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Aim(s): To synthesise the literature about transgender and non‐binary people's experiences of cervical cancer screening and identify ways to improve screening. Background: Transgender people often face barriers to accessing health services including cervical screening, where transgender people have a lower uptake than cisgender women. Design: A scoping review was undertaken following the Arksey and O'Malley (2005) framework and the PRISMA‐ScR checklist. Following database searching of Medline via PubMed, Web of Science, Scopus and CINHAL, 23 papers published between 2008 and 2003 were included. Papers were included if they shared trans and non‐binary people's experiences of cervical screening and were written in English. There were no date or geographical data restrictions due to the paucity of research. Results: Transgender people experience barriers to cervical screening including gender dysphoria, a history of sexual trauma, and mistrust in health professionals or health services, which can result in having negative experiences of screening or avoiding screening. Health professionals can help to create a positive experience by informing themselves about best practices for trans+ health. Conclusion: Changes are required to improve transgender people's experiences and uptake of cervical screening. Improving medical education about trans health and updating health systems would help to combat issues discussed. Implications for the Profession and/or Patient Care: Having an understanding of the reasons why accessing health services can be more difficult for transgender people will help health professionals to provide appropriate care for transgender patients. This paper details this in the context of cervical cancer screening and can be applied to other areas of healthcare. Reporting Method: We have adhered to relevant EQUATOR guidelines and used the PRISMA‐ScR reporting method. No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Culturally and racially responsive practice continues to be a common challenge among Mental Health Practitioners (MHPs). To the authors' knowledge, this systematic review was the first to collate and synthesize clients' perspectives of MHPs' cultural and racial awareness and responsiveness from around the world. Original studies that were published between 2010 and 2021 reporting on qualitative data about clients' perspectives regarding MHPs' cultural-racial awareness and responsiveness were included in the review. The studies' key findings that addressed this review's question were synthesized and analyzed using reflexive thematic analysis. This review found 48 papers that met inclusion criteria, which represented the views of 652 clients across 10 countries. Three major themes and eight subthemes were established that concerned characteristics of the MHP, the client, and the therapeutic alliance. The results of this review indicate individual and systemic factors that influence mental health access for people from culturally and racially marginalized groups. Ongoing training of MHPs, increased racial and cultural representation among MHPs, inclusive physical settings, and reduced discrimination by MHPs are among the key findings and directions based on the results of this review. [ABSTRACT FROM AUTHOR]

Objective Design Setting Participants Results Conclusion There is a shortage of nurses, Aboriginal Health Practitioners, GPs and other staff in remote Australian health clinics. There is also high turnover of staff, leading to questions of ‘who’ is appropriate for remote First Nations practice? The aim of this paper was to identify the characteristics of staff who are likely to work well in remote First Nations settings, from the perspectives of remote health practitioners.This is a qualitative study involving content analysis of interviews.The study is conducted in and with 11 Aboriginal Community Controlled Health Services across northern and central Australia.Eighty‐four staff working in these clinics who spoke about staff qualities suited to remote practice.Participants identified a range of qualities desirable in remote practitioners, which were grouped into three topics: (1) professional qualifications and experience, including cultural skills; (2) ways of working, including holisitic approach, resilience, competence, and being a team player, approachable, flexible and hard‐working; and (3) specific community needs, namely the need for local First Nations staff, male practitioners and returning short‐term staff. The combination of experiences, ways of working, and fit to both the team and community were emphasised.Identifying the characteristics of staff who are likely to work well in these settings can inform recruitment strategies. This study found that a combination of professional qualifications, skills and experience as well as ways of working, individual characteristics and needs of communities are desirable for working in remote, First Nations settings. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, transgender, queer, and other sexual orientation and gender minority (LGBTQ+) youth and families have been under a social and legislative attack in the United States in recent years, marked by a stark increase in gender‐affirming care bans and religious rights cases before the U.S. Supreme Court. LGBTQ+ graduate students in mental health fields—particularly those who seek to work in family court settings—have specific needs that are often unmet in their educational and clinical training environments. Furthermore, the over‐representation of LGBTQ+ youth in the child welfare and juvenile justice systems necessitates specialized knowledge and skills that many clinicians and educators are currently lacking. This paper discusses the unique challenges facing LGBTQ+ graduate students and provides research‐based suggestions for professors, administrators, and supervising clinicians who seek to provide a holistic and humanizing educational experience that produces clinicians who can respond to the evolving needs of LGBTQ+ individuals in family court settings and beyond. Key points for the family court community: LGBTQ+ individuals experience unique stressors stemming from identity‐related stigma, prejudice, and discrimination, which can negatively affect their health and success in educational and work settings.Familiarity with this minority stress may motivate LGBTQ+ individuals to pursue careers in mental health, particularly in family court settings.LGBTQ+ graduate students often lack professors and clinical supervisors who are knowledgeable about working with LGBTQ+ individuals, leading to inadequate training and experiences that negatively impact their functioning across domains.Research highlights the need for more culturally responsive and affirming classroom and field training environments to support LGBTQ+ graduate mental health students who seek to make a difference in the legal system. [ABSTRACT FROM AUTHOR]

Simple Summary: This paper delves into the persistent issue of unequal access to medical imaging, with a particular focus on breast cancer screening and its impact on marginalized communities and racial/ethnic minorities. Central to our discussion is the role of scientific mobility among radiologists in fostering healthcare policy changes that promote diversity and cultural competence. We propose various strategies to bridge this gap, including cultural education, sensitivity training, and diversifying the radiology workforce. These measures aim to improve communication with diverse patient groups and reduce healthcare disparities. Additionally, we explore the challenges and advantages of teleradiology as a means to extend medical imaging services to underserved areas. In the context of artificial intelligence, we emphasize the critical need to validate algorithms across diverse populations to ensure unbiased and equitable healthcare outcomes. Overall, this paper underscores the importance of international collaboration in addressing global access barriers, presenting it as a key to mitigating disparities in medical imaging access and contributing to the pursuit of equitable healthcare. Access to medical imaging is pivotal in healthcare, playing a crucial role in the prevention, diagnosis, and management of diseases. However, disparities persist in this scenario, disproportionately affecting marginalized communities, racial and ethnic minorities, and individuals facing linguistic or cultural barriers. This paper critically assesses methods to mitigate these disparities, with a focus on breast cancer screening. We underscore scientific mobility as a vital tool for radiologists to advocate for healthcare policy changes: it not only enhances diversity and cultural competence within the radiology community but also fosters international cooperation and knowledge exchange among healthcare institutions. Efforts to ensure cultural competency among radiologists are discussed, including ongoing cultural education, sensitivity training, and workforce diversification. These initiatives are key to improving patient communication and reducing healthcare disparities. This paper also highlights the crucial role of policy changes and legislation in promoting equal access to essential screening services like mammography. We explore the challenges and potential of teleradiology in improving access to medical imaging in remote and underserved areas. In the era of artificial intelligence, this paper emphasizes the necessity of validating its models across a spectrum of populations to prevent bias and achieve equitable healthcare outcomes. Finally, the importance of international collaboration is illustrated, showcasing its role in sharing insights and strategies to overcome global access barriers in medical imaging. Overall, this paper offers a comprehensive overview of the challenges related to disparities in medical imaging access and proposes actionable strategies to address these challenges, aiming for equitable healthcare delivery. [ABSTRACT FROM AUTHOR]

This review aims to identify healthcare providers' (HCPs) experiences with issues related to the quality use of medicines among culturally and linguistically diverse (CALD) patients, the underlying factors, and the enablers of and barriers to providing culturally safe care to promote quality use of medicines. The searched databases were Scopus, Web of Science, Academic search complete, CINHAL-Plus, Google Scholar and PubMed/Medline. The initial search returned 643 articles, of which 14 papers were included. HCPs reported that CALD patients were more likely to face challenges in accessing treatment and sufficient information about treatment. According to the theoretical domains framework, determinants such as social influences due to cultural and religious factors, lack of appropriate resources about health information and cultural needs, lack of physical and psychological capabilities such as lack of knowledge and skills, and lack of motivation could impede HCPs' abilities to provide culturally safe care. Future interventions should deploy multilevel interventions, such as education, training, and organisation structural reforms. [ABSTRACT FROM AUTHOR]

Introduction: First Nations, Inuit, and Métis (FNIM) peoples experience systemic health disparities within Ontario's healthcare system. Learning health systems (LHS) is a rapidly growing interdisciplinary area with the potential to address these inequitable health outcomes through a comprehensive health system that draws on science, informatics, incentives, and culture for ongoing innovation and improvement. However, global literature is in its infancy with grounding theories and principles still emerging. In addition, there is inadequate information on LHS within Ontario's health care context. Methods: We conducted an environmental scan between January and April 2021 and again in June 2022 to identify existing frameworks, guidelines, and tools for designing, developing, implementing, and evaluating an LHS. Results: We found 37 relevant sources. This paper maps the literature and identifies gaps in knowledge based on five key pillars: (a) data and evidence‐driven, (b) patient‐centeredness, (c) system‐supported, (d) cultural competencies enabled, and (e) the learning health system. Conclusion: We provide recommendations for implementation accordingly. The literature on LHS provides a starting point to address the health disparities of FNIM peoples within the healthcare system but Indigenous community partnerships in LHS development and operation will be key to success. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this project was to examine the role of cultural differences in shaping the management of diabetes among Ethiopian immigrants living in Israel. Methods: A qualitative, in‐depth study involved semistructured interviews with 16 Ethiopian immigrants with diabetes living in Israel. The interviews were audio‐recorded, transcribed and translated into Hebrew, if necessary. The authors each identified themes in the responses and then through discussion came to a consensus about the most significant ones and how to categorize them. Results: A main theme was revealed structuring the participants' perception of diabetes: an oscillation between a familiar narrative, associated with traditional life in Ethiopia, and a foreign one. Five additional subthemes were also identified as an oscillation about the causes of disease, between collectivism and individualism, between accessible food and a balanced diet, between relying on bodily sensations and prescribed treatment and between culturally oriented and translated knowledge. Conclusion: The participants understood that they could be adversely affected both by the changes in lifestyle following their move and by adhering to the traditional norms. They agreed that professional liaisons and peers who have successfully managed their diabetes could help provide a bridge between the narratives. Summary statement: What is already known about this topic? Diabetes is a worldwide epidemic where immigrant populations are more likely to suffer from it.Language and cultural barriers pose a challenge to immigrants when accessing healthcare.Among immigrants, diabetes‐related distress is often accompanied by distress due to the challenges of immigration and acculturation.What this paper adds? Among Ethiopian immigrants, there exists a division between two main narratives about their illness and the way it is treated: the familiar and the foreign.Ethiopian communities play an important role in the treatment of an individual's illness, for better or worse.Translation alone is not sufficient to make language accessible; it must be combined with a medically‐culturally tailored approach.The implications of this paper: An understanding of the oscillations between narratives that Ethiopian immigrants experience is important for promoting person‐centred care for this population.During individual and group training, nurses should include Ethiopian immigrants who have successfully managed their diabetes.Nurse managers should ensure that their clinic has professional liaisons not only for translation but also for the provision of culture‐based health care. [ABSTRACT FROM AUTHOR]

While the health of and healthcare use by migrants has received significant scholarly and policy attention in Australia, current debates highlight that a critical examination of the theoretical underpinnings of these inquiries and responses is needed. We conducted a systematic review and critical interpretive synthesis (CIS) to critically examine how the policy and scholarly literature conceptualises migrants' interactions with and experiences of the Australian health system. Guided by PRISMA, we searched for literature without imposing any limits. We also searched key State and Federal Government websites for relevant policy documents. Our initially broad inclusion criteria became refined as the CIS progressed. We prioritised the likely relevance and theoretical contribution of the papers to our inquiry over methodological quality. The CIS of 104 papers revealed that the Australian scholarly literature and policy documents consistently homogenise and reduce migrants according to an assumed, (1) cultural identity, (2) linguistic affiliation, and/or (3) broad geographic origin. Based on these three critiques and drawing on the theoretical literature, we propose a synthesising argument on how the Australian literature could better conceptualise migrants' experiences of the Australian health system. We contend that both research and policy should explicitly recognise and engage with the multifaceted and shifting ways that migrants define themselves, generally, and during their encounters with destination country health systems. Engagement with this notion is necessary for also understanding how aspects of migrants' identities are dynamically co-constructed during their interactions with the health system. These understandings have implications for improving the design and implementation of policies and programs directed at improving the responsiveness of Australia's health system to the needs and expectations of migrant communities specifically, and destination countries broadly. [ABSTRACT FROM AUTHOR]

LGBTQ+ communities comprise 16 million individuals in the United States, yet this population is often rendered invisible within disaster policies. Bias in federal disaster response programmes, a lack of recognition of LGBTQ+ families, and the prevalence of faith‐based organisations in disaster relief services together heighten the risks that LGBTQ+ individuals face. This paper describes the ways in which this reality combines with the contextual vulnerability of LGBTQ+ communities, whereby existing inequalities and marginalisation are exacerbated during disasters and in their aftermath. As a result, the immediate trauma of a disaster, such as physical injury or the loss of loved ones or possessions, is compounded in multiple ways for LGBTQ+ individuals, making them less likely to benefit from disaster relief services. To address these inequalities, the paper concludes with a set of policy recommendations to inform prevention, mitigation, and recovery planning, as well as to reduce the impacts of disasters on LGBTQ+ individuals. [ABSTRACT FROM AUTHOR]

The delivery of effective healthcare entails the configuration and resourcing of health economies to address the burden of disease, including acute and chronic heart failure, that affects local populations. Increasing migration is leading to more multicultural and ethnically diverse societies worldwide, with migration research suggesting that minority populations are often subject to discrimination, socio‐economic disadvantage, and inequity of access to optimal clinical support. Within these contexts, the provision of person‐centred care requires medical and nursing staff to be aware of and become adept in navigating the nuances of cultural diversity, and how that can impact some individuals and families entrusted to their care. This paper will examine current evidence, provide practical guidance, and signpost professionals on developing cultural competence within the setting of patients with advanced heart failure who may benefit from palliative care. [ABSTRACT FROM AUTHOR]

Relationship interventions, including healthy relationship education, couple therapy, and dyadic approaches to treating mental and physical health issues, hold promise for promoting relationship and individual health among sexual and gender minority (SGM) populations. Because SGM couples live within a context of societal stigma against their minority identities and relationships, they are likely to be best served by targeted, culturally sensitive relationship interventions that are affirming, free of hetero‐ and cis‐normativity, and address the unique stigma‐based challenges that they face. Therefore, a key goal for the field today is to conduct research evaluating and refining newly developed relationship interventions designed specifically for SGM couples. In this paper, we offer recommendations for effectively recruiting and retaining large, diverse samples of SGM couples for clinical trials of tailored relationship interventions, grounded in guidelines for psychological practice and conducting research with SGM populations. Throughout, we offer examples and lessons learned from our experiences conducting clinical trials of tailored SGM relationship education programs. We encourage the use of recruitment and retention strategies that involve members of the target SGM community from the outset, are informed by knowledge about SGM individuals and relationships, use currently preferred language for individual identities and relationships, attend to issues of confidentiality regarding sexual/gender identity or relationship involvement, and adhere to the norms of the particular community and recruitment venue. [ABSTRACT FROM AUTHOR]

This paper examines the symbolism of the cultural image Sun Wukong (the Monkey King), a Chinese legendary hero, and how it influenced an eight‐year‐old boy's psychic development. Through an analysis of Sun Wukong's life from his birth to attaining Buddhahood, a three‐phase healing process is identified in Sun Wukong's tale and the psychotherapeutic process: "naming and initiating," "nurturing and taming," and "transforming and transcending," proposed by Dr. Heyong Shen. Sandplay visually highlighted these key clinical changes in conscious awareness and developmental behaviour influencing the boy's individuation process. Images found either in cultural traditions or spontaneously emerging from the unconscious in individuals are of significance in human life, offering pathways to psychic healing and development. Further, myths and cultural resources used in clinical work demonstrate that having cultural competency is invaluable in Jungian analysis. Pathogenic and health‐maintenance factors of culture can be explored in future clinical practice and research. [ABSTRACT FROM AUTHOR]

This paper will discuss disability as a neglected aspect of cultural competency in the diversity literature and among social work colleagues. It identifies some of the unconscious intrapsychic and sociocultural concepts that contribute to the avoidance of and malaise around people with disabilities in the community at large as well as in the social work community. Personal and cultural aspects of unanalyzed countertransference and transference are examined. The impact of those internalized sociocultural concepts and projections among colleagues will also be explored. Through anecdote, parallel processing, and the literature, it will be shown how some of the transference issues toward the disabled clinician can become assets in the therapeutic alliance, and how colleagues can become more at ease with differently abled peers particularly through the use of an embodied sense of compassion, greater self-awareness and wisdom. [ABSTRACT FROM AUTHOR]

Culture can broadly be defined as "the values, norms, and assumptions that guide human action" (Wilson 2008, 14). In contrast with the broader civilian society, the experiences and environments within the military community create a unique cultural subset. The United States armed forces are unified by their primary mission to provide external defense, security, and protection, and each branch (Army, Navy, Marine Corp, Air Force, Coast Guard and National Guard) shares a unique core set of values and norms. Because this culture is so complex and unique, it can sometimes be a challenge for many civilian professionals to work with this community, so having a strong competency in understanding military culture, as well as knowledge of specific conflicts and wars, one is not only able to begin to understand the lives and personalities of our soldiers but also able to recognize that this culture aids in survival. This paper will demonstrate and discuss the importance of competency in military culture when practicing music therapy or other interdisciplinary approaches within the process of group therapy with veterans. Other topics covered will include: issues of social transmission as it relates to transitioning into civilian society; the importance of being a witness to veterans' stories; and facilitators' ethical responsibilities when working with this population. [ABSTRACT FROM AUTHOR]

Summary: This study reviews two different types of frontline social services for unaccompanied young adult refugees participating in an intensive Social Support Programme implemented in 2016–2019 by a local municipality. More specifically, the study took a phenomenological research approach to review the impact of intensive case management and specialised educational/occupational orientation services on young refugees' capabilities and agency to reach aspired life goals. The capability approach has been applied as a theoretical framework for identifying opportunities and challenges in this regard. The paper covers a mixed-method design that includes qualitative and quantitative data. The qualitative data are drawn from 42 in-depth interviews with 24 young refugees and one interview and three focus group discussions with 10 service providers. The article also includes a limited amount of longitudinal statistics on the aspirations of 31 young refugees upon entering and exiting the support programme. Findings: This article shows theoretical and empirical evidence for utilising the capability approach to review social services for young refugees. Findings suggest that social workers and refugees face intersecting structural and interpersonal tensions that counteract with the expansion of young refugees' capabilities and agency to reach their aspired life goals. Specific strategies are suggested to diminish described challenges. Applications: Social work with unaccompanied young adult refugees should shift its attention from integrating these young individuals into the dominant social order, to prioritising their human development. [ABSTRACT FROM AUTHOR]

The health of Indigenous peoples across Canada continues to be significantly impacted by experiences of racism when seeking healthcare. Implementing cultural safety was identified by the Truth and Reconciliation Commission of Canada as a critical way to mitigate these negative health consequences. This systematic review aims to outline cultural safety and its associated derivatives in academia, what cultural safety is, and why it is important in the context of indigenous healthcare. A systematic search of PubMed was carried out refining searches to Canadian contexts, published after December of 2015, and limited to peer-reviewed reviews and systematic reviews. A thematic review of the articles identified four central ideas of importance regarding the information presented in the papers; definitions of cultural safety and associated derivatives, the importance of including culture in healthcare, recommendations to healthcare settings, and evaluation methods of cultural safety initiatives. It is clear that there is a need for an explicit and consistent definition of cultural safety with the inclusion of Indigenous peoples in the creation of this definition. To determine effectiveness, gaps and areas for improvement, evaluation methods inclusive of the unique Indigenous worldviews are imperative to develop culturally safe healthcare practices and institutions. [ABSTRACT FROM AUTHOR]

Context: Healthcare programs innovate to improve teaching of Indigenous realities to nonindigenous undergraduates. However, there are no validated French-language scales to measure the impact of those interventions on prejudices toward Indigenous peoples. Goal: This paper aims at presenting the French translation and preliminary validation of the Old-Fashioned and Modern Prejudiced Attitudes Toward Aboriginals Scales (O-PATAS and M-PATAS). Methods: Thirty medical students completed the original version (OV) and translated (TV) and 78 additional students completed the TV. Cronbach’s alpha (α) andMcDonald’s omega(ω) were used to assess the reliability of the scales. Concurrent validity was assessed with intra-class correlations and paired t-tests comparing OV and TV scores. Construct validity was explored with a two-factor factorial analysis. Results: Fidelity of the TV scales is acceptable and comparable to the ones found in the OV (α≥0.81, ω≥0.85). The absence of difference between the OV and TV scores, and the strong intraclass correlation between the total scores in both languages (r ≥0.80, p<0.001) support concurrent validity of the TV. The factor analysis did not reproduce the 2-factors structure expected, likely due to a lack of power. Conclusion: This study reports a TV of the O-PATAS and M-PATAS with similar psychometric properties to their OV. A use of these versions at a larger scale will allow to assess their dimensionalities in French Canadian settings. [ABSTRACT FROM AUTHOR]

Summary: Interdisciplinary contributions to social work have supported the profession's development as a helping profession. Indeed, drawing from other disciplines has been a way to hone intervention approaches. This article analyzes the history of social work's use of anthropological theory about "culture" in order to critically examine the profession's positioning as a "recipient" of theories. At a time when evidence-based practice is a dominant ideal, this paper offers an opportunity to step back and interrogate a key concept, culture, that is often evoked as interventions are tailored for various populations. Findings: While social work has substantially debated and revised how it approaches culture difference, the core conceptualization of culture as a relatively static set of shared values and traits remains ill-suited to the complex negotiation of diversity in social work practice. The limitations of the culture concept are symptomatic of an exchange relationship with anthropology that positions social work practitioners primarily as recipients of concepts, rather than as interlocutors. Application: By treating intervention as an opportunity for theory revision, anthropologists and social workers can better account for the hybridity, change, and contestation of difference in social work practice. As the social work profession expands globally, a more dialogical engagement with anthropological theories about culture and other key concepts may prove fruitful. [ABSTRACT FROM AUTHOR]

Summary: An evolution of thought and practice regarding the relationship of racism to well-being, healing, and trauma continues within social work and the helping professions. Additionally, empirical research on colorism as a key dimension of racism suggests that colorism negatively impacts the psychological and physical well-being of African Americans. However, few studies have examined well-being among African Americans in the context of historical trauma, through the lens of colorism. In this paper, the intersectionality of colorism and historical trauma is explored to inform culturally responsive social work education, practice, and research regarding African American well-being. It is the first step toward developing a colorist-historical trauma framework. The impact of colorism as a function of historical trauma response transmission among African Americans is presented. Findings: Advances in culturally responsive practice in social work address the impact of social determinants of health, such as racism. However, the impact of colorism within systemic racism is often unacknowledged. The authors assert that social work practice must attune to the differentiated socioemotional, political, and economic needs that exist among African Americans due to the impact of colorism and historical trauma. An intersectional lens, such as the colorist-historical trauma framework, is essential for culturally responsive practice. Applications: The colorist-historical trauma framework contributes to the professional social work discourse aimed at strengthening effective micro-, meso-, and macro-level practice with African Americans for well-being. Implications for social work practice, research, and education are presented. [ABSTRACT FROM AUTHOR]

Issue addressed: We currently know very little about the attitudes of young adult Australians from migrant backgrounds towards health service utilisation. This qualitative study aimed to explore their experiences of accessing health services and identify barriers and facilitators to health service utilisation. Methods: Semi‐structured interviews were conducted with young people aged between 18‐24 and living in Greater Western Sydney. Interview questions focused on facilitators and barriers to health service access. NVivo 11 was used to facilitate thematic analysis of the interviews. Results: Twenty‐five young adults between 18‐24 years from migrant backgrounds participated. Twenty semi‐structured individual interviews and one group interview with five participants were conducted. Analysis identified themes relating to health literacy, cultural factors and quality of care and showed the importance of families, the education system and service outreach in facilitating access. Conclusions: Findings indicate that more effective delivery of health services information in education, positive engagement between service‐providers and service‐users, and age‐appropriate, culturally considerate health promotion strategies are needed to overcome barriers to health services accessibility. So what?: The results show the importance of families and communities, the education system and health service outreach in facilitating health service access for young people from migrant backgrounds. The paper highlights the need for more effective health promotion strategies targeting this group, their families and communities. To increase access, health promotion practitioners need to actively reach out to families and young people from migrant backgrounds through education and community‐relevant forums. [ABSTRACT FROM AUTHOR]

Responsible gambling codes of practice and guidelines exist in most regulated gambling environments around the world, however, the extent to which they acknowledge and engage with concepts of cultural and linguistic diversity is significantly lacking, and in many cases, completely absent. If ‘responsible gambling’ is defined as the provision of safe, socially responsible and supportive gambling environments where the potential for harm is minimised, then acknowledgement and engagement with cultural diversity is critical to ‘responsible gambling’ practice. This paper will relate to the Australian context and analyse the extent to which state and territory responsible gambling codes of practice and legislation engage with concepts of cultural diversity. Cultural competency frameworks and strategies have developed internationally in response to the research evidence suggesting the need for culturally responsive services and practices to improve outcomes for culturally diverse groups in society. Cultural competency frameworks suggest that in order for a ‘system’ to be culturally competent it begins at the systemic level, that is, recognising that culturally competent behaviour and practice needs to have policy objectives, procedural requirements, monitoring mechanisms and resource capacity to be achieved. This paper will present a framework for culturally competent responsible gambling practice in Australia that can be implemented at the systemic level. Without a culturally competent ‘system’ the ability of people from culturally diverse backgrounds to make informed choices with respect to their gambling and to minimise harm from gambling in culturally diverse communities is greatly reduced. [ABSTRACT FROM PUBLISHER]

There is abundant literature that teaches social work graduates to be culturally competent and critically reflective on issues of cultural diversity. However, it is evident that many competency based approaches do not effectively address issues of privilege, power and diversity. Such approaches can fail to challenge entrenched and/or unconscious biases concerning other cultures. This paper argues we need to move away from over-prioritizing the teaching and use of competency based models for dealing with diversity in disciplines such as Social Work. Using Sara Ahmed's work on diversity and critical reflection, we present the findings from a survey of social work students. The positive news is that students' reflections in critical essays and their responses to the learnings they achieved from a unit on race, suggested they were becoming more aware of how privilege and power worked in everyday interactions as well as professional interactions. The other side of the coin was their understanding of the social, political and ethical grounding of values was limited. Students tended to focus more on declaring their allegiance to social work values of 'honesty, integrity or social justice' to the point they were mere declarations or saying which become substitutes for actions. [ABSTRACT FROM AUTHOR]

This paper will discuss the efforts of one school-university partnership in providing individualized, high quality professional development in the form of a 9-credit, graduate course certificate program in culturally proficient leadership to in-service teachers across 3 schools in the university's PDS network. The researchers document their collaborative efforts in(l) developing the certificate program; (2) designing and implementing the graduate course work; and (3) using culturally responsive, anti-racist leadership tools to promote teacher awareness and critical reflection of issues related to equity, access, and socialjustice teaching (National Association for Professional Development Schools). Reflections on program implementation and student outcomes are also shared. [ABSTRACT FROM AUTHOR]

Introduction. The current globalized world expresses important challenges for nursing care, so that the suffering is recognized and relieved taking into account the patient’s culture. Objective. To describe the fin¬dings of research into experiences of hospital nurses about compassion and care to culturally diverse people. Method. Systematic review. The searches were conducted in: Web of Science, CINAHL, OVID Nursing, Evidence Based Medicine Reviews, Medline (PubMed), PsycARTICLES, Virtual Health Library, CUIDEN Plus, TripDatabase, Epistemonikos and Descubridor de la Universidad Nacional de Colombia. A total of 83 searches were conducted with MeSH, DeCS and natural language terms, including research or review articles with qualitative approaches, published in Spanish, English or Portuguese. Results. 42 papers were included, with a predominance of phenomenological, ethnographic and grounded theory designs. These reflect the link between compassion and care for culturally diverse people, developed through three themes, and 14 sub-themes. Conclusion. The experiences of nurses and patients are diverse, but the connection between compassion and cultural competence in nursing care in the clinical setting is visible. This systematization shows educational and training needs, demonstrates the tensions between personal, professional and institutional culture. [ABSTRACT FROM AUTHOR]

Background: Increasing diversity in Australia requires healthcare practitioners to consider the cultural, linguistic, religious, sexual and racial/ethnic characteristics of service users as integral components of healthcare delivery. This highlights the need for culturally appropriate communication and care. Indeed the Australian Government in various policies mandates culturally responsive communication. Therefore this paper aims to provide a brief overview of Australian healthcare literature exploring the components; prevalence and effects of this style of communication in healthcare.Methods: A rapid review was conducted using the knowledge to action evidence summary approach. Articles included in the review were those reporting on the components, prevalence and outcomes of culturally responsive communication in Australian healthcare, published in English between 2008 and 2018. Articles were reviewed using reliable critical appraisal procedures.Results: Twenty- six articles were included in the final review (23 qualitative studies; 2 systematic reviews; 1 mixed methods study). The literature indicates knowledge of the positive effects of culturally responsive communication in healthcare. It also highlights the disparity between the perceptions of healthcare practitioners and services users over the existence and components of culturally responsive communication in healthcare. The review identified a limited use of this style of communication, but rather a focus on barriers to culturally appropriate care, lacking an awareness of the importance of culturally responsive communication in this care.Conclusion: While literature suggests the importance and positive effects of culturally responsive communication, evidence suggests inconsistent implementation of this style of communication within Australian healthcare settings. This has implications for the outcomes of healthcare for the diverse population in Australia. [ABSTRACT FROM AUTHOR]

Cultural competence refers to our ability to understand, engage, and treat patients from diverse backgrounds or belief systems different from our own. Although addressing culture and cultural difference as part of diversity is important, it is also critical to consider how systemic and economic forces influence the patient's presenting problem and clinical interactions. Summarizing research on cultural competence, attachment, and inequality, this paper reconsiders diversity considerations by discussing how structural inequities disrupt one's ability to trust others interpersonally and across cultural difference. Psychotherapy from this point of view is a relationship that attempts to address the effects of inequality at an individual level by repairing trust and using that trust to work toward change. To illustrate this perspective, the author presents a case of a Puerto Rican migrant whose developmental and family history was impacted by colonial, racial, cultural, and socioeconomic inequality. [ABSTRACT FROM AUTHOR]

Although the existence of multi-ethnic and pluricultural societies is not new, the perspective of equality and recognition has remained on paper, without permeating citizen attitudes. Migrations and globalization have led to greater international awareness of interculturality, facing challenges at the educational and health care levels, generating regulations in relation to protection and respect for diversity. The emergence and development of the concept of interculturality in education allows us to reflect on its importance and the role it has been given in health and nursing training. It is evident that institutional efforts have been insufficient, as the coloniality of being and knowledge continues to prevail, since Anglo-Saxon and European positions are still assumed that are in tension with the Latin American context. Nursing is still on the way to forging interculturality, it is important to include the subject in the training of professionals, which contributes to the construction of selfcare. The proposal of this article is to approach the notion of interculturality from education and health, to re-think epistemologically another look at the training of professionals in nursing. [ABSTRACT FROM AUTHOR]

Objective: Despite the recognition that refugees should have equitable access to healthcare services, this presents considerable challenges, particularly in rural and regional areas. Because general practitioners (GPs) are critical to resettlement for refugees and play a crucial role in understanding their specific health and social issues, it is important to know more about the needs of GPs. Methods: In-depth interviews were conducted with 14 GPs and GP registrars who trained with a New South Wales regional training provider with the aim of assessing the needs and attitudes of GPs in treating refugees and the perceived effect that refugees have on their practice. Results: The interviews, while acknowledging well-recognised issues such as language and culture, also highlighted particular issues for rural and regional areas, such as employment and community support. International medical graduates identified with resettlement problems faced by refugees and are a potential resource for these patients. A need for greater information for GPs regarding services available to help manage refugees in rural and regional areas and greater access to those services was demonstrated. Conclusions: Issues such as time, costs, language and culture were recognised as challenges in providing services for refugees. GPs highlighted particular issues for rural and regional areas in addressing refugee health, such as finding jobs, problems with isolation and the effect of lack of anonymity in such communities. These social factors have implications for the health of the refugees, especially psychological health, which is also challenged by poor resources. What is known about the topic?: Providing refugees equitable access to healthcare services presents considerable challenges, particularly in rural and regional areas. Time, language and culture are commonly reported barriers in providing services for this population group. What does this paper add?: There are particular issues for rural and regional areas in addressing refugee health, including finding jobs, problems with isolation and the effect of lack of anonymity in rural communities. These social factors have implications for the health of refugees, especially psychological health, which is also challenged by a paucity of services. The findings of this study suggest that international medical graduate doctors identified with resettlement problems faced by refugees and may be an important resource for these patients. This study highlights the awareness, empathy and positive attitudes of GPs in regional and rural areas in their approach to treating patients with a refugee background. What are the implications for practitioners?: International medical graduates often identify with resettlement problems faced by refugees and are an important resource for these patients. A need for greater information for GPs regarding services available to help manage refugees in rural and regional areas and greater access to those services was demonstrated. [ABSTRACT FROM AUTHOR]

This paper presents a pedagogical framework for teaching cross-cultural clinical ethics. The approach, offered at the intersection of anthropology and bioethics, is innovative in that it takes on the 'social sciences versus bioethics' debate that has been ongoing in North America for three decades. The argument is made that this debate is flawed on both sides and, moreover, that the application of cross-cultural thinking to clinical ethics requires using the tools of the social sciences (such as the critique of the universality of the Euro-American construct of 'autonomy') within (rather than in opposition to) a principles-based framework for clinical ethics. This paper introduces the curriculum and provides guidelines for how to teach cross-cultural clinical ethics. The learning points that are introduced emphasize culture in its relation to power and underscore the importance of viewing both biomedicine and bioethics as culturally constructed. [ABSTRACT FROM AUTHOR]

Australia's research and knowledge base on cultural competency has been slow to develop. To help address this gap, the New South Wales (NSW) Department of Family and Community Services (FaCS) funded a large scale study in this area, which included a detailed literature review. The paper reports on key findings from that review including that collectivist values are at odds with 'child-centred' philosophies of child protection; there is an inherent tension between the right to equal protection from harm and the right for respect in cultural differences in parenting and family functioning ('cultural absolutism' versus 'cultural relativism'); there are factors that uniquely characterise 'the migrant context' (especially lack of awareness of child protection laws and systems, economic disadvantage, and fear of authority); and that cultural competency is separable from cultural awareness and cultural sensitivity, and also different from addressing language barriers. However, in reviewing the literature it became apparent that the specific roles and responsibilities of workers, agencies, and systems were not clearly delineated. Thus this paper also aimed to address this unmet need. Identifying their unique roles and responsibilities can help ensure that the delivery of child protection services are efficiently and effectively mobilised from both the 'top' and 'bottom' to benefit all ethnic minority families. Moreover, any implementation of cultural competency needs to move beyond the emphasis on culture and acknowledge the dimensions of inferiority and oppression to truly promote value for diversity and protect ethnic minority children from the dangers of systematic disadvantage that institutional racism represents. [ABSTRACT FROM AUTHOR]

Background: Cultural immersion programs are increasingly offered to medical and health science students in an effort to provide experiential learning opportunities that focus on 'the self' as well as 'the other'. Immersion programs encourage self-reflection on attitudes towards cultural differences, provide opportunities to build relationships and work with community members, and allow students to apply knowledge and skills learned in training programs in a supervised practice setting. The aim of this paper is to describe midwifery students' reflections on a remote Aboriginal clinical placement that has been offered at a Western Australian university since 2010. Methods: Interviews were conducted over a period of 15 months with the first seven participants who completed the program. At the time of interview, four participants were in the final year of their undergraduate degree and three were practicing midwives. In addition, access was given to a detailed journal kept by one participant during the placement. Interviews also were conducted with midwifery staff at the university and practice setting, although the focus of this paper is upon the student experience. Results: Student selection, preparation and learning experiences as well as implications of the placement for midwifery practice are described. The remote clinical placement was highly valued by all students and recommended to others as a profound learning experience. Highlights centred on connections made with community members and cultural knowledge learned experientially, while challenges included geographic and professional isolation and the complexities of health care delivery in remote settings, especially to pregnant and birthing Aboriginal women. All students recognised the transferability of the knowledge and skills acquired to urban settings, and some had already incorporated these learnings into clinical practice. Conclusions: Cultural immersion programs have the potential to provide students with rich learning experiences that cannot be acquired in classroom settings. In Aboriginal communities on the Ngaanyatjarra Lands students gained valuable insights into the impact of isolation on health service delivery, the extent and strength of cultural traditions in the region, and a heightened awareness of the difficulties encountered by pregnant and birthing Aboriginal women in remote locations. [ABSTRACT FROM AUTHOR]

Research linking reading literary fiction to empathy supports health humanities programs in which reflective writing accompanies close readings of texts, both to explore principles of storytelling (narrative arc and concrete language) and to promote an examination of biases in care. Little attention has been paid to the possible contribution of guided fiction-writing in health humanities curricula toward enhancing cultural competence among health professionals, both clinical and community-based. Through an analysis of the short story “Pie Dance” by Molly Giles, juxtaposed with descriptions of specific writing exercises, this paper explains how the demands of writing fiction promote cultural competency. [ABSTRACT FROM AUTHOR]

Summary Cultural competence has commanded respectable attention since its introduction in cross-cultural discourse. Cultural competence has been presented as a framework capable of promoting culturally sensitive practice and for training cross-cultural workers. However, a smorgasbord of definitions and conceptualizations has generated intense controversy around the construct, with many questioning its relevance or ability to address structural problems. Disenchantment has led to calls to jettison and replace cultural competence with cultural humility. This paper presents a critical reflection on cultural competence and cultural humility, including critiquing the critiques of cultural competence. Findings A critically reflective analysis suggests that semantic appeal does not necessarily give cultural humility a utilitarian edge over the construct it seeks to supplant. Cultural humility appears not to add more value to social work practice than cultural competence. From a social work perspective, cultural humility is essentially a repackaging of anti-oppressive practice; the fundamental ideas underpinning cultural humility have previously been developed and are foundational principles of anti-oppressive social work practice and education. Critical analysis also reveals that many of the critiques of cultural competence lack analytical rigour. Applications Deep-level theoretical analyses can lead to innovative perspectives that allow for critical re-examination of extant methodological approaches and promote culturally empowering social work practices in our super-diverse, postmodern world. Rather than dismissing long-standing, potentially effective theoretical and practice tools with happy abandon, adapting them in light of current developments would help move social work to a new, enlightened level of relevance in working with diversity and difference. [ABSTRACT FROM AUTHOR]

This paper investigates how courses and topics about diversity and inclusion are being integrated into the Library and Information Science (LIS) curriculum among selected library schools in the member countries of the Association of Southeast Asian Nations (ASEAN). It also examines the characteristics and roles of culturally responsive LIS faculty in teaching cultural diversity-related issues. In addition, it discusses the approaches, challenges and barriers in advancing cultural competencies of LIS graduates. This study used a mix of qualitative survey research and content analysis of LIS course offerings. Findings show that ASEAN LIS education is inadequate in terms of integration of diversity and inclusion in core courses. Teaching cultural competence and diversity is a lifelong learning process of understanding and appreciating cultural similarities and differences. LIS students may develop their cultural competence through personal experience by engaging in library internship with all library types, community immersion and collaborative group work with diverse members. Infusing diversity-related issues and the principle of inclusion into the LIS curriculum is not easy, yet important and necessary. [ABSTRACT FROM AUTHOR]

Background: There is an important need to evaluate whether rehabilitation services effectively address the needs of minority culture populations with North America's increasingly diverse population. The objective of this paper was therefore to review and assess the state of knowledge of barriers and facilitators to cultural competence in rehabilitation services.Method: Our scoping review focused on cultural competence in rehabilitation services. Rehabilitation services included in this review were: audiology, speech-language pathology, physiotherapy, and occupational therapy. A search strategy was developed to identify relevant articles published from inception of databases until April 2015. Titles and abstracts were screened by two independent reviewers according to specific eligibility criteria with the use of a liberal-accelerated approach. Full-text articles meeting inclusion criteria were then screened. Key study characteristics were abstracted by the first reviewer, and findings were verified by the second reviewer.Results: After duplicates were removed, 4303 citations were screened. Included articles suggest that studies on cultural competence occur most frequently in occupational therapy (n = 17), followed by speech language pathology (n = 11), physiotherapy (n = 6), and finally audiology (n = 1). Primary barriers in rehabilitation services include language barriers, limited resources, and cultural barriers. Primary facilitators include cultural awareness amongst practitioners, cultural awareness in services, and explanations of health care systems.Conclusion: To our knowledge, this review is the first to summarize barriers and facilitators to cultural competence in rehabilitation fields. Insufficient studies were found to draw any conclusions with regards to audiological services. Minimal perspectives based on patient/caregiver experiences in all rehabilitation fields underscore a research gap. Future studies should aim to explore both patient/caregiver and practitioner perspectives as such data can help inform culturally competent practices. [ABSTRACT FROM AUTHOR]

Background: Indigenous representation is essential to ensure the health workforce is culturally capable and safe for Indigenous patients. However, Indigenous Peoples remain underrepresented in tertiary education and the health workforce. Aim: This aim of this paper is to offer an unmediated, Aboriginal nurse's perspective, on the experience, barriers and challenges of undertaking a Bachelor of Nursing degree. Design: Referenced reflection. Results: Education providers must be culturally capable themselves before teaching Indigenous content and facilitating sensitive classroom discussions. Financial, social and educational support is crucial to equip Indigenous students for tertiary study. Conclusion: To retain Indigenous students and contribute to a culturally capable workforce, it is imperative to listen and respond to Indigenous Peoples voices to shape learning experiences and support. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to outline current efforts in the USA to build and create safe and affirming housing for lesbian, gay, bisexual, and transgender (LGBT) older adults.Design/methodology/approach The authors approach this task through a survey of existing publicly available information about LGBT-specific housing projects, as well as literature on methods to make existing housing welcoming to LGBT elders.Findings The authors find that there are a number of LGBT-specific housing options currently available, and many more in the development phase. Additionally, given the large number of LGBT older adults in the USA and the relatively small number of LGBT-specific housing units, the authors also discuss other interventions that can be applied to create safe housing. The practical implication of this research is to provide advocates for LGBT people with a sense of what is happening in the USA, as well as some guidance on how to replicate LGBT affirming housing models in other contexts.Originality/value To the authors’ knowledge, this is the only and most comprehensive survey of LGBT-specific elder housing in the USA to be published in the academic literature. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to provide an annotated bibliography of literature on diversity initiatives for 2010-2015 in academic libraries, both in USA and internationally. It aims to help librarians interested in fostering a welcoming and supporting environment for all individuals and engaging library community in discussions about diversity. Design/methodology/approach: The authors conducted literature review using EBSCOhost multidisciplinary databases and Google Scholar, using the terms "divers*" and "academic librar*" and limiting search results to 2010-2015 dates. Findings: The literature reviewed in this annotated bibliography is a solid start to assist librarians with diversity initiatives from planning collections to wider organization planning purposes. Originality/value: No other annotated bibliography currently exists for those interested in conducting vital work of ensuring a respectful and inclusive library environment. [ABSTRACT FROM AUTHOR]

HIV has created health and socio-economic challenges for Caribbean societies. The HIV prevalence in the Caribbean is high and rates second to that of sub-Saharan Africa. One of the main barriers affecting interventions in the Caribbean is the pervasiveness of stigma and discrimination against persons living with HIV (PLHIV) and marginalized groups. This paper will focus on how theory can be used by social workers, including social workers in the Caribbean, in their work with PLHIV. Initiatives taken within social work education to prepare social workers to adequately address HIV-related stigma and discrimination are discussed. [ABSTRACT FROM AUTHOR]

Evidence suggests that disparities in adult immunization (AI) rates are growing. Providers need adequate patient resources and information about successful interventions to help them engage in effective practices to reduce AI disparities. The primary purposes of this paper were to review and summarize the evidence base regarding interventions to reduce AI disparities and to scan for relevant resources that could support providers in their AI efforts to specifically target disparities. First, building on a literature review conducted by the U.S. Centers for Disease Control and Prevention, we searched the peer-reviewed literature to identify articles that either discussed interventions to reduce AI disparities or provided reasons and associations for disparities. We scanned the articles and conducted an internet search to identify tools and resources to support efforts to improve AI rates. We limited both searches to resources that addressed influenza, pneumococcal, hepatitis B, Tdap, and/or herpes zoster vaccinations. We found that most articles characterized AI disparities, but several discussed strategies for reducing AI disparities, including practice-based changes, communication and health literacy approaches, and partnering with community-based organizations. The resources we identified were largely fact sheets and handouts for patients and journal articles for providers. Most resources pertain to influenza vaccination and Spanish was the most prevalent language after English. More evaluation is needed to assess the health literacy levels of the materials. We conclude that additional research is needed to identify effective ways to reduce AI disparities and more resources are needed to support providers in their efforts. We recommend identifying best practices of high performers, further reviewing the appropriateness and usefulness of available resources, and prioritizing which gaps should be addressed. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare organisations serve clients from diverse Indigenous and other ethnic and racial groups on a daily basis, and require appropriate client-centred systems and services for provision of optimal healthcare. Despite advocacy for systems-level approaches to cultural competence, the primary focus in the literature remains on competency strategies aimed at health promotion initiatives, workforce development and student education. This paper aims to bridge the gap in available evidence about systems approaches to cultural competence by systematically mapping key concepts, types of evidence, and gaps in research. Methods: A literature search was completed as part of a larger systematic search of evaluations and measures of cultural competence interventions in health care in Canada, the United States, Australia and New Zealand. Seventeen peer-reviewed databases, 13 websites and clearinghouses, and 11 literature reviews were searched from 2002 to 2015. Overall, 109 studies were found, with 15 evaluating systems-level interventions or describing measurements. Thematic analysis was used to identify key implementation principles, intervention strategies and outcomes reported. Results: Twelve intervention and three measurement studies met our inclusion criteria. Key principles for implementing systems approaches were: user engagement, organisational readiness, and delivery across multiple sites. Two key types of intervention strategies to embed cultural competence within health systems were: audit and quality improvement approaches and service-level policies or strategies. Outcomes were found for organisational systems, the client/practitioner encounter, health, and at national policy level. Discussion and implications: We could not determine the overall effectiveness of systems-level interventions to reform health systems because interventions were context-specific, there were too few comparative studies and studies did not use the same outcome measures. However, examined together, the intervention and measurement principles, strategies and outcomes provide a preliminary framework for implementation and evaluation of systems-level interventions to improve cultural competence. Identified gaps in the literature included a need for cost and effectiveness studies of systems approaches and explication of the effects of cultural competence on client experience. Further research is needed to explore the extent to which cultural competence improves health outcomes and reduces ethnic and racially-based healthcare disparities. [ABSTRACT FROM AUTHOR]

Young people from minority ethnic, migrant and refugee backgrounds are widely recognised as being under-served by mainstream sexual and reproductive healthcare in developed economy nations. This paper documents the views of professionals in Australia on the complexities of, and best practice approaches to, engaging members of this group with sexual and reproductive health promotion and care. Semi-structured interviews were conducted with 23 purposively selected key informants (health service providers, policymakers, academics and community advocates). Interviews were transcribed verbatim and coded in NVivo10 using interpretive thematic analysis. Principles of ‘cultural competence’ were employed to structure the interpretation of findings. Five key themes reveal pivotal aspects of how professionals work in, and make sense of, this complex field. These may be summarised as: (1) appreciating the complexities of cultural diversity; (2) recognising structural barriers and disincentives to engagement; (3) normalising sexual health; (4) balancing ‘youth-friendly’ and ‘culturally-competent’ priorities; and (5) going beyond simple translation. As migration to Australia continues to diversify the population, an integrated, national approach to the design and delivery of sexual and reproductive health promotion and care would be of value, along with training and support for those involved. Implications may have resonance for other countries similarly engaged in facilitating the successful settlement of migrants and refugees. [ABSTRACT FROM PUBLISHER]

Background: Fear of physicians is associated with a variety of negative relationship and clinical outcomes. Culturally competent communication has been suggested as a way for physicians to reduce patient fear. Previous research has not, however, assessed whether patients’ perceptions of physicians’ cultural competence are associated with the level of felt fear. This study assessed associations between patients’ fear of physicians and their perceptions of physicians’ cultural competence in healthcare interactions. Method: In this cross-sectional study, a purposive sample of 306 patients were recruited from the patient base of a local clinic system with three locations, one rural, one suburban, and one urban in Appalachian Ohio. Using validated paper-and-pencil questionnaires, we assessed patients’ perceptions of physicians’ cultural competence in four domains (macro cultural issues, proxemics/chronemics, language issues, and patient-centeredness) as well as fear of physicians. Results: Fear of physicians was associated with perceptions that physicians’ accommodated cultural differences related to issues of personal space and time and with perceptions of physicians’ provision of patient-centered care. Other domains of intercultural competence indicated negative association, but were not significant. Conclusions: The findings of this study provide evidence that some forms of physician accommodation of cultural difference are associated with reduced fear of physicians. These findings have implications for promoting physicians' cultural competence in healthcare interactions. These implications, with a focus on patient-physician communication are discussed. [ABSTRACT FROM AUTHOR]

African immigrants in the United States may experience barriers to health-care access and effectiveness. This mixed-methods study used paper-based surveys of people (N=101) in the target population from Nigeria, Ghana, and Liberia, recruited through convenience and snowball sampling. Semi-structured interviews were conducted with 3 clergy members who pastor churches with large Nigerian, Ghanaian, and Liberian populations, respectively; and five physicians and a clinical pharmacist who serve African immigrants. Results : Length of stay in the United States was associated with the health status of refugee children. Undocumented immigration status was associated with lack of health insurance. Cardiovascular diseases, uterine fibroids and stress-related disorders were the most prevalent reported conditions. Regardless of English fluency, many immigrants are unfamiliar with medical terminology. Conclusion: African immigrants in the state of Rhode Island need more health education and resources to navigate the US health-care system. [ABSTRACT FROM AUTHOR]

A study was conducted with the aim of identifying themes about the lived experiences of Black men in relation to law enforcement. An all-black male focus group was engaged in discussions on the topic 'Do Black Lives Matter' at an annual conference on counseling racial and ethnic minorities. The group participants consisted of counselors, counselor educators, undergraduate students, graduate students, and a law enforcement representative. Data from the discussion were qualitatively analyzed to identify themes and to give voice to Black male experiences. This paper presents findings regarding these themes (anger, fear, training/re-education) based on the group discussion and group process observations as well as indications on how the findings can be used toward action and change. [ABSTRACT FROM AUTHOR]

Growing health inequities among the increasingly diverse population in Aotearoa New Zealand have prompted responses in the healthcare system. Diversity-related policies and programmes have been developed in some District Health Boards (DHB) to address the issues. The translation of such policy into practice is, however, convoluted by subjective interests and power differentials and thus the outcomes of policies may deviate from their original objectives. In this paper we examine how staff in one DHB translate and implement health equity and diversity initiatives in their everyday practices in hospital settings. In high-level institutional thinking, Māori health equity policy is dictated by the Treaty of Waitangi which sets it apart from the cultural competence focus of programmes for other ethnic groups. Drawing on interviews with clinical staff in the DHB, we reveal how intersecting subject positions, including personal histories and institutional roles, influence the interpretation and enactment of these policies and programmes in ways that blur their distinct agendas. As a result, the paper demonstrates how the politics that underpin agendas that distinctly address equity and diversity, as well as the potential for change in these areas, can be compromised in everyday practice on the hospital floor. • Health equity policy programmes distinct for Māori and culturally diverse groups. • Distinct agendas are blurred as clinical staff translate them into practice. • Intersection of personal subjectivities and positionalities influence translations. • Blurring of agendas in everyday practice compromise potential for change. [ABSTRACT FROM AUTHOR]

Health care employs nearly 1.3 million across the Midwest and generates billions of dollars in wages, making it an integral part of the regional economy. Yet the sector faces a growing crisis, fueled by interconnected trends: the mounting healthcare needs of baby boomers increasingly strain the sector, just as it faces an unprecedented shortage of workers. In response, hospital administrators increasingly look to immigrant workers – foreign-born physicians, researchers, nurses, health aides, and hospital workers – to fill gaps in their workforces. However, their ability to hire this foreign-born talent is limited by an outdated federal immigration system. Informed by interviews with regional healthcare stakeholders and analysis of Census and Bureau of Labor Statistics data, this paper, originally published by the Chicago Council on Global Affairs, explores the implications of a federal immigration system that does not respond to current economic and demographic realities. It includes recommendations for immigration policy reforms that will ensure the sector is able to maximize the contributions of foreign-born talent moving forward. [ABSTRACT FROM AUTHOR]

Background With an increasing number of ethnic minority populations, the use of multiple languages in one research study has increased in recent years. The use of multiple languages helps increase comprehensiveness of educational materials and/or survey questionnaires, and promote ethnic minorities’ participation in research. However, little has been clearly known about practical issues in using multiple languages in one research study. Objectives The purpose of this paper is to explore practical issues in using multiple languages in a study among diverse sub-ethnic groups of Asian American breast cancer survivors in order to propose future directions for the use of multiple languages in research projects. Methods Throughout the research process, research team made written records of practical issues and possible reasons for the issues as they arose. Weekly group discussions among research team members were administered, and the written records of these discussions were reviewed and analyzed using the content analysis. The unit of analysis was individual words. The words in the data (memos and written records) were classified into idea categories that emerged from the coding process. Results The idea categories included issues in: (a) collaborators from various sub-ethnic groups; (b) IRB protocol submissions; (c) consistencies in translation process, (d) conceptual equivalence; (e) cultural differences; (f) existing translated versions; and (g) authorship issues. Based on the issues, we made the following suggestions for multi-lingual research: (a) networking and setting multiple communication channels with potential collaborators; (b) checking the institution's IRB policies related to the use of multiple languages; (c) setting the rules and procedures for translation process; (d) checking existing different language versions of instruments; and (e) setting the rules for authorship in advance. Conclusions The suggestions made in this study would help the researchers be prepared in advance to deal with the challenges. [ABSTRACT FROM AUTHOR]

Public health nurses are on the front line of injury prevention initiatives. However, within injury prevention interventions and research, issues pertaining to culture are often addressed through the employment of one of the three approaches: cultural competency, cultural appropriateness, and/or cultural sensitivity. When using these approaches, it is often suggested that it is only those who are the recipients of an intervention or the focus of research that 'have' culture. The injury prevention designer's/provider's/researcher's own culture, as well as the ways in which it may influence the interventions or research, is typically rendered invisible. In this paper, we provide an overview and illustrations of the use of cultural competency, cultural appropriateness, and cultural sensitivity in injury prevention initiatives, as well as each approach's shortcomings. We then introduce cultural safety, an approach that has not yet gained traction in injury prevention but has had significant uptake within nursing in general, and argue that it has the potential to overcome many other approaches' shortcomings and thus may lead to more effective and socially just injury prevention initiatives. [ABSTRACT FROM AUTHOR]