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Aziz A, Sabqat M, Kiran F, Mirza TI. Exploring the experiences of content experts with item vetting during item bank development. Pak J Med Sci 2024; 40:1241-1246. [PMID: 38952493 PMCID: PMC11190415 DOI: 10.12669/pjms.40.6.8664] [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: 08/28/2023] [Revised: 01/24/2024] [Accepted: 02/28/2024] [Indexed: 07/03/2024] Open
Abstract
Objective To explore content experts' experiences with item vetting during item bank development at a public sector medical university of Rawalpindi, Pakistan. Methods An exploratory study was carried out from December 2022 to February 2023 at a public sector medical college of Rawalpindi. A purposive sampling technique was employed to collect data from all content experts of the study institute who participated in item vetting activity during pre-exam moderation in the university. A pilot-tested semi-structured interview guide was utilized, interviews were audio recorded and later transcribed. Participants' anonymity was ensured. Various quality assurance strategies were employed to ensure the trustworthiness of the findings. Thematic analysis was performed on the transcribed data and themes were finalized by achieving consensus among all authors. Results Six themes overarching the fourteen subthemes emerged from the data. Participants expressed a profound sense of satisfaction and valued their experience in refining expertise in constructing multiple-choice questions (MCQs). It was widely acknowledged that such activities not only contribute to the enhancement of item development skills but also improve quality of items. Conclusions The consistent implementation of item vetting routines, in conjunction with diligent adherence to item writing protocols, contributes to quality assurance measures in assessment. Item bank development for fair and transparent assessment ensures production of competent healthcare professionals filtering incompetent ones hence improving health care services in the community.
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Affiliation(s)
- Anbreen Aziz
- Anbreen Aziz, BDS, MHPE, AFHEA Assistant Professor, Department of Medical Education, HBS Medical and Dental College, Islamabad
| | - Mashaal Sabqat
- Mashaal Sabqat, MBBS, MHPE Assistant Professor, Medical Education, Assistant Director Riphah Institute of Assessment, Riphah International University, Islamabad
| | - Faiza Kiran
- Faiza Kiran, MBBS, MHPE Assistant Professor, Department of Medical Education, Shifa School of Health Professions Education, Shifa Tameer e Millat University, Islamabad, Pakistan
| | - Tayyeba Iftikhar Mirza
- Tayyeba Iftikhar Mirza, MBBS, MHPE Assistant Professor, Department of Medical Education, Foundation University Medical College, Islamabad
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Horwitz R, Brener L, Prankumar SK, de Jesus T, Jaworski A, Jadran A, Bryant J. Understanding cultural inclusion in alcohol and other drug services in New South Wales, Australia and assessing the acceptability of a cultural inclusion audit. Drug Alcohol Rev 2024. [PMID: 38825730 DOI: 10.1111/dar.13883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/27/2024] [Accepted: 05/09/2024] [Indexed: 06/04/2024]
Abstract
INTRODUCTION Cultural inclusion and competence are understood at the most basic level to be the practice of considering culture so as to provide effective services to people of different cultural backgrounds. In order to work better with clients from diverse backgrounds, alcohol and other drug (AOD) services need to offer a service that is designed to be accessible to all people, where systems in place operate in a way that considers different cultural needs. This research aimed to assess the extent to which non-government AOD services in New South Wales are positioned to support cultural inclusion as well as to evaluate the acceptability of a cultural inclusion audit across four AOD sites. METHODS The research adopted a mixed methods approach comprising of a pre-audit online survey (n = 85) designed to assess AOD services' attitudes and practices towards cultural inclusion, and in-depth interviews that were conducted with nine AOD service staff and four cultural auditors to explore the acceptability of a cultural inclusion audit process. RESULTS Findings from the survey indicate cultural inclusion practices are limited. Interview data highlight that while staff are not fully aware of what appropriate cultural inclusions entails, they are receptive to and want a cultural inclusion program. DISCUSSION AND CONCLUSIONS The study illustrates the benefits of implementing a cultural inclusion audit process aimed at raising awareness of what cultural inclusion entails. Including a cultural inclusion service audit is likely to enhance AOD service provision to culturally and linguistically diverse groups and thereby improve treatment outcomes.
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Affiliation(s)
- Robyn Horwitz
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Loren Brener
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | | | - Tata de Jesus
- The Network of Alcohol and other Drugs Agencies, Sydney, Australia
| | - Alison Jaworski
- Drug and Alcohol Multicultural Education Centre, Sydney, Australia
| | - Ahmad Jadran
- Drug and Alcohol Multicultural Education Centre, Sydney, Australia
| | - Joanne Bryant
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
- School of Social Sciences, UNSW Sydney, Sydney, Australia
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Sharma N, Mehta TS, Wahab RA, Patel MM. Facilitating Culturally Competent Breast Imaging Care in South Asian Patients. JOURNAL OF BREAST IMAGING 2024:wbae026. [PMID: 38787594 DOI: 10.1093/jbi/wbae026] [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: 09/29/2023] [Indexed: 05/25/2024]
Abstract
South Asians are a rapidly growing subset of the Asian population in the United States. They comprise people from multiple countries with diverse beliefs, languages, and cultural identities and values. The incidence of breast cancer is rising in South Asian women in the United States, with earlier onset and predilection for HER2-enriched tumors. Despite the rising incidence of breast cancer, participation in screening remains lower than other populations. Health care inequities in South Asian women are multifactorial and may be due to traditional health beliefs and practices, language barriers, cultural differences, and lack of overall awareness. Developing a culturally sensitive environment in breast imaging clinic practice can lead to improved patient care and adherence. Given the scarcity of data specific to the South Asian population in United States, there is a need for health service researchers and practice leaders to obtain more high-quality data to understand the needs of South Asian patient populations.
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Affiliation(s)
- Nidhi Sharma
- Department of Radiology, Texas A&M University, Dallas, TX, USA
| | - Tejas S Mehta
- Department of Radiology, UMass Memorial Medical Center/UMass Chan Medical School, Worcester, MA, USA
| | - Rifat A Wahab
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Miral M Patel
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Draper-Rodi J, Abbey H, Hammond J, Thomson OP, Brownhill K, MacMillan A, Fabusuyi Y, Vogel S. Overcoming barriers to equality, diversity, inclusivity, and sense of belonging in healthcare education: the Underrepresented Groups' Experiences in Osteopathic Training (UrGEnT) mixed methods study. BMC MEDICAL EDUCATION 2024; 24:468. [PMID: 38671395 PMCID: PMC11055260 DOI: 10.1186/s12909-024-05404-3] [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: 02/02/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Individuals from minority groups have historically faced social injustices. Those from underrepresented groups have been less likely to access both healthcare services and higher education. Little is known about the experiences of underrepresented students during their undergraduate studies in osteopathy in the UK. The aim of this project was to explore awareness of cultural diversity and beliefs about patients from underrepresented groups in current osteopathic educational environments and evaluate students' preparedness to manage patients from diverse groups. The project also aimed to investigate the educational experiences of students from underrepresented backgrounds during their training and their opinions on changes that could support better levels of recruitment and achievement. The findings were discussed with stakeholders in interactive workshops with the aim to develop recommendations for action and change. METHODS A transformative action research paradigm informed this mixed methods project. It included: 1/ a survey of students from all seven osteopathic educational providers in the UK using the Multidimensional Cultural Humility Scale (MCHS); 2/ a series of focus groups with students from underrepresented groups (women, students with disabilities, students from minority ethnic backgrounds, and students identifying as LGBTQIA+); and 3/ a workshop forum to discuss findings. RESULTS A total of 202 participants completed the MCHS and demographic questionnaire and seven focus groups were conducted. A model was developed to describe participants' training experiences comprising two main themes: institutional contextual obstacles (with four sub-themes) and underrepresented students' conceptual understanding of Equity, Diversity and Inclusion (EDI). Recommendations for change identified in the workshops were based on three topics: institutions, staff, and students. CONCLUSION Our findings confirm conclusions from other institutions that staff education is urgently needed to create and maintain equitable, inclusive environments in osteopathic educational institutions in the UK to support all students, particularly those from underrepresented groups. Institutional EDI processes and policies also need to be clarified or modified to ensure their usefulness, accessibility, and implementation.
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Affiliation(s)
- Jerry Draper-Rodi
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK.
- National Council for Osteopathic Research, 275 Borough High Street, SE1 1JE, London, UK.
| | - Hilary Abbey
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK
| | - John Hammond
- School of Allied and Public Health Professions, North Holmes Road, CT1 1QU, Canterbury, Kent, UK
| | - Oliver P Thomson
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK
| | - Kevin Brownhill
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK
| | - Andrew MacMillan
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK
- University of Portsmouth, University House, Winston Churchill Ave, PO1 2UP, Hampshire, Portsmouth, England
| | - Yinka Fabusuyi
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK
| | - Steven Vogel
- University College of Osteopathy, 275 Borough High Street, SE1 1JE, London, UK
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Barbo G, Alam S. Indigenous people's experiences of primary health care in Canada: a qualitative systematic review. Health Promot Chronic Dis Prev Can 2024; 44:131-151. [PMID: 38597804 PMCID: PMC11097747 DOI: 10.24095/hpcdp.44.4.01] [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: 04/11/2024]
Abstract
INTRODUCTION Indigenous people in Canada encounter negative treatment when accessing primary health care (PHC). Despite several qualitative accounts of these experiences, there still has not been a qualitative review conducted on this topic. In this qualitative systematic review, we aimed to explore Indigenous people's experiences in Canada with PHC services, determine urban versus rural or remote differences and identify recommendations for quality improvement. METHODS This review was guided by the Joanna Briggs Institute's methodology for systematic reviews of qualitative evidence. MEDLINE, CINAHL, PubMed, PsycInfo, Embase and Web of Science as well as grey literature and ancestry sources were used to identify relevant articles. Ancestry sources were obtained through reviewing the reference lists of all included articles and determining the ones that potentially met the eligibility criteria. Two independent reviewers conducted the initial and full text screening, data extraction and quality assessment. Once all data were gathered, they were synthesized following the meta-aggregation approach (PROSPERO CRD42020192353). RESULTS The search yielded a total of 2503 articles from the academic databases and 12 articles from the grey literature and ancestry sources. Overall, 22 articles were included in this review. Three major synthesized findings were revealed-satisfactory experiences, discriminatory attitudes and systemic challenges faced by Indigenous patients-along with one synthesized finding on their specific recommendations. CONCLUSION Indigenous people value safe, accessible and respectful care. The discrimination and racism they face negatively affect their overall health and well-being. Hence, it is crucial that changes in health care practice, structures and policy development as well as systemic transformation be implemented immediately.
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Affiliation(s)
- Geneveave Barbo
- College of Nursing, Université de la Saskatchewan, Saskatoon (Saskatchewan), Canada
| | - Sharmin Alam
- Chercheure indépendante, Montréal (Québec), Canada
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Egger E, Bitewulign B, Rodriguez HG, Case H, Alemayehu AK, Rhodes EC, Estifanos AS, Singh K, Keraga DW, Zahid M, Magge H, Gleeson D, Barrington C, Hagaman A. 'God is the one who give child': An abductive analysis of barriers to postnatal care using the Health Equity Implementation Framework. RESEARCH SQUARE 2024:rs.3.rs-4102460. [PMID: 38585722 PMCID: PMC10996821 DOI: 10.21203/rs.3.rs-4102460/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Background Postnatal care is recommended as a means of preventing maternal mortality during the postpartum period, but many women in low- and middle-income countries (LMICs) do not access care during this period. We set out to examine sociocultural preferences that have been portrayed as barriers to care. Methods We performed an abductive analysis of 63 semi-structured interviews with women who had recently given birth in three regions of Ethiopia using the Health Equity Implementation Framework (HEIF) and an inductive-deductive codebook to understand why women in Ethiopia do not use recommended postnatal care. Results We found that, in many cases, health providers do not consider women's cultural safety a primary need, but rather as a barrier to care. However, women's perceived refusal to participate in postnatal visits was, for many, an expression of agency and asserting their needs for cultural safety. Trial registration n/a. Conclusions We propose adding cultural safety to HEIF as a process outcome, so that implementers consider cultural needs in a dynamic manner that does not ask patients to choose between meeting their cultural needs and receiving necessary health care during the postnatal period.
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Affiliation(s)
| | | | - Humberto Gonzalez Rodriguez
- UNC Gillings School of Global Public Health: The University of North Carolina at Chapel Hill Gillings School of Global Public Health
| | - Haley Case
- CDC Foundation Inc: National Foundation for the Centers for Disease Control and Prevention Inc
| | | | - Elizabeth C Rhodes
- Hubert Department of Global Health: Emory University Rollins School of Public Health
| | - Abiy Seifu Estifanos
- Addis Ababa University Department of Community Health: Addis Ababa University School of Public Health
| | - Kavita Singh
- The University of North Carolina at Chapel Hill Carolina Population Center
| | - Dorka Woldesenbet Keraga
- Addis Ababa University Department of Community Health: Addis Ababa University School of Public Health
| | | | - Hema Magge
- Addis Ababa University School of Public Health
| | | | - Clare Barrington
- UNC Gillings School of Global Public Health: The University of North Carolina at Chapel Hill Gillings School of Global Public Health
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Bethea M, Silvers S, Franklin L, Robinson RAS, Brady LJ, Vue N, Beasley HK, Kirabo A, Wanjalla CN, Shuler HD, Hinton A, McReynolds MR. A guide to establishing, implementing, and optimizing diversity, equity, inclusion, and accessibility (DEIA) committees. Am J Physiol Heart Circ Physiol 2024; 326:H786-H796. [PMID: 38276949 PMCID: PMC11221803 DOI: 10.1152/ajpheart.00583.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/17/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
Diversity, equity, inclusion, and accessibility (DEIA) efforts are increasingly recognized as critical for the success of academic institutions. These efforts are facilitated mainly through the formation of dedicated DEIA committees. DEIA committees enhance professional development and create a more inclusive environment, which benefits all members of the institution. Although leadership and faculty membership have recognized the importance and necessity of DEIA, the roles of DEIA committees may be more ambiguous. Although leadership and faculty may seek to support DEIA at their institutions, they may not always fully understand the necessity of these committees or how to successfully create a committee, foster and promote its success, and sustain its impact. Thus, here, we offer a background rationale and guide for strategically setting up DEIA committees for success and impact within an academic institution with applicability to scientific societies.
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Affiliation(s)
- Maigen Bethea
- Department of Pediatrics, Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Sophielle Silvers
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, Pennsylvania, United States
| | - Latisha Franklin
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, Pennsylvania, United States
| | - Renã A S Robinson
- Department of Chemistry, Vanderbilt University, Nashville, Tennessee, United States
| | - Lillian J Brady
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, Alabama, United States
| | - Neng Vue
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, United States
| | - Heather K Beasley
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, United States
| | - Annet Kirabo
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Celestine N Wanjalla
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Haysetta D Shuler
- Department of Biological Sciences, Winston-Salem State University, Winston-Salem, North Carolina, United States
- Shuler Consulting, Winston-Salem, North Carolina, United States
| | - Antentor Hinton
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, United States
| | - Melanie R McReynolds
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, Pennsylvania, United States
- The Huck Institute of the Life Sciences, Pennsylvania State University, University Park, Pennsylvania, United States
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Cieślak I, Jaworski M, Panczyk M, Barzykowski K, Majda A, Theofanidis D, Gotlib-Małkowska J. Multicultural personality profiles and nursing student attitudes towards refugee healthcare workers: A national, multi-institutional cross-sectional study. NURSE EDUCATION TODAY 2024; 134:106094. [PMID: 38277758 DOI: 10.1016/j.nedt.2024.106094] [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: 09/20/2023] [Revised: 12/19/2023] [Accepted: 01/12/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Multicultural organizations in the era of globalization require intercultural leadership skills. Healthcare, as a sector serving diverse populations, necessitates culturally sensitive staff. Intercultural nurse education should start in undergraduate education. A tailored approach is needed, especially in the context of Poland's refugee crisis. OBJECTIVE To investigate how a multicultural personality profile and specific intercultural perspectives affect the attitudes of nursing students towards Ukrainian refugee background healthcare professionals. DESIGN A nationwide cross-sectional multicentre online survey study was conducted. The questionnaire was distributed with the aid of the Lime Survey web platform. METHODS The study utilized a Polish version of the Multicultural Personality Questionnaire. The questionnaire also included demographics and questions assessing intercultural competence and attitudes towards refugee medical professionals. K-Means Cluster Analysis was used to classify different patterns of multicultural personality. P-value <0.05 was deemed to be statistically significant. PARTICIPANTS The study sample consisted of 1325 undergraduate nursing students from 39 nursing schools in Poland: 54.0% in first year, 28.7% in second year, and 17.3% in third year. Most respondents were female (N = 1229, 90%). RESULTS Using cluster analysis respondents were categorized into four groups based on their level of three analyzed multicultural personality traits: cultural empathy, social initiative, and open-mindedness (high, low, average or mixed level). Statistical analysis demonstrated that personality profiles significantly affected nursing students' attitudes towards refugee health professionals (p = 0.003). Additionally, students' willingness to engage in intercultural communication classes and their belief in the learnability of intercultural competence also impacted their attitudes (p < 0.001 for both). Further analysis revealed correlations between personality profiles, belief in competency acquisition, and willingness to enhance competencies. CONCLUSION The design of intercultural competence education for undergraduate nursing students should be preceded by a mapping of the students' personality profile and a needs analysis in this regard, which may contribute to long-term effectiveness of such initiatives.
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Affiliation(s)
- Ilona Cieślak
- Department of Education and Research in Health Sciences, Medical University of Warsaw, Litewska 14/16 street, Warsaw 00-581, Poland.
| | - Mariusz Jaworski
- Department of Education and Research in Health Sciences, Medical University of Warsaw, Litewska 14/16 street, Warsaw 00-581, Poland
| | - Mariusz Panczyk
- Department of Education and Research in Health Sciences, Medical University of Warsaw, Litewska 14/16 street, Warsaw 00-581, Poland
| | - Krystian Barzykowski
- Institute of Psychology, Faculty of Philosophy, Jagiellonian University, Ingardena 6 street, 30-060 Kraków, Poland
| | - Anna Majda
- Laboratory of Theory and Fundamentals of Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Kopernika 25 street, 31-501 Kraków, Poland
| | - Dimitros Theofanidis
- Department of Nursing, International Hellenic University, PO. Box 141, Sindos, 57400 Thessaloniki, Greece
| | - Joanna Gotlib-Małkowska
- Department of Education and Research in Health Sciences, Medical University of Warsaw, Litewska 14/16 street, Warsaw 00-581, Poland
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Kerrigan V, McGrath SY, Doig C, Herdman RM, Daly S, Puruntatameri P, Lee B, Hefler M, Ralph AP. Evaluating the impact of 'Ask the Specialist Plus': a training program for improving cultural safety and communication in hospital-based healthcare. BMC Health Serv Res 2024; 24:119. [PMID: 38254093 PMCID: PMC10804863 DOI: 10.1186/s12913-024-10565-4] [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: 05/25/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND First Nations peoples in colonised countries often feel culturally unsafe in hospitals, leading to high self-discharge rates, psychological distress and premature death. To address racism in healthcare, institutions have promised to deliver cultural safety training but there is limited evidence on how to teach cultural safety. To that end, we created Ask the Specialist Plus: a training program that focuses on improving healthcare providers intercultural communication skills to improve cultural safety. Our aim is to describe training implementation and to evaluate the training according to participants. METHODS Inspired by cultural safety, Critical Race Theory and Freirean pedagogy, Ask the Specialist Plus was piloted at Royal Darwin Hospital in Australia's Northern Territory in 2021. The format combined listening to an episode of a podcast called Ask the Specialist with weekly, one-hour face-to-face discussions with First Nations Specialists outside the clinical environment over 7 to 8 weeks. Weekly surveys evaluated teaching domains using five-point Likert scales and via free text comments. Quantitative data were collated in Excel and comments were collated in NVivo12. Results were presented following Kirkpatrick's evaluation model. RESULTS Fifteen sessions of Ask the Specialist Plus training were delivered. 90% of participants found the training valuable. Attendees enjoyed the unique format including use of the podcast as a catalyst for discussions. Delivery over two months allowed for flexibility to accommodate clinical demands and shift work. Students through to senior staff learnt new skills, discussed institutionally racist systems and committed to behaviour change. Considering racism is commonly denied in healthcare, the receptiveness of staff to discussing racism was noteworthy. The pilot also contributed to evidence that cultural safety should be co-taught by educators who represent racial and gender differences. CONCLUSION The Ask the Specialist Plus training program provides an effective model for cultural safety training with high potential to achieve behaviour change among diverse healthcare providers. The training provided practical information on how to improve communication and fostered critical consciousness among healthcare providers. The program demonstrated that training delivered weekly over two months to clinical departments can lead to positive changes through cycles of learning, action, and reflection.
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Affiliation(s)
- Vicki Kerrigan
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia.
| | - Stuart Yiwarr McGrath
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Cassandra Doig
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Rarrtjiwuy Melanie Herdman
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Shannon Daly
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Pirrawayingi Puruntatameri
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Bilawara Lee
- Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Marita Hefler
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Anna P Ralph
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
- Royal Darwin Hospital, Darwin, NT, 0811, Australia
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10
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Lo RF, Sasaki JY. Lay Misperceptions of Culture as "Biological" and Suggestions for Reducing Them. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2024; 19:295-311. [PMID: 37493140 PMCID: PMC10790513 DOI: 10.1177/17456916231181139] [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: 07/27/2023]
Abstract
Culture is typically studied as socialized and learned. Yet lay intuitions may hold that culture is associated with biology via perceptions of race, presenting a problem for those who study culture: There may be a mismatch between how psychologists study culture and how their research is interpreted by lay audiences. This article is a call to researchers to recognize this mismatch as a problem and to critically evaluate the way we study culture. We first describe evidence that laypeople tend to associate culture with notions of folk biology. Next, we propose three suggestions for researchers: explicitly address whether biological processes are, or are not, relevant for studying culture in their work; consider using multiple methods because different methods for studying culture may come with assumptions about culture as more tied to socialization or biology; and represent all people as cultural by studying multiple forms of culture and by contextualizing all psychological research. Last, we provide an example for how researchers can implement these suggestions to encourage more accurate interpretations of findings.
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Affiliation(s)
| | - Joni Y. Sasaki
- Department of Psychology, University of Hawai‘i at Ma-noa
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11
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Rutman SP, Borgen N, Spellen S, King DD, Decker MJ, Rand L, Cobbins A, Brindis CD. Addressing anti-black racism in an academic preterm birth initiative: perspectives from a mixed methods case study. BMC Public Health 2023; 23:2039. [PMID: 37853363 PMCID: PMC10585806 DOI: 10.1186/s12889-023-16812-3] [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: 06/15/2023] [Accepted: 09/21/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Growing recognition of racism perpetuated within academic institutions has given rise to anti-racism efforts in these settings. In June 2020, the university-based California Preterm Birth Initiative (PTBi) committed to an Anti-Racism Action Plan outlining an approach to address anti-Blackness. This case study assessed perspectives on PTBi's anti-racism efforts to support continued growth toward racial equity within the initiative. METHODS This mixed methods case study included an online survey with multiple choice and open-ended survey items (n = 27) and key informant interviews (n = 8) of leadership, faculty, staff, and trainees working within the initiative. Survey and interview questions focused on perspectives about individual and organizational anti-racism competencies, perceived areas of initiative success, and opportunities for improvement. Qualitative interview and survey data were coded and organized into common themes within assessment domains. RESULTS Most survey respondents reported they felt competent in all the assessed anti-racism skills, including foundational knowledge and responding to workplace racism. They also felt confident in PTBi's commitment to address anti-Blackness. Fewer respondents were clear on strategic plans, resources allocated, and how the anti-racism agenda was being implemented. Suggestions from both data sources included further operationalizing and communicating commitments, integrating an anti-racism lens across all activities, ensuring accountability including staffing and funding consistent with anti-racist approaches, persistence in hiring Black faculty, providing professional development and support for Black staff, and addressing unintentional interpersonal harms to Black individuals. CONCLUSIONS This case study contributes key lessons which move beyond individual-level and theoretical approaches towards transparency and accountability in academic institutions aiming to address anti-Black racism. Even with PTBi's strong commitment and efforts towards racial equity, these case study findings illustrate that actions must have sustained support by the broader institution and include leadership commitment, capacity-building via ongoing coaching and training, broad incorporation of anti-racism practices and procedures, continuous learning, and ongoing accountability for both short- and longer-term sustainable impact.
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Affiliation(s)
- Shira P Rutman
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA.
| | - Natasha Borgen
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | - Solaire Spellen
- Department of Obstetrics, Gynecology and Reproductive Sciences, California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Dante D King
- Department of Obstetrics, Gynecology and Reproductive Sciences, California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Martha J Decker
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Larry Rand
- Department of Obstetrics, Gynecology and Reproductive Sciences, California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Alexis Cobbins
- Department of Obstetrics, Gynecology and Reproductive Sciences, California Preterm Birth Initiative, University of California, San Francisco, San Francisco, CA, USA
| | - Claire D Brindis
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
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Leyva-Moral JM, Tosun B, Gómez-Ibáñez R, Navarrete L, Yava A, Aguayo-González M, Dirgar E, Checa-Jiménez C, Bernabeu-Tamayo MD. From a learning opportunity to a conscious multidimensional change: a metasynthesis of transcultural learning experiences among nursing students. BMC Nurs 2023; 22:356. [PMID: 37798717 PMCID: PMC10552190 DOI: 10.1186/s12912-023-01521-4] [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] [Received: 01/24/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Several educational activities in nursing schools worldwide have been implemented to promote transcultural nursing and cultural competence. Despite the diversity of their experiences and outcomes, the available evidence has not been systematically reviewed and reinterpreted. This study aimed to review and reinterpret all rigorous qualitative evidence available, providing an opportunity to understand how students learn transcultural nursing and assisting faculties, researchers, managers, and practitioners in designing new interventions to improve transcultural training. METHODS A meta-synthesis was conducted to review and integrate qualitative studies of these phenomena. English, Spanish and Portuguese articles were searched in Pubmed and Scopus databases. Only peer-reviewed journals in which qualitative approaches were used were included. Quality was assessed using the CASP qualitative version checklist. The metasynthesis technique proposed by Noblit and Hare was used to analyse the data. RESULTS Twenty-nine studies were included in the analysis. Most studies used phenomenological approaches that were conducted in Australia and the United States of America, with international internships being the most popular learning method. The data revealed one central theme, "From learning opportunity to conscious multidimensional change," and six subthemes. The transcultural nursing learning experience is not a simple or linear process. Instead, it appears to be a complex process formed by the interaction between a) self-awareness, b) reflective thinking, c) Cultural Encounters, d) cultural skills, e) Cultural Desire, and f) Cultural Knowledge. CONCLUSIONS Transcultural nursing learning is a multifaceted process that arises from specific learning opportunities. This process is still to evolving. Therefore, specific educational strategies should be implemented to encourage attitudinal change and promote reflective thinking.
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Affiliation(s)
- Juan M Leyva-Moral
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
| | - Betül Tosun
- Nursing Department, Faculty of Health Sciences, University of Hasan Kalyoncu, Gaziantep, Turkey
| | - Rebeca Gómez-Ibáñez
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain.
| | - Laura Navarrete
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
- Consorci Corporació Sanitaria Parc Taulí, Barcelona, Spain
| | - Ayla Yava
- Nursing Department, Faculty of Health Sciences, University of Hasan Kalyoncu, Gaziantep, Turkey
| | - Mariela Aguayo-González
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
| | - Ezgi Dirgar
- Midwifery Department, Faculty of Health Sciences, University of Gaziantep, Gaziantep, Turkey
| | - Caterina Checa-Jiménez
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
| | - M Dolors Bernabeu-Tamayo
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
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13
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Lesińska-Sawicka M. Using graphic medicine in teaching multicultural nursing: a quasi-experimental study. BMC MEDICAL EDUCATION 2023; 23:255. [PMID: 37069640 PMCID: PMC10111694 DOI: 10.1186/s12909-023-04223-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 04/01/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Comics, as an art form that combines words and images, can be used with great success in teaching nursing students. Teaching content on multicultural issues is not easy, especially since, in addition to knowledge, it is important to pay attention to communication skills, attitudes of respect, openness or empathy, among others. It is difficult to recognize or discuss these attitudes without student involvement. Graphic stories, comic strips provide such opportunities and facilitate learning new content, even those difficult to communicate naturally and spontaneously. The aim of this paper is to present the possibilities of using the graphic method, in particular comics and graphic novels, in teaching nursing, based on the example of multicultural nursing. METHODS Quasi-experimental intervention study with a quantitative approach, guided by the STROBE tool The survey was conducted March-May 2022 among State University of Applied Sciences in Piła students. First, students' knowledge of cultural issues was assessed, then they were randomly assigned to two groups. One group had classes using a comic book, and the other group had classes using traditional methods. After the class, the students' knowledge was assessed again. Descriptive statistical analyses were performed to obtain the mean, median, standard deviation (SD). Data followed a normal distribution. Data was verified by the t-Students test for independent groups. RESULTS Respondents' knowledge on cultural issues before taking the course was satisfactory, with a mean score of 19.1. After completing the course, knowledge on cultural issues increased and was rated as very good and the mean score for all respondents was 26.9. Statistical analysis showed that there was statistical significance between the groups and the number of points achieved in the posttest. Respondents in the intervention group scored higher than those in the comparsion group. CONCLUSION The use of the graphic method, which is one of the forms of active learning, in teaching cultural content to nursing students has positive didactic effects. Students achieve better learning outcomes in terms of knowledge, skills and attitudes in a way that is more engaging. This makes learning difficult topics, such as a cultural issue, more effective. It would be worth considering using this method for other courses and/or at other universities as well.
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Feliciano-Rivera YZ, Net J, Sanchez P, Wahab RA, Mehta T, Yepes MM. Culturally Competent Care in the Breast Imaging Clinic: Hispanic/Latino Patients. JOURNAL OF BREAST IMAGING 2023; 5:188-194. [PMID: 38416924 DOI: 10.1093/jbi/wbac074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Indexed: 03/01/2024]
Abstract
Hispanic/Latino people represent 19% of the U.S. population, and this proportion is expected to increase to 26% by 2050. Hispanic/Latino people comprise a diverse ethnic group that includes individuals from all races, religions, languages, cultural identities, and nationalities. Barriers to health care that have created significant disparities in this community include language, low socioeconomic status, and inability to afford health insurance. Health coverage for Hispanic/Latino people has been a longstanding problem in the U.S., stopping many of these patients from seeking preventive care such as screening mammography. Breast cancer is the most common cancer among Hispanic/Latino women in the U.S. and the leading cause of cancer death in this group. Five-year breast cancer survival in Hispanic/Latino women is slightly lower than that in non-Hispanic White women. Some of the factors that account for the ethnic disparities in breast cancer include lower levels of adherence to screening mammography of Hispanic/Latino women as a consequence of inadequate insurance coverage, language barriers, lack of transportation, being unable to leave work, and lack of childcare. By promoting a culturally sensitive clinical environment, breast radiologists can increase patient engagement, utilization of preventive services, treatment adherence rates, and overall health status.
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Affiliation(s)
| | - Jose Net
- University of Miami Miller School of Medicine, Department of Radiology, Miami, FL, USA
| | - Priscila Sanchez
- University of Miami Miller School of Medicine, Department of Radiology, Miami, FL, USA
| | - Rifat A Wahab
- University of Cincinnati Academic Health Center, Department of Radiology, Cincinnati, OH, USA
| | - Tejas Mehta
- UMass Memorial Medical Center-University Campus, Department of Radiology, Worcester, MA, USA
| | - Monica M Yepes
- University of Miami Miller School of Medicine, Department of Radiology, Miami, FL, USA
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15
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Sahamkhadam N, Andersson AK, Golsäter M, Harder M, Granlund M, Wahlström E. Testing the Assumptions in the Process of Cultural Competence in the Delivery of Healthcare Services Using Empirical Data, Focusing on Cultural Awareness. J Transcult Nurs 2023; 34:187-194. [PMID: 36759971 PMCID: PMC10114250 DOI: 10.1177/10436596231152212] [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: 02/11/2023] Open
Abstract
INTRODUCTION Encounters with children of foreign origin call for school nurses' cultural competence during the health visits. This study aimed to investigate the statistical associations between the cultural constructs described by the Process of Cultural Competence in the Delivery of Healthcare Services (PCCDHS) model and whether school nurses' cultural encounters, cultural knowledge, and cultural skill could statistically predict their cultural awareness. METHODOLOGY Spearman correlation and hierarchical regression analyses were conducted using cross-sectional secondary data from 816 Swedish school nurses. The cultural constructs in the theoretical description of the PCCDHS model guided the selection and sorting of the items on cultural competence. RESULTS The constructs of cultural knowledge, cultural skill, cultural encounters, and cultural awareness were positively correlated with each other. However, becoming culturally aware was not statistically predicted by included cultural constructs (R2 = 13.4, p = .06). DISCUSSION Despite the interrelations between the investigated cultural constructs of the PCCDHS model, understanding cultural awareness development requires further empirical testing.
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Affiliation(s)
| | - Anna Karin Andersson
- School of Health and Welfare, Jönköping University, Jönköping, Sweden.,School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Marie Golsäter
- School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Child Health Services and Futurum, Region Jönköping County, Jönköping, Sweden
| | - Maria Harder
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.,Child Health Care Services, Region Västmanland, Västerås, Sweden
| | - Mats Granlund
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Emmie Wahlström
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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16
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Scott MA, Andazola J, Smith T, Castillo Smith A, de la Rosa I, Michael J. Structural competency in New Mexico: Moving outside of medical education. Glob Public Health 2023; 18:2176003. [PMID: 36803417 DOI: 10.1080/17441692.2023.2176003] [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: 02/22/2023]
Abstract
ABSTRACTIn 2019, the Doña Ana Wellness Institute (DAWI), Doña Ana County, New Mexico's health council, sponsored two trainings in structural competency by the Structural Competency Working Group. One focused on health care professionals and learners; the other focused on government, non-profit organisations, and elected officials. DAWI and New Mexico Human Services Department (HSD) representatives attended the trainings and identified the structural competency model as useful for the health equity work both groups were already engaging. These trainings provided the foundation for DAWI and HSD to develop additional trainings, programmes, and curricula founded on structural competency and focused on supporting health equity work.This article describes how DAWI and HSD used the structural competency framework to deepen our work, including how we have expanded the concept beyond its original orientation to support strategic planning, improve communication, and build structurally competent communities. We illustrate how the framework strengthened our existing community and state work and how we adapted the model to better fit our work. Adaptations included changes in language, the use of the lived experiences of organisation members as a foundation for structural competency education, and a recognition that policy work happens at multiple levels and in multiple ways for organisations.
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Affiliation(s)
| | - John Andazola
- Southern New Mexico Family Medicine Residency Program, Las Cruces, NM, USA
| | - Tracy Smith
- New Mexico Human Services Department, Santa Fe, NM, USA
| | | | | | - Jamie Michael
- Doña Ana County Health and Human Services, Las Cruces, NM, USA
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17
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Roberts KJ, Omaits E. Evaluation of a Virtual Health Equity Training for Mid-Career Primary Healthcare Providers. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231219614. [PMID: 38116494 PMCID: PMC10729640 DOI: 10.1177/23821205231219614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 11/22/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES Providing cultural competence training is recommended as a way to improve patient-centered care and reduce health disparities. Increasing awareness of implicit biases and understanding internal motivations for overcoming these biases can influence provider decisions and communications with patients. This study aims to provide a health equity and implicit bias training to healthcare providers and assess knowledge and attitude gains. METHODS Mid-career primary healthcare providers (n = 21) with at least 5 years of primary care experience participated in the training as a prerequisite for providing patient care in a telehealth primary care practice that overwhelmingly serves patients of color. RESULTS There was a significant increase in knowledge (p < .001) as well as attitudes (p < .001) in healthcare providers from pretest to posttest. Almost none (4.5%) of the providers were distracted during the training, which may be due to the interactive nature of the training that included group-based reflection discussions. CONCLUSION A virtual training for primary healthcare providers on health equity and implicit bias improved knowledge and equitable attitudes and had high satisfaction. Additional research is needed to determine if this type of training can influence providers' ability to actively address known disparities in care.
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18
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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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19
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Topp SM, Tully J, Cummins R, Graham V, Yashadhana A, Elliott L, Taylor S. Rhetoric, Reality and Racism: The Governance of Aboriginal and Torres Strait Islander Health Workers in a State Government Health Service in Australia. Int J Health Policy Manag 2022; 11:2951-2963. [PMID: 35569001 PMCID: PMC10105169 DOI: 10.34172/ijhpm.2022.6750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 04/22/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In northern Australia, Aboriginal and Torres Strait Islander Health Workers (A&TSIHWs) are unique members of nominally integrated teams of primary care professionals. Spurred by research documenting ongoing structural violence experienced by Indigenous health providers and more recent challenges to recruitment and retention of A&TSIHWs, this study aimed to explore whether the governance of the A&TSIHW role supports full and meaningful participation. METHODS The qualitative study was co-designed by a team of Aboriginal, Torres Strait Islander and non-Indigenous collaborators. Data collection comprised document review and interviews with A&TSIHWs (n=51), clinicians (n=19) community members (n=8) and administrators (n=5) in a north Queensland health district. We analysed governance at multiple levels (regulatory, organisational, and socio-cultural) and used critical race theory to deepen exploration of the role of race and racism in shaping it. RESULTS Governance of the A&TSIHW role occurs within a health system where racism is built into, and amplified by, formal and informal rules at all levels. Racially discriminatory structures such as the previous but long-standing relegation of A&TSIHW into the same career stream as cleaners were mirrored in discriminatory rules and managerial practices such as an absence of career-specific corporate support and limited opportunities to participate in, or represent to, key leadership groups. These interacted with and helped perpetuate workplace norms permissive of disrespect and abuse by non-Indigenous professionals. Ongoing resistance to the structural violence required of, and demonstrated by A&TSIHWs speaks to the gap between rhetoric and reality of governance for A&TSIHWs. CONCLUSION Strengthening governance to support A&TSIHWs requires critical attention be given to the role of race and racism in regulatory structures, organisational practice, and inter-professional relationships. Addressing all domains will be essential to achieve systemic change that recognises, supports and embeds the unique knowledge, skills and functions of the A&TSIHW role.
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Affiliation(s)
- Stephanie M. Topp
- College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Josslyn Tully
- Torres and Cape Hospital and Health Services (TCHSS), Cairns, QLD, Australia
| | - Rachel Cummins
- College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Veronica Graham
- College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Aryati Yashadhana
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, NSW, Australia
- School of Population Health, UNSW, Sydney, NSW, Australia
- School of Social Sciences, UNSW, Sydney, NSW, Australia
| | - Lana Elliott
- College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
- School of Public Health and Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Sean Taylor
- College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
- NT Health, Darwin, NT, Australia
- Menzies School of Health Research, Darwin, NT, Australia
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20
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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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21
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Bruno G, Bell RC, Parlee B, Lightning P, Bull I, Cutknife B, Oster RT. Mâmawihitowin (bringing the camps together): Perinatal healthcare provider and staff participation in an Indigenous-led experiential intervention for enhancing culturally informed care—a mixed methods study. Int J Equity Health 2022; 21:164. [PMCID: PMC9667858 DOI: 10.1186/s12939-022-01764-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
In partnership with a Nehiyawak (Plains Cree) community of Maskwacîs,central Alberta (Canada), we implemented an Indigenous-led intervention to provide experiential learning opportunities for perinatal health care providers (HCPs) and staff. Our objective was to capture the impact of participating in cultural safety learning opportunities on perceived self-awareness for HCPs and staff to provide enhanced culturally informed care.
Methods
Perinatal HCPs and staff who work regularly with Indigenous women from our partnering community took part in a series of experiential learning activities designed by a Community Advisory Committee. We used an explanatory sequential mixed methods approach informed by community-based participatory research. We compared Cultural Intelligence Scale (CQS) and Maskwacîs-Specific Cultural Scale (MSCS) scores pre- and post-intervention using non-parametrical statistical analysis (Wilcoxon signed rank test). Post-intervention, we conducted a qualitative description study using semi-structured interviews. Qualitative data was analyzed using thematic analysis.
Results
A total of 17 participants completed pre- and post-intervention questionnaires. Responses indicated a shift in perceived cultural and community knowledge and comfort levels, with positive gains in overall mean scores for both the CQS (p = 0.01) and MSCS (p = 0.01). Nine participants completed qualitative interviews. Overall, participants felt better equipped to provide more culturally informed care to their patients post-intervention.
Conclusion
An Indigenous-led experiential learning intervention was effective in enhancing overall perceived cultural awareness and preparedness to provide culturally informed care for perinatal HCPs and staff. This study provides evidence for fostering relationships between Indigenous communities and health systems toward enhanced perinatal care.
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22
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Vella E, White VM, Livingston P. Does cultural competence training for health professionals impact culturally and linguistically diverse patient outcomes? A systematic review of the literature. NURSE EDUCATION TODAY 2022; 118:105500. [PMID: 35964378 DOI: 10.1016/j.nedt.2022.105500] [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: 11/13/2021] [Revised: 06/02/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To assess the impact of cultural competence training for health professionals on patient outcomes. METHOD A systematic review of cultural competence training interventions for healthcare workers including papers published January 2010 to January 2021, identified through MEDLINE, CINAHL, ERIC and APA PsychINFO. Health conditions were not specified, however, only studies reporting patient outcomes were included. Training frameworks and delivery, measures of health professional cultural competence, and patient outcomes were reviewed. RESULTS Of 7879 unique studies identified, five met inclusion criteria including two randomised control trials, two mixed method and one multi-method pre/post study. Professionals reported the training was beneficial, and some improvements in patient perceptions of health providers' cultural competence were found. However, patient health outcomes did not improve significantly in any study. CONCLUSION Cultural competence training is promoted to improve outcomes of patients from culturally diverse backgrounds; however, few studies assess outcomes when examining training impact. Inconsistencies in theoretical frameworks and training makes it difficult to assess the efficacy of training on patient outcomes. RESULTS Of 7879 unique studies identified, five met inclusion criteria including two randomised control trials, two mixed method and one multi-method pre/post study. Professionals reported the training was beneficial, and some improvements in patient perceptions of health providers' cultural competence were found. However, patient health outcomes did not improve significantly in any study. CONCLUSION Cultural competence training is promoted to improve outcomes of patients from culturally diverse backgrounds; however, few studies assess outcomes when examining training impact. Inconsistencies in theoretical frameworks and training makes it difficult to assess the efficacy of training on patient outcomes. PRACTICE IMPLICATIONS To ascertain the benefits of health professional cultural competence training on patient outcomes, research needs to address the issues of definition, theoretical frameworks and implementation approaches to training.
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Affiliation(s)
| | - Victoria M White
- School of Psychology, Faculty of Health, Deakin University, Burwood 3125, Australia
| | - Patricia Livingston
- School of Psychology, Faculty of Health, Deakin University, Burwood 3125, Australia
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23
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Lie Ken Jie C, Finn YF, Bish M, Carlson E, Kumlien C, Chan EA, Leung DY. Mechanisms Driving Postgraduate Health and Social Science Students' Cultural Competence: An Integrated Systematic Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1707-1721. [PMID: 35476677 PMCID: PMC9592147 DOI: 10.1097/acm.0000000000004714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The COVID-19 pandemic revealed a global urgency to address health care provision disparities, which have largely been influenced by systematic racism in federal and state policies. The World Health Organization recommends educational institutions train clinicians in cultural competence (CC); however, the mechanisms and interacting social structures that influence individuals to achieve CC have received little attention. This review investigates how postgraduate health and social science education approaches CC and how it accomplishes (or not) its goals. METHOD The authors used critical realism and Whittemore and Knafl's methods to conduct a systematic integrated review. Seven databases (MEDLINE, CINAHL, PsycINFO, Scopus, PubMed, Web of Science, and ERIC) were searched from 2000 to 2020 for original research studies. Inclusion criteria were: the use of the term "cultural competence" and/or any one of Campinha-Bacote's 5 CC factors, being about postgraduate health and/or social science students, and being about a postgraduate curriculum or a component of it. Thematic analysis was used to reveal the mechanisms and interacting social structures underlying CC. RESULTS Thirty-two studies were included and 2 approaches to CC (themes) were identified. The first theme was professionalized pedagogy, which had 2 subthemes: othering and labeling. The second theme was becoming culturally competent, which had 2 subthemes: a safe CC teaching environment and social interactions that cultivate reflexivity. CONCLUSIONS CC conceptualizations in postgraduate health and social science education tend to view cultural differences as a problem and CC skills as a way to mitigate differences to enhance patient care. However, this generates a focus on the other, rather than a focus on the self. Future research should explore the extent to which insight, cognitive flexibility, and reflexivity, taught in safe teaching environments, are associated with increasing students' cultural safety, cultural humility, and CC.
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Affiliation(s)
- Christopher Lie Ken Jie
- C. Lie Ken Jie is a medical student, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland
| | - Yvonne F. Finn
- Y.F. Finn is a lecturer, clinical skills and clinical methods, School of Medicine, and vice dean for internationalization, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland; ORCID: https://orcid.org/0000-0002-9935-8453
| | - Melanie Bish
- M. Bish is associate professor, associate head, and director of academic partnerships, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia; ORCID: https://orcid.org/0000-0003-4305-6760
| | - Elisabeth Carlson
- E. Carlson is professor, Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden; ORCID: https://orcid.org/0000-0003-0077-9061
| | - Christine Kumlien
- C. Kumlien is professor and vice dean, Department of Care Science, Faculty of Health and Society, Malmö University, and Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden; ORCID: https://orcid.org/0000-0002-1437-5060
| | - E. Angela Chan
- E.A. Chan is associate professor and associate head of undergraduate education, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong; ORCID: https://orcid.org/0000-0003-4411-6200
| | - Doris Y.L. Leung
- D.Y.L. Leung is adjunct assistant professor, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong; ORCID: https://orcid.org/0000-0002-9636-3118
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Goodwin L, Jones A, Hunter B. Addressing social inequity through improving relational care: A social-ecological model based on the experiences of migrant women and midwives in South Wales. Health Expect 2022; 25:2124-2133. [PMID: 34337840 PMCID: PMC9615070 DOI: 10.1111/hex.13333] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/23/2021] [Accepted: 07/25/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Migrant and ethnic inequalities in maternal and perinatal mortality persist across high-income countries. Addressing social adversity and inequities across the childbirth trajectory cannot be left to chance and the good intentions of practitioners. Robust, evidence-based tools designed to address inequity by enhancing both the quality of provision and the experience of care are needed. METHODS An inductive modelling approach was used to develop a new evidence-based conceptual model of woman-midwife relationships, drawing on data from an ethnographic study of relationships between migrant Pakistani women and midwives, conducted between 2013 and 2016 in South Wales, UK. Key analytic themes from early data were translated into social-ecological concepts, and a model was developed to represent how these key themes interacted to influence the woman-midwife relationship. RESULTS Three key concepts influencing the woman-midwife relationship were developed from the three major themes of the underpinning research: (1) Healthcare System; (2) Culture and Religion; and (3) Family Relationships. Two additional weaving concepts appeared to act as a link between these three key concepts: (1) Authoritative Knowledge and (2) Communication of Information. Social and political factors were also considered as contextual factors within the model. A visual representation of this model was developed and presented. CONCLUSIONS The model presented in this paper, along with future work to further test and refine it in other contexts, has the potential to impact on inequalities by facilitating future discussion on cultural issues, encouraging collaborative learning and knowledge production and providing a framework for future global midwifery practice, education and research. PATIENT OR PUBLIC CONTRIBUTION At the outset of the underpinning research, a project involvement group was created to contribute to study design and conduct. This group consisted of the three authors, an Advocacy Officer at Race Equality First and an NHS Consultant Midwife. This group met regularly throughout the research process, and members were involved in discussions regarding ethical/cultural/social issues, recruitment methods, the creation of participant information materials, interpretation of data and the dissemination strategy. Ideas for the underpinning research were also discussed with members of the Pakistani community during community events and at meetings with staff from minority ethnic and migrant support charities (BAWSO, Race Equality First, The Mentor Ring). Local midwives contributed to study design through conversations during informal observations of antenatal appointments for asylum seekers and refugees.
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Affiliation(s)
- Laura Goodwin
- Faculty of Health and Applied SciencesUniversity of the West of EnglandBristolUK
| | - Aled Jones
- School of Healthcare SciencesCardiff UniversityCardiffUK
| | - Billie Hunter
- School of Healthcare SciencesCardiff UniversityCardiffUK
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25
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Robinson A, O'Brien N, Sile L, Guraya HK, Govind T, Harris V, Pilkington G, Todd A, Husband A. Recommendations for community pharmacy to improve access to medication advice for people from ethnic minority communities: A qualitative person-centred codesign study. Health Expect 2022; 25:3040-3052. [PMID: 36161966 DOI: 10.1111/hex.13611] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/11/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Medicines-centred consultations are vital to support medicine effectiveness and optimize health outcomes for patients. However, inequalities negatively impact ethnic minority populations when accessing medicines advice. It is important to identify opportunities to improve access for these communities however, knowledge of how best to achieve this is lacking; this study will generate recommendations to improve access to medicines advice from community pharmacies for people from ethnic minority communities. METHODS A series of codesign workshops, with four groups of patient-stakeholders, were conducted between September-November 2021; they took place in-person or via video call (adhering to COVID-19 restrictions). Existing evidence-based perceptions affecting access to medicines advice were critiqued and recommendations were generated, by use of reflexive thematic analysis, to improve access for ethnic minority patients. The workshops were audio-recorded and transcribed verbatim. QSR NVivo (Version 12) facilitated data analysis. RESULTS Twelve participants were recruited using purposive sampling; including eight UK citizens, two asylum seekers and two participants in receipt of residency visas. In total, four different ethnic minority groups were represented. Each participant took part in a first and second workshop to share and cocreate recommendations to improve access to medicines advice in community pharmacies. Three recommendations were developed and centred on: (i) delivering and providing culturally competent medicines advice; (ii) building awareness of accessing medicines advice from community pharmacies; and (iii) enabling better discussions with patients from ethnic minority communities. CONCLUSIONS These recommendations have the potential to support community pharmacy services to overcome ethnic inequalities affecting medicines advice; service commissioners should consider these findings to best meet the needs of ethnic minority patients. Cultural competence training for community pharmacy staff could support the creation of pharmacies as inclusive healthcare settings. Collaborative working with ethnic minority communities could enable specific tailoring of medicines-centred services to best meet their needs. PATIENT OR PUBLIC CONTRIBUTION The National Institute for Health Research (NIHR) and Newcastle University Patient and Public Involvement and Engagement group had extensive input in the study design and conceptualization. Seven patient champions were appointed to the steering group to ensure that the research was conducted, and findings were reported, with cultural competence. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Anna Robinson
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nicola O'Brien
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Laura Sile
- Alumni, School of Pharmacy, Liverpool John Moores University, Liverpool, UK
| | | | - Thorrun Govind
- Chair of the English Pharmacy Board, Royal Pharmaceutical Society, London, UK
| | - Vicki Harris
- Connected Voice Haref, Higham House, Newcastle upon Tyne, UK
| | - Guy Pilkington
- West End Family Health Primary Care Network, Cruddas Park Surgery, Newcastle upon Tyne, UK
| | - Adam Todd
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Andy Husband
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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26
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Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, Hancock AB, Johnson TW, Karasic DH, Knudson GA, Leibowitz SF, Meyer-Bahlburg HFL, Monstrey SJ, Motmans J, Nahata L, Nieder TO, Reisner SL, Richards C, Schechter LS, Tangpricha V, Tishelman AC, Van Trotsenburg MAA, Winter S, Ducheny K, Adams NJ, Adrián TM, Allen LR, Azul D, Bagga H, Başar K, Bathory DS, Belinky JJ, Berg DR, Berli JU, Bluebond-Langner RO, Bouman MB, Bowers ML, Brassard PJ, Byrne J, Capitán L, Cargill CJ, Carswell JM, Chang SC, Chelvakumar G, Corneil T, Dalke KB, De Cuypere G, de Vries E, Den Heijer M, Devor AH, Dhejne C, D'Marco A, Edmiston EK, Edwards-Leeper L, Ehrbar R, Ehrensaft D, Eisfeld J, Elaut E, Erickson-Schroth L, Feldman JL, Fisher AD, Garcia MM, Gijs L, Green SE, Hall BP, Hardy TLD, Irwig MS, Jacobs LA, Janssen AC, Johnson K, Klink DT, Kreukels BPC, Kuper LE, Kvach EJ, Malouf MA, Massey R, Mazur T, McLachlan C, Morrison SD, Mosser SW, Neira PM, Nygren U, Oates JM, Obedin-Maliver J, Pagkalos G, Patton J, Phanuphak N, Rachlin K, Reed T, Rider GN, Ristori J, Robbins-Cherry S, Roberts SA, Rodriguez-Wallberg KA, Rosenthal SM, Sabir K, Safer JD, Scheim AI, Seal LJ, Sehoole TJ, Spencer K, St Amand C, Steensma TD, Strang JF, Taylor GB, Tilleman K, T'Sjoen GG, Vala LN, Van Mello NM, Veale JF, Vencill JA, Vincent B, Wesp LM, West MA, Arcelus J. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2022; 23:S1-S259. [PMID: 36238954 PMCID: PMC9553112 DOI: 10.1080/26895269.2022.2100644] [Citation(s) in RCA: 583] [Impact Index Per Article: 291.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.
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Affiliation(s)
- E Coleman
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A E Radix
- Callen-Lorde Community Health Center, New York, NY, USA
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - W P Bouman
- Nottingham Centre for Transgender Health, Nottingham, UK
- School of Medicine, University of Nottingham, Nottingham, UK
| | - G R Brown
- James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
- James H. Quillen VAMC, Johnson City, TN, USA
| | - A L C de Vries
- Department of Child and Adolescent Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M B Deutsch
- Department of Family & Community Medicine, University of California-San Francisco, San Francisco, CA, USA
- UCSF Gender Affirming Health Program, San Francisco, CA, USA
| | - R Ettner
- New Health Foundation Worldwide, Evanston, IL, USA
- Weiss Memorial Hospital, Chicago, IL, USA
| | - L Fraser
- Independent Practice, San Francisco, CA, USA
| | - M Goodman
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - J Green
- Independent Scholar, Vancouver, WA, USA
| | - A B Hancock
- The George Washington University, Washington, DC, USA
| | - T W Johnson
- Department of Anthropology, California State University, Chico, CA, USA
| | - D H Karasic
- University of California San Francisco, San Francisco, CA, USA
- Independent Practice at dankarasic.com
| | - G A Knudson
- University of British Columbia, Vancouver, Canada
- Vancouver Coastal Health, Vancouver, Canada
| | - S F Leibowitz
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - H F L Meyer-Bahlburg
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - J Motmans
- Transgender Infopunt, Ghent University Hospital, Gent, Belgium
- Centre for Research on Culture and Gender, Ghent University, Gent, Belgium
| | - L Nahata
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Endocrinology and Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - T O Nieder
- University Medical Center Hamburg-Eppendorf, Interdisciplinary Transgender Health Care Center Hamburg, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Hamburg, Germany
| | - S L Reisner
- Harvard Medical School, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - C Richards
- Regents University London, UK
- Tavistock and Portman NHS Foundation Trust, London, UK
| | | | - V Tangpricha
- Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta VA Medical Center, Decatur, GA, USA
| | - A C Tishelman
- Boston College, Department of Psychology and Neuroscience, Chestnut Hill, MA, USA
| | - M A A Van Trotsenburg
- Bureau GenderPRO, Vienna, Austria
- University Hospital Lilienfeld-St. Pölten, St. Pölten, Austria
| | - S Winter
- School of Population Health, Curtin University, Perth, WA, Australia
| | - K Ducheny
- Howard Brown Health, Chicago, IL, USA
| | - N J Adams
- University of Toronto, Ontario Institute for Studies in Education, Toronto, Canada
- Transgender Professional Association for Transgender Health (TPATH)
| | - T M Adrián
- Asamblea Nacional de Venezuela, Caracas, Venezuela
- Diverlex Diversidad e Igualdad a Través de la Ley, Caracas, Venezuela
| | - L R Allen
- University of Nevada, Las Vegas, NV, USA
| | - D Azul
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - H Bagga
- Monash Health Gender Clinic, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - K Başar
- Department of Psychiatry, Hacettepe University, Ankara, Turkey
| | - D S Bathory
- Independent Practice at Bathory International PLLC, Winston-Salem, NC, USA
| | - J J Belinky
- Durand Hospital, Guemes Clinic and Urological Center, Buenos Aires, Argentina
| | - D R Berg
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J U Berli
- Oregon Health & Science University, Portland, OR, USA
| | - R O Bluebond-Langner
- NYU Langone Health, New York, NY, USA
- Hansjörg Wyss Department of Plastic Surgery, New York, NY, USA
| | - M-B Bouman
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Plastic Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - M L Bowers
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mills-Peninsula Medical Center, Burlingame, CA, USA
| | - P J Brassard
- GrS Montreal, Complexe CMC, Montreal, Quebec, Canada
- Université de Montreal, Quebec, Canada
| | - J Byrne
- University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - L Capitán
- The Facialteam Group, Marbella International Hospital, Marbella, Spain
| | | | - J M Carswell
- Harvard Medical School, Boston, MA, USA
- Boston's Children's Hospital, Boston, MA, USA
| | - S C Chang
- Independent Practice, Oakland, CA, USA
| | - G Chelvakumar
- Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University, College of Medicine, Columbus, OH, USA
| | - T Corneil
- School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada
| | - K B Dalke
- Penn State Health, PA, USA
- Penn State College of Medicine, Hershey, PA, USA
| | - G De Cuypere
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
| | - E de Vries
- Nelson Mandela University, Gqeberha, South Africa
- University of Cape Town, Cape Town, South Africa
| | - M Den Heijer
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - A H Devor
- University of Victoria, Victoria, BC, Canada
| | - C Dhejne
- ANOVA, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - A D'Marco
- UCTRANS-United Caribbean Trans Network, Nassau, The Bahamas
- D M A R C O Organization, Nassau, The Bahamas
| | - E K Edmiston
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - L Edwards-Leeper
- Pacific University, Hillsboro, OR, USA
- Independent Practice, Beaverton, OR, USA
| | - R Ehrbar
- Whitman Walker Health, Washington, DC, USA
- Independent Practice, Maryland, USA
| | - D Ehrensaft
- University of California San Francisco, San Francisco, CA, USA
| | - J Eisfeld
- Transvisie, Utrecht, The Netherlands
| | - E Elaut
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Clinical Experimental and Health Psychology, Ghent University, Gent, Belgium
| | - L Erickson-Schroth
- The Jed Foundation, New York, NY, USA
- Hetrick-Martin Institute, New York, NY, USA
| | - J L Feldman
- Institute for Sexual and Gender Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A D Fisher
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | - M M Garcia
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Departments of Urology and Anatomy, University of California San Francisco, San Francisco, CA, USA
| | - L Gijs
- Institute of Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - B P Hall
- Duke University Medical Center, Durham, NC, USA
- Duke Adult Gender Medicine Clinic, Durham, NC, USA
| | - T L D Hardy
- Alberta Health Services, Edmonton, Alberta, Canada
- MacEwan University, Edmonton, Alberta, Canada
| | - M S Irwig
- Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - A C Janssen
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - K Johnson
- RMIT University, Melbourne, Australia
- University of Brighton, Brighton, UK
| | - D T Klink
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Gent, Belgium
- Division of Pediatric Endocrinology and Diabetes, ZNA Queen Paola Children's Hospital, Antwerp, Belgium
| | - B P C Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - L E Kuper
- Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA
- Department of Endocrinology, Children's Health, Dallas, TX, USA
| | - E J Kvach
- Denver Health, Denver, CO, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - M A Malouf
- Malouf Counseling and Consulting, Baltimore, MD, USA
| | - R Massey
- WPATH Global Education Institute
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - T Mazur
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- John R. Oishei Children's Hospital, Buffalo, NY, USA
| | - C McLachlan
- Professional Association for Transgender Health, South Africa
- Gender DynamiX, Cape Town, South Africa
| | - S D Morrison
- Division of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA
- Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA
| | - S W Mosser
- Gender Confirmation Center, San Francisco, CA, USA
- Saint Francis Memorial Hospital, San Francisco, CA, USA
| | - P M Neira
- Johns Hopkins Center for Transgender Health, Baltimore, MD, USA
- Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, Baltimore, MD, USA
| | - U Nygren
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
| | - J M Oates
- La Trobe University, Melbourne, Australia
- Melbourne Voice Analysis Centre, East Melbourne, Australia
| | - J Obedin-Maliver
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Palo Alto, CA, USA
- Department of Epidemiology and Population Health, Stanford, CA, USA
| | - G Pagkalos
- Independent PracticeThessaloniki, Greece
- Military Community Mental Health Center, 424 General Military Training Hospital, Thessaloniki, Greece
| | - J Patton
- Talkspace, New York, NY, USA
- CytiPsychological LLC, San Diego, CA, USA
| | - N Phanuphak
- Institute of HIV Research and Innovation, Bangkok, Thailand
| | - K Rachlin
- Independent Practice, New York, NY, USA
| | - T Reed
- Gender Identity Research and Education Society, Leatherhead, UK
| | - G N Rider
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J Ristori
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | | | - S A Roberts
- Harvard Medical School, Boston, MA, USA
- Division of Endocrinology, Boston's Children's Hospital, Boston, MA, USA
| | - K A Rodriguez-Wallberg
- Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - S M Rosenthal
- Division of Pediatric Endocrinology, UCSF, San Francisco, CA, USA
- UCSF Child and Adolescent Gender Center
| | - K Sabir
- FtM Phoenix Group, Krasnodar Krai, Russia
| | - J D Safer
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Center for Transgender Medicine and Surgery, New York, NY, USA
| | - A I Scheim
- Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - L J Seal
- Tavistock and Portman NHS Foundation Trust, London, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - K Spencer
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - C St Amand
- University of Houston, Houston, TX, USA
- Mayo Clinic, Rochester, MN, USA
| | - T D Steensma
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - J F Strang
- Children's National Hospital, Washington, DC, USA
- George Washington University School of Medicine, Washington, DC, USA
| | - G B Taylor
- Atrium Health Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Charlotte, NC, USA
| | - K Tilleman
- Department for Reproductive Medicine, Ghent University Hospital, Gent, Belgium
| | - G G T'Sjoen
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Endocrinology, Ghent University Hospital, Gent, Belgium
| | - L N Vala
- Independent Practice, Campbell, CA, USA
| | - N M Van Mello
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - J F Veale
- School of Psychology, University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - J A Vencill
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - B Vincent
- Trans Learning Partnership at https://spectra-london.org.uk/trans-learning-partnership, UK
| | - L M Wesp
- College of Nursing, University of Wisconsin MilwaukeeMilwaukee, WI, USA
- Health Connections Inc., Glendale, WI, USA
| | - M A West
- North Memorial Health Hospital, Robbinsdale, MN, USA
- University of Minnesota, Minneapolis, MN, USA
| | - J Arcelus
- School of Medicine, University of Nottingham, Nottingham, UK
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
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Gagliardi JP, Smith CM, Simmons KL, Tweedy DS. Racial Justice Beyond the Curriculum: Aligning Systems of Care With Anti-Racist Instruction in Graduate Medical Education. J Grad Med Educ 2022; 14:403-406. [PMID: 35991095 PMCID: PMC9380630 DOI: 10.4300/jgme-d-22-00056.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Jane P. Gagliardi
- Jane P. Gagliardi, MD, MHSc, is Associate Professor of Psychiatry and Behavioral Sciences, and Associate Professor of Medicine, Duke University School of Medicine
| | - Colin M. Smith
- Colin M. Smith, MD, is PGY-6 Chief Resident, Internal Medicine-Psychiatry, Duke University Medical Center
| | - Kirsten L. Simmons
- Kirsten L. Simmons, MD, MHSc, is a PGY-1, Department of Ophthalmology, W.K. Kellogg Eye Center, University of Michigan
| | - Damon S. Tweedy
- Damon S. Tweedy, MD, is Associate Professor of Psychiatry and Behavioral Sciences, Duke University School of Medicine, and Staff Psychiatrist, Durham VA Health Care System
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Wilson L, Wilkinson A, Tikao K. Health professional perspectives on translation of cultural safety concepts into practice: A scoping study. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:891571. [PMID: 36189045 PMCID: PMC9397926 DOI: 10.3389/fresc.2022.891571] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022]
Abstract
People from unique and diverse populations, (i.e., social groupings excluded by the dominant majority by, for example, ethnicity, gender, age, sexual orientation, disability or even rurality), experience dissimilar health outcomes. Members of such populations who have long-term health conditions experience further health disparities through inefficient management and treatment. This remains a significant hindrance to achieving equity in health outcomes. Being responsive and acting upon the cultural needs of unique and diverse populations within health services is pivotal in addressing health disparities. Despite provision of professional training to health professionals, cultural competency remains an elusive goal. This scoping study summarized available literature about what helped health professionals translate cultural safety concepts into practice. We searched electronic databases using MeSH terms and keywords for English language articles and reference lists of potentially included studies. Quality appraisal was undertaken using Joanna Briggs Institute critical appraisal tools. Data were charted, with a descriptive numerical summary and thematic analysis of study findings undertaken. Twelve qualitative studies with n = 206 participants were included. Learning through and from direct experience, and the individual qualities of professionals (i.e., individual capacity for relational skills and intentionality of engagement with one's own values and biases) facilitated translation of cultural safety concepts into practice. Also important was the need for cultural training interventions to address both issues of content and process within course design. Doing this would take into consideration the benefits that can come from learning as a part of a collective. In each of these themes was evidence of how health professionals needed the ability to manage emotional discomfort as part of the process of learning. A dearth of information exists exploring professionals' perspectives on translating cultural safety concepts into practice. There may be merit in designing educational interventions that look beyond the classroom. We also suggest that nurturing people's relational skills likely holds benefits to growing culturally safe practice as does increasing health professional's capacity to sit with the discomfort that occurs when paying attention to one's own and others values and biases.
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Kerrigan V, McGrath SY, Herdman RM, Puruntatameri P, Lee B, Cass A, Ralph AP, Hefler M. Evaluation of 'Ask the Specialist': a cultural education podcast to inspire improved healthcare for Aboriginal peoples in Northern Australia. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2022; 31:139-157. [PMID: 35373706 DOI: 10.1080/14461242.2022.2055484] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
In Australia's Northern Territory (NT) most people who access health services are Aboriginal and most healthcare providers are non-Indigenous; many providers struggle to deliver culturally competent care. Cultural awareness training is offered however, dissatisfaction exists with the limited scope of training and the face-to-face or online delivery format. Therefore, we developed and evaluated Ask the Specialist: Larrakia, Tiwi and Yolŋu stories to inspire better healthcare, a cultural education podcast in which Aboriginal leaders of Larrakia, Tiwi and Yolŋu nations, known as the Specialists, answer doctors' questions about working with Aboriginal patients. The Specialists offer 'counterstories' which encourage the development of critical consciousness thereby challenging racist narratives in healthcare. After listening to the podcast, doctors reported attitudinal and behavioural changes which led to stereotypes being overturned and more culturally competent care delivery. While the podcast was purposefully local, issues raised had applicability beyond the NT and outside of healthcare. Our approach was shaped by cultural safety, critical race theory and Freirean pedagogy. This pilot is embedded in a Participatory Action Research study which explores strategies to improve culturally safe communication at the main NT hospital Royal Darwin Hospital.
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Affiliation(s)
- Vicki Kerrigan
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | | | | | | | - Bilawara Lee
- Indigenous leadership, Charles Darwin University, Darwin, Australia
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Anna P Ralph
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Royal Darwin Hospital, Darwin, Australia
| | - Marita Hefler
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
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Smith IA, Griffiths A. Microaggressions, Everyday Discrimination, Workplace Incivilities, and Other Subtle Slights at Work: A Meta-Synthesis. HUMAN RESOURCE DEVELOPMENT REVIEW 2022. [DOI: 10.1177/15344843221098756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Subtle slights refer to a wide range of ambiguous negative interactions between people that may harm individual health, wellbeing and performance at work. This literature review aims to help human resource development practitioners and researchers understand the similarities and distinguishing features of disparate bodies of subtle slight research. A systematic review yielded 338 papers, the majority of which concerned three constructs: microaggressions, everyday discrimination and workplace incivilities. Meta-synthesis revealed that all three categories related to subtle, low-intensity interactions but differed in their descriptions of the type of perceived violation. The most common demographic factors under scrutiny were race or ethnicity, gender, sexual orientation, and age. We propose a framework that involves four dimensions common to all subtle slights: type of violation, intensity, duration and intent (VIDI). This framework may help future efforts to understand, monitor and address this issue of contemporary concern in the workplace.
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Affiliation(s)
- Iain A. Smith
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Amanda Griffiths
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
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Poitras ME, T Vaillancourt V, Canapé A, Boudreault A, Bacon K, Hatcher S. Culturally safe interventions in primary care for the management of chronic diseases of urban Indigenous People: a scoping review. Fam Med Community Health 2022; 10:fmch-2022-001606. [PMID: 35523458 PMCID: PMC9083425 DOI: 10.1136/fmch-2022-001606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives Chronic conditions represent an important source of major health issues among Indigenous People. The same applies to those, who live off-reserve and in urban areas. However, very few healthcare services are considered culturally safe, resulting in some avoidance of the public healthcare system. Our goal was to review the literature on culturally safe practices available to urban Indigenous People who suffer from chronic diseases. Design We conducted a scoping review to determine what culturally safe healthcare services are currently offered for the management of chronic conditions in urban Indigenous populations, to contribute to a tailored, holistic and safe space in mainstream healthcare systems. Eligibility criteria Peer-reviewed original research articles had to be published by 27 October 2020, in English or French. Information source: In October 2020, we searched five academic databases (EBSCO, PsycArticles, SocINDEX, MEDLINE and PsycINFO) and also reviewed grey literature and the websites of organisations or governments. The data were extracted and collected in an EXCEL spreadsheet. Two reviewers independently screened 326 titles and abstracts, followed by an independent evaluation of 48 full text articles. A total of 19 studies were included in this scoping review, as well as 5 websites/documents from the grey literature. Results In total, 19 studies were included in our analysis. We found that Elders, family and the assistance of an interpreter are crucial elements to include to make urban Indigenous feel safe when they seek healthcare services. With this scoping review, we report interventions that are successful in terms of healthcare delivery for this population. Our findings provide insight on what services should be in place in mainstream healthcare settings to create a culturally safe experience for urban Indigenous People. Conclusions In recent years, there appears to be a growing awareness of the need to provide culturally safe health services. This scoping review identified multiple strategies to promote cultural safety in this context, as well as barriers and facilitators to their implementation. These elements, which have been extensively documented in the literature, should be included in the chronic diseases management interventions to be developed by urban and primary care settings.
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Affiliation(s)
- Marie-Eve Poitras
- Department of Family and Emergency Medicine, Université de Sherbrooke, Chicoutimi, Quebec, Canada .,Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean du Québec, Chicoutimi, Quebec, Canada
| | - Vanessa T Vaillancourt
- Department of Family and Emergency Medicine, Université de Sherbrooke, Chicoutimi, Quebec, Canada
| | | | - Amélie Boudreault
- Department of Family and Emergency Medicine, Université de Sherbrooke, Chicoutimi, Quebec, Canada
| | - Kate Bacon
- Patient-Partner, Chicoutimi, Quebec, Canada
| | - Sharon Hatcher
- Department of Family and Emergency Medicine, Université de Sherbrooke, Chicoutimi, Quebec, Canada.,Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean du Québec, Chicoutimi, Quebec, Canada
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Implementing Optimal Care Pathways for Aboriginal and Torres Strait Islander People With Cancer: A Survey of Rural Health Professionals’ Self-Rated Learning Needs. Int J Integr Care 2022; 22:27. [PMID: 35431703 PMCID: PMC8973837 DOI: 10.5334/ijic.6028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 03/16/2022] [Indexed: 11/20/2022] Open
Abstract
Objective: Methods: Results: Conclusion:
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Walpola RL, Harrison R. Community pharmacists are central to improving medication safety for patients from ethnic minority backgrounds. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2022; 30:3-4. [PMID: 34984460 DOI: 10.1093/ijpp/riab082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Reema Harrison
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia
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Antón-Solanas I, Tambo-Lizalde E, Hamam-Alcober N, Vanceulebroeck V, Dehaes S, Kalkan I, Kömürcü N, Coelho M, Coelho T, Casa Nova A, Cordeiro R, Sagarra-Romero L, Subirón-Valera AB, Huércanos-Esparza I. Nursing students' experience of learning cultural competence. PLoS One 2021; 16:e0259802. [PMID: 34919540 PMCID: PMC8683022 DOI: 10.1371/journal.pone.0259802] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/26/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION European societies are rapidly becoming multicultural. Cultural diversity presents new challenges and opportunities to communities that receive immigrants and migrants, and highlights the need for culturally safe healthcare. Universities share a responsibility to build a fair and equitable society by integrating cultural content in the nursing curricula. This paper aims to analyze European student nurses´ experience of learning cultural competence and of working with patients from diverse cultural backgrounds. MATERIALS AND METHODS A phenomenological approach was selected through a qualitative research method. 7 semi-structured focus groups with 5-7 students took place at the participants' respective universities in Spain, Belgium, Turkey and Portugal. RESULTS 5 themes and 16 subthemes emerged from thematic analysis. Theme 1, concept of culture/cultural diversity, describes the participants' concept of culture; ethnocentricity emerged as a frequent element in the students' discourse. Theme 2, personal awareness, integrates the students' self-perception of cultural competence and their learning needs. Theme 3, impact of culture, delves on the participants' perceived impact of cultural on both nursing care and patient outcomes. Theme 4, learning cultural competence, integrates the participants' learning experiences as part of their nursing curricula, as part of other academic learning opportunities and as part of extra-academic activities. Theme 5, learning cultural competence during practice placements, addresses some important issues including witnessing unequal care, racism, prejudice and conflict, communication and language barriers, tools and resources and positive attitudes and behaviors witnesses or displayed during clinical practice. CONCLUSION The participants' perceived level of cultural competence was variable. All the participants agreed that transcultural nursing content should be integrated in the nursing curricula, and suggested different strategies to improve their knowledge, skills and attitudes. It is important to listen to the students and take their opinion into account when designing cultural teaching and learning activities.
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Affiliation(s)
- Isabel Antón-Solanas
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - Elena Tambo-Lizalde
- Instituto de Investigación Sanitaria, Hospital Universitario Miguel Servet, Zaragoza, Spain
- Faculty of Health Sciences, Universidad San Jorge, Zaragoza, Spain
| | - Nadia Hamam-Alcober
- Servicio Aragonés de Salud, Miguel Servet Women’s and Children’s Hospital, Zaragoza, Spain
| | | | - Shana Dehaes
- Department of Nursing, AP University of Applied Sciences and Arts, Antwerpen, Belgium
| | - Indrani Kalkan
- Faculty of Health Sciences, Istanbul Aydin University, Istanbul, Turkey
| | - Nuran Kömürcü
- Faculty of Health Sciences, Istanbul Aydin University, Istanbul, Turkey
| | - Margarida Coelho
- School of Education and Social Science, Instituto Politécnico de Portalegre, Portalegre, Portugal
| | - Teresa Coelho
- School of Education and Social Science, Instituto Politécnico de Portalegre, Portalegre, Portugal
| | - Antonio Casa Nova
- School of Health Sciences, Instituto Politécnico de Portalegre, Portalegre, Portugal
| | - Raul Cordeiro
- School of Health Sciences, Instituto Politécnico de Portalegre, Portalegre, Portugal
| | - Lucía Sagarra-Romero
- Faculty of Health Sciences, Villanueva de Gállego, Universidad San Jorge, Zaragoza, Spain
| | - Ana B. Subirón-Valera
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain
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Gaya-Sancho B, Vanceulebroeck V, Kömürcü N, Kalkan I, Casa-Nova A, Tambo-Lizalde E, Coelho M, Present E, Değirmenci Öz S, Coelho T, Vermeiren S, Kavala A, Jerue BA, Sáez-Gutiérrez B, Antón-Solanas I. Perception and Experience of Transcultural Care of Stakeholders and Health Service Users with a Migrant Background: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10503. [PMID: 34639803 PMCID: PMC8508346 DOI: 10.3390/ijerph181910503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/01/2021] [Accepted: 10/03/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION While European health policies do frequently take into consideration the ideas and experiences of their users, the voices of minority and marginalized communities are not often heard. European healthcare services must address this issue as the number of healthcare users with an MM background increases. AIM To explore the perspectives of key stakeholders and healthcare users with an MM background on transcultural care in four European countries. DESIGN Qualitative phenomenological study. METHODS Semi-structured, individual interviews were conducted with stakeholders and MM users. Interviews were translated and transcribed verbatim and were carried out from February to May 2021. Descriptive statistics was used to describe the characteristics of the sample; qualitative data were analyzed thematically following Braun and Clarke's phases, resulting in 6 themes and 18 subthemes. RESULTS For stakeholders and MM users with long-established residence in their respective countries, cultural differences involve different family and community norms, religious beliefs, lifestyles, and habits. These components are perceived as in tension with healthcare norms and values, and they mediate in two key and related aspects of the relationship between MM users and healthcare providers: accessibility and communication. CONCLUSIONS Communication and access to healthcare are key to MM health service users, and they are the most frequent sources of misunderstanding and conflict between them and healthcare professionals. IMPACT It is important to extend the investigation of cultural issues in healthcare to stakeholders and MM users. There is no doubt that healthcare professionals should be trained in cultural competence; however, cultural competence training is not the only area for improvement. There should be a change in paradigm in healthcare services across Europe: from individual to organizational integration of culture and diversity.
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Affiliation(s)
- Benjamin Gaya-Sancho
- Department of Nursing, Faculty of Health Sciences, Universidad San Jorge, 50830 Zaragoza, Spain; (B.A.J.); (B.S.-G.)
- Research Group of Research on New Targets in Autoimmunity and Oncological Surveillance (INDIVO) (B3_20D), Universidad San Jorge, 50830 Zaragoza, Spain
| | - Valérie Vanceulebroeck
- Department of Nursing, AP University of Applied Sciences and Arts, 2000 Antwerpen, Belgium; (V.V.); (E.P.); (S.V.)
| | - Nuran Kömürcü
- Faculty of Health Sciences, Istanbul Aydin University, Istanbul 34295, Turkey; (N.K.); (I.K.); (S.D.Ö.); (A.K.)
| | - Indrani Kalkan
- Faculty of Health Sciences, Istanbul Aydin University, Istanbul 34295, Turkey; (N.K.); (I.K.); (S.D.Ö.); (A.K.)
| | - Antonio Casa-Nova
- Instituto Politécnico de Portalegre, School of Health Sciences, 7300-110 Portalegre, Portugal;
| | - Elena Tambo-Lizalde
- Instituto de Investigación Sanitaria, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain;
| | - Margarida Coelho
- Instituto Politécnico de Portalegre, School of Education and Social Science, 7300-110 Portalegre, Portugal; (M.C.); (T.C.)
| | - Evy Present
- Department of Nursing, AP University of Applied Sciences and Arts, 2000 Antwerpen, Belgium; (V.V.); (E.P.); (S.V.)
| | - Seda Değirmenci Öz
- Faculty of Health Sciences, Istanbul Aydin University, Istanbul 34295, Turkey; (N.K.); (I.K.); (S.D.Ö.); (A.K.)
| | - Teresa Coelho
- Instituto Politécnico de Portalegre, School of Education and Social Science, 7300-110 Portalegre, Portugal; (M.C.); (T.C.)
| | - Sofie Vermeiren
- Department of Nursing, AP University of Applied Sciences and Arts, 2000 Antwerpen, Belgium; (V.V.); (E.P.); (S.V.)
| | - Arzu Kavala
- Faculty of Health Sciences, Istanbul Aydin University, Istanbul 34295, Turkey; (N.K.); (I.K.); (S.D.Ö.); (A.K.)
| | - Benjamin Adam Jerue
- Department of Nursing, Faculty of Health Sciences, Universidad San Jorge, 50830 Zaragoza, Spain; (B.A.J.); (B.S.-G.)
| | - Berta Sáez-Gutiérrez
- Department of Nursing, Faculty of Health Sciences, Universidad San Jorge, 50830 Zaragoza, Spain; (B.A.J.); (B.S.-G.)
- Research Group of Research on New Targets in Autoimmunity and Oncological Surveillance (INDIVO) (B3_20D), Universidad San Jorge, 50830 Zaragoza, Spain
| | - Isabel Antón-Solanas
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, 50009 Zaragoza, Spain;
- Research Group Nursing Research in Primary Care in Aragón (GENIAPA) (GIIS094), Institute of Research of Aragón, 50009 Zaragoza, Spain
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Corsino L, Fuller AT. Educating for diversity, equity, and inclusion: A review of commonly used educational approaches. J Clin Transl Sci 2021; 5:e169. [PMID: 34733545 PMCID: PMC8532179 DOI: 10.1017/cts.2021.834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 01/29/2023] Open
Abstract
Diversity, equity, and inclusion (DEI) are fundamentally important concepts for advancing clinical and translational science (CTS) education. CTS education spans a wide range of disciplines from cell biology to clinical and community/population research. This large scope both in terms of intellectual areas and target groups requires an understanding of existing educational approaches for DEI as we translate DEI from mere concepts into equitable actions within CTS education. In this review, we provide the readers with the most common DEI educational approaches, including cultural humility, bias training, and improving mentoring to diversify the workforce. DEI educational materials can achieve maximal success and long-term impact when implemented as institutional-wide interventions, and the materials are not seen as an isolated or independent curriculum. Approaches, strategies, and programs to achieve this are many. However, many questions remain unanswered about what the best approach, strategies, and programs are to be implemented in institutional-wide education that will be embedded in CTS education.
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Affiliation(s)
- Leonor Corsino
- Department of Medicine, Division of Endocrinology, Metabolism, and Nutrition, Duke School of Medicine, Durham, North Carolina, USA
- Duke Clinical and Translational Science Institute, Community-Engaged Research Initiative Core, Duke School of Medicine, Durham, North Carolina, USA
| | - Anthony T. Fuller
- Department of Neurosurgery, Division of Global Neurosurgery and Neurology, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Duke Clinical and Translational Science Institute, Center for Pathway Programs, Duke School of Medicine, Durham, North Carolina, USA
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Chauhan A, Walpola RL, Manias E, Seale H, Walton M, Wilson C, Smith AB, Li J, Harrison R. How do health services engage culturally and linguistically diverse consumers? An analysis of consumer engagement frameworks in Australia. Health Expect 2021; 24:1747-1762. [PMID: 34264537 PMCID: PMC8483202 DOI: 10.1111/hex.13315] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/19/2021] [Accepted: 06/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background Engagement frameworks provide the conceptual structure for consumer engagement in healthcare decision making, but the level to which these frameworks support culturally and linguistically diverse (CALD) consumer engagement is not known. Objective This study aimed to investigate how consumer engagement is conceptualised and operationalized and to determine the implications of current consumer engagement frameworks for engagement with CALD consumers. Method Altheide's document analysis approach was used to guide a systematic search, selection and analytic process. Australian Government health department websites were searched for eligible publicly available engagement frameworks. A narrative synthesis was conducted. Results Eleven engagement frameworks published between 2007 and 2019 were identified and analysed. Only four frameworks discussed engagement with CALD consumers distinctly. Organisational prerequisites to enhance engagement opportunities and approaches to enable activities of engagement were highlighted to improve CALD consumers' active participation in decision making; however, these largely focused on language, with limited exploration of culturally sensitive services. Conclusion There is limited discussion of what culturally sensitive services look like and what resources are needed to enhance CALD consumer engagement in high‐level decision making. Health services and policy makers can enhance opportunities for engagement with CALD consumers by being flexible in their approach, implementing policies for reimbursement for participation and evaluating and adapting the activities of engagement in collaboration with CALD consumers. Patient/Public Contribution This study is part of a wider ‘CanEngage’ project, which includes a consumer investigator, and is supported by a consumer advisory group. The study was conceived with inputs from the consumer advisory group, which continued to meet regularly with the project team to discuss the methodology and emerging findings.
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Affiliation(s)
- Ashfaq Chauhan
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Ramesh L Walpola
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia
| | - Holly Seale
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Merrilyn Walton
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Carlene Wilson
- Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia.,School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Allan B Smith
- Centre for Oncology Education and Research Translation (CONSORT), Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, New South Wales, Australia
| | - Jiadai Li
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Reema Harrison
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
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Lin OM, Reid HW, Fabbro RL, Johnson KS, Batch BC, Olsen MK, Matsouaka RA, Sanders LL, Chung ST, Svetkey LP. Association of Provider Perspectives on Race and Racial Health Care Disparities with Patient Perceptions of Care and Health Outcomes. Health Equity 2021; 5:466-475. [PMID: 34316530 PMCID: PMC8309434 DOI: 10.1089/heq.2021.0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Research suggests that providers contribute to racial disparities in health outcomes. Identifying modifiable provider perspectives that are associated with decreased racial disparities will help in the design of effective educational interventions for providers. Methods: This cross-sectional study investigated the association between primary care provider (PCP) perspectives on race and racial disparities with patient outcomes. Results: Study participants included 40 PCPs (70% White, 30% racial minority) caring for 55 patients (45% White, 55% Black) with type 2 diabetes mellitus. Associations of provider perspectives on race and racial disparities with patient variables (Interpersonal Processes of Care [IPC] Survey, which measures patient's ratings of their provider's interpersonal skills; medication adherence; glycemic control) were measured using Spearman correlation coefficients. Results suggest that Black patients of providers who reported greater skill in caring for Black patients had more positive perceptions of care in three of four IPC subdomains (Spearman correlation coefficients of -0.43, 0.44, 0.46, all with p<0.05); however, Black patients of providers who believe that racial disparities are highly prevalent had more negative perceptions of care in three of four IPC subdomains (Spearman correlation coefficients of 0.38, -0.53, -0.51, all with p<0.05). These same provider characteristics had no correlation with outcomes of medication adherence and hemoglobin A1c (HbA1c) or among White patients. Conclusion: Findings suggest that Black patients of providers who felt better equipped to take care of Black patients had a better experience. Therefore, educational interventions for providers may be most effective if they focus on skill development rather than increasing awareness about racial disparities alone.
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Affiliation(s)
- Olivia M Lin
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Hadley W Reid
- Duke University School of Medicine, Durham, North Carolina, USA
| | | | - Kimberly S Johnson
- Division of Geriatrics, Department of Medicine, Duke University School of Medicine Durham, North Carolina, USA.,Center for Aging and Human Development, Duke University School of Medicine, Durham, North Carolina, USA.,Geriatrics Research Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
| | - Bryan C Batch
- Division of Endocrinology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Maren K Olsen
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA.,Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
| | - Roland A Matsouaka
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
| | - Linda L Sanders
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sangyun Tyler Chung
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
| | - Laura P Svetkey
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
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Alraqiq HM, Sahota SK, Franks CL. Cultural awareness training for dental students. J Dent Educ 2021; 85:1646-1654. [PMID: 34091910 DOI: 10.1002/jdd.12696] [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: 02/08/2021] [Revised: 04/16/2021] [Accepted: 05/23/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES This study aimed to assess the impact of a full-day workshop on increasing cultural awareness among incoming first-year (DDS-I) and post-doctoral (PGY-I) dental students at the Columbia University College of Dental Medicine. METHODS The workshop focused on developing students' cultural awareness regarding dimensions of identity, recognition of power and privilege, importance of cross-cultural understanding and communication, and the role of self-reflection through direct teaching, interactive discussions, and reflective writing. A convenience sample of 83 DDS-I and 30 PGY-I students from the 2019 enrollment class were recruited. Assessments included pre- and post-workshop surveys, facilitator interviews, and a formal workshop evaluation. Descriptive and bivariate analyses of students' responses were performed to assess cultural awareness within and between student groups. Facilitator interviews and student feedback were analyzed qualitatively to identify emerging themes. RESULTS Global cultural awareness among both student groups was higher in the post-workshop survey (for DDS-I, mean = 3.46, SD = 0.38; for PGY-I, mean = 3.47, SD = 0.30) than in the pre-workshop survey (for DDS-I, mean = 2.98, SD = 0.34; for PGY-I, mean = 2.90, SD = 0.47), which represented a statistically significant difference (p < 0.001 for both comparisons). Quantitative analysis revealed that the workshop provided a platform to discuss sensitive topics, increased cultural awareness among students and faculty, and provided faculty with different perspectives about culture awareness. CONCLUSIONS The full-day workshop achieved its goals of increasing dental students' self-perceived cultural awareness and capacity to establish cross-cultural professional relationships.
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Affiliation(s)
- Hosam M Alraqiq
- Section of Growth and Development, Division of Pediatric Dentistry, College of Dental Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Sukhneet K Sahota
- The College of Dental Medicine, Columbia University Irving Medical Center, New York, New York
| | - Cheryl L Franks
- The Percy Ellis Sutton SEEK Department, John Jay College of Criminal Justice, City University of New York, School of Social Work, Columbia University, New York, New York, USA.,The College of Dental Medicine, Columbia University Irving Medical Center, New York, New York, USA
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Weber O, Semlali I, Gamondi C, Singy P. Cultural competency and sensitivity in the curriculum for palliative care professionals: a survey in Switzerland. BMC MEDICAL EDUCATION 2021; 21:318. [PMID: 34088305 PMCID: PMC8178817 DOI: 10.1186/s12909-021-02745-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Cultural and linguistic diversity in patients and their relatives represents a challenge for clinical practice in palliative care around the world. Cross-cultural training for palliative care professionals is still scarce, and research can help determine and support the implementation of appropriate training. In Switzerland, health policies address diversity and equity issues, and there is a need for educational research on cross-cultural training in palliative care. The aim of this study was to investigate the clinical challenges faced by Swiss palliative care professionals when working with migrant patients and their relatives. We also documented professionals' interests in cross-cultural training. METHODS A web survey of professionals working in specialized palliative care in the French- and Italian-speaking areas of Switzerland investigated clinical challenges with migrant populations and interests in various training opportunities. RESULTS A total of 204 individuals responded to the survey, 48.5 % of whom were nurses. The major difficulties they reported were communication impediments associated with patients' linguistic and/or cultural backgrounds. In relation to educational needs, they expressed a particular interest in communication techniques that would allow them to deal with these issues autonomously. The professionals expressed less interest in training on collaborating with other professionals and examining one's own stereotypes. CONCLUSIONS Palliative care professionals' post-graduate and continuing education must address communication techniques for sensitive palliative and end-of-life topics in cross-cultural contexts. Beginning with their pre-graduate studies, health professionals should assimilate the importance of collaborating with other professionals in complex cross-cultural situations and learn to reflect on their stereotypes and pre-conceptions in clinical practice.
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Affiliation(s)
- Orest Weber
- Liaison Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Imane Semlali
- Liaison Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
- Liaison Psychiatry service, Av. de Beaumont 23, 1011, Lausanne, Switzerland.
| | - Claudia Gamondi
- Palliative and Supportive Care Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Pascal Singy
- Liaison Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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41
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Atoloye AT, Nur H, Wengreen H, Archuleta M. Tackling Cultural Determinants of Health Through Nutrition Education Among Refugees. Health Equity 2021; 5:390-393. [PMID: 34104845 PMCID: PMC8182646 DOI: 10.1089/heq.2020.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 11/30/2022] Open
Abstract
Nutrition education provides an avenue to address nutrition behavior change needs and prevents chronic disease in refugee communities. Previous studies have consistently identified cultural uniqueness as one of the barriers to meeting the needs of the refugee communities effectively. This current perspective describes the barriers and opportunities to improve nutrition education efforts among this population while taking into account the cultural context.
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Affiliation(s)
- Abiodun T. Atoloye
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, USA
| | - Habiba Nur
- Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan, Utah, USA
| | - Heidi Wengreen
- Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan, Utah, USA
| | - Martha Archuleta
- Department of Nutrition, Dietetics, and Food Sciences, Salt Lake Center, Utah State University, Logan, Utah, USA
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Taylor EV, Lyford M, Holloway M, Parsons L, Mason T, Sabesan S, Thompson SC. "The support has been brilliant": experiences of Aboriginal and Torres Strait Islander patients attending two high performing cancer services. BMC Health Serv Res 2021; 21:493. [PMID: 34030670 PMCID: PMC8142293 DOI: 10.1186/s12913-021-06535-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/17/2021] [Indexed: 12/13/2022] Open
Abstract
Background Improving health outcomes for Indigenous people by providing person-centred, culturally safe care is a crucial challenge for the health sector, both in Australia and internationally. Many cancer providers and support services are committed to providing high quality care, yet struggle with providing accessible, culturally safe cancer care to Indigenous Australians. Two Australian cancer services, one urban and one regional, were identified as particularly focused on providing culturally safe cancer care for Indigenous cancer patients and their families. The article explores the experiences of Indigenous cancer patients and their families within the cancer services and ascertains how their experiences of care matches with the cancer services’ strategies to improve care. Methods Services were identified as part of a national study designed to identify and assess innovative services for Indigenous cancer patients and their families. Case studies were conducted with a small number of identified services. In-depth interviews were conducted with Indigenous people affected by cancer and hospital staff. The interviews from two services, which stood out as particularly high performing, were analysed through the lens of the patient experience. Results Eight Indigenous people affected by cancer and 23 hospital staff (Indigenous and non-Indigenous) were interviewed. Three experiences were shared by the majority of Indigenous cancer patients and family members interviewed in this study: a positive experience while receiving treatment at the cancer service; a challenging time between receiving diagnosis and reaching the cancer centre; and the importance of family support, while acknowledging the burden on family and carers. Conclusions This article is significant because it demonstrates that with a culturally appropriate and person-centred approach, involving patients, family members, Indigenous and non-Indigenous staff, it is possible for Indigenous people to have positive experiences of cancer care in mainstream, tertiary health services. If we are to improve health outcomes for Indigenous people it is vital more cancer services and hospitals follow the lead of these two services and make a sustained and ongoing commitment to strengthening the cultural safety of their service. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06535-9.
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Affiliation(s)
- Emma V Taylor
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia, 6530, Australia.
| | - Marilyn Lyford
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia, 6530, Australia
| | - Michele Holloway
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia, 6530, Australia
| | - Lorraine Parsons
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia, 6530, Australia
| | - Toni Mason
- Aboriginal Health Unit, Mission, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Sabe Sabesan
- Townsville Cancer Centre, Townsville Hospital and Health Service, Douglas, Queensland, Australia
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald Street, Geraldton, Western Australia, 6530, Australia
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Dos Santos LM. Upgrading Nursing Students' Foreign Language and Communication Skills: A Qualitative Inquiry of the Afterschool Enhancement Programmes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105112. [PMID: 34065901 PMCID: PMC8150763 DOI: 10.3390/ijerph18105112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 11/04/2022]
Abstract
Learning a foreign language is not easy for many students, particularly for nursing students who need to complete their internships in the hospital. However, motivation always drives them to the foreign language classrooms. The purpose of this study was to understand the motivations and reasons behind why these nursing students decided to study Mandarin Chinese as part of their personal development and enhancement beyond the curriculum. One main question and one sub-research question were written, why would nursing students decide to take Chinese as the tool for foreign language and culture development? What and why are the reasons and motivations for nursing students to take Chinese beyond their curriculum? The qualitative case study method was employed in order to investigate 36 nursing university students in the United Kingdom. The results of this study concluded that nursing students tend to study Chinese due to personal development and career goals. School leaders, department heads, government leaders, policymakers, human resources professionals, vocational trainers, and researchers may take this study as the opportunity to reform their current human resource and education plans to offer foreign language courses to university students, members of the public, learners, and interested parties for both personal development and career enhancements.
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Affiliation(s)
- Luis Miguel Dos Santos
- Department of Global Convergence Management, Finance and Tax Management, Endicott College, Woosong University, Daejeon 34514, Korea
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Debesay J, Kartzow AH, Fougner M. Healthcare professionals' encounters with ethnic minority patients: The critical incident approach. Nurs Inq 2021; 29:e12421. [PMID: 33978995 DOI: 10.1111/nin.12421] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/06/2021] [Accepted: 04/18/2021] [Indexed: 11/30/2022]
Abstract
Ethnic minority patients face challenges concerning communication and are at higher risk of experiencing health problems and consuming fewer healthcare services. They are also exposed to disparaging societal discourses about migrants which might undermine healthcare institutions' ambitions of equitable health care. Therefore, healthcare professionals need to critically reflect on their practices and processes related to ethnic minority patients. The aim of this article is to explore healthcare professionals' experiences of working with ethnic minority patients by using the critical incident (CI) technique. In two focus group sessions, participants discussed challenging events in their encounters with patients. The critical incidents show that healthcare professionals may experience unfamiliar situations related to their work performance, prejudice toward patients, and labeling by patients the professionals do not identify with. The professionals' reflections are discussed in relation to social discourses on migration and their work conditions, and the possible influence on the professionals' preconceptions and the patient-professional relationship in health care. Reflections about work experiences with ethnic minority patients and aligned societal discourses should be included in healthcare workers' professional development. Critical incident reflections at work may contribute to better-coping strategies for healthcare professionals and improved patient-professional relationships with ethnic minority patients.
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Affiliation(s)
- Jonas Debesay
- Department of Nursing, Oslo Metropolitan University, Oslo, Norway
| | - Anders Huuse Kartzow
- Department of Patient Safety and Equitable Healthcare, Oslo University Hospital, Oslo, Norway
| | - Marit Fougner
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
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45
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Leung DY, Kumlien C, Bish M, Carlson E, Chan PS, Chan EA. Using internationalization-at-home activities to enhance the cultural awareness of health and social science research students: A mixed-method study. NURSE EDUCATION TODAY 2021; 100:104851. [PMID: 33711583 DOI: 10.1016/j.nedt.2021.104851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 02/15/2021] [Accepted: 02/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Despite healthcare scholars valuing diversity, current cultural awareness training does not address mechanisms that drive societal patterns, that generates cultural insensitivity and reinforces stereotypes of minority groups. The influence of culture on thinking is an important issue because of potential ethnocentric biases on the design, data collection, analysis, and dissemination of research. OBJECTIVES Using internationalization-at-home activities to explore the mechanisms that enhance the development of cultural awareness in postgraduate health and social science research students. DESIGN AND METHODS A pragmatic critical realist study, qualitatively dominant, using mixed-methods to integrate and analyze qualitative and quantitative data. Data were collected pre- and post-internationalization-at-home activities. Qualitative data were collected from online discussion forums and focus groups, and quantitative data were collected from a pre-test and post-test measure of cultural awareness. SETTING AND PARTICIPANTS Eighteen research students in postgraduate health and social science programs from three universities (Australia, Hong Kong, and Sweden) participated in five formal internationalization-at-home webinars and informal international group activities. RESULTS Participants reported four mechanisms counteracting structures (i.e., ethnocentric biases) toward the emergence of cultural awareness: 1. awareness of cultural issues motivating people toward achieving a common goal; 2. reflexivity within psychological safety; 3. deliberations that challenge the veracity of individual assumptions; 4. courage coupled with curiosity. When some or all the mechanisms occurred, properties of enhanced cultural awareness emerged, as confirmed by the quantitative data. CONCLUSIONS Cultural awareness training should emphasize social relations to allow cultural safety to develop for postgraduate health and social science research students. Without skills revealing unconsciously held ethical values, this study argues that postgraduate health and social science students may inadvertently reconstitute and reinforce in their research the discrimination of underserved groups.
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Affiliation(s)
- Doris Y Leung
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong Special Administrative Region.
| | | | - Melanie Bish
- La Trobe Rural Health School, La Trobe University, Edwards Rd, Flora Hill, Victoria 3550, Australia.
| | | | - Pui Sze Chan
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong Special Administrative Region.
| | - E Angela Chan
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong Special Administrative Region.
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Lekas HM, Pahl K, Fuller Lewis C. Rethinking Cultural Competence: Shifting to Cultural Humility. Health Serv Insights 2021; 13:1178632920970580. [PMID: 33424230 PMCID: PMC7756036 DOI: 10.1177/1178632920970580] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 10/06/2020] [Indexed: 11/17/2022] Open
Abstract
Healthcare and social services providers are deemed culturally competent when they offer culturally appropriate care to the populations they serve. While a review of the literature highlights the limited effectiveness of cultural competence training, its value remains largely unchallenged and it is institutionally mandated as a means of decreasing health disparities and improving quality of care. A plethora of trainings are designed to expose providers to different cultures and expand their understanding of the beliefs, values and behavior thus, achieving competence. Although this intention is commendable, training providers in becoming competent in various cultures presents the risk of stereotyping, stigmatizing, and othering patients and can foster implicit racist attitudes and behaviors. Further, by disregarding intersectionality, cultural competence trainings tend to undermine provider recognition that patients inhabit multiple social statuses that potentially shape their beliefs, values and behavior. To address these risks, we propose training providers in cultural humility, that is, an orientation to care that is based on self-reflexivity, appreciation of patients’ lay expertise, openness to sharing power with patients, and to continue learning from one’s patients. We also briefly discuss our own cultural humility training. Training providers in cultural humility and abandoning the term cultural competence is a long-awaited paradigm shift that must be advanced.
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Affiliation(s)
- Helen-Maria Lekas
- New York State Office of Mental Health, Social Solutions and Services Research, Nathan S. Kline Institute for Psychiatric Research, New York, NY, USA.,Department of Psychiatry, New York University School of Medicine, USA
| | - Kerstin Pahl
- New York State Office of Mental Health, Social Solutions and Services Research, Nathan S. Kline Institute for Psychiatric Research, New York, NY, USA.,Department of Psychiatry, New York University School of Medicine, USA
| | - Crystal Fuller Lewis
- New York State Office of Mental Health, Social Solutions and Services Research, Nathan S. Kline Institute for Psychiatric Research, New York, NY, USA.,Department of Psychiatry, New York University School of Medicine, USA
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Koh JHL, Scott N, Lucas A, Kataoka M, MacDonell S. Developing Dietetic Students' Confidence in Multicultural Communication through Flipped Learning. TEACHING AND LEARNING IN MEDICINE 2021; 33:67-77. [PMID: 32706631 DOI: 10.1080/10401334.2020.1794880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Problem: In a Master of Dietetics program, cultural competence was originally taught with lectures of cultural food practices. Course evaluations reflected that students wanted more opportunities to practice multicultural communication skills whereas lecturers felt that students' personal inquiry of cultural competence could be strengthened. This study explores whether the combination of self-directed pre-class learning and in-class activities through flipped learning could address these instructional issues. Three research questions were examined: (1) How did dietetic students' perceived confidence in multicultural communication change before and after undergoing flipped learning? (2) Which aspects of cultural competence influenced students' confidence in multicultural communication before and after flipped learning? (3) Which aspects of cultural competence were students' cultural learning goals based upon after flipped learning? Intervention: The intervention began with an introductory lesson in which students attended a lecture on New Zealand's cultural landscape, self-assessed their cultural influences, and completed self-directed learning of cultural competence concepts. After this, students participated in two flipped learning lessons; the first lesson focused on cultural knowledge and the second on multicultural communication skills. For both lessons, students completed preparatory activities before engaging in small-group activities during the class sessions. Before and after the flipped learning lessons, students wrote online reflections about the reasons underlying their confidence in multicultural communication. Context: The intervention was carried out with 32 early dietetic students who were in their first semester of postgraduate studies and 31 students consented to study participation. The majority of study participants were female (n = 30, 97%), European or Asian (n = 28, 91%), and between 21-30 years old (n = 27, 87%). Impact: Pre and post module surveys submitted by 31 students showed that more of them reported being confident or very confident in multicultural communication after flipped learning. Reflections submitted by 31 students before flipped learning showed that their confidence in multicultural communication was based upon their cultural knowledge and cultural interaction experiences. Reflections submitted by 19 students after flipped learning indicated that they developed cultural skill which helped them become confident in multicultural communication. These students set goals to continue developing their cultural knowledge, engaging in cultural interaction, and optimizing opportunities for applying cultural skill during clinical practice. Lessons learned: The study results showed that flipped learning can be used for cultural learning. As compared to lectures, flipped learning can provide students with more authentic contexts to practice multicultural communication. These learning experiences model how students might continue to self-direct their cultural competence development throughout their professional practice.
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Affiliation(s)
- Joyce Hwee Ling Koh
- Higher Education Development Center, University of Otago, Dunedin, New Zealand
| | - Nikki Scott
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Angela Lucas
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Minako Kataoka
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Sue MacDonell
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
- Department of General Practice and Primary Care, University of Auckland, Auckland, New Zealand
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Charleston L, Spears RC, Flippen C. Equity of African American Men in Headache in the United States: A Perspective From African American Headache Medicine Specialists (Part 1). Headache 2020; 60:2473-2485. [PMID: 33140448 DOI: 10.1111/head.14004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/09/2020] [Accepted: 10/09/2020] [Indexed: 12/17/2022]
Abstract
Migraine and severe headache affect approximately 1 in 6 U.S. adults and migraine is one of the most disabling disorders worldwide. Approximately 903,000 to 1.5 million African American (AA) men are affected by migraine in the United States. Racial disparities in headache medicine exist. In addition, there are limited headache studies that attest to the inclusion of or have robust data on AA men in headache medicine in the United States. Racial concordance between provider and patient may ameliorate some aspects of care disparities. Moreover, it has been demonstrated that diversity and inclusion particularly in leadership of organizations has consistently produced positive change, increased innovation, and long-term success. Most national headache organizations strive to improve the care and lives of people living with headache disorders yet only ~0.5% of their physician members are AA men. Herein, we provide an observation of equity issues from the perspective of AA men in the headache medicine subspecialty. Part 1 of this manuscript explores inherent and potential challenges of the equity of AA men in headache medicine including headache disparities, mistrust, understudied/lack of representation in research, cultural differences, implicit/explicit bias, and the diversity tax. Part 2 of this work offers possible solutions to achieve equity for AA men in headache including: (1) addressing head and facial pain disparities and mistrust in AA men; (2) professionalism and inclusion; (3) organizational/departmental leadership buy-in for racial diversity; (4) implicit/explicit and other bias training; (5) diversity panels with open discussion; (6) addressing diversity tax; (7) senior mentorship; (8) increased opportunities for noteworthy and important roles; (9) forming and building alliances and partnerships; (10) diversity leadership training programs; (11) headache awareness, education, and literacy with focus to underrepresented in medicine trainees and institutions; and (12) focused and supported the recruitment of AA men into headache medicine. More work is needed for equity of AA men in headache medicine.
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Affiliation(s)
- Larry Charleston
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Roderick C Spears
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Charles Flippen
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
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Kluger BM, Pantilat S, Miyasaki J. Palliative Care in Parkinson Disease-Is It Beneficial for All?-Reply. JAMA Neurol 2020; 77:1450-1451. [PMID: 32897303 DOI: 10.1001/jamaneurol.2020.3215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Benzi M Kluger
- University of Rochester Medical Center, Rochester, New York
| | - Steven Pantilat
- University of California School of Medicine, San Francisco, San Francisco
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Trauma and Violence Informed Care Through Decolonising Interagency Partnerships: A Complexity Case Study of Waminda's Model of Systemic Decolonisation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207363. [PMID: 33050193 PMCID: PMC7601198 DOI: 10.3390/ijerph17207363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 12/21/2022]
Abstract
Through the lens of complexity, we present a nested case study describing a decolonisation approach developed and implemented by Waminda South Coast Women’s Health and Welfare Aboriginal Corporation. Using Indigenous research methods, this case study has unfolded across three phases: (1) Yarning interviews with the workforce from four partner health services (n = 24); (2) Yarning circle bringing together key informants from yarning interviews to verify and refine emerging themes (n = 14); (3) Semi-structured interviews with a facilitator of Waminda’s Decolonisation Workshop (n = 1) and participants (n = 10). Synthesis of data has been undertaken in stages through collaborative framework and thematic analysis. Three overarching themes and eight sub-themes emerged that centred on enhancing the capabilities of the workforce and strengthening interagency partnerships through a more meaningful connection and shared decolonisation agenda that centres Aboriginal and Torres Strait Islander families and communities. Health and social services are complex systems that function within the context of colonisation. Waminda’s innovative, model of interagency collaboration enhanced workforce capability through shared language and collective learning around colonisation, racism and Whiteness. This process generated individual, organisational and systemic decolonisation to disable power structures through trauma and violence informed approach to practice.
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