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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]

Research indicates that health problems are becoming increasingly complex and prevalent among college students, while largely going without recognition or treatment. Low-income racial minority students may have additional personal and academic issues associated with demonstrating grit and overcoming barriers to entry (i.e. institutional racism) over the course of their lives. When the campus environment is not socially or culturally supportive of racial minority and first-generation college students, there is an added risk of mental health deterioration stemming from isolation for these students. The struggle to persist in college, and do so alone, can lead many to experience symptoms of impending "burnout," or disengagement from academic settings. Drawing from a sample of interviews with low-income racial minority strivers—students who were once highly engaged—this paper offers insight into both causes and solutions for college burnout. Findings suggest that it is important to understand how experiences of isolation manifest to better support minority student populations and foster their academic reengagement to achieve at high levels. This paper outlines recommendations for improving the college experiences of racial minority and first-generation students, including examples of resources and recommendations to improve the higher education landscape towards more inclusivity and equity. [ABSTRACT FROM AUTHOR]

Research demonstrates ongoing health inequities for those from the most marginalized communities. To address these health inequities, medical educators have attempted to incorporate education that targets cultural competence of providers. Over the last decade, increasing evidence has demonstrated limitations to a competency-based approach. In this paper, we outline how utilizing critical reflection strategies in clinical supervision can be a long-term, sustainable approach for addressing health inequities, while improving the existing cultural competency model. We begin by demonstrating how existing ideas of critical reflection can be adopted to enhance learning within supervision by encouraging providers to evaluate and re-evaluate existing beliefs and biases. We then propose how an existing approach to treatment (i.e., Metacognitive Reflection and Insight Therapy) may serve as an example for how to activate critical reflection in supervision using three essential factors. Finally, we propose three clinical implications for providers that may work to dismantle existing healthcare inequities including: an increased comfort in feedback seeking, improved confidence working with diverse populations, and increased insight into how inequities emerge in clinical practice and how best to respond when they do. [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]

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]

Abstract: Cultural competency has become a keystone in forming a successful doctor-patient relationship to provide culturally appropriate services that respect patients' ethno-cultural beliefs, values, attitudes, and conventions. In cosmetic surgery, an often-overlooked aspect of a patient's cultural is his and her religious beliefs. In response to this paucity of resources for cosmetic surgeons to enable them to properly service their religious patients, this project was undertaken. This review article covers the three main Abrahamic religions (Judaism, Christianity, and Islam) and was written with the assistance of a prominent bioethicist from each religion (see Acknowledgements). In discussing each religion, the article has been divided into two sections. The first section is a general overview of the religion's relationship with cosmetic surgery as summary provided by the consulting bioethicist. The second portion is an annotated review of additional resources providing the reader further details on that religion. For example, our bioethicists provide a general perspective on Christianity as a whole, and the annotated review focuses on differences between Catholics and Protestants. We recognize the heterogeneity that is inherent in religion and the cultural and geographic biases that affect it. However, we aim to provide the reader a broad and basic foundation of the relationship between Judaism, Christianity, and Islam with cosmetic surgery to begin to create common ground between the physician and the patient and improve the process of shared decision-making and thus our outcomes. This paper should be seen as a foundation to build upon rather than an authoritative source, and specific patient concerns should be addressed with the patient's own religious advisor.Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [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]

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]

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]

Culturally differing approaches to the distinction between physical and mental health contribute to cultural differences in explanatory models of what we call "mental" health in a Western context. For this reason, we use "(mental) health" in this study when referring to these models or differences in understanding. This interpretative, interview-based qualitative study focuses on Belgian mental health professionals' perceptions of the (mental) health explanatory models held by their patients of sub-Saharan African (SSA) descent. The study goals were threefold: first, to assess professionals' perceptions of the explanatory models of their patients of SSA descent; second, to examine how these perceptions influence treatment practices; and third, to investigate the role of the professionals' cultural backgrounds, comparing the results between professionals with and without an SSA background. Twenty-two in-depth interviews with mental health professionals were thematically analyzed, with ten of the participants of SSA descent. Results show that all professionals perceived differences between Western and SSA explanatory models of (mental) health. Causal beliefs were mentioned as the most important difference, including their influence on coping strategies and health-seeking behavior among patients of SSA descent. Professionals' perceptions and familiarity with SSA explanatory models of (mental) health affected their treatment practices. Language and conceptual interpretation difficulties were encountered less frequently by professionals of SSA descent. Those with a Western background applied "culturally sensitive" practices, while professionals of SSA descent implemented an integrated approach. These results contribute to ongoing discussions about what is considered "cultural competency." [ABSTRACT FROM AUTHOR]

Introduction: Cultural competency has been identified as a barrier to lesbian, gay, bisexual and transgender (LGBT) populations seeking care. Mystery shopping has been widely employed in the formal health care sector as a quality improvement (QI) tool to address specific client needs. The approach has had limited use in community-based organizations due in part to lack of knowledge and resource requirement concerns. Several mystery shopping initiatives are now being implemented which focus on the LGBT population with the goal of reducing barriers to accessing care. One subset targets men who have sex with men (MSM) to increase uptake of human immunodeficiency virus (HIV) testing. No study investigates the costs of these initiatives. Get Connected was a randomized control trial with the objective of increasing uptake of HIV-prevention services among young men who have sex with men (YMSM) through use of a resource-locator application (App). The initial phase of the trial employed peer-led mystery shopping to identify culturally competent HIV testing sites for inclusion in the App. The second phase of the trial randomized YMSM to test the efficacy of the App. Our objective was to determine the resource inputs and costs of peer-led mystery shopping to identify clinics for inclusion in the App as costs would be critical in informing possible adoption by organizations and sustainability of this model. Methods: Through consultation with study staff, we created a resource inventory for undertaking the community-based, peer-led mystery shopping program. We used activity-based costing to price each of the inputs. We classified inputs as start-up and those for on-going implementation. We calculated costs for each category, total costs and cost per mystery shopper visit for the four-month trial and annually to reflect standard budgeting periods for data collected from September of 2019 through September of 2020. Results: Recruitment and training of peer mystery shoppers were the most expensive tasks. Average start-up costs were $10,001 (SD $39.8). Four-month average implementation costs per visit were $228 (SD $1.97). Average annual implementation costs per visit were 33% lower at $151 (SD $5.60). Conclusions: Peer-led, mystery shopping of HIV-testing sites is feasible, and is likely affordable for medium to large public health departments. [ABSTRACT FROM AUTHOR]

Objective: The widespread use of pesticides poses serious health hazards to farmers and their families. Some evidence shows that culturally sensitive interventions could be associated with improved outcomes; however, little is known about the effectiveness of cultural adaptations in interventions among farmers and farmworkers. Therefore, the purpose of this study was to summarize strategies used in the cultural adaptation interventions addressing the reduction of pesticide exposure in farmers and farmworkers, as well as assessing the effects of these strategies. Methods: A comprehensive systematic literature search was conducted on PubMed, Embase, Clarivate Web of Science, Scopus, NIOSHTIC, Agricola, Agris, as well as reference lists to identify randomized controlled trials (RCTs) published in English from January 2000 until March 2022. Data were extracted to examine the characteristics of interventions in terms of the cultural adaptation strategies and their effectiveness by two independent reviewers. Results: Eleven articles from ten trials met the inclusion criteria. The majority of studies were conducted in the USA (n = 7) and were ranked as poor quality (n = 5). Four of the ten studies were rated moderate, and six were rated weak. The socio-cultural and constituent-involving strategies were the most commonly reported across the included studies, followed by linguistic strategy. Six studies (seven articles) were tailored for subgroups or individuals. Overall, 8 of 10 studies reported significant changes in whole and some outcomes in the intervention groups over controls. Seven studies received moderate cultural adaptation scores which may reflect the moderate effectiveness of the interventions. Conclusion: Our review underscored the paucity and low quality of existing studies investigating the culturally adapted interventions in reducing farmers' and farmworkers' pesticide exposure. Future high-quality culturally sensitive studies could increase our knowledge regarding the culture's role in reducing pesticide exposure in farmers and farmworkers. [ABSTRACT FROM AUTHOR]

The rapid growth of cultural diversity in the US population has urged training programs to prepare school psychologists and related school-based mental health practitioners to work with students from culturally diverse backgrounds. Accreditation bodies, such as the National Association of School Psychologists and the American Psychological Association, charge graduate programs with measuring growth in trainees in terms of competencies. As a result, multicultural competency is a domain of professionalism deserving of further study. The current study investigated the effects of a 10-week standalone graduate course on multicultural issues in school psychology, designed to increase self-assessed multicultural competencies in preservice school psychologists. The results indicated a significant increase in students' perceptions of multicultural competence across all 5 years of the investigation. In addition, using a two-way analysis of variance, cohort effects on growth over time suggested that the demographic composition of cohorts affected the growth in multicultural awareness, knowledge, and skills. Implications and recommendations for future school psychology research are discussed. [ABSTRACT FROM AUTHOR]

This is a reflective account of an inquiry learning process that took place as a small country school corrected its name from Tiritea to Turitea. We discuss the process as an example of how boards in mainstream schools can work collaboratively to uphold te ao Māori (the Māori world) in schools and to recognise obligations under the Te Tiriti o Waitangi. School Boards of Trustees set the strategic direction to ensure that Māori students achieve educational success as Māori. The name correction demonstrated the school's willingness to embrace te ao Māori, and to build a closer relationship with tāngata whenua to enrich students' learning and success. The inquiry learning process carried out brought to light existing and new knowledge from all participants, and aligned well with the school goal of providing an environment where students are encouraged to think critically, creatively and reflectively. We use the Tātaiako competency framework to discuss various elements of the process: ako, wānanga, manaakitanga, tāngata whenuatanga and whanaungatanga. [ABSTRACT FROM AUTHOR]

The U.S. children's mental health system is faced with ameliorating the impacts of significant ethnic disparities in service utilization and outcomes. Furthermore, there has been little effort to assess the quality of children's mental health care. In this study, we compare Haitian, African-American, and White caregiver perceptions of the quality of their child's mental health care. Four overarching domains were examined: access to care, cultural and linguistic competence, engagement of caregivers, and appropriateness of services. Through the analysis, we identify ethnic differences in the experiences of caregivers in accessing and receiving services for their children, with minority caregivers reporting greater barriers and poorer quality of care. Structural and cultural factors are explored to understand the interaction of multiple processes that shape access to and quality of care. Implications for policy and practice are discussed, including the need for greater cultural competency and responsiveness in mental health care, and the need to build greater trust between providers and minority communities. Highlights: Study provides unique assessment of the quality of children's mental health care. Compares service experiences of White, African American, and Haitian caregivers. White caregivers reported better quality of care compared to non-white caregivers. Differences between African American and Haitian caregivers were found but smaller. Differences were also observed in severity of symptoms and socioeconomic variables. [ABSTRACT FROM AUTHOR]

Background: Transgender people and racial/ethnic minorities separately report poor healthcare experiences. However, little is known about the healthcare experiences of transgender people of color (TPOC), who are both transgender and racial/ethnic minorities.Objective: To investigate how TPOC healthcare experiences are shaped by both race/ethnicity and gender identity.Design and Participants: Semi-structured, in-depth individual interviews (n = 22) and focus groups (2; n = 17 total); all taken from a sample of TPOC from the Chicago area. All participants completed a quantitative survey (n = 39).Approach: Interviews and focus groups covered healthcare experiences, and how these were shaped by gender identity and/or race/ethnicity. The interviews and focus groups were audio recorded, transcribed verbatim, and imported into HyperRESEARCH software. At least two reviewers independently coded each transcript using a codebook of themes created following grounded theory methodology. The quantitative survey data captured participants' demographics and past healthcare experiences, and were analyzed with descriptive statistics.Key Results: All participants described healthcare experiences where providers responded negatively to their race/ethnicity and/or gender identity. A majority of participants believed they would be treated better if they were cisgender or white. Participants commonly cited providers' assumptions about TPOC as a pivotal factor in negative experiences. A majority of participants sought out healthcare locations designated as lesbian, gay, bisexual, and transgender (LGBT)-friendly in an effort to avoid discrimination, but feared experiencing racism there. A minority of participants expressed a preference for providers of color; but a few reported reluctance to reveal their gender identity to providers of their own race due to fear of transphobia. When describing positive healthcare experiences, participants were most likely to highlight providers' respect for their gender identity.Conclusions: TPOC have different experiences compared with white transgender or cisgender racial/ethnic minorities. Providers must improve understanding of intersectional experiences of TPOC to improve quality of care. [ABSTRACT FROM AUTHOR]

The increasing diversity in classrooms throughout the U.S. calls for teachers who are culturally competent and have quality professional development in working with dual language learners (DLLs) in order to ensure children from diverse groups are receiving equitable and high-quality education. This study focuses on teacher characteristics that play a significant role in the development of young children's bilingual abilities with regard to language, literacy and math. We examined the school readiness skills of 217 Latino DLLs attending Head Start taking into account specific teacher characteristics that may impact the development of readiness skills. Different teacher characteristics have different effects on the developmental outcomes. Amount of training had a positive significant effect on several children's outcomes in English and in Spanish. The years of experience a teacher had working in classrooms with DLLs had a positive effect on children's English spelling skills. Teachers' cultural competency rating had a positive effect on receptive language and literacy in Spanish. Findings and implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Transgender people, those whose gender identity does not match their sex assigned at birth, face barriers to receiving health care. These include discrimination, prohibitive cost, and difficulty finding transgender-inclusive providers. As transgender identities are not typically recognized in public health research, the ability to compare the health of the transgender population to the overall population is limited.Objective: The Colorado Transgender Health Survey sought to explore current disparities and their effects on the health of transgender people in Colorado.Design and Participants: The Colorado Transgender Health Survey, based on the Behavioral Risk Factor Surveillance System (BRFSS), was developed by the Colorado Department of Public Health and Environment, transgender advocates, and transgender community members. Outreach was targeted to transgender-inclusive events and organizations.Main Measures: Responses to the 2014 Colorado Transgender Health Survey were compared side by side to Colorado 2014 BRFSS data.Results: Results from 406 transgender or gender-nonconforming adults who live in Colorado were included in the analysis. Forty percent of respondents report delaying medical care due to cost, inadequate insurance, and/or fear of discrimination. Respondents report significant mental health concerns, with 43% reporting depression, 36% reporting suicidal thoughts, and 10% attempting suicide in the past year. Respondents with a transgender-inclusive provider were more likely to receive wellness exams (76 versus 48%), less likely to delay care due to discrimination (24 versus 42%), less depressed (38 versus 54%), and less likely to attempt suicide (7 versus 15%) than those without.Conclusions: The transgender community in Colorado faces significant disparities, especially around mental health. However, a transgender-inclusive provider is associated with improved mental and physical health and health behaviors. Further population-level research and provider education on transgender health should to be incorporated into national efforts to eliminate health disparities. [ABSTRACT FROM AUTHOR]

The article offers information regarding importance of cultural competence and cultural humility for eliminating healthcare disparities and providing high-quality patient care. It mentions that pre-clerkship curriculum emphasizes active learning instructors have become experienced in writing Team Based Learning exercises on a wide variety of bioscience and ethical topics.

Despite initiatives to increase the enrollment of racial and ethnic minorities into cancer clinical trials in the National Cancer Institute National Cancer Clinical Trials Network (NCCTN), participation by Latino and African American populations remain low. The primary aims of this pilot study are (1) to develop a Cultural Competency and Recruitment Training Program (CCRTP) for physician investigators and clinical research associates (CRAs), (2) to determine if the CCRTP increases cultural competency scores among physician investigators and CRAs, and (3) to determine the impact of the CCRTP on minority patient recruitment into NRG Oncology Radiation Therapy Oncology Group (RTOG) clinical trials. Sixty-seven CRAs and physicians participated in an in-person or online 4-h CRRTP training. Five knowledge and attitude items showed significant improvements from pre- to post-training. A comparison between enrolling sites that did and did not participate in the CCRTP demonstrated a pre to 1-year post-incremental increase in minority accrual to clinical trials of 1.2 % among participating sites. While not statistically significant, this increase translated into an additional 300 minority patients accrued to NCCTN clinical trials in the year following the training from those sites who participated in the training. [ABSTRACT FROM AUTHOR]

Research suggests that culturally and linguistically diverse (CLD) youths are underserved by mental health systems; CLD youths are less likely to receive mental health services and more likely to receive services that are inappropriate or inadequate. The lack of well-established treatments for CLD youths has been cited as one contributing factor to this problem. Consequently, it has been suggested that therapists should incorporate cultural awareness frameworks into their practice and adapt interventions in order to best serve youths from this population. The purpose of this literature review is to present established models that incorporate principles of cultural awareness and systematic intervention adaptation. Related studies that describe the applications of these models are also reviewed. Commonalities between different culturally responsive adaptation models are discussed, and implications for school-based practice are explored. [ABSTRACT FROM AUTHOR]

Background: The influence of societal inequities on health has long been established, but such content has been incorporated unevenly into medical education and clinical training. Structural competency calls for medical education to highlight the important influence of social, political, and economic factors on health outcomes.Aim: This article describes the development, implementation, and evaluation of a structural competency training for medical residents.Setting: A California family medicine residency program serving a patient population predominantly (88 %) with income below 200 % of the federal poverty level.Participants: A cohort of 12 residents in the family residency program.Program Description: The training was designed to help residents recognize and develop skills to respond to illness and health as the downstream effects of social, political, and economic structures.Program Evaluation: The training was evaluated via qualitative analysis of surveys gathered immediately post-training (response rate 100 %) and a focus group 1 month post-training (attended by all residents not on service).Discussion: Residents reported that the training had a positive impact on their clinical practice and relationships with patients. They also reported feeling overwhelmed by increased recognition of structural influences on patient health, and indicated a need for further training and support to address these influences. [ABSTRACT FROM AUTHOR]

The majority of literature on mentoring focuses on mentee training needs, with significantly less guidance for the mentors. Moreover, many mentoring the mentor models assume generic (i.e. White) mentees with little attention to the concerns of underrepresented racial/ethnic minorities (UREM). This has led to calls for increased attention to diversity in research training programs, especially in the field of HIV where racial/ethnic disparities are striking. Diversity training tends to address the mentees' cultural competency in conducting research with diverse populations, and often neglects the training needs of mentors in working with diverse mentees. In this article, we critique the framing of diversity as the problem (rather than the lack of mentor consciousness and skills), highlight the need to extend mentor training beyond aspirations of cultural competency toward cultural humility and cultural safety, and consider challenges to effective mentoring of UREM, both for White and UREM mentors. [ABSTRACT FROM AUTHOR]

The concept of cultural competence has long been promoted as a key educational practice priority in the profession of social work. However, assuming uniformity in a given culture and its values and beliefs without allowing for within-group diversity and the consideration of the intercultural interaction is problematic. This article delineates the dynamics of tapping into 'cultural intelligence', which uses a different approach to understanding cultural diversity and cross-cultural interactions by focusing on the interactional field that operates in cross-cultural clinical encounters. [ABSTRACT FROM AUTHOR]

Limited research has investigated how culture impacts expressions of social support, which is crucial in developing culturally sensitive care. Using a classification based on theories of social support, we examined the social support experiences of 49 Chinese immigrant mental health consumers with psychosis, paying particular attention to frequency and sources. We found that the most common forms of social support were belonging and companionship, perceived emotional support, social control, and perceived instrumental support, while self-esteem and sense of mastery were the least common forms. Family and friends were the main sources of support. These results demonstrate the influence of Confucian values of renqing (or fulfillment of relational obligations) and guanxi (or social networks) and the negative effects of stigma in diminishing the social standing of these consumers by compromising 'personhood.' Clinical implications for increasing the cultural competency of clinicians and improving the mental health outcomes of Chinese immigrants are discussed. [ABSTRACT FROM AUTHOR]

Addressing cultural competency in health care involves recognizing the diverse characteristics of the patient population and understanding how they impact patient care. Spirituality is an aspect of cultural identity that has become increasingly recognized for its potential to impact health behaviors and healthcare decision-making. We consider the complex relationship between spirituality and health, exploring the role of spirituality in primary care, and consider the inclusion of spirituality in existing models of health promotion. We discuss the feasibility of incorporating spirituality into clinical practice, offering suggestions for physicians. [ABSTRACT FROM AUTHOR]

It is important to understand East Asian immigrants (EAIs)' unique perspectives in managing diabetes in order to provide culturally-competent care. However, it is not known whether EAIs' perspectives are addressed in diabetes self-management interventions developed for EAIs. Therefore, a mixed-study review was conducted to identify EAIs' perspective from qualitative research (n = 9 studies) and to evaluate the components of EAI diabetes self-management interventions (n = 7). Themes from the qualitative synthesis demonstrated that EAIs have unique cultural values and traditional health beliefs while struggling with multi-contextual barriers due to immigration. The evaluation of EAI diabetes self-management interventions revealed that there was a lack of consensus on cultural strategies for EAIs' across the interventions. Addressing language barriers was the only factor consistently integrated in the cultural components of intervention by employing bilingual interventionists. EAIs' perspectives and experiences need to be incorporated in the future diabetes self-management interventions to better provide culturally-competent care. [ABSTRACT FROM AUTHOR]

The article offers practical suggestions for adapting and implementing trauma-informed evidence-based practice (EBP) with refugee youth in real-world settings located in Western countries and proposes EBP's "three-legged stool" model to therapeutically address the impact of trauma in refugee youth.

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Our study of queer women patients and their primary health care providers (HCPs) in Halifax, Nova Scotia, reveals a gap between providers' theoretical knowledge of 'cultural competency' and patients' experience. Drawing on Patricia Benner's Dreyfusian model of skill acquisition in nursing, we suggest that the dissonance between the anti-heteronormative principles expressed in interviews and the relative absence of skilled anti-heteronormative clinical practice can be understood as a failure to grasp the field of practice as a whole. Moving from 'knowing-that' to 'knowing-how' in terms of anti-heteronormative clinical skills is not only a desirable epistemological trajectory, we argue, but also a way of understanding better and worse ethical practice. [ABSTRACT FROM AUTHOR]