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Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper. Methods: The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback. Results: The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations. Conclusion: The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery. [ABSTRACT FROM AUTHOR]

EU-US data transfers for health research remain a particularly thorny issue in view of the stringent rules of the EU General Data Protection Regulation (GDPR) and the challenges related to US mass surveillance programs, particularly the manner in which US law enforcement and national security agencies can access personal data originating from the EU. Since the entry into force of the GDPR, evidence of impeded collaborations is increasing, particularly in the case of sharing data with US public institutions. The adoption of a new EU-US adequacy decision in July 2023 does not hold the promise for a long-lasting solution due to the risks of being challenged and invalidated – yet again – at the Court of Justice of the EU. As the research community is calling for answers, the new proposal for a European Health Data Space regulation may hold a key to solving some of the existing issues. In this paper, we critically discuss the current rules and outline a possible way forward for transfers between public bodies. [ABSTRACT FROM AUTHOR]

Against the backdrop of a global pandemic, this study investigates how U.S. higher education leaders have centered their crisis management on values and guiding ethical principles. We conducted 55 in-depth interviews with leaders from 30 U.S. higher education institutions, with most leaders participating in two interviews. We found that crisis plans created prior to the COVID-19 pandemic were inadequate due to the long duration and highly uncertain nature of the crisis. Instead, higher education leaders applied guiding principles on the fly to support their decision-making. If colleges and universities infuse shared values into their future crisis plans, they will not have to develop a moral compass on the fly for the next pandemic. This paper suggests the following somewhat universal shared values: (1) engage in accuracy, transparency, and accountability; (2) foster deliberative dialog; (3) prioritize safety; (4) support justice, fairness, and equity; and (5) engage in an ethic of care. To navigate ethics tensions, leaders need to possess crisis-relevant expertise or ensure that such expertise is present among crisis management team members. Standing up formal ethics committees composed of diverse stakeholders also is instrumental in navigating tensions inherent in crises. The next pandemic is already on the horizon according to experts. Through infusing values into future crisis plans, higher education leaders can be confident that their responses will be grounded in their communities' shared values. [ABSTRACT FROM AUTHOR]

Drawing upon Bourdieu's conceptualization of habitus, this ethnographic study explores the cultural bases guiding engineering makerspaces at a public university in the United States. Students carry forms of capital that impact their entry into these learning spaces, over time becoming disciplined in the "game" of makerspaces as they accumulate capital through everyday talk and storytelling. Communication constructs the makerspace habitus as students (1) move from outsider to insider as they acquire forms of capital; (2) negotiate a habitus characterized by tensions of access vs. exclusivity; (3) learn to use the vocabularies of innovation and creativity; and (4) cultivate supportive making communities. Findings point to the critical role of intentional communication and space design in cultivating inclusive makerspace cultures. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic disproportionately affected racial and ethnic minorities in the United States, including many with limited English proficiency (LEP). These patients face various communication barriers, including a shortage of available interpreters and the need for masks that exacerbated communication barriers. It is not known how hospitals responded to these unique challenges to providing language services for the large number of patients with LEP during COVID-19. This narrative review assessed literature and lay media to identify strategies utilized by hospitals to communicate with patients with LEP hospitalized during the COVID-19 pandemic. A search of APA PsychInfo, EBM Reviews, Embase, Ovid MEDLINE, Epub Ahead of Print, and Ebsco Megafile initially yielded 61 articles, 6 of which were ultimately included after reviewing abstracts and full texts. The identified interventions, which sought to increase accessibility of language-concordant care, increase accessibility of professional interpretation, and improve family communication and understanding, were described positively, though only one was tested for effectiveness. [ABSTRACT FROM AUTHOR]

Background: This study examined the conflicts between different generations working in US emergency departments (ED). We sought to record generational differences involving communication preferences, perceived areas of conflict, work motivations, and attitudes regarding work-life balance. Methods: We developed a survey to assess the physician perspective on generational conflict in the ED. The survey was distributed to members of the American College of Emergency Physicians, a professional organization comprising emergency medicine physicians in the USA. Results: We received 696 completed responses. Men represented 60% of respondents and the largest proportion of respondents were emergency physicians working in community settings (53%); 11% were residents. Generation representation was smallest for Traditionalist (2%) and largest for Gen X (43%). Seventy percent reported observing conflict due to generational communication with the largest frequency being once a week (26%). In the associated open-ended questions, 247 (33%) provided 316 anecdotal descriptions of observed conflict. Responses clustered into seven themes (ordered by frequency): Work Ethic, Treatment Approach, Technology Application, Entitlement, Professionalism, Work Life/Balance, and Communication Style. Comparing Work Ethic responses, 52–70-year-olds reported that younger providers are less interested in "accomplishing anything" while 26–34-year-olds resented that attitude. Respondents completing the open-ended questions regarding preventing and responding to conflict provided some insight into helpful strategies including actions supportive of clear communication and standardized policies and expectations. Only 5% of respondents reported that they had discussed generational communication in department meetings with the odds of a woman reporting conflict being less than males (p =.01). Conclusion: Conflicts in the ED in the USA can be attributed to how an individual views the values of someone from another generation. Understanding the frequency and areas of generational conflict in the ED can help medical leaders find strategies to mitigate negative workplace interactions. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the relationship between parental sexual passion styles and parent-child communication about sex. The central research questions were how parent sexual passion was associated with parent-child communication about sex and whether commonalities emerged in communication patterns across passion styles. Data were taken from a US national sample; participants were 801 mothers and 838 fathers (n = 1639). Comprehensive measures of parent-child sexual communication and sexual passion were used in a structural equation model. Among both mothers and fathers, harmonious sexual passion was associated with higher communication frequency, openness, and adolescent disclosure. Obsessive and inhibited sexual passion were associated with parental control of communication. Inhibited sexual passion was associated with adolescent secrecy. Additionally, for mothers only, obsessive sexual passion was associated with higher adolescent disclosure; for fathers only, inhibited sexual passion was associated with higher communication frequency and adolescent disclosure. These results help to connect the individual-level concept of sexual passion with dyad-level communication about sex; they also can help lead researchers and practitioners to better understand the influence of motivation and sexual passion on parental participation in sex education, which may lead to more effective efforts to educate adolescents about sex. Highlights: Parents with higher levels of harmonious passion had higher levels of communication about sex with their adolescents. Parents with higher levels of inhibited and obsessive sexual passion had higher levels of controlling communication about sex with their adolescents. Parents with higher levels of inhibited passion had adolescents with higher levels of secrecy about their sexuality. [ABSTRACT FROM AUTHOR]

We identified (a) sources of and communication about HPV information and (b) factors (e.g., religious affiliations) related to information sources and communication regarding HPV among Hispanic/Latino college students attending US institutions. Applying a cross-sectional design, we recruited 209 participants from US colleges. Most participants used healthcare professionals for their sources and communication about HPV-related information. Respondents who were practicing Catholics tended to use the Internet and healthcare professionals as their sources for HPV-related information. Healthcare professionals, TV, schoolteachers, same-sex friends, and family members affected participants' HPV vaccination, knowledge, and attitudes. Religious faith may influence information-seeking behaviors and requires more research. [ABSTRACT FROM AUTHOR]

The COVID-19 crisis has exposed the public to considerable scientific uncertainty, which may promote vaccine hesitancy among individuals with lower tolerance of uncertainty. In a national sample of US adults in May–June 2020, we examined how both perceptions of uncertainty about COVID-19 and trait-level differences in tolerance of uncertainty arising from various sources (risk, ambiguity, and complexity) are related to vaccine hesitancy-related outcomes, including trust in COVID-19 information, COVID-19 vaccine intentions, and beliefs that COVID-19 vaccines should undergo a longer testing period before being released to the public. Overall, perceptions of COVID-19 uncertainty were not associated with trust in information, vaccine intentions, or beliefs about vaccine testing. However, higher tolerance of risk was associated with lower intentions to get vaccinated, and lower tolerance of ambiguity was associated with lower intentions to get vaccinated and preferring a longer period of vaccine testing. Critically, perceptions of COVID-19 uncertainty and trait-level tolerance for uncertainty also interacted as predicted, such that greater perceived COVID-19 uncertainty was more negatively associated with trust in COVID-19 information among individuals with lower tolerance for risk and ambiguity. Thus, although perceptions of uncertainty regarding COVID-19 may not reduce trust and vaccine hesitancy for all individuals, trait-level tolerance of uncertainty arising from various sources may have both direct and moderating effects on these outcomes. These findings can inform public health communication or other interventions to increase COVID-19 vaccination uptake. [ABSTRACT FROM AUTHOR]

Background: Although gun owners overwhelmingly support violence prevention policies, they are hesitant to speak up publicly to advocate for these policies. We tested a series of communication messages on gun owners' level of support for various firearm violence prevention policies and on their willingness to engage in gun violence prevention advocacy. Methods: We conducted three consecutive experiments, testing a total of thirteen messages on a sample of gun owners over 18 years old who live in the U.S. The first was a random experiment, the second a quasi-experiment, and the third a randomized control trial. The goal of having these varied methods was to develop messages applicable to different contexts with different levels of information about the audience. Results: The most effective message was a script showing respect for gun owners' decisions to purchase a firearm and proposing a balanced policy roadmap to end gun violence, which led to an increase in gun owner's willingness to engage in eight different advocacy activities. We also found a value-based message conveying loyalty to increase support for domestic violence related prohibitions and willingness to engage in advocacy for gun violence prevention policies. Conclusions: Public health professionals need to develop communication strategies that are aligned with gun owners' values and that affirm respect for gun culture and for gun owners' decisions to own a gun. [ABSTRACT FROM AUTHOR]

Purpose: Understand whether and how Black adolescent daughters' relationships with their single mothers could be strengthened through an intervention to address adverse experiences and stress during the COVID-19 pandemic. Methods: Five Black adolescent daughters of single mothers and five Black single mothers with adolescent daughters were interviewed during the pandemic who participated in a program designed to improve Black adolescent daughter-single mother relationships. Results: Changes in work and school requirements impacted the daughter-mother relationship, with most respondents suggesting their relationships improved during COVID-19 due to involvement in this program. Conclusions: Despite the stress and strain of COVID-19, involvement in similar programs can strengthen daughter-mother relationships. [ABSTRACT FROM AUTHOR]

We examined whether an internet use promotion intervention influences low-income older adults' communication modes, internet use, and social networks using existing data collected for an intervention. Participants living in public senior housing facilities in the United States (n = 77) completed surveys before and after a 12-week computer and internet training. The six-item Lubben Social Network Scale (LSNS-6) was used to measure the extent of older adults' social networks. The primary mode of communication shifted from more traditional means to internet-based communications (p <.0005 in a Fisher's exact test). The frequency of internet use significantly increased (p <.00005 in a one-sided Sign test). Overall, the LSNS-6 score increased by 4.1 points (p <.00005 in a Welch's t-test). The LSNS-6 score increase was significantly larger among African Americans than Whites, controlling for gender (p <.05 in negative binomial regression). Moderate (p <.005) and frequent internet users (p <.05) had higher LSNS-6 scores than rare internet users at posttest when gender and race were controlled for in linear regression. Comparatively more improvement in the extent of social networks among African Americans suggests greater benefits of such interventions for population groups of disadvantaged backgrounds. Larger social networks among moderate and frequent internet users than rare users suggest positive impacts of internet communications on social networks. [ABSTRACT FROM AUTHOR]

Purpose An increasing number of workers in the US have chronic health conditions that limit their ability to work, and few worksite interventions have been tested to improve worker coping and problem solving at work. The purpose of this study was to evaluate a worksite-based health self-management program designed to improve workplace function among workers with chronic health conditions. Methods We conducted a randomized, controlled trial of a worksite self-management program ("Manage at Work") (clinicaltrials.gov #NCT01978392) for workers with chronic health conditions (N = 119; 82% female, ages 20–69). Most workers were recruited from the health care or light manufacturing industry sectors. Workers attended a 5-session, facilitated psychoeducational program using concepts of health self-management, self-efficacy, ergonomics, and communication. Changes on outcomes of work engagement, work limitation, job satisfaction, work fatigue, work self-efficacy, days absent, and turnover intention at 6-month follow-up were compared to wait-list controls. Results The most prevalent chronic health conditions were musculoskeletal pain, headaches, vision problems, gastrointestinal disorders, respiratory disorders, and mental health disorders. The self-management program showed greater improvement in work engagement and turnover intent at 6-month follow-up, but there was no evidence of a parallel reduction in perceived work limitation. Trends for improved outcomes of work self-efficacy, job satisfaction, and work fatigue in the intervention group did not reach statistical significance in a group x time interaction test. Conclusions Offering a worksite self-management program to workers with chronic health conditions may be a feasible and beneficial strategy to engage and retain skilled workers who are risking disability. Clinical trial registration: Clinicaltrials.gov #NCT01978392. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to identify key challenges and opportunities to better support non-clinician clinic staff at family planning centers in Southern US states. Methods: We conducted qualitative interviews with 15 individuals in clinic staff and leadership positions at family planning centers in seven Southern states. Results: Turnover had negative impacts on both clinic functioning as well as patient care. Participants identified several challenges related to recruitment and retention in family planning health centers in the South, including the conservative contextual landscape, the perceived value of support staff, gaps in communication, and rural locations. In response to these challenges, staff also identified key strategies to better support and retain health center workers. These included prioritizing investment in management, creating career advancement opportunities, prioritizing staff retention, and creating space for self-care. Health center staff and leadership who used these strategies to support and retain staff noted improvements in the effectiveness of staff work as well as increases in patient volume. Conclusions for Practice: Study findings provide key areas for intervention including providing development opportunities, commitment from leadership to recognize and invest in staff and supporting self-care. Focusing on ensuring internal organizational justice for staff may also facilitate resilience to external challenging environments. Better supporting clinic staff is likely also important for quality services and ensures the full workforce involved in providing family planning care can work at full capacity. [ABSTRACT FROM AUTHOR]

Integrated health care includes joint, outpatient delivery of medical and behavioral health services. Traditional patient satisfaction measures might fail to capture the discrete delivery approaches in this model. To identify patient satisfaction measures used in integrated health care settings, a systematic review was conducted of US-based studies conducted in adult outpatient integrated care settings from 1999 through 2020. Study quality was assessed using standards recommended by the COSMIN guidelines. The review yielded a sample of 23 studies, consisting of 10 standardized measures and 6 self-developed tools. All studies/measures met at least one of the identified COSMIN guidelines, demonstrating quality of the measures. While most measures evaluated key elements of integration, including access, communication, and relationships, only one standardized measure evaluated elements of care specific to practice in integrated care. Findings suggest a need for a comprehensive patient satisfaction measure that captures important aspects of the integrated health care experience. [ABSTRACT FROM AUTHOR]

Objectives: Educational attainment has been demonstrated as a protective factor for the physical and mental health of children into adulthood, yet there has been limited research on the association between positive childhood experiences (PCEs) and school success. The purpose of this study is to examine the associations between PCEs and challenges to school success. Methods: This cross-sectional study used data of 33,450 children from the 2017–2018 National Survey of Children's Health to examine PCEs and two challenges to school success (school absenteeism and repeated grades), using multivariable logistic regression analysis. Results: The most prevalent types of PCEs were mentor for advice or guidance (89.8%), family resilience (81.1%), and after-school activity participation (79.8%). Children who participated in after-school activities had lower odds of reported school absenteeism (aOR 0.59; 95% CI 0.46–0.76) and repeating a grade (aOR 0.75; 95% CI 0.59–0.97) than their counterparts. Children who shared ideas with their caregiver had lower odds of repeating a grade (aOR 0.78; 95% CI 0.63–0.97) than children who did not share ideas with their caregiver. Children who lived in a supportive neighborhood were less likely to have reported school absenteeism than children who did not live in a supportive neighborhood (aOR 0.77; 95% CI 0.60–0.98). Conclusions for Practice: Participation in after-school activities had optimal associations with both school absenteeism and repeated grade, suggesting its potential protective effect for school success. Promoting PCEs at the school, family, and community levels may help address school absenteeism and grade retention. [ABSTRACT FROM AUTHOR]

For 2 weeks, participants (282 US collegians) used a diary technique to describe the social interactions they had each day. These descriptions included how enjoyable the interaction was, how confident they felt, and how intimate the interaction was. They also completed a measure of Allport's Intrinsic–Extrinsic religious orientation, the Christian Orthodoxy scale, and the Beck Depression Inventory. A series of multilevel modeling analyses found that enjoyment and confidence in social interaction were positively related to the Extrinsic Personal factor of the IE scale, whereas intimacy of interactions was not related to any of these measures. These relationships remained after controlling for orthodox beliefs and depression. These results suggest that the extent to which people find comfort in religious beliefs and practices (e.g., prayer) is positively related to the quality of their daily social experiences. [ABSTRACT FROM AUTHOR]