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Nagy GA, Cassiello-Robbins C, Anand D, Arnold ML, Coleman JN, Nwosu J, Singh RS, Woodward EN. Building a multicultural peer-consultation team: Planning, implementing, and early sustainment evaluation. Transcult Psychiatry 2022; 59:844-862. [PMID: 35866216 DOI: 10.1177/13634615221105117] [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: 01/20/2023]
Abstract
This article represents an implementation-focused evaluation of a multicultural peer-consultation team situated within a psychiatry department in a large academic medical center in the Southern United States. The evaluation comprised anonymous self-report questionnaires (n = 14) as well as individual (n = 3) or group interviews (n = 10) conducted by outside independent evaluators. Participants were current and former team members (i.e., graduate trainees, mental health care providers, clinical and research staff members) who voluntarily participated in this multimethod implementation evaluation. Results indicated that attendance on the team had several important impacts on members, and most notably an increased ability to provide multiculturally competent care, that is treatment that carefully and routinely considers the influence of culture and context on patients and therefore their clinical presentation. Further, no negative impacts from participating on the team were noted. A primary strength of the team's sustainability is that participation on the team was deemed to be relevant and useful by current and former team members. A major barrier to participation on the team is competing demands, such as high clinical loads. We conclude that this model for multicultural peer-consultation holds promise as an effective and implementable educational method for mental health care professionals. We discuss strengths, limitations, and future directions for research.
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Affiliation(s)
- Gabriela A Nagy
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine & School of Nursing, Durham, NC, USA
| | - Clair Cassiello-Robbins
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Deepika Anand
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Macey L Arnold
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Jessica N Coleman
- Duke University Department of Psychology and Neuroscience, Durham, NC, USA
| | - Joshua Nwosu
- Psychology Service, Washington DC Veterans Affairs Health Center, Washington, DC, USA
| | - R Sonia Singh
- VA Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA.,Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Eva N Woodward
- VA Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA.,Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Nagy PhD GA, Arnold Bs ML, Gagliardi Md JP, Convoy Dnp S, Molloy Dnp Rn Cne Chse MA, Wall PhD Rn Pmhnp-Bc Faanp P, Mauro PhD C, Rosenthal PhD MZ. Adaptation of the TEAM Mental Healthcare Delivery Model: A Mixed-Methods Evaluation. Issues Ment Health Nurs 2022; 43:239-250. [PMID: 34543149 DOI: 10.1080/01612840.2021.1975330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We report on the adaptation and evaluation of an existing approach to multicultural education into an eight-session online, modular curriculum for psychiatric mental health nurse practitioner students (n = 6) and psychology interns (n = 10). Training participants were invited to complete verbal feedback, self-report questionnaires, and a high-fidelity patient simulation before and after the training. Self-report questionnaire results revealed no changes in knowledge or attitudes, but qualitative analysis of verbal feedback reflected improvements in attitudes and behaviors relevant to cultural competence. Results from the simulation also demonstrated an increase in measurable cultural competence behavioral indicators.
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Affiliation(s)
- Gabriela A Nagy PhD
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Duke University School of Nursing, Durham, North Carolina, USA
| | - Macey L Arnold Bs
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Jane P Gagliardi Md
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sean Convoy Dnp
- Duke University School of Nursing, Durham, North Carolina, USA
| | | | | | - Christian Mauro PhD
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - M Zachary Rosenthal PhD
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
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Xavier SM, Jarvis GE, Ouellet-Plamondon C, Gagné G, Abdel-Baki A, Iyer SN. Comment les services d’intervention précoce pour la psychose peuvent-ils mieux servir les migrants, les minorités ethniques et les populations autochtones ? SANTE MENTALE AU QUEBEC 2021. [DOI: 10.7202/1088188ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gordon EJ, Romo E, Amórtegui D, Rodas A, Anderson N, Uriarte J, McNatt G, Caicedo JC, Ladner DP, Shumate M. Implementing culturally competent transplant care and implications for reducing health disparities: A prospective qualitative study. Health Expect 2020; 23:1450-1465. [PMID: 33037746 PMCID: PMC7752187 DOI: 10.1111/hex.13124] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/24/2020] [Accepted: 07/25/2020] [Indexed: 12/27/2022] Open
Abstract
Background Despite available evidence‐based interventions that decrease health disparities, these interventions are often not implemented. Northwestern Medicine's® Hispanic Kidney Transplant Program (HKTP) is a culturally and linguistically competent intervention designed to reduce disparities in living donor kidney transplantation (LDKT) among Hispanics/Latinos. The HKTP was introduced in two transplant programs in 2016 to evaluate its effectiveness. Objective This study assessed barriers and facilitators to HKTP implementation preparation. Methods Interviews and group discussions were conducted with transplant stakeholders (ie administrators, nurses, physicians) during implementation preparation. The Consolidated Framework for Implementation Research (CFIR) guided interview design and qualitative analysis. Results Forty‐four stakeholders participated in 24 interviews and/or 27 group discussions. New factors, not found in previous implementation preparation research in health‐care settings, emerged as facilitators and barriers to the implementation of culturally competent care. Implementation facilitators included: stakeholders’ focus on a moral imperative to implement the HKTP, personal motivations related to their Hispanic heritage, and perceptions of Hispanic patients’ transplant education needs. Implementation barriers included: stakeholders’ perceptions that Hispanics’ health insurance payer mix would negatively impact revenue, a lack of knowledge about LDKT disparities and patient data disaggregated by ethnicity/race, and a perception that the family discussion component was immoral because of the possibility of coercion. Discussion and Conclusions Our study identified novel barriers and facilitators to the implementation preparation of a culturally competent care intervention. Healthcare administrators can facilitate organizations’ implementation of culturally competent care interventions by understanding factors challenging care delivery processes and raising clinical team awareness of disparities in LDKT.
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Affiliation(s)
- Elisa J Gordon
- Division of Transplantation, Department of Surgery, Northwestern Medicine, Chicago, IL, USA.,Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Feinberg School of Medicine, Chicago, IL, USA.,Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Bioethics and Medical Humanities, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Elida Romo
- Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Daniela Amórtegui
- Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alejandra Rodas
- Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Naomi Anderson
- Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jefferson Uriarte
- Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gwen McNatt
- Kovler Organ Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Juan Carlos Caicedo
- Division of Transplantation, Department of Surgery, Northwestern Medicine, Chicago, IL, USA.,Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Feinberg School of Medicine, Chicago, IL, USA
| | - Daniela P Ladner
- Division of Transplantation, Department of Surgery, Northwestern Medicine, Chicago, IL, USA.,Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Feinberg School of Medicine, Chicago, IL, USA
| | - Michelle Shumate
- Department of Communication Studies, Northwestern University, Chicago, IL, USA
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