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Canada's 2015 Truth and Reconciliation Commission published 94 Calls to Action including direction to post-secondary institutions "to integrate Indigenous knowledge and teaching methods into classrooms" as well as to "build student capacity for intercultural understanding, empathy, and mutual respect." In response, Canadian universities have rushed to "Indigenize" and are now competing to hire Indigenous faculty, from a limited pool of applicants. However, it is missing the true spirit of reconciliation for non-Indigenous faculty to continue with the status quo while assigning the sole responsibility of Indigenizing curriculum to these new hires. How can non-Indigenous psychology professors change their teaching to ensure that all students acquire an appreciation of traditional Indigenous knowledge about holistic health and healing practices, as well as an understanding of Canada's history of racist colonization practices and its intergenerational effects? Community psychologists, particularly those who have established relationships with Indigenous communities, have an important role to play. In this article, I survey the existing literature on Indigenizing and decolonizing psychological curriculum and share ways in which I have integrated Indigenous content into my psychology courses. I also reflect upon the successes, questions, and ongoing challenges that have emerged as I worked in collaboration with first Anisinaabek First Nations and then Mi'kmaw/L'nu First Nations., (© 2019 Society for Community Research and Action.)

Cultural safety is increasingly recognised as imperative to delivering accessible and acceptable healthcare for First Nations Peoples within Australia and in similar colonised countries. A literature review undertaken to inform the inaugural Caring for Australians with Renal Insufficiency (CARI) guidelines for clinically and culturally safe kidney care for Aboriginal and Torres Strait Islander peoples revealed a timeline of the emergence of culturally safe kidney care in Australia. Thirty years ago, kidney care literature was purely biomedically focused, with culture, family and community viewed as potential barriers to patient 'compliance' with treatment. The importance of culturally informed care was increasingly recognised in the mid-1990s, with cultural safety within kidney care specifically cited from 2014 onwards. The emergence timeline is discussed in this paper in relation to the five principles of cultural safety developed by Māori nurse Irihapeti Ramsden in Aotearoa/New Zealand. These principles are critical reflection, communication, minimising power differences, decolonisation and ensuring one does not demean or disempower. For the kidney care workforce, culturally safe care requires ongoing critical reflection, deep active listening skills, decolonising approaches and the eradication of institutional racism. Cultural safety is the key to truly working in partnership, increasing Indigenous Governance, respectful collaboration and redesigning kidney care., (© 2024 The Authors. Nursing Inquiry published by John Wiley & Sons Ltd.)

Introduction: British South Asians have a higher prevalence of overweight and obesity than the wider population. Bradford (UK), with its high Pakistani presence and levels of economic deprivation, has exceptionally high instances, especially in deprived areas where many Pakistanis reside. British Pakistani women in Bradford are more likely to be overweight and obese. There is uncertainty on how these women can be aided to manage their weight. Therefore, the objective of this study was to explore the obesity concerns of Pakistani women living in deprived inner-city areas of Bradford., Methods: Three focus groups interviews were carried out with 23 Pakistani women living in deprived areas of Bradford. Data were analysed thematically., Results: This exploratory study identified a wide range of concerns that women had around managing their weight. Participants disclosed distrust in information given around medication, conflicting dietary information and reported low levels of trust in women-only organized physical activities. Cultural barriers were identified, which included the gender role of the woman, the lack of culturally appropriate dietary advice, cultural misunderstandings of what constitutes a healthy diet and healthy weight, the lack of culturally suitable exercise facilities and conforming to family and community expectations. Other concerns were language barriers around a lack of understanding, the inability to read Urdu and reliance on others to translate information., Conclusion: These findings have implications for researchers, local authorities, policy makers and others with an interest in reducing the rates of obesity in this population. Recommendations include training health practitioners to be culturally aware of the diet and eating practices of this community, exploring different ways to support socially isolated women to be more physically active at home, addressing physical activity and diet misconceptions and designing obesity management information materials appropriate for a range of literacy levels., Patient or Public Contribution: Public contributors were involved in the development of the interview guide and design of the research. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Interview transcripts were member checked by participants, and participants assisted with data analysis., (© 2022 The Authors. Health Expectations published by John Wiley & Sons Ltd.)

The importance of developing cultural competence among healthcare professionals is well recognized. However, the widespread reports of insensitivity and deficiencies in care for culturally diverse patients illuminate the need to review how cultural competence development is taught, learnt and applied in practice. Unless we can alter the 'hearts and minds' of practising nurses to provide the care that they know they should, culturally insensitive care will continue operating in subtle ways. This paper explores the ideas behind nurses' actions and omissions when caring for culturally diverse patients and proposes the need to examine cultural competence development through a moral reasoning lens. Examining cultural competence development through a moral reasoning lens can help empower nurses, whilst nurturing commitment and courage to providing quality care that meets the needs of culturally diverse patients. The model of morality provides a framework that explores how moral motivation and behaviour occur and can provide a vehicle for critically examining the knowledge, skills and attitudes required to provide culturally responsive care., (© 2020 John Wiley & Sons Ltd.)

With the growing appreciation of the importance of early learning experiences for children's healthy development, attention to the cultivation and maintenance of a qualified workforce has steadily increased. Such a workforce must have not just the knowledge and skills related to child development and early learning, but also be linguistically and culturally prepared to meet the needs of an increasingly diverse child and family population. To ensure a highly qualified workforce, programs and policymakers must attend to both the "pipeline" through which new early childhood educators (ECEs) enter the workforce and the "pathways" by which ECEs work toward and obtain the necessary education and credentials for different roles within the field. In line with the aims of this special issue, this paper leverages the first-person account style to describe barriers to and creative solutions for the development of practitioners in low-resourced communities in Chicago, with the goal of informing practice and policy. We describe three prior and ongoing partnership programs between community-based organizations and institutions of higher education, each tailored to support a unique population in the ECE pipeline on the pathway for increased educational attainment and credentialing. Each program is grounded in a specific community of Chicago, a diverse city with a sizable population of children raised in non-English speaking homes. Each program addresses specific needs of the communities they serve, especially around the recruitment, retention, and promotion of bilingual ECEs. Program administrators and community members describe each programs' goals, development, and key components unique to their target population as well as key takeaways. We conclude with an overview of critical components that we identified across these programs in order to create pathways for change within the workforce and the communities they serve., (© 2019 Society for Community Research and Action.)

The purpose of the study was to develop an understanding of how nursing students gained perspective on nursing care of diverse populations through watching documentaries in a cultural diversity course. The basis of this paper is our analyses of students' written responses and reactions to documentaries viewed in class. The guiding theoretical frameworks for the course content and the study included postcolonial feminism, Foucauldian thought, and cultural safety. Krathwohl's Taxonomy of the Affective Domain was used to identify themes and determine how undergraduate nursing students were progressing in achieving learning outcomes. Our findings suggest that while the use of documentaries serves as a tool for deepening students' understanding of the realities of various populations, this activity, in the absence of critical reflection, may inadvertently promote stereotypes and further marginalize different people groups. Even though nursing students reflected on the importance of cultural safety in nursing, our findings indicate that their actions may not reflect this, especially since these students are in the early stages of the nursing program. Students need to be provided with a space where they can explore implicit biases evoked by exposure to new information about different people groups as a way of enhancing culturally safe care., (© 2018 John Wiley & Sons Ltd.)

This paper describes the factor analysis testing and construct validation of the Japanese version of the Caffrey Cultural Competence Health Services (J-CCCHS). The inventory, composed of 28 items, was translated using language and subject matter experts. Psychometric testing (exploratory factor, alpha reliability, and confirmatory factor analyses) was undertaken with nurses (N = 7494, 92% female, mean age 32.6 years) from 19 hospitals across Japan. Principal components extraction with varimax rotation yielded a 5-factor solution (62.31% variance explained) that was labeled: knowledge, comfort-proximal, comfort-distal, awareness, and awareness of national policy. Cronbach α for the subscales ranged from 0.756 to 0.892. In confirmatory factor analysis using the robust maximum likelihood estimator, the chi-square test was as follows: χ 2 (340) = 14604.44, P < .001. After correlated errors were introduced, there was evidence of improved model fit (χ 2 (335) = 8681.61, P < .05) but the other indices showed improvement (RMSEA = .058 [90% CI, 0.057-0.059], TLI = .891, CFI = .903, and SRMR = .059). The discriminating power of the J-CCCHS was indicated by statistically mean differences in J-CCCHS subscale scores between predefined groups. Taking into consideration that this is the first foray into construct validation for this instrument, and that fit was improved when a subsequent data driven model was tested, and it has the ability to distinguish between known groups that are expected to differ in cultural competence, the instrument can be of value to clinicians and educators alike., (© 2017 John Wiley & Sons Australia, Ltd.)

Problem: The concept of cultural competency has developed a substantial presence in nursing education and practice since first attracting widespread attention in the 1990s. While several theories and corresponding measures of cultural competency have been advanced and tried, much work remains, as many nursing professionals continue to call for greater evidence-based research and attention to patient perspectives and outcomes., Methods: Using a method provided by Hawker et al. to appraise articles, this paper compares nine recent (2008-2013) studies (including two composite studies) related to cultural competency, undergraduate curricula, and teaching strategies in nursing to assess the state of the art in this important area of care., Findings: The studies applied phenomenological, study abroad, online, and service learning strategies, four of which relied on some version of Campinha-Bacote's IAPCC© model. These studies reported a general improvement in competency among students, though generally only to a level of cultural awareness, and admitted being constrained by several common limitations., Conclusion: Improved results and more realistic expectations in this area may require a closer understanding of the nature of the "culture" that underlies cultural competence. Harkess Kaddoura., (© 2015 Wiley Periodicals, Inc.)

Health promotion researchers must consider the ethics of their research, and are usually required to abide by a set of ethical requirements stipulated by governing bodies (such as the Australian National Health and Medical Research Council) and human research ethics committees (HRECs). These requirements address both deontological (rule-based) and consequence-based issues. However, at times there can be a disconnect between the requirements of deontological issues and the cultural sensitivity required when research is set in cultural contexts and settings etic to the HREC. This poses a challenge for health promotion researchers who must negotiate between meeting both the requirements of the HREC and the needs of the community with whom the research is being conducted. Drawing on two case studies, this paper discusses examples from cross-cultural health promotion research in Australian and international settings where disconnect arose and negotiation was required to appropriately meet the needs of all parties. The examples relate to issues of participant recruitment and informed consent, participants under the Australian legal age of consent, participant withdrawal when this seemingly occurs in an ad hoc rather than a formal manner and reciprocity. Although these approaches are context specific, they highlight issues for consideration to advance more culturally appropriate practice in research ethics and suggest ways a stronger anthropological lens can be applied to research ethics to overcome these challenges.

Chapter 4.7 of the National Statement on Ethical Conduct in Human Research refers specifically to Aboriginal and Torres Strait Islander Peoples. It lays out the points at which researchers working with Aboriginal and Torres Strait Islanders must consider their approach, and the engagement with individuals, communities or groups who are involved in or affected by their research. History, of Australia and of research involving Aboriginal and Torres Strait Islander Australians, has informed this approach. The response to that history has been a rational, institutionalised, systematic demand for a different perception of what should direct research and research processes to ensure engagement with and service to the community with whom the researchers wish to do the work. This paper considers whether these principles could inform the approach to other research work.

Abstract 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.