cultural proficiency of non-First Nations health researchers. Also, whether a set of novel cultural proficiency resources, designed in the Sydney region could be applied broadly across First Nations contexts within Australia. The evaluation adopted a mixed-methods, cross-cultural (First Nations and non-First Nations) design to appraise the novel cultural proficiency resources, identifying participant perceptions to First Nations research engagement, as well as views regarding the feasibility of universal application of the resources. A quantitative pre- and post-workshop evaluation was also undertaken to measure differences in self-reported cultural proficiency. Qualitative data underwent thematic analysis and quantitative data were analysed applying t-tests. Both qualitative and quantitative evaluation showed minimal variation between the cultural groups regarding research engagement perceptions, based on viewing of the online resources. A statistically significant increase in self-reported cultural proficiency was found in non-First Nations workshop participants. Cultural proficiency education and training programs that promote an immersive, interactive, and ongoing framework can build the perceived cultural proficiency of non-First Nations health researchers, however First Nations expertise must validate this perceived cultural proficiency to be beneficial in practice. Based on the research findings, applying the underlying ethical principles of First Nations research with a local, context-centred approach allows for the broad application of cultural proficiency research education and training programs within Australia.
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Affiliation(s)
- Paul Saunders
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Aunty Kerrie Doyle
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
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193
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Bressan T, Valdivia-Gago A, Silvera-Ccallo RM, Llanos-Cuentas A, Condor DF, Padilla-Huamantinco PG, Vilcarromero S, Miranda JJ, Zavaleta-Cortijo C. Challenges of design, implementation, acceptability, and potential for, biomedical technologies in the Peruvian Amazon. Int J Equity Health 2022; 21:183. [PMID: 36536404 PMCID: PMC9762865 DOI: 10.1186/s12939-022-01773-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Biomedical technologies have the potential to be advantageous in remote communities. However, information about barriers faced by users of technology in general and in remote Indigenous communities is scarce. The purpose of this study was to characterize the leading challenges faced by researchers who have used biomedical technologies in the Peruvian Amazon. METHODS This exploratory, qualitative study with a phenomenological approach depicts the lived experience of participants who were researchers with experience working with biomedical technologies in the Peruvian Amazon in the past five years. Analysis was based on three core themes: design, implementation, and acceptability. Sub-themes included environment, community, and culture. Of the 24 potential participants identified and contacted, 14 agreed to participate, and 13 met inclusion criteria and completed semi-structured interviews. Results were sent to each participant with the opportunity to provide feedback and partake in a 30-minute validation meeting. Five participants consented to a follow-up meeting to validate the results and provide further understanding. RESULTS Participants recognized significant challenges, including technologies designed out-of-context, difficulty transporting the technologies through the Amazon, the impact of the physical environment (e.g., humidity, flooding), and limited existing infrastructure, such as electricity and appropriately trained health personnel. Participants also identified cultural factors, including the need to address past experiences with technology and health interventions, understand and appropriately communicate community benefits, and understand the effect of demographics (e.g., age, education) on the acceptance and uptake of technology. Complementary challenges, such as corruption in authority and waste disposal, and recommendations for technological and health interventions such as co-design were also identified. CONCLUSIONS This study proposes that technological and health interventions without efforts to respect local cultures and health priorities, or understand and anticipate contextual challenges, will not meet its goal of improving access to healthcare in remote Amazon communities. Furthermore, the implications of corruption on health services, and improper waste disposal on the environment may lead to more detrimental health inequities.
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Affiliation(s)
- Tiana Bressan
- grid.34429.380000 0004 1936 8198School of Engineering, University of Guelph, 50 Stone Rd E, Guelph, ON N1G 2W1 Canada
| | - Andrea Valdivia-Gago
- grid.11100.310000 0001 0673 9488Escuela de Nutrición, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
| | - Rosa M. Silvera-Ccallo
- grid.11100.310000 0001 0673 9488Unidad de Ciudadania Intercultural y Salud Indigena, Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
| | - Alejandro Llanos-Cuentas
- grid.11100.310000 0001 0673 9488Unidad de Ciudadania Intercultural y Salud Indigena, Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.11100.310000 0001 0673 9488Instituto de Medicina Tropical Alexander von Humboldt, Lima, Peru Av. Honorio Delgado 430, 15102
| | - Daniel F. Condor
- grid.11100.310000 0001 0673 9488School of Nursing, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.11100.310000 0001 0673 9488Biomedical Informatics in Global Health Unit, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.11100.310000 0001 0673 9488 CuidART-e Research Group, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
| | - Pierre G. Padilla-Huamantinco
- grid.11100.310000 0001 0673 9488Instituto de Medicina Tropical Alexander von Humboldt, Lima, Peru Av. Honorio Delgado 430, 15102 ,Health Innovation Lab, Institute of Tropical Medicine Alexander von Humboldt, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.7870.80000 0001 2157 0406Institute for Biological and Medical Engineering, Schools of Engineering, Medicine, and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile Av Vicuña Mackenna 4860,
| | - Stalin Vilcarromero
- grid.420173.30000 0000 9677 5193Hospital Nacional Edgardo Rebagliati Martins (HNERM), EsSalud, Lima, Peru Av. Edgardo Rebagliati 490, 15072
| | - J. Jaime Miranda
- grid.11100.310000 0001 0673 9488CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.11100.310000 0001 0673 9488 School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.1005.40000 0004 4902 0432The George Institute for Global Health, UNSW, Sydney, Australia
| | - Carol Zavaleta-Cortijo
- grid.11100.310000 0001 0673 9488Unidad de Ciudadania Intercultural y Salud Indigena, Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.11100.310000 0001 0673 9488Unidad de Ciudadanía Intercultural y Salud Indígena (UCISI), Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
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Allice I, Acai A, Ferdossifard A, Wekerle C, Kimber M. Indigenous Cultural Safety in Recognizing and Responding to Family Violence: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16967. [PMID: 36554846 PMCID: PMC9779508 DOI: 10.3390/ijerph192416967] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
This systematic scoping review synthesizes the recommended approaches for providing culturally safe family violence interventions to Indigenous peoples in health care and social service settings. A total of 3783 sources were identified through our electronic database searches, hand-searching of Indigenous-focused journals, and backward and forward citation chaining. After screening those sources in duplicate, 28 papers were included for synthesis in June 2020. Forward citation chaining of these 28 included articles in June 2022 identified an additional 304 possible articles for inclusion; following the screening of those 304 articles, an additional 6 were retained in the review. Thus, a total of 34 articles were included for data extraction and narrative synthesis. Initial results were presented to members of the Six Nations of the Grand River Youth Mental Wellness Committee, and their feedback was incorporated into our inductive organization of findings. Our findings represent three thematic areas that reflect key recommendations for health care and social service provision to Indigenous families for whom family violence is a concern: (1) creating the conditions for cultural safety; (2) healing at the individual and community level; and (3) system-level change. These findings demonstrate the need to center Indigenous peoples and perspectives in the development and implementation of cultural safety approaches, to acknowledge and address historically contingent causes of past and present family violence including colonization and related state policies, and to transform knowledge and power relationships at the provider, organization, and government level.
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Affiliation(s)
- Ilana Allice
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Anita Acai
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Ayda Ferdossifard
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Christine Wekerle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4L8, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4L8, Canada
- Optentia Research Unit, North-West University, Potchefstroom 2520, South Africa
| | - Melissa Kimber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4L8, Canada
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Sturm A, Ager AL, Roth R. Western ideals and global realities – physiotherapists’ views on factors that play a role in ethical decision-making: an international qualitative analysis. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2155240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Andrea Sturm
- Interuniversity College for Health and Development Graz, Leibnitz, Austria
| | - Amanda L. Ager
- Doctoral School of Life Sciences and Medicine, Gent University, Gent, Belgium
| | - Roswith Roth
- Interuniversity College for Health and Development Graz, Leibnitz, Austria
- Institute of Psychology, University of Graz, Graz, Austria
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Williams JH, Silvera GA, Lemak CH. Learning Through Diversity: Creating a Virtuous Cycle of Health Equity in Health Care Organizations. Adv Health Care Manag 2022; 21:167-189. [PMID: 36437622 DOI: 10.1108/s1474-823120220000021009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
In the US, a growing number of organizations and industries are seeking to affirm their commitment to and efforts around diversity, equity, and inclusion (DEI) as recent events have increased attention to social inequities. As health care organizations are considering new ways to incorporate DEI initiatives within their workforce, the anticipated result of these efforts is a reduction in health inequities that have plagued our country for centuries. Unfortunately, there are few frameworks to guide these efforts because few successfully link organizational DEI initiatives with health equity outcomes. The purpose of this chapter is to review existing scholarship and evidence using an organizational lens to examine how health care organizations can advance DEI initiatives in the pursuit of reducing or eliminating health inequities. First, this chapter defines important terms of DEI and health equity in health care. Next, we describe the methods for our narrative review. We propose a model for understanding health care organizational activity and its impact on health inequities based in organizational learning that includes four interrelated parts: intention, action, outcomes, and learning. We summarize the existing scholarship in each of these areas and provide recommendations for enhancing future research. Across the body of knowledge in these areas, disciplinary and other silos may be the biggest barrier to knowledge creation and knowledge transfer. Moving forward, scholars and practitioners should seek to collaborate further in their respective efforts to achieve health equity by creating formalized initiatives with linkages between practice and research communities.
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McPherson K, Nahon I. Culturally responsive women’s and men’s health physiotherapy for Indigenous people living in regional, rural, and remote Australia. PHYSICAL THERAPY REVIEWS 2022. [DOI: 10.1080/10833196.2022.2152553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Kerstin McPherson
- Faculty of Health, University of Canberra, Canberra, Australia
- Faculty of Science, Charles Sturt University, Orange, Australia
| | - Irmina Nahon
- Faculty of Health, University of Canberra, Canberra, Australia
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Campbell S, Carnevale FA. Children as an afterthought during COVID-19: defining a child-inclusive ethical framework for pandemic policymaking. BMC Med Ethics 2022; 23:126. [PMID: 36471326 PMCID: PMC9720957 DOI: 10.1186/s12910-022-00866-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 11/23/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Following the SARS pandemic, jurisdictions around the world began developing ethical resource allocation frameworks for future pandemics-one such framework was developed by Thompson and colleagues. While this framework offers a solid backbone upon which decision-makers can rest assured that their work is driven by rigorous ethical processes and principles, it fails to take into account the nuanced experiences and interests of children and youth (i.e., young people) in a pandemic context. The current COVID-19 pandemic offers an opportunity to re-examine this framework from young people's perspectives, informed by advances in childhood ethics and children's rights. MAIN BODY In this paper, we revisit the Thompson et al. framework and propose adaptations to the ethical processes and values outlined therein. This work is informed by expertise in clinical ethics and literature related to impacts of COVID-19 and other pandemics on the health and well-being of children around the world, though with particular attention to Canada. During the processes of drafting this work, stakeholders were consulted-aligned with the approach used by Thompson and colleagues-to validate the interpretations provided. We also propose a new principle, namely practicability, to indicate the complex balance between what is possible and what is convenient that is required in ethically sound decisions in the context of services affecting young people. We outline and discuss the strengths and limitations of our work and indicate next steps for scholars in the areas of childhood studies and child health. CONCLUSION Efforts to ensure frameworks are truly child-inclusive should be the status-quo, so pandemic impacts and policy implications can be considered in advance of emergency preparedness contexts.
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Affiliation(s)
- Sydney Campbell
- grid.14709.3b0000 0004 1936 8649VOICE Childhood Ethics Research Team, McGill University, Montreal, QC Canada ,grid.17063.330000 0001 2157 2938Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, Toronto, ON M573M6 Canada ,grid.17063.330000 0001 2157 2938Joint Centre for Bioethics, University of Toronto, Toronto, Canada
| | - Franco A. Carnevale
- grid.14709.3b0000 0004 1936 8649VOICE Childhood Ethics Research Team, McGill University, Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649Ingram School of Nursing, McGill University, Montreal, QC Canada
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Walsh M, Huggins B, Kondas CA. A Mother's Loss and a Case of Failed Cultural Humility. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20221109-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Lavoie JG, Stoor JP, Rink E, Cueva K, Gladun E, Larsen CVL, Healey Akearok G, Kanayurak N. Cultural competence and safety in Circumpolar countries: an analysis of discourses in healthcare. Int J Circumpolar Health 2022; 81:2055728. [PMID: 35451927 PMCID: PMC9037165 DOI: 10.1080/22423982.2022.2055728] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/17/2022] [Accepted: 03/16/2022] [Indexed: 11/05/2022] Open
Abstract
Circumpolar Indigenous populations continue to experience dramatic health inequities when compared to their national counterparts. The objectives of this study are first, to explore the space given in the existing literature to the concepts of cultural safety and cultural competence, as it relates to Indigenous peoples in Circumpolar contexts; and second, to document where innovations have emerged. We conducted a review of the English, Danish, Norwegian, Russian and Swedish Circumpolar health literature focusing on Indigenous populations. We include research related to Alaska (USA); the Yukon, the Northwest Territories, Nunavik and Labrador (Canada); Greenland; Sápmi (northmost part of Sweden, Norway, and Finland); and arctic Russia. Our results show that the concepts of cultural safety and cultural competence (cultural humility in Nunavut) are widely discussed in the Canadian literature. In Alaska, the term relationship-centred care has emerged, and is defined broadly to encompass clinician-patient relationships and structural barriers to care. We found no evidence that similar concepts are used to inform service delivery in Greenland, Nordic countries and Russia. While we recognise that healthcare innovations are often localised, and that there is often a lapse before localised innovations find their way into the literature, we conclude that the general lack of attention to culturally safe care for Sámi and Greenlandic Inuit is somewhat surprising given Nordic countries' concern for the welfare of their citizens. We see this as an important gap, and out of step with commitments made under United Nations Declarations on the Rights of Indigenous Peoples. We call for the integration of cultural safety (and its variants) as a lens to inform the development of health programs aiming to improve Indigenous in Circumpolar countries.
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Affiliation(s)
- Josée G. Lavoie
- Ongomiizwin Research, University of Manitoba, Winnipeg, MBCanada
| | - Jon Petter Stoor
- Department of Epidemiology and Global Health, Umeå University, Centre for Sami Health Research, UiT – the Arctic University of Norway, Sweden, Norway
| | - Elizabeth Rink
- Health & Human Development, Montana State University, USA
| | - Katie Cueva
- Institute of Social and Economic Research (ISER), University of Alaska, Anchorage, AK, USA
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