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Coulter E, McQueen C, Abu-Jurji Z, Chan-Emery I, Rukavina M, Solecki R, Wojkowski S, Dhir J. Development and delivery of justice, equity, diversity, inclusion, and anti-oppression concepts in entry-level health professional education: a scoping review protocol. JBI Evid Synth 2024; 22:1103-1114. [PMID: 38165208 DOI: 10.11124/jbies-23-00223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The objective of this scoping review is to identify the frameworks, guidelines, and models used to develop and deliver justice, equity, diversity, inclusion (JEDI), and anti-oppression (AO) principles in mandatory, entry-level health care professional program curricula (EHCPPC). A secondary objective will be to examine how these frameworks, guidelines, and models are used. INTRODUCTION Health inequities are perpetuated globally, as observed by the suboptimal quality of care and health outcomes among equity-deserving groups. An understanding of JEDI and AO concepts is necessary in health care settings to promote culturally safe and high-quality care; however, entry-level health care programs may lack adequate integration of content and/or delivery of these principles. This scoping review will summarize the international literature on frameworks, guidelines, and models used to develop and deliver JEDI and AO concepts in EHCPPC. INCLUSION CRITERIA This review will consider articles that discuss frameworks, models, or guidelines included in EHCPPC that guide the development and/or delivery of JEDI and AO principles in any country. Studies will be considered if they were published from 2015 to the present and are in English. All study designs will be considered for inclusion. METHODS This review will be conducted in accordance with the JBI methodology for scoping reviews. A search of MEDLINE (Ovid), Embase (Ovid), and CINAHL (EBSCOhost) will be conducted. Two or more independent reviewers will assess titles and abstracts, screen full-text studies, and extract data from included studies. Data from the included studies will be collated into tables or figures and described in a narrative summary. REVIEW REGISTRATION Open Science Framework osf.io/ewqf8.
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Affiliation(s)
- Emma Coulter
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Slaughter-Acey J, Simone M, Hazzard VM, Arlinghaus KR, Neumark-Sztainer D. More Than Identity: An Intersectional Approach to Understanding Mental-Emotional Well-Being of Emerging Adults by Centering Lived Experiences of Marginalization. Am J Epidemiol 2023; 192:1624-1636. [PMID: 37401016 DOI: 10.1093/aje/kwad152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 04/12/2023] [Accepted: 06/30/2023] [Indexed: 07/05/2023] Open
Abstract
Understanding social determinants that shape pertinent developmental shifts during emerging adulthood (i.e., ages 18-25 years) and their associations with psychological health requires a nuanced approach. In our exploratory study, we investigated how multiple social identities and lived experiences generated by systems of marginalization and power (e.g., racism, classism, sexism) intersect in connection to the mental-emotional well-being of emerging adults (EAs). Eating and Activity Over Time (EAT, 2010-2018) data were collected from 1,568 EAs (mean age = 22.2 (standard deviation, 2.0) years) recruited initially in 2010 from Minneapolis/St. Paul schools. Conditional inference tree analyses were employed to treat "social location" and systems of marginalization and power as interdependent social factors influencing EAs' mental-emotional well-being outcomes: depressive symptoms, stress, self-esteem, and self-compassion. Conditional inference tree analyses identified EAs' subgroups with differing mean levels of mental-emotional well-being outcomes, distinguished primarily by marginalized social experiences (e.g., discrimination, financial difficulties) rather than social identities themselves. The relative positioning of EAs' experiences of social marginalization (e.g., discrimination) to their social identities (e.g., race/ethnicity) suggests that the social experiences generated by systems of privilege and oppression (e.g., racism) are more adjacent social determinants of mental-emotional well-being than the social identities used in public health research to proxy the oppressive systems that give them social meaning.
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Hajibonabi F, Taye M, Ubanwa A, Rowe JS, Sharperson C, Hanna TN, Johnson JO. Time ratio disparities among ED patients undergoing head CT. Emerg Radiol 2023; 30:453-463. [PMID: 37349643 DOI: 10.1007/s10140-023-02152-7] [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: 05/09/2023] [Accepted: 06/15/2023] [Indexed: 06/24/2023]
Abstract
PURPOSE To assess if patients who underwent head computed tomography (CT) experienced disparities in the emergency department (ED) and if the indication for head CT affected disparities. METHODS This study employed a retrospective, IRB-approved cohort design encompassing four hospitals. All ED patients between January 2016 and September 2020 who underwent non-contrast head CTs were included. Furthermore, key time intervals including ED length of stay (LOS), ED assessment time, image acquisition time, and image interpretation time were calculated. Time ratio (TR) was used to compare these time intervals between the groups. RESULTS A total of 45,177 ED visits comprising 4730 trauma cases, 5475 altered mental status cases, 11,925 cases with head pain, and 23,047 cases with other indications were included. Females had significantly longer ED LOS, ED assessment time, and image acquisition time (TR = 1.012, 1.051, 1.018, respectively, P-value < 0.05). This disparity was more pronounced in female patients with head pain complaints compared to their male counterparts (TR = 1.036, 1.059, and 1.047, respectively, P-value < 0.05). Black patients experienced significantly longer ED LOS, image acquisition time, and image assessment time (TR = 1.226, 1.349, and 1.190, respectively, P-value < 0.05). These disparities persisted regardless of head CT indications. Furthermore, patients with Medicare/Medicaid insurance also faced longer wait times in all the time intervals (TR > 1, P-value < 0.001). CONCLUSIONS Wait times for ED head CT completion were longer for Black patients and Medicaid/Medicare insurance holders. Additionally, females experienced extended wait times, particularly when presented with head pain complaints. Our findings underscore the importance of exploring and addressing the contributing factors to ensure equitable and timely access to imaging services in the ED.
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Affiliation(s)
- Farid Hajibonabi
- Department of Radiology and Imaging Sciences, Emory University, 1364 Clifton Road, Atlanta, GA, 30322, USA.
| | - Marta Taye
- Department of Radiology and Imaging Sciences, Emory University, 1364 Clifton Road, Atlanta, GA, 30322, USA
| | - Angela Ubanwa
- Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop Street Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Jean Sebastien Rowe
- Department of Radiology, Cooper University Hospital, 1 Cooper Plaza, Camden, NJ, 08103, USA
| | - Camara Sharperson
- Department of Radiology and Imaging Sciences, Emory University, 1364 Clifton Road, Atlanta, GA, 30322, USA
| | - Tarek N Hanna
- Department of Radiology and Imaging Sciences, Emory University, 1364 Clifton Road, Atlanta, GA, 30322, USA
| | - Jamlik-Omari Johnson
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, USA
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Aranas K, Al-Habyan L, Akhtar N, Ng I, Noor H, Poirier M, Dhir J, Wojkowski S. Entry-to-practice competency expectations for health justice in Canadian physiotherapy curricula: A scoping review protocol. MEDEDPUBLISH 2022; 12:31. [PMID: 39219597 PMCID: PMC11362729 DOI: 10.12688/mep.19126.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 09/04/2024] Open
Abstract
Background: In Canada, physiotherapists are expected to possess and demonstrate several essential competencies upon entry-to-practice. Over the past decade, knowledge and skills relating to health justice have become increasingly important for healthcare professionals. However, health justice is still an emerging topic among Canadian physiotherapy programs and current curricula may be lacking explicit content to develop knowledge, skills and behaviours related to health justice which can be used to prepare students for entry-to-practice. This paper outlines a protocol for a planned scoping review. The purpose of this scoping review will be to examine existing Canadian entry-level competencies for physiotherapy related to health justice. Methods: A comprehensive literature search will be completed on four databases: OVID MEDLINE, OVID Emcare, OVID Embase, and EBSCOhost CINAHL. This scoping review will include both quantitative and qualitative methodological study designs. A grey literature search will involve advanced Google searches. Two authors will independently screen titles and abstracts to select articles for full text review. Data extraction for each selected paper will be completed independently by two authors using the proposed data extraction form. The extracted data will be presented through tables and a narrative summary that aligns with the objectives and scope of this review. Conclusion: The data collected from this proposed review will identify existing competencies and gaps related to health justice in current entry-level physiotherapy curricula. This information will assist academic programs in understanding how to integrate and identify competencies and frameworks related to health justice into Canadian physiotherapy programs to ensure students are better prepared to provide culturally competent and inclusive care and promote health justice in practice.
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Affiliation(s)
- Kimberly Aranas
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, L8S1C7, Canada
| | - Lina Al-Habyan
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, L8S1C7, Canada
| | - Narmeen Akhtar
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, L8S1C7, Canada
| | - Isabel Ng
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, L8S1C7, Canada
| | - Haleema Noor
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, L8S1C7, Canada
| | - Mae Poirier
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, L8S1C7, Canada
| | - Jasdeep Dhir
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, L8S1C7, Canada
| | - Sarah Wojkowski
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, L8S1C7, Canada
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Dhir J, Blake T, Cleaver S, Smith-Turchyn J, Miller P, Smith M, Udarbe Han M, Gasparelli K, Wojkowski S. La recherche de la justice : acquérir une compréhension intégrative de la justice en santé en physiothérapie. Physiother Can 2022; 74:229-231. [PMID: 37325214 PMCID: PMC10262827 DOI: 10.3138/ptc-74-3-gef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Affiliation(s)
- Jasdeep Dhir
- École des sciences de la réadaptation, Physiothérapie, Université McMaster, Hamilton, Ontario, Canada
| | - Tracy Blake
- École des sciences de la réadaptation, Physiothérapie, Université McMaster, Hamilton, Ontario, Canada
- Sciences du sport Canada
- Toronto Western Hospital, Réseau universitaire de santé, Toronto, Ontario, Canada
| | - Shaun Cleaver
- Faculté de médecine et des sciences de la santé, Université McGill, Montréal, Québec, Canada
| | - Jenna Smith-Turchyn
- École des sciences de la réadaptation, Physiothérapie, Université McMaster, Hamilton, Ontario, Canada
| | - Patricia Miller
- École des sciences de la réadaptation, Physiothérapie, Université McMaster, Hamilton, Ontario, Canada
| | - Meredith Smith
- Département de physiothérapie, Université de Toronto, Toronto, Ontario, Canada
- Institut de réadaptation de Toronto, Réseau universitaire de santé, Toronto, Ontario, Canada
- Black Physiotherapy Association, Canada
| | - Mari Udarbe Han
- 519Physio, London, Ontario, Canada
- London Health Sciences Centre; London, Ontario, Canada
- Black, Brown, Indigenous, Person of Colour (BBIPOC) Physiotherapy Student Collective en collaboration avec l’Assemblée nationale des étudiants, Association canadienne de physiothérapie, Canada
| | | | - Sarah Wojkowski
- École des sciences de la réadaptation, Physiothérapie, Université McMaster, Hamilton, Ontario, Canada
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Dhir J, Blake T, Cleaver S, Smith-Turchyn J, Miller P, Smith M, Udarbe Han M, Gasparelli K, Wojkowski S. The Search for Justice: Developing a Collaborative Understanding of Health Justice in Physiotherapy. Physiother Can 2022; 74:227-229. [PMID: 37325207 PMCID: PMC10262822 DOI: 10.3138/ptc-74-3-gee] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Affiliation(s)
- Jasdeep Dhir
- School of Rehabilitation Science, Physiotherapy, McMaster University, Hamilton, Ontario, Canada
| | - Tracy Blake
- School of Rehabilitation Science, Physiotherapy, McMaster University, Hamilton, Ontario, Canada
- Sport Scientist Canada
- Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Shaun Cleaver
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Jenna Smith-Turchyn
- School of Rehabilitation Science, Physiotherapy, McMaster University, Hamilton, Ontario, Canada
| | - Patricia Miller
- School of Rehabilitation Science, Physiotherapy, McMaster University, Hamilton, Ontario, Canada
| | - Meredith Smith
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Black Physiotherapy Association, Canada
| | - Mari Udarbe Han
- 519Physio, London, Ontario, Canada
- London Health Sciences Centre; London, Ontario, Canada
- Black, Brown, Indigenous, Person of Colour (BBIPOC) Physiotherapy Student Collective in collaboration with the National Student Assembly, Canadian Physiotherapy Association, Canada
| | | | - Sarah Wojkowski
- School of Rehabilitation Science, Physiotherapy, McMaster University, Hamilton, Ontario, Canada
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Aranas K, Al-Habyan L, Akhtar N, Ng I, Noor H, Poirier M, Dhir J, Wojkowski S. Entry-to-practice competency expectations for health justice in Canadian physiotherapy curricula: A scoping review protocol. MEDEDPUBLISH 2022. [DOI: 10.12688/mep.19126.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: In Canada, physiotherapists are expected to possess and demonstrate several essential competencies upon entry-to-practice. Over the past decade, knowledge and skills relating to health justice have become increasingly important for healthcare professionals. However, health justice is still an emerging topic among Canadian physiotherapy programs and current curricula may be lacking explicit content to develop knowledge, skills and behaviours related to health justice which can be used to prepare students for entry-to-practice. This paper outlines a protocol for a planned scoping review. The purpose of this scoping review will be to examine existing Canadian entry-level competencies for physiotherapy related to health justice. Methods: A comprehensive literature search will be completed on four databases: OVID MEDLINE, OVID Emcare, OVID Embase, and EBSCOhost CINAHL. This scoping review will include both quantitative and qualitative methodological study designs. A grey literature search will involve advanced Google searches for sources from Canada, the United States of America, Australia, and New Zealand. Two authors will independently screen titles and abstracts to select articles for full text review. Data extraction for each selected paper will be completed independently by two authors using the proposed data extraction form. The extracted data will be presented through tables and a narrative summary that aligns with the objectives and scope of this review. Conclusion: The data collected from this proposed review will identify existing competencies and gaps related to health justice in current entry-level physiotherapy curricula. This information will assist academic programs in understanding how to integrate and identify competencies and frameworks related to health justice into Canadian physiotherapy programs to ensure students are better prepared to provide culturally competent and inclusive care and promote health justice in practice.
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Medvedyuk S, Govender P, Raphael D. The reemergence of Engels' concept of social murder in response to growing social and health inequalities. Soc Sci Med 2021; 289:114377. [PMID: 34662784 DOI: 10.1016/j.socscimed.2021.114377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/29/2021] [Accepted: 09/04/2021] [Indexed: 12/18/2022]
Abstract
In 1845, Friedrich Engels identified how the living and working conditions experienced by English workers sent them prematurely to the grave, arguing that those responsible for these conditions -- ruling authorities and the bourgeoisie -- were committing social murder. The concept remained, for the most part, dormant in academic journals through the 1900s. Since 2000, there has been a revival of the social murder concept with its growth especially evident in the UK over the last decade as a result of the Grenfell Tower Fire and the effects of austerity imposed by successive Conservative governments. The purpose of this paper is to document the reemergence of the concept of social murder in academic journal articles. To do so we conducted a scoping review of content applying the social murder concept since 1900 in relation to health and well-being. We identified two primary concepts of social murder: social murder as resulting from capitalist exploitation and social murder as resulting from bad public policy across the domains of working conditions, living conditions, poverty, housing, race, health inequalities, crime and violence, neoliberalism, gender, food, social assistance, deregulation and austerity. We consider reasons for the reemergence of Engels' social murder concept and the role it can play in resisting the forces responsible for the living and working conditions that kill.
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Affiliation(s)
- Stella Medvedyuk
- School of Health Policy and Management, York University, Toronto, Canada
| | - Piara Govender
- School of Health Policy and Management, York University, Toronto, Canada
| | - Dennis Raphael
- School of Health Policy and Management, York University, Toronto, Canada.
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Embracing challenging complexity: exploring handwashing behavior from a combined socioecological and intersectional perspective in Sierra Leone. BMC Public Health 2021; 21:1857. [PMID: 34649535 PMCID: PMC8515313 DOI: 10.1186/s12889-021-11923-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/05/2021] [Indexed: 11/30/2022] Open
Abstract
Background Handwashing with soap is a cost-effective, efficient health behavior to prevent various diseases. Despite its immense health benefits, the lowest prevalence of handwashing is found in low-income countries. Here, its practice is not only determined by individual behavior, but also heavily shaped by deprivations in the social and structural ecology. Moreover, handwashing barriers are not equally experienced as overlapping social identities (e.g., age and gender) intersect and create inequities between members of different social groups. To embrace the complexities of handwashing beyond individual-level behavior and singular social identities, a combined socioecological and intersectional perspective is employed. This multi-level approach with regards to intersecting privileges and disadvantages serves as a basis to promote this highly important health behavior. Methods This study used a qualitative, theory-based approach and combined data from two samples: experts in health promotion (n = 22) and local citizens stratified by gender and rural/urban location (n = 56). Data was collected in face-to-face interviews in Sierra Leone between November 2018 and January 2019 and analyzed using thematic analysis and typology of the qualitative data. Results The conceptualization of multi-level determinants of handwashing within a socioecological model showed the high relevance of inhibiting social and structural factors for handwashing practice. By establishing seven distinguishing social identity dimensions, data demonstrates that individuals within the same social setting yet with distinct social identities experience strikingly differing degrees of power and privileges to enact handwashing. While a local leader is influential and may also change structural-level determinants, a young, rural wife experiences multiple social and structural constraints to perform handwashing with soap, even if she has high handwashing intentions. Conclusion This study provides a holistic analytical framework for the identification of determinants on multiple levels and accumulating intersections of socially produced inequalities for handwashing and is applicable to other health topics. As the exploration of handwashing was approached from a solution-focused instead of a problem-focused perspective, the analysis can guide multi-level intervention approaches (e.g., using low-cost, participatory activities at the community level to make use of the available social capital). Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11923-1.
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