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Adebayo CT, Olukotun OV, Olukotun M, Kirungi J, Gondwe KW, Crooks NK, Singer RB, Adams S, Alfaifi FY, Dressel A, Fahmy L, Kako P, Snethen J, Valhmu LM. Experiences of gender-based violence among Somali refugee women: a socio-ecological model approach. CULTURE, HEALTH & SEXUALITY 2024; 26:654-670. [PMID: 37516928 PMCID: PMC10825063 DOI: 10.1080/13691058.2023.2236163] [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: 09/01/2022] [Accepted: 07/10/2023] [Indexed: 07/31/2023]
Abstract
Gender-based violence (GBV) is an all-encompassing term that speaks to acts or threats that may lead to physical, sexual or emotional harm to an individual based on their gender. This paper provides a scoping review of research on gender-based violence among Somali refugee women in different parts of the world. Using the socio-ecological model as a framework, we reviewed 30 empirical studies focusing on some form of GBV among Somali refugee women. We identified societal, community and individual factors contributing to the experience of GBV. We also discuss how these factors influence women's willingness to access care, especially healthcare and social services. The review reveals that oftentimes, institutions that work closely with this population have a limited understanding of how closely culture affects the willingness and ability to seek help about GBV. Based on our analysis, we suggest ways in which social institutions and healthcare providers can provide culturally-safe support to Somali refugee women who have experienced some form of GBV.
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Affiliation(s)
| | | | - Mary Olukotun
- Faculty of Nursing, University of Alberta-Edmonton, Edmonton, AB, Canada
| | - Jackline Kirungi
- Department of African & African Diaspora Studies, University of Wisconsin, Milwaukee, WI, USA
| | | | - Natasha K. Crooks
- Human Development Nursing Science, University of Illinois, Chicago, IL, USA
| | - Randi B. Singer
- Human Development Nursing Science, University of Illinois, Chicago, IL, USA
| | - Shukri Adams
- Ras Al Khaimah School of Nursing, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | | | - Anne Dressel
- College of Nursing, University of Wisconsin, Milwaukee, WI, USA
| | - Laila Fahmy
- Department of Psychology, Towson University, Towson, MD, USA
| | - Peninah Kako
- College of Nursing, University of Jazan, Gizan, Saudi Arabia
| | - Julia Snethen
- College of Nursing, University of Jazan, Gizan, Saudi Arabia
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Patient activation reduces effects of implicit bias on doctor-patient interactions. Proc Natl Acad Sci U S A 2022; 119:e2203915119. [PMID: 35914161 PMCID: PMC9371681 DOI: 10.1073/pnas.2203915119] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Disparities between Black and White Americans persist in medical treatment and health outcomes. One reason is that physicians sometimes hold implicit racial biases that favor White (over Black) patients. Thus, disrupting the effects of physicians' implicit bias is one route to promoting equitable health outcomes. In the present research, we tested a potential mechanism to short-circuit the effects of doctors' implicit bias: patient activation, i.e., having patients ask questions and advocate for themselves. Specifically, we trained Black and White standardized patients (SPs) to be "activated" or "typical" during appointments with unsuspecting oncologists and primary care physicians in which SPs claimed to have stage IV lung cancer. Supporting the idea that patient activation can promote equitable doctor-patient interactions, results showed that physicians' implicit racial bias (as measured by an implicit association test) predicted racially biased interpersonal treatment among typical SPs (but not among activated SPs) across SP ratings of interaction quality and ratings from independent coders who read the interaction transcripts. This research supports prior work showing that implicit attitudes can undermine interpersonal treatment in medical settings and provides a strategy for ensuring equitable doctor-patient interactions.
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Adebayo CT, Parcell ES, Mkandawire-Valhmu L, Olukotun O. African American Women's Maternal Healthcare Experiences: A Critical Race Theory Perspective. HEALTH COMMUNICATION 2022; 37:1135-1146. [PMID: 33601991 DOI: 10.1080/10410236.2021.1888453] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Black women are experiencing pregnancy-related complications at a significantly higher rate than women of other races in the U.S., as Black women are three to four times likely to die from pregnancy-related complications compared to non-Hispanic White women. Structural barriers and different forms of marginalization continue to limit Black women's access to quality healthcare services. Through critical race theory, we examine what structural barriers exist in the U.S. healthcare system, one that limits access to quality care during their prenatal and postnatal doctor's visits. Using qualitative in-depth interviews, 31 African American women, living in Milwaukee, WI, shared their pregnancy stories. The emergent themes include, institutionalized care - racially insensitive biomedical approach, race and class - unfair treatment based on health insurance, and race as a social concept - dismissed pain concerns because you are a strong Black woman. These themes reveal the experience of racial discrimination toward African American women through healthcare [communicative] practices that are often times seen as "standard" practices, albeit marginalizing minority populations. Findings from this study offer insights for healthcare providers on communicative practices that foster a racially-safe healthcare environment for African American women.
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Landman JM, Steger-May K, Joynt Maddox KE, Hammond G, Gupta A, Rauseo AM, Zhao M, Foraker RE. Estimating the effects of race and social vulnerability on hospital admission and mortality from COVID-19. JAMIA Open 2022; 4:ooab111. [PMID: 35146378 PMCID: PMC8822405 DOI: 10.1093/jamiaopen/ooab111] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/16/2021] [Accepted: 12/06/2021] [Indexed: 12/18/2022] Open
Abstract
Objective To estimate the risk of hospital admission and mortality from COVID-19 to patients and measure the association of race and area-level social vulnerability with those outcomes. Materials and Methods Using patient records collected at a multisite hospital system from April 2020 to October 2020, the risk of hospital admission and the risk of mortality were estimated for patients who tested positive for COVID-19 and were admitted to the hospital for COVID-19, respectively, using generalized estimating equations while controlling for patient race, patient area-level social vulnerability, and time course of the pandemic. Results Black individuals were 3.57 as likely (95% CI, 3.18–4.00) to be hospitalized than White people, and patients living in the most disadvantaged areas were 2.61 times as likely (95% CI, 2.26–3.02) to be hospitalized than those living in the least disadvantaged areas. While Black patients had lower raw mortality than White patients, mortality was similar after controlling for comorbidities and social vulnerability. Discussion Our findings point to potent correlates of race and socioeconomic status, including resource distribution, employment, and shared living spaces, that may be associated with inequitable burden of disease across patients of different races. Conclusions Public health and policy interventions should address these social factors when responding to the next pandemic. Using records from a hospital system spanning multiple sites and 2 states, we examined patients’ risk of hospital admission and death due to COVID-19 over the first 6 months of the pandemic. Specifically, we measured the association of race and social vulnerability with the likelihood of admission and death. Our statistical models showed that Black patients were 3.57 times more likely than White patients to be hospitalized. We also took into account how socially vulnerable a given US Census tract is, and when incorporating that into our models, we estimated that patients living in the most disadvantaged areas were 2.61 times as likely to be hospitalized as those living in the least disadvantaged areas. We found no difference in mortality by race when controlling for underlying conditions and social vulnerability. These findings suggest that public health and policy interventions should address such things as resource distribution, employment, and shared living spaces, and other social factors that may be associated with race, socioeconomic status, and the inequitable burden of disease across patients of different races.
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Affiliation(s)
- Joshua M Landman
- Institute for Informatics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.,Division of Computational and Data Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Karen Steger-May
- Division of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Karen E Joynt Maddox
- Cardiovascular Division, Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Gmerice Hammond
- Cardiovascular Division, Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Aditi Gupta
- Institute for Informatics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.,Division of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Adriana M Rauseo
- Division of Infectious Diseases, Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Min Zhao
- Institute for Informatics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Randi E Foraker
- Institute for Informatics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.,Division of General Medical Sciences, Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
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Simonetti JA, Dorsey Holliman B, Holiday R, Brenner LA, Monteith LL. Firearm-related experiences and perceptions among United States male veterans: A qualitative interview study. PLoS One 2020; 15:e0230135. [PMID: 32155211 PMCID: PMC7064196 DOI: 10.1371/journal.pone.0230135] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 02/21/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/OBJECTIVE Male veterans ages 55-74 comprise a disproportionate number of suicide deaths among United States veterans, for whom a majority of suicides are firearm-related. Little is known about the firearm-related experiences and beliefs of veterans, which could be informative for firearm-related lethal means safety interventions. The aim of this qualitative study was to identify themes relevant to developing such interventions among older male veterans. METHODS We conducted semi-structured qualitative interviews with seventeen United States male veterans, ages 50-70, who were eligible to receive Veterans Health Administration services, and were current or former firearm owners or users. Transcripts were analyzed via thematic analysis using an inductive approach. RESULTS Six themes were identified: 1) Firearm experiences were usually facilitated by male family members and occurred at an early age; 2) Safety lessons during early firearm encounters focused on preventing unintentional injuries through safe firearm handling and using "common sense;" 3) Firearms serve an important social function across veterans' lifespans (e.g., hunting with friends); 4) Veterans perceive firearms as useful for protection; 5) Veterans believe that not everyone should have access to firearms, and some described scenarios in which they acted to limit others' access during unsafe situations; and 6) Veterans have preferences for who is involved in firearm safety discussions. CONCLUSIONS We identified themes relevant to developing firearm-specific lethal means safety interventions among older male veterans. Findings suggest potential obstacles (e.g., sociocultural value of firearms) to affecting changes in firearm behaviors, and factors that could potentially facilitate interventions (e.g., family involvement). Consideration of these findings may be important for developing personalized, effective interventions for this population.
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Affiliation(s)
- Joseph A. Simonetti
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Rocky Mountain Regional VA Medical Center, Veterans Health Administration, Aurora, Colorado, United States of America
- Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Health Administration, Aurora, Colorado, United States of America
- Hospital Medicine Group, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, United States of America
| | - Brooke Dorsey Holliman
- Department of Community and Behavioral Health, University of Colorado Anschutz School of Public Health, Aurora, Colorado, United States of America
| | - Ryan Holiday
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Rocky Mountain Regional VA Medical Center, Veterans Health Administration, Aurora, Colorado, United States of America
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Lisa A. Brenner
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Rocky Mountain Regional VA Medical Center, Veterans Health Administration, Aurora, Colorado, United States of America
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz School of Medicine, Aurora, Colorado, United States of America
- Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Lindsey L. Monteith
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Rocky Mountain Regional VA Medical Center, Veterans Health Administration, Aurora, Colorado, United States of America
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
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