RESUMEN

The last 40 years have been marked by a growing appreciation of organized afterschool activities as a developmental context, with evidence that these activities are linked to academic, social, and behavioral outcomes at least in the short term. In this chapter, we focus on research that builds on these earlier advances to extend afterschool research in two areas that are critical to the future of this field. First, we feature research that examines organized activities longitudinally from kindergarten through the end of high school, enabling us to study organized activities in relation to academic, social-emotional, behavioral, and health outcomes in both the short-run and long-run, including into adulthood. We then turn to a second advance: research focused on organized activities that serve minoritized children and adolescents. These studies identify the barriers minoritized youth often face and how activities can be designed to support their positive development, including efforts to provide culturally responsive programming. Promising directions for future research are presented in a third section.

Asunto(s)

RESUMEN

The rising incidence of suicide-related thoughts and behaviors among international students presents a significant public health challenge and growing concern among college campuses. Current intervention strategies often rely on Western-centric and colonized approaches developed and tested with primarily Western, Educated, Industrialized, Rich and Democratic (WEIRD) samples. Exclusion and historical underrepresentation of ethnoracially minoritized groups in suicide prevention treatment trials create gaps in advancing our science because they often miss the cultural contextualization crucial for effective prevention and intervention in diverse groups from different countries of origin. To address the limitations of these Western-centric strategies, we explored existing prevention recommendations and approaches through the lens of an expanded version of the newly developed Protective Factors Framework, tailored for non-Western cultural perspectives. We propose significant opportunities for enhancing current practices and point to promising future directions. The primary areas for development include: (1) bolstering community empowerment and ownership, (2) refining mechanisms of change to encompass multicultural viewpoints, and (3) focusing on effective implementation and thorough evaluation for ongoing refinement. This methodology not only shows promise for enhancing international student suicide prevention but also offers insights for broader application in suicide prevention among other culturally diverse populations.

RESUMEN

BACKGROUND: Current suicide prevention approaches are not adapted to international student needs, and participatory design is a method that may facilitate the development or adaptation of appropriate programmes for this group. METHODS: This qualitative study investigated the experiences of international university students studying in Australia who participated in a co-consultation process to adapt the LivingWorks safeTALK suicide prevention programme. Eight international students from the co-consultation workshop completed semi-structured interviews about their workshop experience. The data were analysed using reflexive thematic analysis. RESULTS: The findings showed that participants found the co-consultation process empowering and engaging. They also reported that the experience promoted mutual learning and challenged simplistic views of suicide. No students reported experiencing distress. Suggestions for improving participatory design for international students focussed on enhancing participant interaction, supporting quiet voices to be heard and ensuring understanding of mental health and suicide through shared language. CONCLUSIONS: This study underscores the value of participatory design in suicide prevention, emphasising its potential to empower international students and facilitate culturally sensitive programme adaptations. PATIENT OR PUBLIC CONTRIBUTION: International students were involved in the co-consultation process to redevelop the training content and provided a series of recommendations for improving such processes for international students in the future. The two researchers who conducted the interviews and data analysis were former international students.

Asunto(s)

RESUMEN

Disaster experiences and explorations of preparedness among Asian, Pacific Islander, and Desi Americans (APIDA) in the United States are often overlooked owing to their relatively smaller population share. APIDA are not homogenous, and their disaster experiences warrant further examination. This paper does so by investigating disaster preparedness using disaggregated information about APIDA. The study utilises nationally representative data from the 2017 American Housing Survey, analysing sociodemographic covariates. The disaster preparedness score among APIDA communities was approximately 4.81 on a zero to nine scale. APIDA renters and non-US citizens were less prepared than homeowners and US citizens. Among subgroups, Korean, Chinese, and Vietnamese respondents who were non-US citizens were less prepared than those who were US citizens. Marital status was significantly and positively associated with preparedness among Indians, Japanese, Vietnamese, and multiracial respondents. The findings underscore the importance of data disaggregation and tailored preparedness information and resources to address specific challenges APIDA communities face instead of a one-size-fits-all approach.

RESUMEN

Is there room for spirituality and reflection in gross anatomy? While Jesuit institutions have incorporated contemplation and reflection into their curricula for centuries; the integration of reflective practices into the gross anatomy curriculum has gained traction in recent years. Additionally, more emphasis has been placed on diversity, equity, inclusion, and belonging within health professions education. As a Jesuit, Catholic university that is simultaneously classified as a Hispanic-Serving Institute (HSI), Regis University was well-positioned to integrate reflective and celebratory activities in honor of Día de Muertos (the Day of the Dead) into a graduate level anatomy course for Doctor of Physical Therapy students. From a communal ofrenda (altar) to a celebration during a lecture to a reflective ceremony honoring body donors in the laboratory, students and faculty constructed a learning environment that incorporated spirituality and culture into anatomy in a thoughtful manner. Furthermore, by seeking student input on the design of this innovative educational experience, each of these activities aided in fostering a sense of cultural and spiritual belonging for Hispanic and Latine students who are historically marginalized in health professions, thereby promoting diversity, equity, inclusion, and belonging through a gross anatomy course.

RESUMEN

AIMS: To explore levers and barriers to providing culturally responsive care for general practice nurses (GPNs) using normalization process theory. DESIGN: A self-administered online cross-sectional survey. METHODS: A participatory co-designed adapted version of the normalization of complex interventions measure (NoMAD) validated tool was distributed to a convenience sample of GPNs between December 2022 and February 2023. The sample comprised of GPNs working in general practice services in Ireland (n = 122). Data were analysed using descriptive and analytical statistics (Pearson correlations) and principles of content analysis. This study was conducted and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). RESULTS: GPNs in this study indicated their familiarity with, acknowledged the importance of and were committed to, providing culturally responsive care. However, implementing culturally responsive care in daily practice was problematic due to insufficient education and training, scarcity of resources and supports and a lack of organizational leadership. Subsequently, GPNs experience difficulties adapting everyday practices to respond appropriately to the care needs of culturally and linguistically diverse (CaLD) patients. CONCLUSION: This analysis highlights the necessity of exploring the intricacies of factors that influence capabilities and capacity for providing culturally responsive care. Despite demonstrating awareness of the importance of providing nursing care that responds to the needs of CaLD patients, GPNs do not have full confidence or capacity to integrate culturally responsive care into their daily work practices. IMPACT: Using normalization process theory, this study elucidates for the first time how GPNs in Ireland make sense of, legitimize, enact and sustain culturally responsive care as a routine way of working. It illuminates the multitude of micro-level (individual), meso-level (organizational) and macro-level (structural) factors that require attention for normalizing culturally responsive care in general practice services. PATIENT OR PUBLIC CONTRIBUTION: The study question was identified in a participatory research prioritization for Irish research about migrant health that involved migrants in the process.

RESUMEN

AIM: To describe how clinicians provide culturally responsive care to culturally diverse people with kidney failure in haemodialysis centres. BACKGROUND: Culturally diverse individuals receiving in-centre maintenance haemodialysis have unique cultural needs. Unmet cultural needs can impair and profoundly affect their experiences. Given culturally responsive care has the potential to enhance the experiences of culturally diverse people, it is vital to understand how clinicians provide culturally responsive care. METHOD: A scoping review was undertaken using Arksey and OMalleys framework. Five databases: Medline and CINAHL Complete (EBSCO), PsycINFO, Embase (OVID) and ProQuest Theses and Dissertation databases were searched for research literature published in English between 1990 and 2023. Narrative synthesis was used to synthesise the data. RESULTS: From the 17,271 records screened, 17 papers reporting 14 studies met the inclusion criteria. Narrative synthesis revealed two themes: (i) communication enablers and barriers including linguistic differences, professional and lay interpreter use; and (ii) the importance of culture, which encompassed acknowledging cultural priorities, accommodating cultural food preferences and access to cultural training. CONCLUSION: While competing priorities associated with haemodialysis may be a challenge for clinicians, recognising the significance of cultural care needs and accommodating them in care is important. Demonstrating respect towards cultural diversity and providing person-centred care by facilitating the unique cultural needs of people with kidney failure in haemodialysis is imperative. RELEVANCE TO CLINICAL PRACTICE: Culturally responsive care is complex and multidimensional. Individuals' cultural care needs should be acknowledged, respected, and accommodated in care. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. The study protocol was registered in the Open Science Framework. https://osf.io/uv8g3.

RESUMEN

PROBLEM: Indigenous populations experience higher odds of poor maternal and infant health outcomes than non-Hispanic White mothers yet have lower odds of receiving adequate prenatal care. BACKGROUND: Many Indigenous communities rely on modern Western medical institutions to provide pregnancy related health care. These systems were not developed with or for Indigenous communities and often fail to meet the needs of Indigenous pregnant patients. Offering culturally congruent models of care may increase prenatal care utilization. QUESTION, HYPOTHESIS OR AIM: This paper used qualitative inquiry to identify Indigenous approaches to caring for pregnancy. METHODS: Our team conducted 16 semi-structured individual interviews and one group interview with a total of 19 respondents. To arrive at thematic categories, the research team engaged in a modified pile sorting technique. The final set of categories, along with sub-themes, descriptions and example quotes, were sent to interviewees for approval. FINDINGS: Ten Foundational Features of Indigenous Pregnancy Care were identified. These covered themes related to Indigenous cultural practices, relationships, Indigenous sovereignty, local Indigenous community, full spectrum care, wholistic care, birthing person's wisdom, power and autonomy, flexibility, historical trauma, and cultural awareness. DISCUSSION: Modern midwifery care delivered by Indigenous practitioners may partially bridge the cultural gap; however, intentional effort is needed to integrate Indigenous ways into medical doctor practice models and facilities. CONCLUSION: This paper identifies ten foundational features of Indigenous pregnancy care and demonstrates the importance of recognizing the effects of trauma and providing opportunities for healing, upholding sovereignty, and centering relationships when caring for Indigenous pregnancies.

Asunto(s)

RESUMEN

Scholars have developed culturally responsive frameworks and interventions to support educators as they aim to create inclusive and equitable classroom environments. Despite the number of frameworks on the topic, research on culturally responsive practices (CRPs) is limited by the lack of clear definitions or evidence on the effectiveness of in-classroom culturally responsive interventions. With the aim to understand which characteristics are important for in-classroom CRPs, this qualitative study explored students' perceptions of practices teachers use to respond to students' learning and cultural identities. We conducted 23 focus groups with 103 Black, Latine, and White students in middle and high school from two midwestern schools. After analyzing the data, we identified four overarching themes: (a) inclusive classroom instruction, (b) emotional safety in the classroom, (c) relational quality with the teachers, and (d) racism and other "isms" in the classroom. Students consistently commented on the importance of teacher support for students' emotional and academic well-being while also describing teachers that demeaned them or their peers, in turn, obstructing their learning. The findings hold promise to clarify and strengthen professional development CRP interventions as students offer insight about teacher cultural responsiveness and non-responsiveness.

Asunto(s)

RESUMEN

PURPOSE: Domestic violence manifests in unique ways in South Asian immigrant communities. Given the need to uphold family honor, formal help-seeking remains minimal within this community. Individuals experiencing victimization rely on friends and family members as informal sources of support. These friends and family members may also be bystanders who witness victimization. Therefore, the goal of this study was to examine differences in participant responses to an online interactive bystander intervention developed for South Asians. METHODS: To get community response to the intervention, B.R.A.K.E. The Cycle, a Qualtrics link with all the intervention scenarios was posted on 21 sub-Reddit pages. Screeners to ensure that participants were of South Asian origin, 18 or older and currently residing in the United States (US) were added. True to the study purpose, to examine differences across gender and generational position, we conducted descriptive analysis and chi-square tests. RESULTS: There were differences in scenarios by gender and immigration position. Some of the main findings point to the need to report domestic violence, seek help (formal or informal) as well as surprisingly some responses justified the use of force by a male partner. We discuss these in-depth by scenarios. DISCUSSION: This is the first study to examine differences in bystander preference and response to using an intervention that was developed specifically for the South Asian community. Social workers can utilize this intervention to create dialogue around domestic violence prevention and the role of bystander within the South Asian and potentially other immigrant communities.

Asunto(s)

Asunto(s)

RESUMEN

Despite increased risks associated with intimate partner violence (IPV) among Latinas, there is limited knowledge about interventions focused on preventing and responding to IPV among this group or the culturally relevant components of these interventions. To address this gap, we conducted a systematic review of IPV interventions for Latinas. To be included in the review, articles had to be peer-reviewed and available in English or Spanish; evaluate an IPV intervention conducted in the U.S. (including Puerto Rico); include Latinas; and quantitatively report at least one outcome. Our initial search yielded 3,344 unduplicated peer-reviewed articles, of which 20 met the inclusion criteria. The 20 resultant articles evaluated 14 unique interventions among 16 different study samples. Half of the studies focused on interventions that aimed to prevent IPV, whereas the other half focused on interventions that aimed to respond to IPV (i.e., provide services to those who had experienced or were experiencing IPV). Eight of the 14 interventions integrated culturally specific elements. While six studies were randomized controlled trials, most were pre-experimental in design. Interventions generally demonstrated positive outcomes on various measures. However, nine interventions reported mixed findings, emphasizing the complex factors influencing IPV among Latinas. Findings suggest the need for more mechanistic and nuanced research on potentially relevant culturally responsive content and approaches in IPV programming with Latinas, focusing on cultural strengths and structural challenges. Policies are needed to expand funding for innovative and rigorous IPV intervention research to further advance and strengthen existing practice options for Latina survivors.

RESUMEN

The authors report on their development of a National Advisory Board (NAB) to guide a funded project: Two in One: HIV + COVID-19 Screening and Testing Model. This project aimed to improve primary care practitioners' capacity to routinize HIV, PrEP/PEP, and COVID-19 vaccine screenings for all their patients while relying on culturally responsive communication with their minoritized patients. To approach their monumental research and education tasks, they created a NAB, drawing from the literature on advisory boards to (a) promote board member engagement and (b) progress successfully through the six stages suggested for successful advisory boards. A midpoint survey and final focus groups with NAB members indicated mixed levels of engagement, a sense of time and work being valued, and pride in the media and academic reach of the project. The authors offer considerations for others considering forming a NAB to guide primary care research and interventions.

Asunto(s)

RESUMEN

Evidence-based parenting interventions (EBPI) support children and families to promote resilience, address emotional and behavioral concerns, and prevent or address issues related to child maltreatment. Critiques of EBPIs include concerns about their relevance and effectiveness for diverse populations when they are implemented at population scale. Research methods that center racial equity and include community-based participatory approaches have the potential to address some of these concerns. The purpose of the present review was to document the extent to which methods associated with promoting racial equity in research have been used in studies that contribute to the evidence base for programs that meet evidentiary standards for a clearinghouse that was developed to support the Family First Prevention Services Act in the United States. We developed a coding system largely based on the Culturally Responsive Evaluation model. A sample of 47 papers that are part of the evidence base for ten in-home parent skill-based programs were reviewed and coded. Only three of 28 possible codes were observed to occur in over half of the studies (including race/ethnicity demographic characteristics, conducting measure reliability for the study sample, and including information on socioeconomic status). Although the overall presence of equity-informed methods was low, a positive trend was observed over time. This review highlights ways in which rigorous research can incorporate racial equity into the planning, design, execution, and interpretation and dissemination of programs of study. We posit that doing so improves the external validity of studies while maintaining high-quality research that can contribute to an evidence base.

Asunto(s)

RESUMEN

BACKGROUND: Since returning to in-person instruction after the emergence of COVID-19 schools have seen a dramatic increase in the number of students chronically absent, with data indicating a greater increase for low-income, Black, and Hispanic students. Given the role of school attendance in both promoting positive educational outcomes as well as providing students with physical and mental health supports, it is critical to identify ways to re-engage families in a manner that is culturally responsive and equitable. CONTRIBUTIONS TO THEORY: Current attendance interventions focus primarily on school-based academic and behavioral supports for students while excluding the family. Additionally, traditional family engagement models do not address the sociocultural realities of low-income and/or minoritized families. We present a strengths-based model of family engagement to support attendance. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Along with our model, we provide concrete supports that schools can provide, including example measurement items. In this way, schools and districts can self-assess as well as identify action steps to promote positive school-family partnerships for equitable family engagement. CONCLUSIONS: Without consistent attendance, schools cannot support positive educational outcomes nor provide important safety net services for students. Attendance is a family engagement challenge, which addressing holistically can reduce racial and socioeconomic educational and health disparities.

Asunto(s)

RESUMEN

Before formally introducing chemistry in schools, Africans practiced it as ethnochemistry as they lived in their ethnic groupings. To a large extent, it may be true for other ethnic groups and communities across the globe as well. This study aimed to document a drop from the ocean of ethnochemistry knowledge that people in Zambia practiced in the past and modern times to use such ethnochemistry knowledge to teach chemistry in ethnically responsive ways. Further, this study sought to raise the profile of indigenous cultural knowledge in the globalized world dominated by modernity. Ethnography research design was used including unstructured interviews for data collection. This study purposively selected twenty (20) research participants using snowball sampling. Results show that many relevant ethnochemistry practices in Zambia can be used to grow the national economy, enrich the teaching of Secondary School Chemistry to ethnically diverse students, and generate secondary school students' interest and better familiarity with Chemistry.

RESUMEN

Background: There is a lack of mindfulness instructors from underserved/underrepresented communities who have completed systematic mindfulness teacher-training programs to meet the growing demand for culturally responsive mindfulness training in those communities. Objectives: To investigate strategies for increasing the representation of Mindfulness-Based Stress Reduction (MBSR) teachers who serve historically underrepresented racial and ethnic groups. Methods: Conducted through 4 one-hour Zoom focus groups (n = 54; women = 74%), this study queried individuals with experience serving underrepresented racial and ethnic communities, and had mindfulness experience, on how to increase participation from underrepresented communities in mindfulness. Thematic analysis of transcripts of participant responses involved double-coding by three team members, supporting rigorous evaluation of the data. All respondents who expressed interest in participating enrolled (no dropout from study enrollment to participation in focus groups). Results: The study identified four key themes that illuminate challenges and essential adaptations for MBSR teacher training aimed at individuals serving historically underrepresented racial and ethnic groups. These themes include: (1) Cost and time commitment; (2) Trauma sensitivity; (3) Cultural Awareness; and (4) Diversity in teachers. Conclusion: Participants provided actionable recommendations poised to facilitate the expansion of MBSR into more diverse communities, emphasizing optimal benefits and effective communication of inherent healing strengths within these communities. The findings underscore the compelling interest among leaders in marginalized communities to extend the reach of MBSR through culturally responsive approaches. This involves guiding pertinent adjustments and encouraging greater involvement of underserved communities in MBSR teacher training programs.

RESUMEN

The experience of menopause is not "one size fits all." Instead, biologic, physiologic, and sociocultural factors strongly affect women's experiences of menopause symptoms and the ways in which they would like to manage their care. By providing culturally sensitive and patient-centered care, clinicians may be able to improve menopause experiences for all of their patients. However, a literature review revealed a lack of information about culturally responsive care for menopause. The first objective of this review is to discuss the ways in which sociocultural identity influences menopause care-seeking and management. The second objective is to introduce a framework of culturally responsive care for menopause.

Asunto(s)

RESUMEN

Forcibly displaced Muslims, including refugees, internally displaced persons, and asylum seekers who have fled their homes to escape violence, conflict, and persecution, often have inequitable access to quality mental health services, despite substantial trauma exposure and high rates of posttraumatic stress disorder (PTSD). Understanding factors associated with domains of perceived need (i.e., community, individual, friends/family) for culturally-responsive, trauma-focused mental health interventions among forcibly displaced Muslims may provide insight into those most likely to seek psychological treatment. A sample of 108 forcibly displaced Muslims endorsed moderate to high perceived need across all three domains for a trauma healing group tailored for Muslim refugees. PTSD severity related to perceived individual need, regardless of locus of displacement. Among participants with minimal PTSD symptoms, those who were externally displaced had higher perceived community and friends or family need than those who were internally displaced. Findings highlight a need for culturally responsive, trauma-focused mental health services to facilitate access to mental health care for forcibly displaced Muslims.

RESUMEN

BACKGROUND: The World Health Organization stresses the need for tailored COVID-19 models of vaccination to meet the needs of diverse populations and ultimately reach high rates of vaccination. However, little evidence exists on how COVID-19 models of vaccination operated in the novel context of the pandemic, how vulnerable populations, such as refugees, experience COVID-19 vaccination systems in high-income countries, and what lessons may be learned from vaccination efforts with vulnerable populations. To address this gap, this study explored COVID-19 vaccine delivery models available to newcomer refugees and immigrants, and refugee experiences across different COVID-19 vaccine delivery models in Calgary, Canada, and surrounding area in 2021 and 2022, to understand the barriers, strengths, and strategies of models to support access to COVID-19 vaccination for newcomer refugees and immigrants. METHODS: Researchers conducted structured interviews with Government Assisted Refugees (n = 39), and semi-structured interviews with Privately Sponsored Refugees (n = 6), private refugee sponsors (n = 3), and stakeholders involved in vaccination systems (n = 13) in 2022. Thematic analysis was conducted to draw out themes related to barriers, strengths, and strategies of vaccine delivery models and the intersections with patient experiences. RESULTS: Newcomer refugee and immigrant focused vaccination models and strategies were explored. They demonstrated how partnerships between organizations, multi-pronged approaches, and culturally responsive services were crucial to navigate ongoing and emergent factors, such as vaccine hesitancy, mandates, and other determinants of under-vaccination. Many vaccination models presented through interviews were not specific to refugees and included immigrants, temporary residents, ethnocultural community members, and other vulnerable populations in their design. CONCLUSIONS: Increasing COVID-19 vaccine uptake for newcomer refugees and immigrants, is complex and requires trust, ongoing information provision, and local partnerships to address ongoing and emerging factors. Three key policy implications were drawn. First, findings demonstrated the need for flexible funding to offer outreach, translation, cultural interpretation, and to meet the basic needs of patients prior to engaging in vaccinations. Second, the research showed that embedding culturally responsive strategies within services ensures community needs are met. Finally, collaborating with partners that reflect the diverse needs of communities is crucial for the success of any health efforts serving newcomers.