Supporting and Uplifting New and Diverse Scientists in HIV Research (San Diego SUN): A Research Education and Training Program to Promote the Success of Black, Indigenous, and People of Color Predoctoral and Postdoctoral Fellows

BACKGROUND

We implemented a mentored research education and training program for underrepresented minorities (URMs) and Black, Indigenous, and People of Color (BIPOC) predoctoral and postdoctoral fellows called San Diego SUN (SD SUN): Supporting and Uplifting New and Diverse Scientists in HIV Research. The SD SUN program aimed to prepare fellows for an academic career trajectory in HIV science focused on ameliorating HIV-related disparities in communities of color.

SETTING

The program leveraged a strong interinstitutional collaboration between San Diego State University and the University of California, San Diego, that share commitments to diversity, equity, and inclusion and an established history of training programs for URM/BIPOC investigators.

METHODS

During a 9-month training period, launched in February 2022, fellows supported by a mentoring team completed ten 3-hour training sessions (core curriculum) and a mentored research project. The curriculum included seminars on building skills for a productive academic research career and reflective discussions around issues uniquely faced by URM/BIPOC investigators. Standardized measures developed for Center for AIDS Research Diversity, Equity, and Inclusion Pipeline Initiative (eg, around benefits gained) were used to evaluate the program.

RESULTS

Six fellows participated in the SD SUN program. The results demonstrated a successful first year. Fellows were highly engaged and reported positive experiences, satisfaction with their mentor(s), various benefits gained from the program, and gains in numerous skillsets.

CONCLUSIONS

Challenges were faced during implementation (eg, teaching grant writing to fellows at different skill levels). Time constraints were reported by some faculty mentors with limited bandwidth. We describe insights and solutions to the major challenges to sustaining the successful SD SUN program.

Partnering and Programming for a Black, Indigenous, and People of Color Sexual and Gender Minority Pathway to HIV Research

BACKGROUND

There is an urgent need to conduct innovative research on the health needs of populations whose intersecting identities, such as being Black, Indigenous, and other People of Color (BIPOC) and sexual and gender identity (SGM) persons, put them at greater risk of HIV infection. More so, as important as it is to train on the best practices, it is as important to train aspiring BIPOC SGM scholars in intersectional HIV science so that they can address the HIV-related issues of BIPOC SGM populations.

METHODS

In line with guidelines to increase diversity in the HIV workforce, we sought to (1) solidify the interest of BIPOC SGM trainees engaging in intersectional HIV science by piloting a 2-week Summer Intensive Program, (2) leverage the relationships and resources of our community partner to enhance our recruitment from HBCUs and MSIs, and (3) identify opportunities for postprogram training and mentoring activities.

RESULTS

Our data suggest that participants gained a great deal from the instructional sessions. Participants commented on the quality of the sessions, effectiveness of the instructional faculty, and a confirmed interest in HIV science.

CONCLUSIONS

We succeeded in promoting interest in and commitment to HIV science among early career BIPOC SGM scholars. An instructional program of this intensity is best suited to those with some experience in graduate school and existing interest in HIV science. As a program serving multiply minoritized populations, clarification of host institution policies and procedures, as well as administrative support, are essential for ensuring a smooth experience for scholars visiting from outside institutions.

Team Science: Advancing Women and Black, Indigenous, and other People of Color on the Pathway of Conducting Clinical Research

Introduction:

Innovative discovery begins with diverse perspectives; research teams should harness this model. Black, Indigenous, and other People of Color (BIPOC) and women are underrepresented as researchers. Team science leverages collaborative and cross-disciplinary approaches to diversify the research workforce, and introduces academic (and non-academic) faculty with limited research exposure/experience to clinical research.

Methods:

In 2020, two Black women academic physicians implemented an academic collaborative – COVID-19 Characteristics, Readmissions, Outcomes, and Social Determinants of Health (CROSS) – to investigate COVID-19 health inequities, with intentional recruitment of BIPOC and women. The 37 CROSS team members were of diverse races, ethnicities, sex, specialties, and disciplines, and represented eight hospitals. Team members were electronically surveyed to determine their interest, desired activities, and level of participation in research activities; concurrently, self-identified demographics (including race, ethnicity, sex, and language(s) spoken) were obtained.

Results:

All team members completed the survey: 78.4% (n = 29) were BIPOC and 78.4% (n = 29) were women. Team members spoke 18 languages (including English). Academic medical ranks included Assistant Professor (32.4%; n = 12), Associate Professor (16.2%; n = 6), and Full Professor (2.7%; n = 1). Each member identified desired activities (data collection, data analytics, manuscript development, abstract development/poster presentation, serving as a consultant) and the percentage of time they intended to allocate to each. Between June 2020 and February 2023, the team produced five original peer-reviewed manuscripts (including this article); five members served as first or senior authors. Twenty-one abstracts were presented at local conferences, and 10 at national and regional conferences. Five members achieved academic promotion, and team members were awarded three intramural grants resulting directly from team collaborations.

Conclusion:

Intentional recruitment and assessment of team members’ desired levels of participation in an integrated clinical research team is an effective strategy to engage BIPOC and women. The CROSS Collaborative is a model for diversity and inclusion in team science and clinical research.

Inequitable Care Delivery for COVID-19 Positive People of Color and People With Disabilities

Research Objectives

To explore provider observations of inequitable care delivery towards COVID-19 positive patients who are Black, Indigenous, and People of Color (BIPOC) and/or have disabilities and to identify ways health providers may be contributing to and compounding inequitable care.

Design

Qualitative research design using thematic analysis of data collected via individual semi-structured interviews between April and November 2021.

Setting

Hospitalized and ambulatory care.

Participants

A total of 19 pandemic frontline health care providers including nine physicians, five nurses, three rehabilitation professionals, and two nurse practitioners from Washington, Florida, Illinois, and New York were recruited through convenience and snowball sampling. The majority of participants were female (n=12) and White (n=11).

Interventions

Not applicable.

Main Outcome Measures

A semi-structured interview guide included questions regarding equity in treatments among COVID-19 patients who are BIPOC or have disabilities and perceptions around stigma related to COVID-19.

Results

Discriminatory treatment included decreased care (i.e., less explanation due to communication barriers, less interaction with health care providers, no access to telehealth follow-ups), delayed care, and fewer options for care. Health care providers’ bias and stigma (racism, ableism, and ageism), patient mistrust and provider-patient disconnect, lack of resources (e.g., staff, interpreter services, funding, or collaboration across health systems), fear of transmission, and burnout were mentioned as drivers for discriminatory treatment. COVID-19 related health system policies such as visitor restrictions and telehealth follow-ups also inadvertently resulted in discriminatory practices towards BIPOC patients and patients with disabilities.

Conclusions

BIPOC patients and patients with disabilities may experience lower quality of healthcare related to COVID-19 due to factors such as providers’ biases, fear, burnout, and lack of needed resources in their work settings. In addition, COVID-19-related restrictions and policies compounded existing inequitable care for these populations.

Author(s) Disclosures

Authors do not have conflicts to disclose.

Future Directions on BIPOC Youth Mental Health: The Importance of Cultural Rituals in the COVID-19 Pandemic

Culture plays an important role in the development of mental health, especially during childhood and adolescence. However, less is known about how participation in cultural rituals is related to the wellbeing of youth who are Black, Indigenous, and People of Color (BIPOC), and part of the Global Majority. This is crucial amid the COVID-19 pandemic, a global event that has disproportionally affected BIPOC youth and disrupted participation in rituals. The goal of this paper is to promote advances in clinical child and adolescent psychology focused on rituals. We begin by defining culture and rituals and examining their role on development. We illustrate these issues with the Lunar New Year in China, Maya rituals in México, Ramadan in Turkey, and Black graduations and Latinx funerals in the United States. We discuss how the pandemic has affected participation in these rituals and their potential impact on BIPOC children and adolescents' mental health. We propose future directions and recommendations for research.