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BackgroundCancer is the leading cause of death among Asian Americans, who often face barriers to cancer care. Cancer supportive care needs among Asian Americans remain understudied.AimsWe examined cancer supportive care needs and participant factors correlated with these needs, identified profiles of supportive care needs, and examined whether needs profiles are associated with quality of life among Asian American adults.Methods and resultsWe recruited 47 Asian American adults with colorectal, liver, or lung cancer who spoke Chinese, English, or Vietnamese, and were starting or undergoing cancer treatment. We assessed cancer supportive care needs in four domains: cancer information, daily living, behavioral health, and language assistance. Hierarchical cluster analysis was used to identify clusters of participants based on their supportive need profiles to further examine the association between need profiles and quality of life (QoL) assessed by the Functional Assessment of Cancer Therapy. Participants (mean age = 57.6) included 72% males and 62% spoke English less than very well. Older participants (age ≥ 65) and those with annual income

Deficit thinking, or a "blame the victim" mentality for academic failure, continues to plague higher education since it often requires specific training to recognize. International students are particularly vulnerable victims of instructors exhibiting a deficit viewpoint. Instruction librarians can break out of the deficit mindset by acknowledging the actual issues that impact international students, critically examining their own teaching background and identity, demonstrating cultural humility, employing culturally responsive teaching methods, and intentionally designing classroom experiences that will equip international students with the tools they need to succeed. [ABSTRACT FROM AUTHOR]

Aim Materials and Methods Results Conclusion The present review and meta‐analysis sought to synthesise previous findings of studies examining the correlation between therapist cultural humility, the quality of the therapeutic alliance and psychotherapy outcomes.Three databases were searched for relevant citations, yielding 548 records for review. After the systematic review of these articles, a final sample of 13 citations was submitted for coding and analysis. A random‐effects meta‐regression model was used to synthesise correlations collected from the final sample of studies. Heterogeneity was assessed using Cochran's Q, I2 and τ2. Publication bias was assessed using contour‐enhanced funnel plots and Egger's test for asymmetry.There was a statistically significant, positive correlation between cultural humility and alliance quality (r = .66, 95% CI = [0.64, 0.68]). Similarly, a smaller, yet still statistically significant and positive association between cultural humility and psychotherapy outcomes was also found (r = .39, 95% CI = [0.36, 0.42]). Moderators related to client race, gender and lesbian, gay and bisexual (LGB) status were also examined though nonsignificant.Such results suggest that therapist cultural humility is an important part of a strong working relationship and eventual positive outcomes in psychotherapy regardless of race, gender or LGB status. Thus, efforts should be made to foster cultural humility among therapists. [ABSTRACT FROM AUTHOR]

Summary Background Methods Results Discussion Skilled facilitators are essential to drive effective simulation training in healthcare. Competency‐based frameworks support the development of facilitation skills but, to our knowledge, there are no frameworks that specifically address context‐sensitive priorities developed with practitioners working in low‐resource settings.We aimed to develop a core competency framework for healthcare simulation facilitation in low‐resource settings using a modified Delphi process. We drew on the domain expertise of members of the Vital Anaesthesia Simulation Training Community of Practice, with the study guided by a four‐member steering group experienced in the conduct of simulation in low‐resource settings. In survey round 1, participants (n = 54) were presented with an initial competency set derived from a previous qualitative study and co‐created a set of 57 competencies for effective simulation facilitation in low‐resource settings. In survey round 2, participants (n = 52) ranked competencies by relevance into three performance categories: techniques; artistry; and values. In survey round 3, participants (n = 50) ranked competencies on their importance. The steering group collated results and presented a draft core competency framework. In survey round 4, participants (n = 50) voted with 98% agreement that this framework represented the most relevant and important competencies for effective facilitation of simulation sessions in low‐resource settings.The final 32‐item framework encompasses core competencies found in existing standards and includes important new concepts such as demonstration of cultural sensitivity; humility; ability to recognise and respond to potential language barriers; facilitation team collaboration; awareness of logistics; and contingency planning.This competency‐based framework highlights specific practices required for effective simulation facilitation in low‐resource settings. Further work is required to refine and validate this tool to train simulation facilitators to deliver effective training to improve patient safety. [ABSTRACT FROM AUTHOR]

Background: Clinician bias contributes to health disparities; therefore, educational standards and professional expectations incorporate cultural humility. Vague standards and numerous pedagogical methods make implementing an effective and uniform curriculum challenging. Classroom and clinical faculty's attitudes and behaviors are pivotal; however, evidence on roles beyond instruction is lacking. Purpose: This study explored physical therapy (PT) students' perceptions of faculty's role in improving their cultural humility. Methods: This study was rooted in a phenomenological approach that incorporated elements of both descriptive and interpretive phenomenology. Thirteen first-year PT students participated in one-on-one interviews which underwent reflexive thematic analysis. Results: Reflexive thematic analysis generated two hundred-ninety codes, six categories, and one overarching theme. Dissonance emerged between students' perceptions of faculty's role and the explicit and implicit curriculum. Conclusion: Explicit messaging from classroom instruction and implicit messaging from clinical encounters and unspoken attitudes, values, and behaviors were disparate. Faculty role modeling, diversity, cultural awareness, and perceived comfort interacting with a diverse patient population improved students' self-confidence and cultural humility. Professional development including field experience with a cognitive apprenticeship approach, and standardized, discipline-specific cultural humility competencies may provide uniform and clear guidelines. [ABSTRACT FROM AUTHOR]

In recent years, discourse on topics like cultural humility, social determinants of health (SDOH), and health disparities and inequities has greatly increased in medical education as attention to their impact on health has magnified. Unfortunately, traditional medical education models may fail to optimize learning in this area. To address these complex social health issues, we must find innovative ways to engage students in an educational partnership in which they are challenged to critically think and reflect on their attitudes, role, and actions in health equity and culturally responsive care. Through reviews of existing literature coupled with our own experience with iterative implementation of a model that includes interpersonal engagement paired with individual self-directed learning, we assembled 12 tips on how to prepare diverse students to practice lifelong cultural humility and provide culturally and socially responsive care in an ever-changing social landscape. [ABSTRACT FROM AUTHOR]

Global migration significantly impacts demographic patterns in the United States, intensifying the need for nurses to deliver culturally competent healthcare to refugees, immigrants, and migrants. By integrating global service-learning (GSL) into nursing curricula, this study aims to provide a comprehensive understanding of GSL benefits in fostering effective intercultural communication, cultural humility, spiritual growth, and global health knowledge among nursing students. The findings suggest that GSL enhances the educational experience and equips nurses with the skills necessary to address the complex needs of a diverse patient population. [ABSTRACT FROM AUTHOR]

This editorial discusses the field of Global Health and its interdisciplinary approach to understanding and addressing global health issues. It highlights concerns that activities in Global Health often perpetuate colonial assumptions, racism, and biases. The editorial presents a research topic that explores and addresses these biases, focusing on decolonization, bidirectional learning, and partnerships in global health education. It provides examples of articles that examine the impact of historical biases and propose new pathways forward. The document also explores the use of learning platforms in Global Health Education and emphasizes the need to confront and mitigate colonialist and supremacist biases in the field. [Extracted from the article]

Background: Current definitions of professionalism for healthcare trainees often lack equity, diversity and inclusion (EDI) in the expectations and assessment of professionalism. While professionalism teaching is incorporated in healthcare training, equity-deserving groups still experience discrimination. This scoping review investigates the literature to understand how EDI and associated domains of cultural humility, and advocacy can be incorporated in healthcare trainees' education and assessment of professionalism. Methods: The Arksey and O'Malley framework was applied to this scoping review. MEDLINE, Embase & PsychINFO were searched up to March 2023, with terms surrounding health professionals, professionalism, EDI, cultural humility, and advocacy. Titles and abstracts (n = 3870) and full-texts (n = 140) were independently screened by two reviewers. Articles were included if they focused on EDI, cultural humility, or advocacy among healthcare students/trainees, and had outcomes related to professionalism. Articles lacking discussion of professionalism as an outcome were excluded. Themes were generated by mutual discussion. Risk of bias was assessed using the Cote et al. and Medical Education Research Study Quality Instrument (MERSQI) tools. Results: 48 articles underwent thematic analysis. Studies investigated the disciplines of medicine, nursing, social work, physiotherapy, and dentistry. Most studies were qualitative in methodology (n = 23). Three themes emerged: (1) EDI-related interventions are associated with improved professionalism of healthcare trainees/workers (n = 21). Interventions employed were either an EDI-associated educational course (n = 8) or an exchange program to promote EDI competencies among trainees (n = 13). (2) Trainee definitions and perceptions of professionalism include themes related to EDI and cultural humility (n = 12). (3) Current standards of professionalism are perceived as non-inclusive towards historically-marginalized populations (n = 15). Literature investigating advocacy as it relates to professionalism is limited. Conclusion: This review identified that core EDI principles and its associated domains of cultural humility and advocacy are often viewed as integral to professionalism. These findings create a strong impetus to incorporate EDI principles within professionalism frameworks in healthcare education. Future research should employ standardized tools for professionalism assessment to provide more conclusive evidence. Incorporating patient perspectives of professionalism can inform actionable recommendations for fostering inclusive healthcare environments. [ABSTRACT FROM AUTHOR]

AbstractThis first-of-its-kind study explored the essential competencies healthcare chaplaincy hiring managers (HCHMs) sought for entry-level healthcare chaplains (HCCs). We conducted qualitative interviews with 16 HCHMs and using reflexive thematic analysis (RTA), developed nine key themes: interpersonal skills, teamwork, knowledge of family and group dynamics, understanding of the healthcare system, professionalism, proficiency in spiritual assessment, effective communication, commitment to lifelong learning, and knowledge of various religious and spiritual beliefs, extending beyond one’s own faith tradition. These themes reflected HCCs roles as healthcare professionals who contribute to patient care, interdisciplinary collaboration, and spiritual leadership responsibilities. The study underscored the need for chaplaincy education to integrate healthcare-specific coursework, interprofessional training, cultural and religious humility, and deeper knowledge of diverse belief systems. Developing and incorporating curriculum standards based on these themes could enhance the readiness of HCCs to deliver comprehensive care and meet the dynamic demands of diverse patient populations within today’s healthcare landscape. [ABSTRACT FROM AUTHOR]

AbstractIn this article, we provide Christian higher education administrators and faculty with an emerging conceptual model for the development of global kingdom citizens. Cultivating global kingdom citizens requires intentionality in both the curricular and co-curricular realms of Christian higher education, utilizing a holistic intercultural competence development framework as a heuristic. While some institutions may be focused on developing the intercultural competence (IC) of their constituents, others have rejected that term in favor of a more biblical-sounding term—cultural humility (CH). Still others, following the frameworks of a popular Christian businessperson, have preferred to employ the construct of cultural intelligence (CQ). In comparing the philosophical underpinnings and components of these three widely used intercultural competence frameworks, we posit that the cultivation of global kingdom citizens can best be achieved by combining current models into a holistic model entitled Global Kingdom Citizenship (GKC). We likewise propose that this holistic approach is better aligned with the spiritual objectives of Christian higher education, as it appropriately addresses the development of intercultural knowledge, skills, and attitudes for today’s students. [ABSTRACT FROM AUTHOR]

A growing body of evidence has shown the influence that religion and spirituality have on individuals duelling with illness, especially at advanced stages of disease. It is often vital for such individuals to have their spiritual and religious beliefs respected and, potentially, integrated in a compassionate caregiving setting for healthcare systems. However, given the diversity in religions and spiritual practices, healthcare professionals ought to approach such cultural significance with cultural humility, i.e., approaching differences in beliefs without relying on stereotypes or assumptions. This process requires sufficient training and communication skills among healthcare providers, as well as a successful medico-pastoral partnership. The aim of this review is to provide insight into one specific religion, Eastern Orthodoxy, and discuss current evidence of the religion's influence on healthcare and medicine. Within this review, we aim to provide a summary on religion and spirituality specific to the Eastern Orthodox identity and religious practices, along with providing clinical guidance on approaching people who identify with this faith in certain healthcare settings in a manner compatible with the principles of cultural humility. The review will discuss important key elements of religious belief and practice of Εastern Orthodoxy that may influence health and healthcare decisions by patients. [ABSTRACT FROM AUTHOR]

Mental illness is a significant public health concern prevalent in America. Over one in five U.S. adults are affected, yet less than half receive treatment. Among African Americans, only one in three seek treatment with statically lower rates among Black males. Therefore, an accurate diagnosis is crucial for appropriate treatment, while misdiagnosis leads to stigma, discrimination, and untreated illness. This paper examines the implications of misdiagnosing trauma responses in Black men, highlighting systemic biases that impede suitable care and perpetuate negative narratives. The authors propose a conceptual framework incorporating historical trauma, discrimination, and traumatic stress reactions, emphasizing the need for cultural competence and humility. This framework involves public narratives that influence perceptions and judgments, reviewing research evidence, advocating for competent trauma assessments, community empowerment, and future research directions. This paper underscores the importance of understanding and addressing the unique challenges Black men face in mental health diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Physician virtues, including humility, are crucial for shaping a physician's identity and practice. This review aimed to develop a cohesive conceptualization of physician humility and to define how it functions in medical practice. Physician virtues, including humility, are crucial for shaping a physician's identity and practice. The health care literature offers varied views on humility, and the rising call for discussing virtues as a framing for professional identity formation underscores the need for a clearer understanding of physician humility. This review aimed to develop a cohesive conceptualization of physician humility and to define how it functions in medical practice. To achieve this, a comprehensive search was done across PubMed, Ovid MEDLINE, Web of Science, Embase, ERIC, and PsycInfo, covering all records up to 30 October 2023. Articles were included if they discussed physician humility and excluded if they were unrelated to physician humility, focused on nonphysician health professionals, lacked conceptual depth, or focused solely on cultural humility. An applied thematic analysis was conducted. The results provide a synthesized conceptualization of physician humility across stances toward self, others, and the profession. The included articles identified the pivotal role of physician humility within the following 5 domains of medical practice: learning and professional growth, navigating error, uncertainty tolerance, trust and entrustment, and teamwork and communication. The authors highlight some of the intrapersonal, interpersonal, and sociocontextual challenges to cultivating and practicing physician humility. These findings highlight the importance of promoting humility in shaping physicians' actions, thoughts, and relationships with patients, colleagues, and their profession. Integrating such virtues as humility into medical education is essential for upholding the ideals of the medical profession and cultivating moral agents who engage in self-reflection and embody the principles of exemplary physicians. [ABSTRACT FROM AUTHOR]

Simple Summary: AAC involves a trained mental health practitioner, a therapy animal, and a client participating in goal-oriented interventions. These sessions, characterized by human–animal interactions, aim to strengthen the human–animal bond when beneficial to both client and animal. Through this bond, clients may experience reduced mental health symptoms, improved communication skills, and a stronger therapeutic relationship. While research suggests that human–animal interactions can enhance rapport in counseling, it is crucial to recognize that clients and practitioners may have varying perceptions of these interactions. Historically, animals have been used in aggressive and violent practices within communities of color, and, across different cultures and religions, animals may be revered, forbidden, or slaughtered. Therefore, animal-assisted practitioners must address trauma, race, culture, and religion as they relate to animals before introducing AAC. This article aims to explore how AAC practitioners can prevent harm to the human–animal bond by practicing cultural humility. The purpose of this manuscript is to enhance the understanding of how racial, social, and cultural factors influence animal-assisted counseling (AAC). As AAC gains popularity, there is an increasing need for clinicians to practice cultural humility and awareness. While AAC has proven beneficial, clinicians must consider the diverse cultural, religious, and trauma-related perceptions of animals. The American Counseling Association (ACA) has established AAC competencies that highlight the importance of understanding these social and cultural factors, assessing past animal-related trauma, and evaluating client suitability for AAC in the United States. Similarly, in 2018, the International Association of Human-Animal Interactions Organizations (IAHAIO) and, in 2024, the Association of Animal-Assisted Intervention Professionals (AAAIP) set standards for competencies related to clients' cultural backgrounds, trauma, and historical oppressions related to certain species. By addressing these considerations, clinicians can better promote and protect the welfare of both clients and therapy animals. While these organizations generally emphasize ethical standards, professional guidelines, and safeguarding client–animal relationships, this manuscript advocates for a more robust examination of cultural, racial, and societal factors in the use of AAC. This includes not only recognizing the ethical implications but also understanding how diverse backgrounds and access disparities shape the effectiveness, acceptability, and accessibility of AAC interventions. This approach integrates culturally responsive practices and promotes a deeper exploration of how race, culture, religion, and societal factors influence human–animal relationships. [ABSTRACT FROM AUTHOR]

Background: Due to the COVID-19 pandemic, health professional training programs made substantial changes to shift previously in-person student training opportunities to remote settings. Objectives: We present lessons learned from changes made to one community-engaged internship program, Bridging the Gaps (BTG)-Pittsburgh, that should prove helpful in future times of crisis. Methods: BTG-Pittsburgh places inter-disciplinary graduate pairs of students in community-based organizations that serve marginalized populations, to work directly with program participants and develop tangible products aimed to build organizational capacity. Students get additional training on poverty awareness, health literacy, community violence, food justice, trauma-informed self-care, cultural and academic humility, oral health and advocacy. Upon pandemic onset, given increased community need and community partner feedback, BTG-Pittsburgh pivoted quickly, shifting to remote engagement and making critical adjustments to ensure responsiveness to student and community partner needs. Adjustments included: 1) adopting a trauma-informed approach, 2) developing remote mentoring guidance, and 3) doubling site visits to ensure that students and site mentors felt sufficiently supported. Conclusions: Several program and partnership attributes contributed to our overall program success, including a model of reciprocal benefits, providing supports, flexibility, and long-standing relationships. The university's quick adoption of remote technology and each participating school's commitment to supporting the program model, further enabled effective student-organization-program collaboration. These lessons can inform community-partnered experiential learning programs that may need to incorporate remote components moving forward. [ABSTRACT FROM AUTHOR]

The principles of social justice, equity, diversity, inclusion (JEDI) have received increasing attention in behavior analysis circles, but the conversation has largely centered on implications for applied behavior analysis practice and research. It may be less clear to researchers who conduct basic and translational research how JEDI principles can inform and inspire their work. This article synthesizes publications from behavior analysis and other scientific fields about tactics of JEDI‐informed research. We organized this scholarship across five stages of research from developing the research question to sharing findings and curated sources for an audience of behavioral science researchers. We discuss reflexive practice, representation, belongingness, participatory research, quantitative critical theory, and open science, among other topics. Some researchers may have already adopted some of the practices outlined, some may begin new practices, and some may choose to conduct experimental analyses of JEDI problems. Our hope is that those actions will be reinforced by the behavior analysis scientific community. We conclude by encouraging the leadership of this journal to continue to work toward the structural changes necessary to make the experimental analysis of behavior just, equitable, diverse, and inclusive. [ABSTRACT FROM AUTHOR]

Background: Despite the extensive use of community-based participatory research (CBPR) in health-related projects, there is limited work on how CBPR processes result in outcomes, especially in household and ambient air pollution (HAAP) research. This study explores the reflections of key informants on factors that shape the implementation and outcomes of CBPR in HAAP projects. Methods: We conducted semi-structured interviews with 13 key stakeholders, including academic researchers, non-governmental organisation administrators, a policymaker, and community members. All interviewees have experience in CBPR projects. Interviews were analysed using framework analysis, and findings were mapped to Wallerstein et al.'s CBPR conceptual model, which consists of four constructs: context, partnership processes, intervention and research, and outcomes. Results: The findings are described under two main categories: 'barriers to participation' and 'good practices for effective CBPR design and implementation'. Relevant sub-categories were barriers at the structural, research, community, and individual levels. Suggestions for good practices included respect, cultural humility, trust, effective communication, suitable and affordable interventions such as improved cookstoves, appropriate participatory research tools, and gratuity for the community's time. Conclusion: Key informants' perspectives identified factors supported by the CBPR model to inform the design and implementation of the CBPR approach. The add-ons to some of the model's factors, such as intra-community dynamics, give value to the informants' knowledge to support community-research partnerships and improve outcomes in HAAP intervention projects. Addressing these factors at the design stage and reporting CBPR evaluation could deepen the understanding of community-research partnerships. [ABSTRACT FROM AUTHOR]

Background: Sexual minority men (SMM) face severe health inequities alongside negative experiences that drive avoidance of medical care. Understanding how SMM experience healthcare is paramount to improving this population's health. Patient-centered care, which emphasizes mutual respect and collaboration between patients and providers, may alleviate the disparaging effects of the homophobia that SMM face in healthcare settings. Objective: To explore how SMM perceive their experiences with healthcare providers and how care can most effectively meet their needs. Design: Semi-structured qualitative interviews focused on healthcare experiences, pre-exposure prophylaxis (PrEP), and HIV-related beliefs were conducted between July and November 2018. Participants: The study included a sample of 43 young adult SMM (ages 25–27), representing diverse socioeconomic, racial, and ethnic backgrounds, in New York City. Approach: Researchers utilized a multiphase, systematic coding method to identify salient themes in the interview transcripts. Key Results: Analyses revealed three main themes: (1) SMM perceived that their clinicians often lack adequate skills and knowledge required to provide care that considers participants' identities and behaviors; (2) SMM desired patient-centered care as a way to regain agency and actively participate in making decisions about their health; and (3) SMM felt that patient-centered care was more common with providers who were LGBTQ-affirming, including many who felt that this was especially true for LGBTQ-identified providers. Conclusions: SMM expressed a clear and strong desire for patient-centered approaches to care, often informed by experiences with healthcare providers who were unable to adequately meet their needs. However, widespread adoption of patient-centered care will require improving education and training for clinicians, with a focus on LGBTQ-specific clinical care and cultural humility. Through centering patients' preferences and experiences in the construction of care, patient-centered care can reduce health inequities among SMM and empower healthcare utilization in a population burdened by historic and ongoing stigmatization. [ABSTRACT FROM AUTHOR]

The article describes the five evidence-based steps to use in structuring a personal diversity statement. These steps include preparing an introduction that goes beyond demonstrating one's definitional knowledge of diversity, equity, inclusion, and access (DEIA), stating DEIA academic or healthcare-related teaching contributions, and stating service-related contributions to advance DEIA.

BackgroundApproachEvaluationImplicationsIntroducing medical students to the concept of Cultural Humility, we devised a teaching initiative for students to consider how power manifests through the use of language in clinical communication, with a focus on General Practice. Cultural Humility is a pedagogical framework, introduced by Tervalon and Murray-Garcia, to address what they consider as the limitations of the Cultural Competence model.Our teaching initiative specifically focused on power in clinical communication, both oral consultations and written notes. The session was delivered to third-year medical students during their first ‘clinical’ year, where they regularly witness and are involved in clinical communication across primary and secondary care placements. Ethical approval was in place to analyse students’ reflections on the session.Students who attended engaged well. They evaluated the session positively as increasing their awareness of the power of clinical language in negatively stereotyping and dehumanising patients. They demonstrated Cultural Humility in their reflections of the unintentional harm of clinical language commonly used for the doctor–patient relationship. However, most striking for us, and where our learning as educators lies, was the low attendance at the session, despite our attempts to underline clinical relevance and importance for development as future doctors.This article offers a framework for educators interested in Cultural Humility. The implications of this initiative are how (or how not) to develop and deliver training in this space. More consideration is required as educators, including around our own language, as to how to engage students to think around the complex topic of power. [ABSTRACT FROM AUTHOR]

Rationale Aims and Objectives Method Results and Conclusion The Joint Commission emphasizes the importance of cultural competence and effective communication in quality medical care, particularly during end‐of‐life (EOL), when decisions are influenced by diverse cultural and religious backgrounds. For Orthodox Jewish patients, the philosophical framework used for EOL decision‐making may conflict with that used in traditional Western medical ethics. In this paper, we explore the complexities of EOL decision‐making for devout Jewish patients and highlight how approaches may differ from a Western ethical framework.This paper aims to familiarize clinicians with EOL preferences of Orthodox Jewish patients, organized into an ethical framework called ‘casuistic deontology’. Leading with an open‐minded approach emphasizing cultural humility, we explore ways in which integrating this perspective can allow for culturally appropriate and compassionate EOL care.Using a case study methodology, we focus on a 79‐year‐old Orthodox Jewish male hospitalized with severe injuries. The patient's medical course is analyzed, highlighting how the decisions made by his family in consultation with their Rabbi may differ from the decisions made with a philosophy of a Western ethical framework.This case illustrates the ethical tensions that may arise when Western medical practices intersect with Orthodox Jewish beliefs, particularly regarding brain death, resuscitation, and artificial nutrition. We underscore the need for cultural sensitivity when approaching EOL decision‐making, allowing for compassionate and comprehensive care that respects religious perspectives. This paper helps provide a structure for clinicians to navigate the complex EOL care needs for the devout Jewish patient in a manner consistent with their cultural and religious identity. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to increase understanding of the forms of systemic racism experienced by Latinx communities in North Carolina during the COVID-19 pandemic as identified by Latinx community health workers (CHWs) and community-based organization (CBO) leaders. Methods: We held three focus groups in July 2022 (N = 16) with CHWs and CBO leaders in Spanish to discuss policy and community interventions that improved access to resources during the COVID-19 pandemic; policy or community interventions needed to improve care of Latinx communities; and lessons learned to improve the health of Latinx communities in the future. We performed directed and summative qualitative content analysis of the data in the original language using the Levels of Racism Framework by Dr. Camara Jones to identify examples of implicitly and explicitly discussed forms of systemic racism. Results: Latinx CHWs and CBO leaders implicitly discussed numerous examples of all levels of racism when seeking and receiving health services, such as lack of resources for undocumented individuals and negative interactions with non-Latinx individuals, but did not explicitly name racism. Themes related to institutionalized racism included: differential access to resources due to language barriers; uninsured or undocumented status; exclusionary policies not accounting for cultural or socioeconomic differences; lack of action despite need; and difficulties obtaining sustainable funding. Themes related to personally-mediated racism included: lack of cultural awareness or humility; fear-inciting misinformation targeting Latinx populations; and negative interactions with non-Latinx individuals, organizations, or institutions. Themes related to internalized racism included: fear of seeking information or medical care; resignation or hopelessness; and competition among Latinx CBOs. Similarly, CHWs and CBO leaders discussed several interventions with systems-level impact without explicitly mentioning policy or policy change. Conclusion: Our research demonstrates community-identified examples of racism and confirms that Latinx populations often do not name racism explicitly. Such language gaps limit the ability of CHWs and CBOs to highlight injustices and limit the ability of communities to advocate for themselves. Although generally COVID-19 focused, themes identified represent long-standing, systemic barriers affecting Latinx communities. It is therefore critical that public and private policymakers consider these language gaps and engage with Latinx communities to develop community-informed anti-racist policies to sustainably reduce forms of racism experienced by this unique population. [ABSTRACT FROM AUTHOR]

Student resistance due to difficult thoughts and emotions that arise during discussions on culture is an ongoing challenge in multicultural counseling training. This manuscript describes the cultural humility choice point as a tool counselor educators may use to prepare counselors-in-training to discuss cultural topics in the classroom setting. A brief review of the theoretical frameworks undergirding the tool is provided, followed by a description of the tool’s primary elements and an illustration of how it may be used in a classroom setting. The manuscript is concluded with a discussion of considerations that may influence use of the cultural humility choice point with diverse learners and recommendations for future research. [ABSTRACT FROM AUTHOR]

The current mixed-method study in India and the United States assessed understanding of what evidence-based practice in psychology (EBPP) is, how EBPP training and implementation occurs, and perceived barriers and needs related to EBPP training. Graduate students (India, n = 282; United States, n = 214), faculty (India, n = 24; United States, n = 67), and practitioners (India, n = 24; United States, n = 49) were surveyed, and focus groups with students (India, n = 31; United States, n = 12), faculty (India, n = 10, United States, n = 9), and practitioners (India, n = 28; United States, n = 17) were held. Individuals across countries and across the professional continuum were only somewhat aware of EBPP, largely equating it to just using empirically supported treatments. In both the United States and India, EBPP training was largely infused across the curriculum, though a sizable percentage of participants did report only limited exposure to EBPP training. Participants perceived themselves as engaging in EBPP. The biggest barriers to EBPP training (largely shared across countries) were hesitancy about EBPP, investing the time in training, and being wedded to a single school of thought. Indian participants also noted a limitation in primarily relying on data from Western countries. EBPP training needs identified included desire for greater flexibility within EBPP, receiving more theoretical foundation in EBPP, and more applied EBPP training. Results demonstrated advances in EBPP training in the past 15 years since the release of American Psychological Association's task force report but also provide areas for growth in training, specifically surrounding balancing research evidence with clients' cultural context as well as ways to promote lifelong EBPP learning. Public Significance Statement: Using surveys and focus groups in both the United States and India, this study asked current trainees, professors, and practitioners about their understanding of evidence-based practice in psychology (EBPP) as well as about strengths and needs in EBPP training. Individuals in both countries demonstrated a partial understanding of EBPP and identified gaps in training, particularly in incorporating clients' cultural identities into science-based interventions. Recommendations for training are provided. [ABSTRACT FROM AUTHOR]

Collaborative Online International Learning (COIL) is a simulated global exchange experience that utilizes technology to bridge the gap between classrooms worldwide. Past research suggests that COIL may be useful in facilitating intercultural communication effectiveness and cultural humility for adult learners. As such, this quantitative study sought to examine the effects of a COIL experience that connected adult learners in the United States and Brazil on their intercultural effectiveness and cultural humility. Two instruments were used to collect data, including the Cultural Humility Scale and Intercultural Effectiveness Scale before and after the COIL experience. Data analyses revealed statistically significant increases in participants' intercultural effectiveness and cultural humility following the COIL experience. These findings provided insights into the effects of COIL on the intercultural effectiveness and cultural humility of adult learners. They also informed andragogical practices for cultivating attitudes, skills, and behaviors for intercultural interactions among adult learners in educational and other professional settings. However, further research on the outcomes of COIL is beneficial. [ABSTRACT FROM AUTHOR]

Despite requirements by the American Psychological Association and the Psychological Clinical Science Accreditation System regarding training and education in cultural humility, questions remain regarding the presence and quality of the training in clinical psychology PhD and PsyD programs. This is a critical issue as inadequate training in diversity, cultural humility, and multiculturalism has substantial downstream effects on care for clients of color and may contribute to racial disparities and inequities in mental health services. We seek to explicitly evaluate key features of the conceptual model thought to improve the provision of mental health services for clients facing oppression and marginalization which includes perceptions of clinical psychology graduate programs' training in and assessment of cultural humility. We also assess self-efficacy related to the application of cultural humility as well as actual practice of actions associated with cultural humility. Each of these domains is evaluated among a sample of 300 graduate students and faculty, clinical supervisors, and/or directors of clinical training, and differences across position and race of participants were tested. Study findings highlight significant gaps between what trainees need to develop cultural humility and what they may actually be receiving from their respective programs. While findings suggest that there is still a lot of work to be done, understanding the state of the field with regard to clinical training in cultural humility is an important first step toward change. Public Significance Statement: The present study took stock of clinical training initiatives in cultural humility and student self-perceived cultural humility and effectiveness in addressing racism-related stressors. By improving our understanding of the current state of the field with regard to clinical training in cultural humility, findings from this article will help guide improvements to training programs. [ABSTRACT FROM AUTHOR]

Addressing systemic injustices and racism in training and clinical service provision are key next steps in clinical science. While the American Psychological Association Multicultural Guidelines and accreditation standards have long emphasized this need, most graduate programs offer a single course on diversity, equity, and inclusion topics, which is inadequate to train and sustain culturally humble providers and redress systemic injustices and racism within psychology. Few "real-world" examples exist to guide the development of training models. We provide background on the development and components of a specialty clinic, the University of New Mexico's Cultural Counseling Center, whose mission is providing culturally informed clinical services to diverse clientele, and to infuse multicultural training throughout the graduate program. Informed by the racial–spatial framework for psychology and critical race theory, we describe our approach intended to (a) offer applications for the operationalization and delivery of multicultural and antiracist training, (b) enhance supervisory models, and (c) increase awareness of structural competence. Our clinic, developed collaboratively among students and faculty, serves as a safe forum for dialogue around structural injustices and seeks to improve treatment for diverse clients and those underserved in mental health care. We discuss issues of student and faculty engagement and offer the perspectives of faculty and students of color, case examples illustrating our services, and current efforts to expand and formalize community collaborations. We offer a model that integrates coursework, informal activities, and multicultural supervision for comprehensive student training and that promotes a departmental culture of dialogue and support around equity, diversity, and justice. Public Significance Statement: We provide background on the development of a specialty clinic, the University of New Mexico Cultural Counseling Center, as a training model and "real-world" example of operationalization and delivery of multicultural and antiracist training and clinical services. Program description and recommendations based on our experience can inform the development and implementation of similar centers in other departments and aid in the training of the next generation of clinicians equipped to provide culturally informed care. [ABSTRACT FROM AUTHOR]

The newest generation of psychologists in the United States will serve the most diverse public in recorded history. Although some health service psychology training programs have systematically integrated antiracist initiatives into their training curriculums and supervision, many have not. There is an urgent call to increase antiracist training in health psychology as the field navigates the dismantling of oppressive systems. This article details how an American Psychological Association (APA)-accredited pediatric psychology internship training program has intentionally addressed pipeline problems related to the recruitment and retention of diverse trainees over 10 years. It outlines the steps taken to create a diversity mission and vision statement, cultivate a training culture that elevates contributions of individuals from traditionally underrepresented groups, emphasize antiracism in recruitment materials, and develop an experiential, intersectional, and antiracist cultural humility curriculum for predoctoral interns. Quantitative ratings and qualitative feedback from trainees about the experiential curriculum and outcomes related to recent recruitment and retention are described. This article clearly demonstrates how an investment of multiple antiracist training resources within a training program across several years can result in the recruitment and retention of diverse trainees, a more inclusive and protective training culture, and the advancement of antiracism within the field of health service psychology. Public Significance Statement: Predoctoral internship training program leadership report wanting strategies to improve the recruitment and retention of diverse trainees, innovative approaches to cultivating more inclusive training cultures, and the advancement of antiracist action within the field of health service psychology. This article outlines multiple antiracist and cultural humility training initiatives within a predoctoral internship training program across several years, associated trainee-related outcomes, and recommendations for implementation. [ABSTRACT FROM AUTHOR]

Humility, in a variety of forms, has been examined in educational contexts in recent years. However, its association with a particular pedagogical method remains an unexplored area of inquiry. Likewise, social justice and student voice are a concern in international education arenas, including in higher education, but are not usually connected to virtue acquisition or demonstration. The student voice for social justice (SVSJ) pedagogical method, based on the framework of Nancy Fraser, seeks to aid practitioners in higher education to ensure that social justice and student voice, mediated by notions of humility, are at the forefront of higher education practices across disciplines. This is accomplished by creating spaces for students' active participation and voice in course content development and classroom learning. In this paper, we expand philosophical explorations of intellectual humility (IH) and cultural humility (CH) as virtues that mediate teaching and learning practices and interactions in classrooms during SVSJ implementation. This ensures that each student is recognised as an important knowledge holder and that diverse ways of knowing, knowledge systems and cultural traditions are valued in higher education teaching and learning spaces. [ABSTRACT FROM AUTHOR]

Building a diverse laboratory that is equitable is critical for the retention of talent and the growth of trainees professionally and personally. Here, we outline several strategies including enhancing understanding of cultural competency and humility, establishing laboratory values, and developing equitable laboratory structures to create an inclusive laboratory environment to enable trainees to achieve their highest success.

Abstract Background Current definitions of professionalism for healthcare trainees often lack equity, diversity and inclusion (EDI) in the expectations and assessment of professionalism. While professionalism teaching is incorporated in healthcare training, equity-deserving groups still experience discrimination. This scoping review investigates the literature to understand how EDI and associated domains of cultural humility, and advocacy can be incorporated in healthcare trainees’ education and assessment of professionalism. Methods The Arksey and O’Malley framework was applied to this scoping review. MEDLINE, Embase & PsychINFO were searched up to March 2023, with terms surrounding health professionals, professionalism, EDI, cultural humility, and advocacy. Titles and abstracts (n = 3870) and full-texts (n = 140) were independently screened by two reviewers. Articles were included if they focused on EDI, cultural humility, or advocacy among healthcare students/trainees, and had outcomes related to professionalism. Articles lacking discussion of professionalism as an outcome were excluded. Themes were generated by mutual discussion. Risk of bias was assessed using the Cote et al. and Medical Education Research Study Quality Instrument (MERSQI) tools. Results 48 articles underwent thematic analysis. Studies investigated the disciplines of medicine, nursing, social work, physiotherapy, and dentistry. Most studies were qualitative in methodology (n = 23). Three themes emerged: (1) EDI-related interventions are associated with improved professionalism of healthcare trainees/workers (n = 21). Interventions employed were either an EDI-associated educational course (n = 8) or an exchange program to promote EDI competencies among trainees (n = 13). (2) Trainee definitions and perceptions of professionalism include themes related to EDI and cultural humility (n = 12). (3) Current standards of professionalism are perceived as non-inclusive towards historically-marginalized populations (n = 15). Literature investigating advocacy as it relates to professionalism is limited. Conclusion This review identified that core EDI principles and its associated domains of cultural humility and advocacy are often viewed as integral to professionalism. These findings create a strong impetus to incorporate EDI principles within professionalism frameworks in healthcare education. Future research should employ standardized tools for professionalism assessment to provide more conclusive evidence. Incorporating patient perspectives of professionalism can inform actionable recommendations for fostering inclusive healthcare environments.

Background: The Confederated Tribes of the Grand Ronde Community of Oregon began a Mobile Medication Unit (MMU) as part of their Great Circle Recovery Opioid Treatment Program (OTP) to address elevated rates of opioid use disorder (OUD) among American Indians and Alaska Natives in Oregon. The MMU provides methadone or buprenorphine for individuals with OUD, enrolled in the OTP, who are living either on the reservation or in surrounding rural communities. An implementation study describes the service through document review and qualitatively assesses patient and staff experiences and the perceived barriers and facilitators to mobile services. Methods: Semi-structured qualitative interviews with patients (n=11), MMU staff (n=5), and the state opioid treatment authority (n=1) gathered details on the initiative's development and operations. Provider interviews probed implementation experiences. Patient interviews focused on their experiences with the MMU and staff, changes in quality of life and recommendations for enhancing treatment. Interviews were transcribed and analysed using a Thematic Analysis approach. Results: Staff themes identified two driving forces (i.e. staff desire for an inclusive approach to wellness that is accessible to all community members; the catalysts for the MMU), two steps toward MMU development (i.e. Tribal approvals and support; the construction and maintenance of community relationships) and two perspectives on MMU implementation and impact (i.e. initial implementation barriers; facilitators and observations of how the MMU reduced stigma associated with agonist therapy). Patients' themes noted the MMU's professional and 'caring' environment, accessible rural locations and general suggestions including culturally responsive ancillary services. Conclusion: The Great Circle MMU enhanced access to opioid agonist therapy for people with OUD (i.e. American Indians/Alaska Natives, and non-natives) living in rural communities. The Confederated Tribes of Grand Ronde operates the first Tribally owned OTP MMU, grounded in cultural humility and committed to Tribal members and the great circle of the larger community. [ABSTRACT FROM AUTHOR]

Aim: To describe how clinicians provide culturally responsive care to culturally diverse people with kidney failure in haemodialysis centres. Background: Culturally diverse individuals receiving in‐centre maintenance haemodialysis have unique cultural needs. Unmet cultural needs can impair and profoundly affect their experiences. Given culturally responsive care has the potential to enhance the experiences of culturally diverse people, it is vital to understand how clinicians provide culturally responsive care. Method: A scoping review was undertaken using Arksey and OMalleys framework. Five databases: Medline and CINAHL Complete (EBSCO), PsycINFO, Embase (OVID) and ProQuest Theses and Dissertation databases were searched for research literature published in English between 1990 and 2023. Narrative synthesis was used to synthesise the data. Results: From the 17,271 records screened, 17 papers reporting 14 studies met the inclusion criteria. Narrative synthesis revealed two themes: (i) communication enablers and barriers including linguistic differences, professional and lay interpreter use; and (ii) the importance of culture, which encompassed acknowledging cultural priorities, accommodating cultural food preferences and access to cultural training. Conclusion: While competing priorities associated with haemodialysis may be a challenge for clinicians, recognising the significance of cultural care needs and accommodating them in care is important. Demonstrating respect towards cultural diversity and providing person‐centred care by facilitating the unique cultural needs of people with kidney failure in haemodialysis is imperative. Relevance to Clinical Practice: Culturally responsive care is complex and multidimensional. Individuals' cultural care needs should be acknowledged, respected, and accommodated in care. Patient or Public contribution: No patient or public contribution. The study protocol was registered in the Open Science Framework. https://osf.io/uv8g3. [ABSTRACT FROM AUTHOR]

This article examines the trends in psychotherapy utilization for perinatal mental health disorders among privately insured adults in the United States from 2008 to 2020. The study found that psychotherapy rates increased by 250% during this period, with the highest rates among white individuals, followed by black, Hispanic, and Asian individuals. However, after adjusting for age and comorbidity, the rate of increase in psychotherapy among Asian individuals decreased, while the rate among white individuals slightly increased. The findings highlight the need for further research to understand the factors driving these trends and to ensure appropriate mental health care for all individuals during the perinatal period. [Extracted from the article]

Background: The circumstances surrounding chronic kidney disease and its impact on families can be complex and difficult to navigate, leading to these cases being labeled "challenging." Case presentation: We present the case of an adolescent with kidney failure due to unremitting systemic illness and multiple complications ultimately resulting in the family's request to forgo dialysis. Medical team members wrestled with meeting the family's needs among internal and external constraints. Conclusion: Past experiences, systemic inequities, differing perspectives, and consequential decision-making within individual belief systems can lead to friction between and among medical team members and families. As pediatric nephrologists, we must shift our focus from the "challenging" patient or family to addressing what is challenging their ability to flourishing. [ABSTRACT FROM AUTHOR]

Dotun Ogunyemi,1 Birpartap S Thind,2 Amir Teixeira,2 Clarence M Sams,3 Matthias Ojo,3 Grace Anne E Dinkins,1 Dragos Serseni1 1DIO, Associate Dean of Graduate Medical Education; Charles R Drew University, College of Medicine, Los Angeles, CA, USA; 2Medical Student, California University of Science and Medicine, Colton, CA, USA; 3Medical Student, Charles R Drew University, College of Medicine, Los Angeles, CA, USACorrespondence: Dotun Ogunyemi, DIO, Associate Dean of Graduate Medical Education Chair, Department of Obstetrics & Gynecology Charles Drew University, College of Medicine, 1731 E 120th St, Los Angeles, CA, 90059, Tel +310-279-3538, Email Dogunye@outlook.comBackground: Cultural humility is a lifelong commitment to self-evaluation, redressing power imbalances in patient–physician relationships and developing mutually trusting beneficial partnerships.Objective: The objective of this study was to determine the feasibility and efficacy of cultural humility training.Methods: From July 2020-March 2021, 90-minute educational workshops attended by 133 medical students, resident physicians and medical education faculty included 1) pre- and post- intervention surveys; 2) interactive presentation on equity and cultural humility principles; 3) participants explored sociocultural identities and power; and 4) reflective group discussions.Results: There were significant increases from pre to post intervention assessments for perception scores (3.89 [SEM= 0.04] versus 4.22 [0.08], p< 0.001) and knowledge scores (0.52 [0.02] versus 0.67 [0.02], p< 0.001). Commonest identities participants recognized as changing over time were personality = 40%, appearance = 36%, and age =35%. Commonest identities experienced as oppressed/subjugated were race/ethnicity = 54%, gender = 40% and religion = 28%; whilst commonest identities experienced as privileged were gender= 49%, race/ethnicity = 42% and appearance= 25%. Male participants assigned mean power score of 73% to gender identity compared to mean power score of − 8% by female participants (P< 0.001). Non-Hispanic Whites had mean power score for race identity of 62% compared to 13% for non-white participants (p< 0.001). English as a second language was only acknowledged as an oppressed/subjugated identity by those born outside the United States (p< 0.001).Conclusion: An interactive educational workshop can increase participants’ knowledge and perceptions regarding cultural humility. Participants can self-reflect to recognize sociocultural identities that are oppressed/subjugated or privileged.Keywords: cultural humility, patient experience, sociocultural identities, intersectionality

AbstractRacial and socioeconomic disparities in maternal health outcomes are significant in the United States. Expanded access to obstetric care through Medicaid, a public health insurance program, aims to address these disparities among racially and economically marginalized birthing people. However, limited research has examined the experiences of women whose obstetric care was covered by Medicaid. This study utilized a birth equity framework informed by reproductive justice principles to analyze interviews with 30 Medicaid-insured women in South Carolina. The analysis focused on study participants’ perceptions of their obstetric care experiences during their most recent pregnancy and hospital stay for labor and delivery. Thematic analysis revealed that participants felt disrespected, dismissed, and ignored by their obstetric care providers. Problems included insurance-related discrimination, insufficient explanations about treatment protocols, mismanagement of pregnancy complications, disregarded pain medication requests, inadequate monitoring of labor progression, and physician absences during delivery. The results substantiate the need for birth equity–informed interventions that facilitate structural competency and cultural humility among medical professionals to improve obstetric care quality among marginalized patients. [ABSTRACT FROM AUTHOR]

AbstractLimited research on sexual minority women migrants demonstrate that they face elevated rates of mental health problems compared to their heterosexual and male counterparts, and less is known about their healthcare seeking behaviours. This study aimed to identify barriers and facilitators to mental and physical healthcare utilisation among first-generation (foreign-born) Arab sexual minority women migrants in the USA and to assess whether Penchansky and Thomas’ theory of access can be used to understand their healthcare utilisation behaviours. We conducted 20 semi-structured interviews via Zoom. Employing community-engaged research methods, four advisors, Arab sexual minority women migrants and a mental health service provider, assisted in recruitment and thematic data analysis providing a rich and nuanced understanding of study findings. Five main themes demonstrated the pivotal role of cultural humility from providers and access to medical insurance in shaping healthcare-seeking decisions. Difficulties finding therapists and navigating the referral process and wait times encouraged participants to seek care outside of the USA in their Arab countries of origin. Stigma and social support further influenced participants’ decisions to seek mental healthcare. The study findings inform policy and practice to foster the development of inclusive healthcare services grounded in cultural humility and to develop support groups specifically for Arab sexual minority women migrants to the USA. [ABSTRACT FROM AUTHOR]

This article explores the consequences of the loss of indigenous languages on native health, healing, and cultural wellbeing. It emphasizes the connection between indigenous languages and native medicine, noting that as these languages decline, so do the medicinal benefits of native medicine. The article discusses how colonization has intentionally eroded native medicinal knowledge, leading to negative health outcomes for indigenous communities. It argues that reconnecting young natives to their cultural practices, including language, can improve health outcomes, and suggests incorporating native language and cultural views into healthcare appointments for more inclusive and effective care. The text also highlights the impact of language loss on Native American communities and their traditional medicine practices, emphasizing the need to preserve indigenous languages and cultural practices to improve the health outcomes of Native Americans. [Extracted from the article]

In recent years, Black people in the U.S. have had one of the highest increases in opioid overdose mortality rates, despite being less likely to be prescribed opioids for pain. This population is also less likely to receive medications for opioid use disorder (MOUD). Chronic pain is a central factor in understanding this crisis, as minoritized people are more likely to live with undertreated pain, a major risk factor for developing opioid use disorder (OUD). Current practices fail to effectively treat pain among persons with OUD, a missed opportunity that is worse in minoritized populations and further producing disparities. In this perspective, we discuss how racism-related stress and disparities in addiction treatments may impact the pain experience, diagnosis, treatment, contribute to developing OUD, and perpetuate stigma. This high-level perspective invites clinicians and researchers to reflect on the biopsychosocial burden imposed upon historically minoritized people with pain and OUD. To address such complex issues, multidisciplinary efforts and methodological improvements are required, imbued by antiracist values. Collaboration across disciplines is necessary toward the common goal of improving pain management and mitigating opioid mortality among minoritized populations. As antiracist perspectives inform research practices and cultural humility principles guide care, we will be better equipped to close current gaps in knowledge and address widening healthcare disparities. [ABSTRACT FROM AUTHOR]

Cultural humility is important in supervision; however, studies have primarily sampled White supervisees. Racially and ethnically minoritized trainees experience microaggressions during their training, yet cross-racial supervision is less often studied. We examined a moderated mediation model to test whether the supervisory working alliance mediated the relationship between frequency of racial microaggressions and satisfaction with supervision, and whether the impact of racial microaggressions on the supervisee and supervisor cultural humility moderated the relationship between racial microaggression frequency and the supervisory working alliance. In a sample of supervisees of color (N = 102; majority cisgender women, 86.2%, and heterosexual, 59.8%; 35.3% Black/African American, 28.4% Asian/Pacific Islander, 18.6% Hispanic/Latine) receiving clinical supervision from White supervisors, we found that racial microaggression frequency was negatively associated with satisfaction with supervision, and this relationship was fully accounted for by the supervisory working alliance. Racial microaggressions in supervision were found to be detrimental to the supervisory working alliance, which was then related to lower satisfaction with supervision. Further, racial microaggression impact and cultural humility moderated the relationship between racial microaggression frequency and the supervisory working alliance; this relationship was strongest when racial microaggression impact was high and cultural humility was average or high. The social bond hypothesis suggests we are more likely to allow ourselves to be vulnerable when we assess cultural humility to be high. We posit that the observed moderation effect may be due to supervisees experiencing greater shock when experiencing racial microaggressions from supervisors whom they perceived to be culturally humble. Public Significance Statement: The current findings demonstrate that racial microaggressions in cross-racial clinical supervision are negatively related to supervisees' satisfaction with supervision through their detrimental impact on the supervisory working alliance; and they appear to be most impactful when supervisor cultural humility is high. Still, even when microaggressions occurred, the supervisory working alliance was still stronger when supervisory cultural humility was higher. These results emphasize the importance of cultural humility as well as repairing microaggression-related ruptures in cross-racial clinical supervision. [ABSTRACT FROM AUTHOR]

This article discusses the importance of the clinical interview in healthcare and the shift towards person-centered and value-based medicine. It emphasizes the need for clinicians to adopt patient-centered approaches and collaborate with patients in agenda setting and shared decision-making. The article acknowledges the challenges posed by time constraints and the use of electronic devices during consultations. It also explores the potential barriers to successful implementation of person-centered care and highlights the impact of new technologies on the interview dynamics. The text concludes by emphasizing the benefits of person-centered interviews and the need for specific training to achieve successful implementation. [Extracted from the article]

Service engagement is critical when working with children and families experiencing chronic adversities because of their socially marginalized status. Further, sociodemographic disparities exist in service engagement within service systems including Community-Based Behavioral Health; likely in part, a result of structural issues driving unresponsive service systems. Despite this knowledge, a large proportion of the family engagement literature continues to be approached through a deficit-based and family-centric lens leaving out important systemic considerations and furthering health inequities. Drawing from a Socio-Ecological Framework (Stokols, 1996), this study focuses on exploring the value of peer support providers (PSPs) to understand how sociocultural responsiveness functions under this service model. Individual interviews and focus group data were collected from both families and PSPs. Thematic analysis (Braun & Clarke in Qualitative Research in Psychology, 3(2), 77–101, 2006) was utilized to code and synthetize the data collected. Findings highlight the importance of capitalizing on meaningful and trusting relationships to foster family engagement in services. These findings solidify the understanding that family engagement is a function of crucial relationships between family, provider, and systems. This work also illustrates how PSPs organic embodiment of sociocultural responsiveness through cultural humility is an avenue through which family engagement can be sustained. [ABSTRACT FROM AUTHOR]

Literature suggests LGBTQ+ cultural competencies and cultural humility as critical components to providing counseling services to LGBTQ+ clients. Previous research has shown that cultural humility leads to better counseling outcomes through the counseling alliance in sexual minority clients. This study investigated the relationships among cultural humility, counseling alliance, and counseling outcome among 584 LGBTQ+ counseling clients (38.5% were non‐cisgender). The results revealed that all three constructs were positively related to one another. Counseling alliance mediated the relationship between cultural humility and counseling outcome. The overall mediation model indicated that cultural humility had direct and indirect effects accounting for 58% of the variance in counseling outcome when controlling for gender, sexual orientation, and level of education. The findings underscore the importance of cultivating cultural humility among counselors working with LGBTQ+ clients to improve counseling alliance and counseling outcomes. [ABSTRACT FROM AUTHOR]

The field of mixed methods research embraces diversity and encourages researchers to combine different perspectives, approaches, and methods to achieve meaningful insights. Navigating such rich diversity can pose challenges that can benefit from ongoing, critical self-reflection. This article introduces the concept of cultural humility in the context of mixed methods research. We aim to enhance understanding of how cultural humility can foster awareness and encourage constructive critique of assumptions, policies, and practices in the field of mixed methods research. This article serves as a foundational resource for mixed methods researchers, practitioners, and scholars to embrace cultural humility in the field. We close with a set of prompts to spark critical self-reflection and dialogue within the field. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONThe purpose of this study was to evaluate the effectiveness of custom seating and mobility services provided via an international service learning (ISL) model on the occupational performance of individuals with disabilities in Guatemala. A one-group prospective pretest-posttest design was implemented using the standardized Wheelchair Outcome Measure (WhOM – Spanish) administered on the day of wheelchair fitting, and at 3- and 6-month intervals after receiving seating and mobility services. A two-tailed t-test demonstrated a statistically significant (p < 0.001) improvement in satisfaction for in-home and out-of-home occupations for all participants (n = 71) at 3-months with a huge effect size (d > 2) and this improvement was maintained at the 6-month interval. The results were consistent for various areas of occupational performance (e.g. activities of daily living). The provision of customized seating and mobility services by occupational therapists through an ISL model demonstrated effectiveness at improving satisfaction with occupational performance for individuals with disabilities in Guatemala. Cultural humility, customization of equipment based on personal and environmental factors, inclusion of education and training, and collaboration with in-country partners were identified as contributors to positive outcomes.Custom seating and mobility services provided by licensed occupational therapists via an international service learning (ISL) model demonstrated a significant improvement on the occupational performance of individuals with disabilities in Guatemala.The customization of equipment based on environmental and personal factors and the provision of education and training were identified as contributors to positive outcomes.Rehabilitation services delivered using an ISL model should be developed and implemented with cultural humility in collaboration with in-country partners.Custom seating and mobility services provided by licensed occupational therapists via an international service learning (ISL) model demonstrated a significant improvement on the occupational performance of individuals with disabilities in Guatemala.The customization of equipment based on environmental and personal factors and the provision of education and training were identified as contributors to positive outcomes.Rehabilitation services delivered using an ISL model should be developed and implemented with cultural humility in collaboration with in-country partners. [ABSTRACT FROM AUTHOR]

Objectives: Medical schools have sought to incorporate concepts of race and racism in their curricula to facilitate students' abilities to grapple with healthcare disparities in the United States; however, these efforts frequently fail to address implicit bias or equip students with cultural humility, reflective capacity, and interpersonal skills required to navigate racialized systems in healthcare. The purpose of this study was to develop and evaluate an antiracism narrative medicine (NM) program designed by and for preclinical medical students. Method: Preclinical medical students at a single center were eligible to participate from June-July 2021. Program evaluation included a postprogram qualitative interview and electronic survey. The semistructured interview included questions about program experience, lessons learned, and perspectives on antiracism curricula in medical education. Interviews were qualitatively analyzed using open and axial coding. Survey data were analyzed with descriptive statistics. Results: A total of 30 students registered. All (100%) respondents reported "somewhat true" or "very true" in the postprogram survey when asked about their ability to reflect on their own racial identity, racial identity of others, and influence of their racial identity on their future role as a healthcare worker through the program. Qualitative analysis revealed 3 themes: (1) curricular engagement; (2) racism and antiracism in medicine; and (3) group experience. Subthemes included: meaningful theoretical content; multimodal works and unique perspectives; race, identity, and intersectionality; deeper diversity, equity, and inclusion engagement; reconstructive visions; future oriented work; close reading and writing build confidence in discomfort; community and support system; and authentic space among peer learners. Conclusion: This virtual, peer-facilitated antiracism NM program provided an engaging and challenging experience for participants. Postprogram interviews revealed the program deepened students' understanding of racism, promoted self-reflection and community building, and propagated reconstructive visions for continuing antiracism work. [ABSTRACT FROM AUTHOR]