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Background: Health promotion programs and interventions are designed to encourage behavioral changes in children, encouraging them to make safe and healthy life choices. This systematic review seeks to examine how social impact is measured in primary school health promotion interventions. Method: A systematic search and review process was used to identify and examine primary school health promotion interventions. The PRISMA guidelines were followed to source articles from 6 electronic databases reporting school health promotion programs or interventions in Australia, Canada, New Zealand, or the United Kingdom. Results: A total of 77 studies were located, representing 55 health promotion interventions delivered in primary school settings. Of these interventions, only 8 (15%) measured or attempted to measure social impact, whereas another 8 (15%) alluded to social impact. The predominant theories reported were social based theories (theories which examine the social influences on people, environments, and behaviors) (n = 17, 59%), with almost a third not informed by an overt health promotion framework or model (n = 34, 59%). A systematic rating system identified some level of stakeholder engagement (n = 30, 53%). Conclusions: This systematic review highlights the need for social impact measurement within health promotion to illuminate the role of school programs in delivering lasting change.

Through this study, we explore 26 Multiracial tenured and tenure track faculty members' experiences with Multiracial microaggressions while working within historically white 4-year colleges and universities in the United States. Findings from the research suggest that Multiracial faculty members often encounter Multiracial microaggressions that stifle their professional success. Yet Multiracial microaggressions may also provide some faculty with unique access within the academy. This study centers Multiracial faculty members' experiences in an effort to inform institutional procedures that support and retain Multiracial faculty and to complicate a monoracial-only paradigm of race, or the dominant ideology that race only exists in strict monoracial categories.

Background Bleeding among populations undergoing percutaneous coronary intervention or coronary artery bypass grafting and among conservatively managed patients with acute coronary syndrome exposed to different dual antiplatelet therapy and triple therapy (i.e. dual antiplatelet therapy plus an anticoagulant) has not been previously quantified. Objectives The objectives were to estimate hazard ratios for bleeding for different antiplatelet and triple therapy regimens, estimate resources and the associated costs of treating bleeding events, and to extend existing economic models of the cost-effectiveness of dual antiplatelet therapy. Design The study was designed as three retrospective population-based cohort studies emulating target randomised controlled trials. Setting The study was set in primary and secondary care in England from 2010 to 2017. Participants Participants were patients aged ≥ 18 years undergoing coronary artery bypass grafting or emergency percutaneous coronary intervention (for acute coronary syndrome), or conservatively managed patients with acute coronary syndrome. Data sources Data were sourced from linked Clinical Practice Research Datalink and Hospital Episode Statistics. Interventions Coronary artery bypass grafting and conservatively managed acute coronary syndrome: aspirin (reference) compared with aspirin and clopidogrel. Percutaneous coronary intervention: aspirin and clopidogrel (reference) compared with aspirin and prasugrel (ST elevation myocardial infarction only) or aspirin and ticagrelor. Main outcome measures Primary outcome: any bleeding events up to 12 months after the index event. Secondary outcomes: major or minor bleeding, all-cause and cardiovascular mortality, mortality from bleeding, myocardial infarction, stroke, additional coronary intervention and major adverse cardiovascular events. Results The incidence of any bleeding was 5% among coronary artery bypass graft patients, 10% among conservatively managed acute coronary syndrome patients and 9% among emergency percutaneous coronary intervention patients, compared with 18% among patients prescribed triple therapy. Among coronary artery bypass grafting and conservatively managed acute coronary syndrome patients, dual antiplatelet therapy, compared with aspirin, increased the hazards of any bleeding (coronary artery bypass grafting: hazard ratio 1.43, 95% confidence interval 1.21 to 1.69; conservatively-managed acute coronary syndrome: hazard ratio 1.72, 95% confidence interval 1.15 to 2.57) and major adverse cardiovascular events (coronary artery bypass grafting: hazard ratio 2.06, 95% confidence interval 1.23 to 3.46; conservatively-managed acute coronary syndrome: hazard ratio 1.57, 95% confidence interval 1.38 to 1.78). Among emergency percutaneous coronary intervention patients, dual antiplatelet therapy with ticagrelor, compared with dual antiplatelet therapy with clopidogrel, increased the hazard of any bleeding (hazard ratio 1.47, 95% confidence interval 1.19 to 1.82), but did not reduce the incidence of major adverse cardiovascular events (hazard ratio 1.06, 95% confidence interval 0.89 to 1.27). Among ST elevation myocardial infarction percutaneous coronary intervention patients, dual antiplatelet therapy with prasugrel, compared with dual antiplatelet therapy with clopidogrel, increased the hazard of any bleeding (hazard ratio 1.48, 95% confidence interval 1.02 to 2.12), but did not reduce the incidence of major adverse cardiovascular events (hazard ratio 1.10, 95% confidence interval 0.80 to 1.51). Health-care costs in the first year did not differ between dual antiplatelet therapy with clopidogrel and aspirin monotherapy among either coronary artery bypass grafting patients (mean difference £94, 95% confidence interval –£155 to £763) or conservatively managed acute coronary syndrome patients (mean difference £610, 95% confidence interval –£626 to £1516), but among emergency percutaneous coronary intervention patients were higher for those receiving dual antiplatelet therapy with ticagrelor than for those receiving dual antiplatelet therapy with clopidogrel, although for only patients on concurrent proton pump inhibitors (mean difference £1145, 95% confidence interval £269 to £2195). Conclusions This study suggests that more potent dual antiplatelet therapy may increase the risk of bleeding without reducing the incidence of major adverse cardiovascular events. These results should be carefully considered by clinicians and decision-makers alongside randomised controlled trial evidence when making recommendations about dual antiplatelet therapy. Limitations The estimates for bleeding and major adverse cardiovascular events may be biased from unmeasured confounding and the exclusion of an eligible subgroup of patients who could not be assigned an intervention. Because of these limitations, a formal cost-effectiveness analysis could not be conducted. Future work Future work should explore the feasibility of using other UK data sets of routinely collected data, less susceptible to bias, to estimate the benefit and harm of antiplatelet interventions. Trial registration This trial is registered as ISRCTN76607611. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 27, No. 8. See the NIHR Journals Library website for further project information. Plain language summary People who have a heart attack are treated with a stent to open up the blocked artery that caused the heart attack, with surgery to bypass the blocked artery or with medication only. Whatever the treatment, they are prescribed one or more antiplatelet drugs, either aspirin only or aspirin and an additional antiplatelet (clopidogrel, prasugrel or ticagrelor), for 12 months after the heart attack. Antiplatelets are given to prevent another heart attack, but increase the risk of bleeding. We used a large general practice database and a database describing patients’ attendances and admissions to hospital to determine how many people bleed with different antiplatelet combinations. We found that, overall, up to 1 in 10 people taking antiplatelets (rising to 2 in 10 if also taking an anticoagulant such as warfarin or dabigatran) reported a bleed. Among patients treated with surgery or medication only, we compared aspirin only (which is a less potent therapy) with aspirin and clopidogrel (a more potent therapy). Among patients treated with stents, we compared aspirin and clopidogrel (less potent therapy) with aspirin and prasugrel or ticagrelor (more potent therapy). In all three populations, the more potent therapy increased the risk of bleeding by about one and a half times, but this was not offset by a reduced risk of having a subsequent heart attack. This may be explained by low adherence to the medication: between one-third and almost half of all patients did not adhere to their regimen, and non-adherence was generally higher among patients taking a more potent therapy. It may also be explained by bias inherent in the study, for example if the groups prescribed different antiplatelet regimens had different risks of having another heart attack. Nevertheless, the results show that doctors should be cautious about prescribing more potent antiplatelet therapy because it may increase serious bleeds without necessarily reducing the number of heart attacks. Scientific summary Background Dual antiplatelet therapy (DAPT), a combination of aspirin and clopidogrel, prasugrel or ticagrelor, is recommended for up to 12 months for secondary prevention of ischaemic events (heart attack and stroke) among people undergoing coronary interventions [coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI)] and people with acute coronary syndrome (ACS) who are medically managed. Randomised controlled trials (RCTs) in these populations suggest that DAPT increases the risk of bleeding compared with aspirin monotherapy, and that more potent DAPT (with prasugrel and ticagrelor) increases the risk of bleeding compared with less potent DAPT (with clopidogrel). Adding an anticoagulant to DAPT (e.g. for the management of atrial fibrillation), known as triple therapy (TT), increases risk further. ‘Real-world’ bleeding among populations exposed to different DAPT and TT regimens has not been previously quantified. The economic impact of bleeding events is poorly characterised, in particular for minor bleeding, as is their impact on health-related quality of life (HRQoL). Objectives 1.Estimate rates of major and minor bleeding events with different DAPT (and TT) exposures among CABG, PCI and conservatively treated ACS patients. 2.Estimate hazard ratios (HRs) for bleeding for different antiplatelet regimens: for the PCI cohort, we compared aspirin and clopidogrel (AC) with aspirin and prasugrel (AP) or aspirin and ticagrelor (AT); for the CABG and ACS no-procedure cohorts, we compared aspirin with AC. 3.Review the literature to estimate the deterioration in utility (quality-adjusted life-years) of patients who have minor or major bleeding events. 4.Revise/extend existing economic models of the cost-effectiveness of different DAPT regimens to include estimates of the incidence of minor and major bleeding events and associated impacts on utility in the general population. 5.Estimate the resources required and associated costs incurred of treating major and minor events of the alternative DAPT (TT) exposures in the three specified patient populations. 6.Understand patients’ perspectives of DAPT, and the factors that influence responses to nuisance bleeding focusing on adherence and information-seeking (this objective was identified through the patient and public involvement work after the start of the ADAPTT study). Methods Objectives 1 and 2 We conducted a study to identify confounders systematically by performing a systematic review of RCTs and cohort studies; conducting semistructured interviews with six cardiac surgeons, six cardiologists and five general practitioners (GPs); and conducting a survey of 79 cardiologists and 31 cardiac surgeons. We used linked Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES) data to assemble populations (CABG, PCI and conservatively managed ACS patients) eligible for three ‘target trials’. Inclusion criteria for the target trial were as follows: ≥ 18 years of age, ≥ 1 year of data in CPRD before the index event, no prescription for DAPT or anticoagulants in the preceding 3 months and a prescription for aspirin or DAPT within 2 months of discharge after the index event. The primary outcome was any bleeding event (CPRD or HES data) up to 12 months after the index event. We described rates of bleeding among patients prescribed different DAPT regimens and TT. We estimated adjusted HRs for time to first bleed comparing DAPT with AC (reference) versus aspirin monotherapy for CABG and conservatively managed ACS patient, and, in the emergency PCI population, DAPT with prasugrel versus DAPT with clopidogrel for ST-elevation myocardial infarction (STEMI) patients only and DAPT with ticagrelor versus DAPT with clopidogrel for all the emergency PCI population. We prespecified five sensitivity analyses and conducted three: sensitivity analysis 1 – multiple imputation for eligible patients for whom we had no data to assign an intervention; sensitivity analysis 3 – restricted to patients at low risk of bleeding; and sensitivity analysis 4 – repeating primary outcome analysis without censoring of any CPRD or HES bleed events at transfer-out or last collection date. The transfer-out or last collection date reflect the date that a patient leaves the general practice or the date that the last capture from CPRD was made. Objective 3 A systematic review was conducted of primary research and decision-analytic modelling studies reporting utility decrements for bleeds related to DAPT through a search of MEDLINE, PubMed and references of included studies. A health elicitation study was undertaken, comprising 21 participants (PCI, CABG and conservatively managed ACS) who completed an elicitation exercise involving vignettes describing minor and major bleeds and the EuroQol-5 Dimensions, three-level version (EQ-5D-3L), and the EuroQol-5 Dimensions, five-level version (EQ-5D-5L). Utility decrements were derived using linear regression, and were compared with existing estimates. Objective 4 No formal cost-effectiveness evaluation was undertaken. Objective 5 Data on health-care use were derived from the linked CPRD–HES data set. The total health-care costs associated with the different antiplatelet regimens in the three target trials were measured at 1, 2 and 3 years after the start of follow-up. We used inverse probability of treatment weighting to adjust for the same confounders identified for the main ADAPTT analysis. The total health-care costs at 1, 2 and 3 years of follow-up were estimated by fitting weighted generalised linear models with gamma distribution and log-link. Objective 6 Two focus groups were conducted with patients at the early stages of treatment (0–3 months, nine participants), and two with patients coming to the end of treatment (9–12 months, 12 participants), to explore their experiences with DAPT. Recordings were transcribed verbatim, anonymised and analysed using framework analysis. Research findings Objectives 1 and 2 Confounders study A total of 70 potential confounders were identified by systematic review, clinician interviews and surveys; of these, 34 (49%) were classified as true confounders (factors that influence both the assigned intervention and the outcome), of which 31 (91%) were identified by systematic review and three (9%) by clinician interview, and 31 (91%) were confirmed by the survey. The clinician interviews identified hard-to-measure factors not identified in the review (drug potency, resistance to antiplatelet medication and clinician concerns about adherence). Data that would enable the characterisation of risk, including presentation risk and procedural risk factors, were unavailable for 17 of the 34 confounders (50%). The ADAPTT study A proportion of eligible participants were excluded from each target trial because they could not be assigned an intervention at baseline (17%, 40% and 9% of the CABG, conservatively managed ACS and emergency PCI patients, respectively). The incidence of any bleeding was 5%, 10% and 9% in CABG patients, conservatively managed ACS patients and emergency PCI patients, respectively; the corresponding rates of minor bleeding were 4%, 7% and 7%, respectively. Compared with aspirin monotherapy, DAPT was associated with an increase in the hazards of any bleeding and of major adverse cardiovascular events (MACEs) among CABG [HR 1.72, 95% confidence interval (CI) 1.15 to 2.57, and HR 2.06, 95% CI 1.23 to 3.46, respectively] and conservatively managed ACS patients (HR 1.43, 95% CI 1.21 to 1.69, and HR 1.57, 95% CI 1.38 to 1.78, respectively). Among emergency PCI patients, compared with less potent DAPT (with clopidogrel), more potent DAPT with ticagrelor (ACS and STEMI patients only) or prasugrel (STEMI patients only) increased the hazard of bleeding (HR 1.47, 95% CI 1.19 to 1.82; HR 1.47, 95% CI 1.08 to 2.00; and HR 1.77, 95% CI 1.21 to 2.58, respectively), but there was no association with MACEs (HR 1.06, 95% CI 0.89 to 1.27; HR 1.21, 95% CI 0.94 to 1.56; and HR 1.10, 95% CI 0.80 to 1.51, respectively). Sensitivity analyses using multiple imputation to impute for the intervention assigned at baseline did not materially change these results. Non-adherence to the treatment assigned at baseline was generally higher in the CABG and conservatively-managed ACS target trials (affecting up to 46% and 44% of patients, respectively) than in the in emergency PCI (affecting up to 33% of patients). Triple therapy The median duration of TT was 3.5 months. The incidence of any bleeding among patients prescribed TT was 18%. There was no difference in the incidence of any bleeding, or of major bleeding or minor bleeding, between patients on TT with warfarin and patients on TT with a non-vitamin K oral anticoagulant (NOAC). However, mortality from bleeding was higher among patients on TT with a NOAC than among patients on TT with warfarin (2% vs. 0%), as was the incidence of stroke (4% vs. 0%). Objective 3 Twelve eligible studies were included for review. Reported utility decrements ranged from –0.002 to –0.03 for minor bleeds and –0.007 to –0.05 for major bleeds. Data sources used to estimate the decrements lacked relevance to our population group, and few studies adequately reported details of their measurement and valuation approaches. Our patient health elicitation study elicited utility decrements that overlapped existing estimates, ranging from –0.000848 to –0.00828 for minor bleeds and from –0.0187 to –0.0621 for major bleeds. However, the magnitude of difference depended on the instrument (EQ-5D-5L or EQ-5D-3L), estimation method and valuation approach applied. Objective 5 The mean total health-care cost in the year prior to the index event was much higher for CABG patients (£13,601) than for conservatively managed ACS (£3528) or emergency PCI patients (£3625). For CABG patients, mean costs were similar between different antiplatelet regimens (£13,623 for aspirin monotherapy and £13,537 for DAPT with clopidogrel). For conservatively managed ACS, patients on DAPT with clopidogrel had a lower mean total health-care cost in the year prior to the index date than patients on aspirin monotherapy (£3317 vs. £3857, respectively). Among emergency PCI patients, those initiated on DAPT with clopidogrel had a higher mean total health-care cost in the year prior to the index event (£4492) than those initiated on DAPT with prasugrel (STEMI patients only) (£1660) or ticagrelor (£2829). Among the CABG population, there was no difference in mean cumulative health-care costs between initiation of DAPT with clopidogrel and initiation of aspirin monotherapy; the mean difference at 1, 2 and 3 years was £94 (95% CI –£555 to £763), £236 (95% CI –£831 to £1223) and £113 (95% CI –£1318 to £1102), respectively. Among the conservatively managed ACS population, the mean cumulative health-care costs were estimated to be slightly higher if all patients were treated with DAPT with clopidogrel than if all were treated with aspirin monotherapy; the mean difference at 1, 2 and 3 years was £610 (95% CI –£626 to £1516), £1118 (95% CI –£226 to £2206) and £1225 (95% CI –£426 to £2423), respectively, although there was considerable overlap between CIs. For emergency PCI patients, the estimated cumulative health-care costs were comparable under the different antiplatelet regimens among patients not receiving concurrent proton pump inhibitor (PPI) prescriptions, but were higher for patients receiving DAPT with ticagrelor than for patients receiving DAPT with clopidogrel. At 1 year, for example, the predicted mean difference in health-care costs if all patients received DAPT with ticagrelor rather than DAPT with clopidogrel was £72 (95% CI –£532 to £762) among those not receiving concurrent PPI therapy and £1145 (95% CI £269 to £2195) among those receiving concurrent PPI therapy. Among STEMI patients receiving concurrent PPI therapy, DAPT with prasugrel was associated with higher costs than DAPT with clopidogrel or DAPT with ticagrelor. Objective 6 Participants would adhere to DAPT when they believed that DAPT was important to ACS outcomes. Those who had experienced nuisance bleeding reported symptoms to be mild and manageable and did not report the bleed to their GP. Adherence was influenced by participants’ and their families’ understanding of the risks and benefits of DAPT, and their ability to manage symptoms. Factors influencing knowledge about DAPT included access to medication counselling; processing of and engaging with information communicated during medication counselling; and access to timely, relevant and expert information and advice after discharge from hospital. Conclusions There is underascertainment of minor/nuisance bleeding in the CPRD, probably as a result of under-reporting of nuisance bleeding by patients to their GPs. In three retrospective population-based cohort studies emulating target trials, there was an increased risk of bleeding among patients receiving DAPT compared with those receiving aspirin monotherapy (CABG and conservatively managed ACS patients) and among patients receiving more potent DAPT than among those receiving less potent DAPT (emergency PCI patients), but not the expected decrease in MACEs. We identified several potential biases that may have influenced the results of the ADAPTT study as a result of imperfect emulation of the defined target trials: (1) selection bias – we excluded a subgroup of the eligible population because they could not be assigned an intervention; (2) confounding – we had no data for half of the confounders identified, including procedure-related characteristics and disease complexity, and evidence from clinician interviews and surveys that clinicians balance bleeding and ischaemic risk when prescribing DAPT to their patients; and (3) non-adherence to DAPT, which was substantial, and generally higher in the stronger antiplatelet treatment groups. Medication knowledge and understanding, and confidence in dealing with symptoms facilitate positive attitudes towards adherence to DAPT, but may be hindered by opportunities to access relevant, timely and appropriate medication counselling. Although we derived relevant utility decrements for the included population using a patient elicitation exercise, based on standardised definitions of minor and major bleeding events, using a validated HRQoL instrument and valued using general population tariffs, we could not conduct a formal cost-effectiveness analysis given the uncertainty around the estimates for bleeding. Nevertheless, the results using routinely collected data need to be carefully considered by clinicians and decision-makers, given that the increased risk of bleeding we observed with more potent DAPT was not offset by a reduced risk of cardiovascular events and that several recent large meta-analyses of RCTs have also failed to show a conclusive benefit of more potent antiplatelet therapy on cardiovascular events. Future work Future research should explore the feasibility of using other UK data sets of routinely collected data, less susceptible to bias, to estimate the benefit and harm of antiplatelet interventions. Research is needed to develop guidance for identifying confounders and how confounders should be organised into confounding domains to facilitate consistent implementation of the Risk Of Bias In Non-randomized Studies – of Interventions (ROBINS-I) tool. The principle of designing an observational study to emulate a RCT by first defining a target trial appears to be a robust approach, highlighting where the emulation succeeds or fails. Nevertheless, further research is required to validate instances in which an emulation is considered to have been successful, ideally prospectively (i.e. using observational data to emulate ongoing RCTs before their data are analysed and the results are known).We recommend that our utility decrements are used in future cost-effectiveness analyses of DAPT in a UK setting, particularly for minor bleeding events for which existing evidence is limited. In addition, we recommend that future research focuses on quantifying the value of information from reducing the uncertainty of our estimated utility decrements. This research would demonstrate whether or not conducting a larger, more robust study to collect additional information on the HRQoL impact of minor and major bleeds for patients taking DAPT would be an efficient use of resources. The qualitative study with patients highlighted that medication knowledge and understanding, and confidence in dealing with symptoms, facilitate positive attitudes towards adherence to DAPT, but that, currently, there are limited opportunities for patients to access relevant, timely and appropriate DAPT medication counselling. Future qualitative research should focus on developing an intervention to support service users taking DAPT. Trial registration This trial is registered as ISRCTN76607611. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 27, No. 8. See the NIHR Journals Library website for further project information.

In this article, Jessica C. Harris, Nadeeka Karunaratne, and Justin A. Gutzwa examine the modalities Women of Color student survivors perceive as helpful in healing from campus sexual assault. Existing scholarship on healing from campus sexual assault largely relies on the reduction of psychological symptoms of trauma, an understanding that is often race-neutral and founded on the narratives of white women. Centering the experiences of 34 Women of Color undergraduate student survivors, this qualitative study reimagines healing through a race-conscious lens and positions it as a community-oriented and culturally contextual process that is often at odds with the ways US institutions of higher education aim to support survivors of sexual assault on their campuses. The authors' findings guide implications for how institutions and individuals can account for and support student survivors' multiple and intersecting identities in their healing journeys and also inform future research that centers minoritized students' experiences with sexual assault in postsecondary contexts.

Framed by the concept of biculturalism this study explores how 26 Multiracial faculty members form and use biculturalism to navigate an academy steeped in monoculturalism, or the belief that all people should conform to a dominant white westernized worldview. Findings from this study suggest that many Multiracial faculty members form and use a unique form of biculturalism, borderlands biculturalism, to navigate postsecondary contexts. Study findings encourage the expansion of binary understandings of biculturalism, support the retention and success of a growing Multiracial faculty population in U.S. higher education, and guide implications for institutional transformation.

This study centers 26 Multiracial faculty members' voices to explore the research question: What are Multiracial tenured and tenure-track faculty members' experiences with teaching, research, and service within 4-year colleges and universities in the United States? Findings suggest that Multiracial faculty members use their research as a mechanism for social change, but that this research may also be invalidated by monoracial colleagues. Some Multiracial faculty also explored how they hold and use a unique (Multi)racial consciousness to approach their teaching and service work. Finally, some participants perceived that their Multiraciality made them less "threatening" to the institution, which tokenized them in different manners than what is currently known about tokenization for monoracial Faculty of Color. Findings from this research inform institutional policies and procedures that support Multiracial faculty members and contribute to institutional diversity and equity. The research also aims to disrupt the dominant ideology that race exists in strict monoracial-only categories; an ideology that may inform and be upheld by the existing literature on the experiences of Faculty of Color in the academy.

Postsecondary institutions remain bastions of oppression, threat and harm for faculty who hold minoritized identities. While some scholars have explored the ways in which monoracial faculty of color and LGBT faculty members navigate an academy that is steeped in racism, genderism, sexism and other systems of oppression, there remains a paucity of scholarship focused on the experiences of multiracial faculty and nonbinary trans* faculty. Given the need to focus on faculty who hold liminal identities in relation to hegemonic identitarian illogic, we used Gloria Anzaldúa's borderlands theory and an auto-ethnographic analysis to explore our academic experiences as faculty members whose identities place us betwixt-and-between socially constructed monolithic identity categories.

Because Multiracial people are often pressed between socially constructed monoracial categories and forced to navigate a monoracial-only paradigm of race, Multiracial individuals may develop a heightened (Multi)racial consciousness, through which they queer race, or (un)consciously challenge normative, often-oppressive racial constructs. While the word 'queer' has come to signify an essential identity for some, specifically those who identify as gay, lesbian, bisexual, and/or transgender, it is also a political identity that applies to people at odds with the dominant, such as Multiracial people. This study focuses on 24 Multiracial campus professionals' experiences with frustrating race in post-secondary contexts in the U.S. by exploring the question, "What are Multiracial campus professionals' experiences with queering race in U.S. postsecondary contexts?" In exploring Multiracial professionals' experiences with queering race, this study aims to better inform institutional and individual understandings of advancing racial equity.

Grounded in Black feminist and critical race theories, legal scholar Kimberlé Crenshaw introduced the term "intersectionality" to the academy in 1989 to demonstrate how U.S. structures, such as the legal system, and discourses of resistance, such as feminism and anti-racism, often frame identities as isolated and mutually exclusive, resulting in the "theoretical erasure" of Black women who hold multiple minoritized identities. Since 1989, intersectionality has become a "traveling theory," that has crossed into and influenced almost every academic discipline, including higher education. Through this study, we examined how researchers in higher education do and undo intersectionality and, subsequently, how intersectional analyses may advance a radical social justice agenda in higher education. To explore how scholars un/do intersectionality in higher education, we conducted a summative content analysis of 97 higher education articles that used the term "intersectionality" in some manner. The goal of the study was not to offer a prescriptive way to use intersectionality. In fact, theoretically musing over the precise way in which intersectionality should be done may confine the concept to an overly academic contemplative exercise and therefore, undo intersectionality. Instead, through this research, we aimed to explore and use intersectionality in a manner that advances a transformative social justice agenda.

In this chapter, the authors outline the property functions of whiteness within fraternity and sorority culture from both a historical and present-day perspective.

Utilizing critical Multiracial theory, this study explores how Multiracial campus professionals' experiences with racial authenticity influence their work in postsecondary contexts. Three themes were generated from 24 Multiracial campus professionals' narratives, including encountering racial authenticity tests, navigating the authenticity trap, and Black Lives Matter and professionals' internalization of racial authenticity tests. This study explores how Multiracial professionals' experiences with racial authenticity often constrain their ability to foster inclusion and educational equity on campus and mediates their connections with students and colleagues.

Immersive global learning experiences like Collaborative Online International Learning (COIL) offer students cross-cultural knowledge, awareness, and language fluency, fostering critical analysis, and problem-solving. This paper focuses on U.S. and Dutch students' perceptions of personal growth as future health education specialists regarding cultural sensitivity and competence within a COIL course. The study explores valuable skills for professionals engaging with diverse populations, contributing to the literature on faculty-led internationalization initiatives. Both the COIL research model and the cultural intelligence (CQ) framework guided the design and implementation of the COIL course. A thematic analysis of self-reflection narratives from N = 49 undergraduate students from the U.S. and the Netherlands revealed categories and themes related to cultural perspectives in health promotion, cultural sensitivity and competence, and essential skills for health education specialists. The findings demonstrate the impact of COIL on students' cultural perspectives and knowledge, their awareness of cultural norms, and the importance of diverse strategies and approaches in health promotion. The study highlights the value of COIL courses in developing cultural understanding within educational settings and provides insights for educators and students interested in engaging with diverse populations. [ABSTRACT FROM AUTHOR]

The research presented in this article utilizes data from four years of the National Survey of Student Engagement to shed light on the biracial student population and their engagement practices in postsecondary contexts. Specifically, this study explored the ways in which biracial students with different racial heritages engage differently from one another and from their monoracial peers on campus. Study findings complicate the ideology that biracial individuals are a monolithic group, fostering a conversation concerning multiraciality in higher education and providing critical implications for future research and practice.

This study examines how directors of Black culture centers (BCCs) address Black students' intersectional identities. We highlight the challenges that directors of BCCs face as they attempt to preserve a race salient agenda, while accounting for other critical facets of students' social identities. Findings explore how directors hold differing approaches to addressing the intersections of Black students' intersectional identities and the ways in which these attempts were hindered by a lack of funding and postracial ideology. From the findings, the authors provide rich recommendations to staff who work in BCCs and other identity-based centers on the theory of intersectionality and how to incorporate the theory into one's daily practice and programming.

Previous research demonstrates that businesses that are Indigenous‐owned are far more likely to employ Indigenous people than non‐Indigenous‐owned businesses (Hunter, 2015). The majority of the literature on Indigenous employment uses a deficit discourse, describing factors that prevent or exclude Indigenous people from non‐Indigenous‐owned organisations. There is markedly less literature using a strength‐based approach, detailing how Indigenous‐owned businesses create workplaces without barriers to Indigenous employment. Through 32 semistructured interviews with Indigenous business owners, managers, and Indigenous employees of Indigenous‐owned businesses, this paper provides insights into how participants' businesses create workplaces that are more supportive of, and conducive to, Indigenous employment. This paper finds that Indigenous approaches to governance inform an organisational level of cultural competence, which creates tailored and specific practices that support better Indigenous employment outcomes. This resonates with the concept of Indigenous ways of "knowing, being, and doing," and how this framework encompasses participants' approaches to business operations. In the light of increasing public and private policy commitments to improve Indigenous employment outcomes, it is imperative that the Indigenous business sector's best practice inform said policies, given its successes. However, inherent in these findings are broader discussions into more systemic and societal issues that go beyond workplace policy. [ABSTRACT FROM AUTHOR]

Author Anne Lamott wrote "This is a difficult country to look different in...and if you are too skinny or too tall or dark or weird or short or frizzy or homely or poor or nearsighted, you get crucified." Lamott's comment speaks to what happens when people do not fit into neat social categories. Such experiences of not fitting, of being deemed too much or not enough, extend not just to those with singular marginalized identities but people who are between identities, such as being multiracial and/or having a nonbinary gender identity. For faculty student affairs staff who are betwixt-and-between racialized and gendered identities, they often have to navigate tricky situations in terms of how they work, research, and teach alongside students, faculty, and staff on campus. Given their life experiences, this group of author-educators began to wonder what their experiences say about their field, and how educators can better work alongside students. This dialogue begins with them sharing several of their counter-stories to highlight the complexities of staff and faculty who are at the crossroads between various social identities. By sharing their own counter-stories, the authors intend to draw parallels between their experiences as faculty and staff, and those of students who are in a similar position. They hope to promote a way of rethinking of higher-education practice that is not so focused on figuring out "where students are" but allows students to explore the borderlands between and among identities, experiences, and positionalities.

While research on monoracial college students' experiences with racial microaggressions increases, minimal, if any, research focuses on multiracial college students' experiences with racial microaggressions. This manuscript addresses the gap in the literature by focusing on multiracial college students' experiences with multiracial microaggressions, a type of racial microaggression. Utilizing qualitative data, this study explored 3 different multiracial microaggressions that 10 multiracial women experienced at a historically white institution including, "Denial of a Multiracial Reality, Assumption of a Monoracial Identity," and "Not (Monoracial) Enough to 'Fit In.'"