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IntroductionGlobalization has increased the importance of multicultural research to address health disparities and improve healthcare outcomes for underrepresented communities. The International Nursing Network for HIV Research (The Network) serves as a platform for researchers to collaborate on cross-cultural and cross-national HIV studies. This article discusses the Network's approach to overcoming barriers in multicultural and multinational research in a qualitative context.MethodsThe network created a protocol to guide decision-making throughout the translation process of qualitative data collected from participants in their native languages. The protocol includes aspects of why, when, what, who, how, where, and by what means the translation is completed.ResultsThe protocol has allowed researchers to enhance the validity, reliability, and cultural sensitivity of translation process, ensuring the clarity and impact of their research findings.DiscussionRigorous translation practices promote cross-cultural understanding and respect for participants' perspectives, fostering global collaborations and knowledge exchange.

Broaching involves the intentional engagement of race, ethnicity and culture (REC) in therapy, fostering deeper client self-disclosure and strengthening the therapeutic alliance. Despite its benefits, many psychologists avoid broaching due to fear, discomfort, and uncertainty, often exacerbated by limited training and personal biases. To address these issues, this article introduces the Broaching Readiness Framework, which emphasizes four key competencies: self-awareness, cognitive reframing, discomfort tolerance, and education. A case vignette illustrates the framework in action, and the paper concludes with recommendations for integrating the Broaching Readiness Framework into clinical training and supervision to enhance cultural competency and therapeutic effectiveness. [ABSTRACT FROM AUTHOR]

Experienced and anticipated discrimination during health care visits result in lower health care utilization rates, which contribute to persistent health disparities between transgender and gender diverse (TGD) individuals and the general population. Most strategies for improving health care delivery to TGD patients place the responsibility on providers, overlooking the role of medical systems and institutions in creating the environments where negative health care experiences occur. Relying on the inhabited institutionalism framework, this study explores system- and institutional-level barriers to the provision of quality care to TGD patients identified by health care providers and administrators, including relevant contextual details of, and interactions between, these barriers. Based on interview data from health care providers and administrators from a variety of practices across Texas, we identified two overarching themes and six subthemes. We demonstrate how our interviewees' responses reveal an institutional logic of "two-gender medicine," which creates barriers to health care provision in both formal medical education and training and throughout the managed care model of practice. We also illustrate how health care workers find ways to resist this logic in the course of their practice. Addressing these barriers to delivering competent and compassionate care to TGD patients that providers encounter could make long overdue strides toward addressing health disparities. [ABSTRACT FROM AUTHOR]

Background: Indigenous Australians are disproportionately affected by diabetes, with a diagnosis rate nearly four times higher than people from a non-Indigenous background. This health disparity highlights the urgent need for healthcare providers to develop cultural empathy – a critical competency for delivering culturally safe and person-centered care. Cultural empathy is essential for building trust and effective communication in diabetes education and management within Indigenous people. However, there is a significant gap in targeted interventions to enhance this skill among healthcare providers.Aims: The aim of this study was to evaluate the effectiveness of a digital storytelling intervention for enhancing cultural empathy levels of postgraduate diabetes education students.Design: This study has a pre-post survey design to measure changes in participants’ cultural empathy levels after exposure to a digital story.Methods: Students enrolled in a postgraduate diabetes education course at an Australian university were eligible to participate. The intervention included a first-person digital story about an Indigenous man with type 2 diabetes, accompanied by group-based discussions and self-reflection. The Comprehensive State Empathy Scale was utilised to assess empathy levels.Results: A total of 98 students completed both pre- and post-intervention surveys. There was a statistically significant increase in mean Comprehensive State Empathy Scale scores post-intervention (p < 0.001), indicating higher empathy levels. Improvements were observed across all six Comprehensive State Empathy Scale subscales, suggesting a multidimensional impact of the intervention.Conclusions: The digital story intervention significantly enhanced the cultural empathy levels of postgraduate diabetes education students. This study contributes to the evidence base for narrative-based pedagogies in cultivating empathy among healthcare providers. The findings highlight the potential of digital storytelling as a tool for improving cultural competency in healthcare education and practice, ultimately contributing to more empathic care for Indigenous people with diabetes. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The current study examines the help-seeking experience of Latina intimate partner violence (IPV) survivors. By relying on data from a statewide IPV service needs assessment, this study answers the following research questions: (RQ1) What is the experience of seeking help from an IPV service agency like for Latina survivors? (RQ2) What are the most prevalent unmet needs among Latina survivors seeking help from an IPV service agency? Based on various rounds of thematic analysis, findings reveal there is a lack of culturally competent services and that housing, language barriers, and legal status are all interrelated factors that serve as a triple disadvantage for Latina IPV survivors. [ABSTRACT FROM AUTHOR]

Systemic racism is a public health crisis that needs to be urgently and effectively addressed. Historical racism, contemporary biases, and prejudicial attitudes have persistently affected and damaged the mental health of people of color (POC) throughout the world. Although the 2021 apology from American Psychological Association (APA) acknowledged the profession's contribution to racism, much more work needs to be done to rectify and address past and current harm. A comprehensive, actionable, and concrete plan is needed to catalyze change. Adopting a socioecological approach can help tackle the multiple levels in which discrimination and unequal treatment take place. This necessitates more than just addressing the social determinants of illness, but also transforming the cultural competence of providers, organizations, and the mental health delivery system. Key to improving outcomes for POC domestically and abroad is increasing the affordability and access to care, diversifying and improving the cultural competence of the mental health workforce, and developing culturally adapted and effective care tailored to meet the culture-specific needs of diverse communities. Progress can only happen through proactive action and utilization of an anti-racist stance that commits significant financial and scientific resources to promote institutional, structural, systemic, and policy changes. [ABSTRACT FROM AUTHOR]

Recent literature addressing the development of cultural competencies and antiracism in behavior-analytic graduate training programs has focused primarily on the perspectives of faculty and current practitioners. The present study reports survey data on the perceptions of graduate students actively enrolled in those programs with respect to their racial equity and inclusion practices, as one important dimension of establishing cultural competency. Verified course sequence coordinators in the United States were asked to forward an invitation with an electronic survey link to the students in their programs. Survey questions asked about perceived: (1) racial diversity of fellow students and faculty; (2) race-related experiences during recruitment; (3) inclusion of race-related topics and materials in program curricula and course content; (4) availability and adequacy of resources to support racially diverse graduate students and other diversity efforts; and (5) composition and climate of the campus, department, and program with respect to racial equity and inclusion. Overall, the survey results indicate that there is work still to be done if behavior-analytic training programs are to reflect recommended practices in equity and inclusion for our students and contribute maximally to creating antiracist graduate programs. These findings may stand as a source of some concern in our efforts to prepare developing professionals as culturally competent and antiracist researchers and practitioners. [ABSTRACT FROM AUTHOR]

The article discusses the principles and practices of Indigenous authorship in health research, focusing on the importance of respecting, recognizing, and honoring Indigenous Knowledges. The authors, a collective of Aboriginal and non-Indigenous researchers, share their team's approach to promoting Aboriginal and Torres Strait Islander self-determination and well-being. They emphasize the need to privilege Indigenous ways of knowing, being, and doing, and to engage in transformative actions to mitigate the ongoing effects of colonization. The article provides guidelines for Indigenous authorship, highlighting the importance of community ownership, informed consent, and de-centering oneself to work collectively with Indigenous peoples. [Extracted from the article]

The X-Culture program provides students with the opportunity to work as part of a global virtual team to solution a real-world business challenge. Given the reliance of multinational organizations on virtual teams, it has become valuable, if not critical, for students to develop cultural intelligence, the soft skills and business discipline skills to work effectively across all business functions with a multicultural perspective. Increasing our understanding of the XCulture learning outcomes for the business discipline areas and associated soft skills may contribute to the X-Culture program curriculum development and student success. This paper explores the perceptions of student participants in the X-Culture project on their learning outcomes across business disciplines, and soft skills areas such as global team leadership and collaboration. Our findings suggest that X-Culture students report learning in all the business disciplines, and soft skill areas, however the level of learning varies significantly across disciplines and skill areas. An exploratory analysis of the data suggests that the benefit of participating in X-Culture may vary by ethnic group. [ABSTRACT FROM AUTHOR]

As of July 1st, 2021, the US Hispanic/Latinx community is estimated at 62.6 million, making up 18.9% of the population. Despite federal regulations requiring access to medical interpreters, clinicians often resort to alternative translation methods, increasing the risk of errors. Medical Spanish education lacks standardization in US medical schools, and information on curricula provided by International Medical Schools (IMGs) is limited. We aimed to demonstrate the effectiveness of virtual, peer-led Medical Spanish education for an international medical school cohort. The course consisted of 10 weekly one-hour lectures via Zoom. From 2022 to 2023, three cohorts successfully completed the course. Through realistic clinical scenarios, students practiced and reinforced their clinical knowledge in Spanish. The final exam involved a 20-minute patient encounter on Zoom, with the instructor acting as the patient and the student as the physician. Performance evaluation followed a standardized checklist. Each question was worth 3 points, with a total of 63 potential points. The passing score ratio was set at 2, equivalent to 66.7%, calculated by dividing the score by 21 (the number of questions). Student's self-reported comfort in obtaining a history and physical exam in Spanish, obtained before and after completion of the course post-comfort scores (median, 3), increased significantly compared to pre-course comfort scores (median, 0.5) - increased by an average of 2.5. This Online Spanish Medical Course (OSMC) requires no prior Spanish background or exposure, providing a notable advantage. Most students praised the convenient and effective online format. Despite its short duration, the course yielded significant benefits. [ABSTRACT FROM AUTHOR]

There is a paucity of rigorous longitudinal data regarding the relationship between humanities and their effect on multiple psychometrics. Using an observational art course, we assessed pre- and post-course metrics and longitudinal impacts with 120 preclinical medical students taking the "Art of Observation" between 2016 and 2019. Jefferson Scale of Empathy (JSE) and Jeffreys Transcultural Self-Efficacy Tool (TSET) were assessed annually for four years. Budner Tolerance of Ambiguity (TOA) Scale was administered before and after the course. The JSE showed no drop in empathy as students progressed from first to fourth year (p = 0.374). The TSET showed statistically significant increases in cultural self-efficacy (p < 0.001) in the cognitive and practical components but no change in the affective component of the scale. After the art course, TOA significantly improved on two [solubility (p = 0.009) and complexity (p = 0.21)] of the three subscales, but not novelty (p = 0.62). Empathy and cultural self-efficacy remained consistently high throughout medical school and did not decrease during the clinical years in an institution prioritizing the humanities and community engagement. Comfort with cultural competency generally improved throughout training. After taking an art course that emphasizes cognitive flexibility and a multiple perspectival approach, students demonstrated greater tolerance for ambiguity. [ABSTRACT FROM AUTHOR]

Background: Language and cultural discordance refer to when a physician and patient do not share the same language or culture. This can create barriers to providing high-quality care at the end-of-life (EoL). This study explores the intersections of language, culture, geography, and care model in EoL care from the perspectives of palliative care physicians. Methods: In this exploratory-descriptive qualitative study, semi-structured interviews (1-h) were conducted virtually between July and November 2023. We interviewed 16 family physicians with experience providing linguistic and/or culturally discordant palliative/EoL care in various urban, suburban, and rural regions of Ontario, who practiced at community and hospital outpatient clinics, home-based care, or long-term care homes. We used reflexive thematic analysis to identify themes across the interviews guided by the intersectionality theoretical framework. Results: We identified three themes 1) Visible barriers to care access due to the inability to communicate accurate information and insufficient time spent during appointments with patients; 2) Invisible barriers to care access, shaped by the Eurocentric approach to palliative care and physicians' lack of awareness on cultural discordance; 3) Workplace supports that currently exist and interventions that physicians would like to see. Community physicians following fee-for-service models were less likely to have access to professional interpreter services. Physicians in long-term care emphasized resource limitations to providing culturally-appropriate care environments. Conclusion: Cultural discordance required awareness of personal biases, while language discordance hindered basic communication. These findings will be useful in informing clinical practice guidelines and mobilizing policy-level change to improve palliative/EoL care for patients from linguistic and cultural minority groups. [ABSTRACT FROM AUTHOR]

Abstract As of July 1st, 2021, the US Hispanic/Latinx community is estimated at 62.6 million, making up 18.9% of the population. Despite federal regulations requiring access to medical interpreters, clinicians often resort to alternative translation methods, increasing the risk of errors. Medical Spanish education lacks standardization in US medical schools, and information on curricula provided by International Medical Schools (IMGs) is limited. We aimed to demonstrate the effectiveness of virtual, peer-led Medical Spanish education for an international medical school cohort. The course consisted of 10 weekly one-hour lectures via Zoom. From 2022 to 2023, three cohorts successfully completed the course. Through realistic clinical scenarios, students practiced and reinforced their clinical knowledge in Spanish. The final exam involved a 20-minute patient encounter on Zoom, with the instructor acting as the patient and the student as the physician. Performance evaluation followed a standardized checklist. Each question was worth 3 points, with a total of 63 potential points. The passing score ratio was set at 2, equivalent to 66.7%, calculated by dividing the score by 21 (the number of questions). Student’s self-reported comfort in obtaining a history and physical exam in Spanish, obtained before and after completion of the course post-comfort scores (median, 3), increased significantly compared to pre-course comfort scores (median, 0.5) - increased by an average of 2.5. This Online Spanish Medical Course (OSMC) requires no prior Spanish background or exposure, providing a notable advantage. Most students praised the convenient and effective online format. Despite its short duration, the course yielded significant benefits.

Abstract There is a paucity of rigorous longitudinal data regarding the relationship between humanities and their effect on multiple psychometrics. Using an observational art course, we assessed pre- and post-course metrics and longitudinal impacts with 120 preclinical medical students taking the “Art of Observation” between 2016 and 2019. Jefferson Scale of Empathy (JSE) and Jeffreys Transcultural Self-Efficacy Tool (TSET) were assessed annually for four years. Budner Tolerance of Ambiguity (TOA) Scale was administered before and after the course. The JSE showed no drop in empathy as students progressed from first to fourth year (p = 0.374). The TSET showed statistically significant increases in cultural self-efficacy (p

BACKGROUND: A large body of evidence indicates that spiritual and religious backgrounds, beliefs, and practices (SRBBPs) are related to better psychological health. Spirituality and religion (R/S) are also important aspects of multicultural diversity. There is evidence that clients would like to talk about their spirituality, and that including it in assessment and treatment planning can be beneficial. However, the extent to which practicing mental health professionals view SRBBPs as relevant to mental health and clinical practice is unclear. METHODS: A survey examining several aspects of addressing SRBBPs in clinical practice was distributed to 894 professionals across mental health disciplines, including psychiatry, psychology, social work, marriage family therapy, licensed professional counselors, certified chemical dependency counselors, and psychiatric mental health nurses. RESULTS: 89% of mental health professionals agreed that clinicians should receive training in R/S competencies. There were no differences between mental health disciplines in ratings of importance of such training. Younger individuals and those who identify as more spiritual were more likely to consider R/S training as important. Although 47.1% of professionals had not received much R/S training, many perceived themselves to be highly competent in R/S clinical integration practices (57.8% considered themselves able to display them very much or completely). In addition, respondents with more R/S training evaluated themselves as more proficient in R/S clinical integration. Nearly two-thirds (65.2%) of respondents reported encountering few to no barriers to engaging in R/S competent mental health care. CONCLUSIONS: There is a growing consensus among mental health care professionals that mental health professionals should be trained in R/S competencies. Strong agreement exists that basic R/S competencies include respect, empathy, examination of bias, and routine assessment of R/S in mental health care. Four in five of those surveyed agree that more active competencies, such as identifying and addressing religious and spiritual struggles and problems and helping clients explore and access R/S strengths and resources should be included, whereas one in five report less comfort with these competencies.

Introduction Immigrants comprised a significant portion of the total population in the United States (US), and a considerable number of children in the US live with at least one immigrant parent, which has continued to increase over the past decades. However, healthcare providers (HPs) in the US report lack of comfort in interacting with immigrant and refugee populations. Methods The authors, in partnership with the Midwest Consortium of Global Health Educators, developed an innovative, interactive ethics curriculum within the Immigrant Partnership Advocacy and Curricular Kit (I-PACK). They sought to increase HPs confidence in navigating complex encounters with immigrant families by teaching a relevant ethical framework, highlighting the importance of cultural humility, and equipping learners with an ethics tool (five-box Method) for use in clinical encounters. They piloted the curriculum during three workshop sessions in 2020-2021, and this curriculum continues to be used nationally as a part of I-PACK. Results Pre- and post-session surveys indicated that all participants (100%, n=22) reported acquisition of new skills/knowledge and 19 (86%) felt confident applying this to their clinical practice. The participants reported appreciation for an ethical framework with which to analyze cases, enjoyment of active participation in small group discussions, and utility of the five-box method tool. Some areas of improvement offered were to have more cases and more time dedicated to small-group discussions. Conclusions Given the success of the I-PACK ethics curriculum pilot, the authors plan to incorporate immigrant health cases in the general ethics training in medical school classes and pediatric residency training. Furthermore, they will advocate for the importance of including immigrant health ethics across graduate medical education, as fluency and competence in navigating the ethics of immigrant health are required to provide patient-centered, culturally informed care to all populations.

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.

Aims: CUSTOM is a culturally sensitive diabetes self-management education and support programme tailored to Urdu, Turkish and Arabic-speaking people in Denmark. The aim of this study was twofold: first, to examine the functional social support perceived by CUSTOM participants before and after the intervention; and, second, to explore how participants' structural social support affected the physical and mental health benefits of the intervention. Methods: The participants were people with type 2 diabetes whose primary language was Urdu, Arabic or Turkish (n = 73). Outcomes included A1C, body fat percentage, diabetes distress, well-being and functional social support. Changes were observed between baseline and six months after participation in a single-group pre-test/post-test design. The Cochran–Armitage trend test was used to assess pre–post differences in functional social support. The role of structural social support was assessed using moderation regression analysis. Results: Participants reported higher availability of functional social support after the programme (p < 0.05), although the change in loneliness was not significant. In addition, cohabitating with adult children increased the average body fat percentage reduction achieved following the programme, while living with a partner lowered the average body fat percentage reduction achieved. The intervention was particularly successful in improving diabetes distress among those with weak structural social support. Conclusions: Culturally sensitive diabetes self-management education and support can improve social support among people with an ethnic minority background. The structure of social relations may influence the benefit of culturally sensitive diabetes self-management education and support. Future programmes should include family members and other social relations more actively, drawing attention to both positive and negative aspects of social relations. [ABSTRACT FROM AUTHOR]

Background: Considering the significant volume of non‐English speakers seeking medical care in the United States and the challenges they may encounter within the hospital environment, it is necessary to assess the satisfaction of non‐English‐speaking families during their hospital stays and to determine potential areas of improvement in order to optimize care. Aims: We aimed to evaluate and describe the satisfaction of Arabic‐, Spanish‐, and English‐speaking families at a quaternary pediatric hospital. From the measures assessed, we sought to identify perceived strengths and weaknesses of the inpatient experience for families who spoke different languages. In doing so, we aimed to identify ways to improve the hospital experience for patients and their families. Methods: We created a 23‐item satisfaction questionnaire that was vetted by the hospital's Global Services Department, professionally translated into Arabic and Spanish, and tested by native speakers. The survey contained questions pertaining to parent/guardian demographics, their experience with the hospital environment, and their care team or services. Using the questionnaire, we surveyed Arabic‐, Spanish‐, and English‐speaking parents/guardians of post‐procedural patients under 18 years of age in intensive care units (ICUs) and on inpatient floors. Results: A total of 162 surveys were collected with roughly equal distribution across the three language groups (52 Arabic, 53 Spanish, 57 English). We found no statistically significant difference in satisfaction scores across the three language groups, nor across self‐reported English‐proficient and non‐English‐proficient Arabic and Spanish respondents. In addition, there was no statistically significant difference in satisfaction between parents/guardians in ICUs and those on inpatient floors. Conclusions: This pilot survey suggests that inclusivity and availability of interpretation resources play a role in successfully creating an environment where both English and non‐English speakers are satisfied. Further development and validation of the survey instrument should be performed, along with testing at other institutions. [ABSTRACT FROM AUTHOR]

Objective: There is a shortage of nurses, Aboriginal Health Practitioners, GPs and other staff in remote Australian health clinics. There is also high turnover of staff, leading to questions of 'who' is appropriate for remote First Nations practice? The aim of this paper was to identify the characteristics of staff who are likely to work well in remote First Nations settings, from the perspectives of remote health practitioners. Design: This is a qualitative study involving content analysis of interviews. Setting: The study is conducted in and with 11 Aboriginal Community Controlled Health Services across northern and central Australia. Participants: Eighty‐four staff working in these clinics who spoke about staff qualities suited to remote practice. Results: Participants identified a range of qualities desirable in remote practitioners, which were grouped into three topics: (1) professional qualifications and experience, including cultural skills; (2) ways of working, including holisitic approach, resilience, competence, and being a team player, approachable, flexible and hard‐working; and (3) specific community needs, namely the need for local First Nations staff, male practitioners and returning short‐term staff. The combination of experiences, ways of working, and fit to both the team and community were emphasised. Conclusion: Identifying the characteristics of staff who are likely to work well in these settings can inform recruitment strategies. This study found that a combination of professional qualifications, skills and experience as well as ways of working, individual characteristics and needs of communities are desirable for working in remote, First Nations settings. [ABSTRACT FROM AUTHOR]

This paper explores the future of college student mental health from students' perspective. The authors of this manuscript are four undergraduate and graduate students from two different universities. In the context of growing demand and intensity of mental health issues and the increased diversity of student identities on college campuses, the authors outline students' specific needs and what institutions can do to support their mental health needs. Two specific strategies are highlighted – peer support and mental health days. [ABSTRACT FROM AUTHOR]

BACKGROUND: While issues related to lesbian, gay, bisexual, and transgender (LGBT) health are increasingly incorporated into medical training, there remains limited guidance and opportunities for continuing medical education in LGBT health. It is unclear how participation in LGBT-specific training is distributed across physician specialties and practice regions. Additionally, national data assessing cultural competency training for physicians are scarce and do not delineate LGBT-specific training or training completed prior to, during, or after graduate medical education. METHODS: Using data from the 2016 National Culturally and Linguistically Appropriate Services Physician Survey, this study evaluated patterns of post-residency cultural competency training, as well as associations between LGBT-specific training and provider perceptions of patient care outcomes. RESULTS: Provider specialty, practice region, and receiving cultural competency training as a trainee were associated with post-residency LGBT-specific training. Surgical providers (odds ratio [OR]: 0.42; confidence interval [CI] 0.25–0.73; p =.002) and those practicing in the South (OR: 0.49; CI: 0.26–0.92; p =.025) had lower odds of completing LGBT-specific cultural competency training while in independent practice. Post-residency LGBT-specific training was associated with provider agreement that cultural competency training improves the quality of care (OR: 2.76; CI: 1.44–5.28; p =.002), patient satisfaction (OR: 2.55; CI: 1.32–4.93; p =.005), and patient comprehension (OR: 2.03; CI: 1.05–3.90; p =.034). CONCLUSIONS: Our findings provide disaggregated analyses that nuance the assessment of cultural competency interventions and support a broader effort to increase attention to LGBT health in continuing medical education. [ABSTRACT FROM AUTHOR]

Racial and ethnic minority groups are underrepresented in chiropractic education and the profession, and are less likely than individuals identifying as White to have access to or use chiropractic care. Stakeholders with leadership positions in USA-based chiropractic colleges and organizations participated in 3 online diversity, equity, and inclusion (DEI) summit meetings to foster a deeper understanding of DEI, identify DEI objectives, and develop action steps and drive change. Summit I (51 attendees) comprised 3 presentations that provided background about DEI in chiropractic education and practice. Summit II (32 attendees), comprised 4 breakout sessions addressing organizational issues in DEI. Summit III (65 attendees) comprised 5 collaborative sessions focused on implementation of DEI objectives. We use aggregate data and qualitative summaries to provide a descriptive narrative. Data sources include pre/post-summit quantitative surveys, items from open-ended questionnaires, and a spreadsheet of recommendations for increasing organizational DEI. Before attending Summit I, 48% rated their understanding of DEI issues as "moderately" or "very" high, compared with 74% afterward. Summit II participants suggested actions that should be taken by their institutions and the profession. Summit III participants stressed the need for DEI-supportive data, policies, and resources. They identified > 150 action steps to address DEI objectives. A listserv was established to facilitate ongoing institutional collaboration. Summit participants recognized the importance of developing a diverse, culturally aware chiropractic workforce. The summits provided structure and support for stakeholders to effectively plan for and implement DEI in their organizations and institutions. [ABSTRACT FROM AUTHOR]

The Navajo Nation is one of the many reservations that lack access to health care services, leading to increasing chronic health conditions. Navajo rug weaving is a common creative occupation on the reservation. Navajo rug weaving involves multiple steps in creating a beautiful rug. The multiple steps include repetitive gripping, pinching, reaching, pulling, and prolonged sitting. Therefore, weavers are at risk for developing musculoskeletal disorders (MSDs), preventing individuals from participating in meaningful occupations. Occupational therapists have the skills to provide appropriate education through active listening, visual handouts, and family members. However, occupational therapists must demonstrate and understand cultural sensitivity to address cultural occupations. This article will provide strategies for modeling understanding of the Navajo people, Diné, and rug weaving. [ABSTRACT FROM AUTHOR]

The Jewish population's high risk for certain genetic conditions is well established. The Orthodox Jewish community, a denomination of the larger Jewish population, has distinct customs and cultural practices and a complex relationship with Western medicine and medical genetics. Clergy play a central role as stakeholders in the Orthodox Jewish community, and their input often informs key medical decisions for their congregants. Orthodox clergy have a unique structure for advising their community members, which is based on Jewish law. A qualitative research methods study was conducted to learn more about the needs of Orthodox Jewish clergy in the greater Los Angeles area with regard to prenatal genetic testing. The present study aims to understand the function of clergy, cultural implications in genetics care, and ways to improve cooperation between clergy and medical providers. 18 clergy members were recruited to join the study, with a 100% participation rate. Thematic analysis of individual interviews highlighted four major themes: the multitude of roles of clergy; pragmatic testing; a need for mutual respect; and interactions between medical providers and clergy. The existing community infrastructure may be used as the framework to provide a greater awareness of genetic care to this community. Future research should be conducted to explore how to improve interactions between genetic counselors and Orthodox Jewish clergy and the best practices for cultural competency. [ABSTRACT FROM AUTHOR]

This commentary examines the experiences of medical interpreters through a collection of narratives exploring the complex interplay of language, culture, and power dynamics within the healthcare setting reported by medical interpreters. By analyzing themes of power differentials, language barriers, and vulnerability, this commentary highlights the critical role of interpreters in bridging communication gaps and advocating for patient needs. In addition, this commentary explores the personal and professional challenges faced by interpreters, emphasizing the impact of working conditions on interpretation quality. This commentary contributes to a deeper understanding of the experiences of medical interpreters and underscores the importance of supporting their work to improve patient care and health outcomes. [ABSTRACT FROM AUTHOR]

In the United States, African American (AA) men disproportionately experience kidney failure, representing 16.6% of all cases in 2018—more than double their percentage in the general population. This significant health disparity arises from socioeconomic factors, access issues, and higher disease prevalence. The article highlights the importance of adopting a patient-centered and culturally competent approach to improve health outcomes for AA men with kidney disease. It advocates for ongoing research and educational efforts to enhance cultural competence in healthcare settings. By exploring current practices and the benefits of culturally informed training, the article underscores the crucial role of cultural competence in advancing healthcare equity. It calls for healthcare institutions to not just adopt, but actively implement, patient-centered and culturally sensitive care models, promoting social justice and better health outcomes for all. [ABSTRACT FROM AUTHOR]

This literature review explores breast cancer screening practices among transgender individuals globally, emphasizing the overlooked population in Pakistan. With an overview of intersex and transgender terminology, the study delves into screening guidelines for transfeminine and transmasculine patients, considering hormone therapy and surgery. Worldwide statistics on transgender and intersex populations are provided, highlighting the unique challenges they face, particularly in Pakistan, where societal discrimination and healthcare barriers persist. Databases searched included PubMed, Scopus, and Google Scholar from the Year 2000 till todate.The review synthesizes breast cancer screening recommendations in transgender population from ACR, WPATH, UCSF, and the Canadian Cancer Society, revealing variations in guidelines. It concludes with a call for tailored screening protocols for Pakistan’s transgender community and recommends a comprehensive study due to the absence of data in Southeast Asia. The unstructured abstract underscores the need for nuanced, personalized screening strategies and emphasizes the critical gap in knowledge specific to breast cancer in this marginalized population. [ABSTRACT FROM AUTHOR]

Culturally and racially responsive practice continues to be a common challenge among Mental Health Practitioners (MHPs). To the authors' knowledge, this systematic review was the first to collate and synthesize clients' perspectives of MHPs' cultural and racial awareness and responsiveness from around the world. Original studies that were published between 2010 and 2021 reporting on qualitative data about clients' perspectives regarding MHPs' cultural-racial awareness and responsiveness were included in the review. The studies' key findings that addressed this review's question were synthesized and analyzed using reflexive thematic analysis. This review found 48 papers that met inclusion criteria, which represented the views of 652 clients across 10 countries. Three major themes and eight subthemes were established that concerned characteristics of the MHP, the client, and the therapeutic alliance. The results of this review indicate individual and systemic factors that influence mental health access for people from culturally and racially marginalized groups. Ongoing training of MHPs, increased racial and cultural representation among MHPs, inclusive physical settings, and reduced discrimination by MHPs are among the key findings and directions based on the results of this review. [ABSTRACT FROM AUTHOR]

To meet the population's increasing diversity and the health system's needs, it is necessary to prepare nursing schools to produce culturally qualified students. This study aimed to extract the experiences of nursing educators about the cultural competence of nursing students. In this qualitative descriptive study, data were collected through in-depth, semi-structured interviews with 15 nursing educators affiliated with three medical sciences universities in southeastern Iran. Purposive data sampling and analysis were performed using Graneheim and Lundman's conventional content analysis methods. One main theme, 5 categories, and 18 subcategories were extracted. The main theme was "cultural equality, the essence of care and education". Categories included "Toward culturally-based caring and education", "Charter of cultural rights", "The need for cultural competence facilitators", "Cultural exposure", and "Modifying the curriculum policies". This study shows that nursing educators strive to take into account students' cultural competence, even though cultural competence is not explicitly integrated into nursing curricula. The acquisition of cultural competence requires multifaceted changes in education, in clinical centers, and in the creation of cultural infrastructure. • Holistic nursing care will be achieved when a nurse understands the patient's cultural values. • Nursing educators play an important role in the process of cultural empowerment of nursing students. • Cultural equality is the essence of care and education. • Cultural competencies should be incorporated into the nursing curriculum. [ABSTRACT FROM AUTHOR]

Social justice movements have sought public awareness and positive change for marginalized communities, including the intersection of Black, Indigenous and People of Color (BIPOC) and disabled students. Despite significant strides made to decrease the inequities experienced by marginalized communities, gaps still exist. Increasingly, the fields of special education and related services (e.g., social services providers who support disabled students in schools) have been encouraging and requiring their practitioners to be taught culturally relevant content, such as cultural competency. Despite the push to incorporate cultural competency training, no systematic approach to providing this training has been identified. The current systematic literature review was conducted to identify common practices for training cultural competency within social service professions. A search across five databases yielded 53 studies that met inclusion criteria. The results demonstrate that cultural competency content and knowledge is taught and measured using a variety of methods and assessments; cultural competency was most often taught within academic programs and assessed using the Multicultural Counseling Inventory. This review contains a variety of methods that have been shown to teach cultural competency and thus can be used by educational programs and organizations across the social service professions to aid in creating trainings for their practitioners. [ABSTRACT FROM AUTHOR]

Purpose: Although more people from Middle Eastern countries are visiting South Korea for medical treatment, Korean nurses lack experience in treating them. Understanding and describing Korean nurses' experiences can help them provide quality care to these patients by enhancing their competency in culturally appropriate care. This study described the experiences of nurses who provide care to Middle Eastern patients in clinical settings in South Korea. Methods: We conducted a phenomenological study to describe nurses' experience of caring for patients from Middle Eastern countries. Ten nurses with prior experience in caring for these patients were recruited from a university-affiliated tertiary hospital. Semi-structured face-to-face interviews were conducted between May 1 and June 4, 2020. The transcribed data were analyzed using Giorgi's phenomenological method to identify the primary and minor categories representing nurses' experiences. Results: Four major categories (new experiences in caring for culturally diverse patients, challenges in caring for patients in a culturally appropriate manner, nursing journey of mutual agreement with culturally diverse patients, and being and becoming more culturally competent) and 11 subcategories were identified. Conclusion: Nurses experience various challenges when caring for Middle Eastern patients with diverse language and cultural needs. However, nurses strive to provide high-quality care using various approaches and experience positive emotions through this process. To provide quality care to these patients, hospital environments and educational programs must be developed that center on field nurses and students and support them in delivering quality care while utilizing their cultural capabilities. [ABSTRACT FROM AUTHOR]

BackgroundHealth equity and access to essential medical information remain significant challenges, especially for the Spanish-speaking Hispanic population, which faces barriers in accessing living kidney donation opportunities. ChatGPT, an AI language model with sophisticated natural language processing capabilities, has been identified as a promising tool for translating critical health information into Spanish. This study aims to assess ChatGPT’s translation efficacy to ensure the information provided is accurate and culturally relevant.MethodsThis study utilized ChatGPT versions 3.5 and 4.0 to translate 27 frequently asked questions (FAQs) from English to Spanish, sourced from Donate Life America’s website. The translated content was reviewed by native Spanish-speaking nephrologists using a standard rubric scale (1–5). The assessment focused on linguistic accuracy and cultural sensitivity, emphasizing retention of the original message, appropriate vocabulary and grammar, and cultural relevance.ResultsThe mean linguistic accuracy scores were 4.89 ± 0.32 for GPT-3.5 and 5.00 ± 0.00 for GPT-4.0 (p = 0.08). The percentage of excellent-quality translations (score = 5) in linguistic accuracy was 89% for GPT-3.5 and 100% for GPT-4.0 (p = 0.24). The mean cultural sensitivity scores were 4.89 ± 0.32 for both GPT-3.5 and GPT-4.0 (p = 1.00). Similarly, excellent-quality translations in cultural sensitivity were achieved in 89% of cases for both versions (p = 1.00).ConclusionChatGPT 4.0 demonstrates strong potential to enhance health equity by improving Spanish-speaking Hispanic patients’ access to LKD information through accurate and culturally sensitive translations. These findings highlight the role of AI in mitigating healthcare disparities and underscore the need for integrating AI-driven tools into healthcare systems. Future efforts should focus on developing accessible platforms and establishing guidelines to maximize AI’s impact on equitable healthcare delivery and patient education.

Social equity is a central concern in public service provision. As a concept, social equity is comprised of several disparate concepts including representative bureaucracy, diversity management, and cultural competency, each focusing on a specific function necessary for achieving equitable processes, outputs, and outcomes. While many organizations implement reforms across all three of these dimensions simultaneously, existing applications in the literature tend to only focus on one at a time—potentially obfuscating the true impact of social equity reforms within public organizations. By constructing a dataset of over 600 nursing homes in Florida, our descriptive analysis reveals that nursing homes are unrepresentative, lack diversity, and tend to provide culturally competent care in underperforming homes. We further examine the sectoral differences between for-profit homes and not-for-profit. Our article contributes to the literature by providing an in-depth audit of how nursing homes practice representation, diversity, and cultural competency.

Background: Understanding the challenges and problems faced by pediatric nurses is vital for enhancing their professional practice and improving patient outcomes. Objectives: The objective of this systematic review is to investigate and summarize the existing literature regarding the challenges and problems faced by pediatric nurses in Iran. Methods: In this systematic review, nine scientific research databases, such as PubMed, ScienceDirect, Wiley Online, Scopus, SciELO, LILACS, Google Scholar and some Persian databases, including Magiran and SID were searched from January 1, 2015 to January 3, 2023. The following keywords were used: ([“Pediatric nursing”] AND [“challenges”] AND [“problems”]AND [“pediatric” OR “children”] AND [“Iran”]) in both English and Persian. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed to ensure a rigorous and transparent review process. Results: A total of 965 articles were initially identified. After removing duplicates and screening titles and abstracts, 28 full-text articles met the inclusion criteria for analysis, while 909 articles were excluded for not meeting the eligibility requirements. The major themes addressed different aspects of the challenges and problems in delivering pediatric nursing care. The most significant issues were challenges in age-specific drug administration, pharmaceutical errors related to pediatric dosing, cultural sensitivities unique to pediatric care, moral dilemmas in pediatric decision-making, language barriers in pediatric communication and organizational limitations in pediatric units. Conclusions: This review highlights major challenges in pediatric nursing, such as drug administration issues, medication errors, cultural and language barriers, moral dilemmas, and organizational constraints. To improve pediatric care, it is essential to implement targeted strategies, enhance training, and strengthen support systems.

Anne C Jones,1 Kristin N Bertsch,1 Deborah Williams,2 Millicent King Channell1,3 1Department of Family Medicine; Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA; 2Department of Cell Biology and Neuroscience; Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA; 3Department of Osteopathic Manipulative Medicine; Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USACorrespondence: Anne C Jones, Email jonesan@rowan.eduAbstract: Due to growing health disparities in underserved communities, a comprehensive approach is needed to train physicians to work effectively with patients who have cultures and belief systems different from their own. To address these complex healthcare inequities, Rowan-Virtua SOM implemented a new curriculum, The Tensegrity Curriculum, designed to expand beyond just teaching skills of cultural competence to include trainees’ exploration of cultural humility. The hypothesis is that this component of the curriculum will mitigate health inequity by training physicians to recognize and interrupt the bias within themselves and within systems. Early outcomes of this curricular renewal process reveal increased student satisfaction as measured by course evaluations. Ongoing course assessments examine deeper understanding of the concepts of implicit bias, social determinants of health, systemic discrimination and oppression as measured by performance on graded course content, and greater commitment to continual self-evaluation and critique throughout their careers as measured by course feedback. Structured research is needed to understand the relationship between this longitudinal and integrated curricular design, and retainment or enhancement of empathy during medical training, along with its impact on health disparities and community-based outcomes.Keywords: health equity, cultural competency, bias, implicit, social determinants of health, Osteopathic medicine, diversity, equity, inclusion

Low HPV vaccination rates among Latina young adults perpetuate HPV-associated cancer disparities. Using qualitative methods, this study explored individual, interpersonal, and community factors that influence HPV vaccine delay and refusal among Mexican- and U.S.-born Mexican American young adult women. Participants (N = 30) between 18 and 26 years old were purposively sampled from two federally qualified health centers in Orange County, California. The National Institute on Minority Health and Health Disparities research framework and narrative engagement theory guided semi-structured phone interviews coded inductively and deductively. Participants primarily attributed vaccine status to individual and interpersonal reasons. Emerging themes included low HPV vaccine knowledge, insufficient provider communication, negative perceptions about HPV and the vaccine, motherhood responsibilities, mother's communication about HPV, cultural family norms, health care access, and misinformation. Compared to U.S.-born Latinas, Mexican-born participants more frequently expressed avoiding health care discussions with family. HPV vaccine recommendations for young Mexican American women should include socioculturally tailored messages that may improve HPV vaccination acceptance and uptake.

Rural transgender individuals face heightened disparities relative to other transgender individuals. However, social workers and psychologists receive minimal training in transgender client care. The current study used one-way repeated measures ANOVAs to investigate the effectiveness of transgender-specific cultural competency training for social workers and psychologists working with rural clients to improve knowledge, awareness, and self-efficacy (i.e., competency) concerning transgender clients' needs. Results indicated significant differences in the change of competency among participants assigned to a transgender-specific group compared to those assigned to a general multicultural group. Thematic analysis of participants' responses to course evaluations also supported the course effectiveness. [ABSTRACT FROM AUTHOR]