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Food systems students can benefit from a critically reflective, anti-oppressive, and culturally responsive classroom. In this paper, we share 37 students’ reflections on their experiences in two su...

Non-profit organizations that address gender-based violence must create diverse, inclusive, and equitable workplaces for advocates so that they can adequately serve diverse survivors. Despite recent efforts, differential treatment and high turnover among minority advocates continue. Further strategies to eliminate discriminative organizational practices are needed. We interviewed 25 advocates employed by non-profit organizations in a Southeastern state to examine how race, ethnicity, gender, and sexuality shape their work experiences. Guided by constructivist grounded theory and intersectionality, data analysis yielded four major themes that covered white dominance in advocacy, essentialized womanhood and heteronormativity, serving communities of color, working in the Deep South. Patriarchal values, religious norms, and gender roles influenced how advocates’ work was received by the communities. Racial/ethnic minority, and sexual and/or gender minority advocates faced discrimination, tokenism, and negative stereotypes. Transforming organizational climate and policies is necessary to support minority advocates’ work engagement and ability to serve marginalized communities.

This brief report provides an overview of lessons learned through evaluation of the first five years of the NIA-funded South Carolina-Advancing Diversity in Aging Research (SC-ADAR) undergraduate program, whose goal is to increase the number of qualified underrepresented minority (URM) students who pursue scientific graduate studies in programs focusing on medicine, science, technology, engineering, and mathematics and aging. Partnering with five Historically Black Colleges and Universities in South Carolina, we implemented a research training approach that included two consecutive summers of research training in a University of South Carolina faculty laboratory, as part of a comprehensive 24-month research education program. In addition to the mentored research experience in a laboratory, students had coursework in the biology of aging and social gerontology, with additional workshops tailored to emergent student needs including basic academic skills development, work-life management skills, reflective social experiences, and enhanced support in the transition from undergraduate to graduate school. We provide an overview of lessons learned throughout the early program period, and a description of the iterative changes we made in the program in response to this learning, all of which have been incorporated into the existing SC-ADAR program.

Background:The Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) older adult population may have a heightened need of medical and supportive care while aging. This makes appointment of a healthcare power of attorney (HCPoA) an essential component of end-of-life care to ensure patients’ wishes are honored at the end of their lives. The objective of this study was to evaluate the prevalence and preferences for HCPoA appointment among older LGBTQ adults living in the Southern United States.Methods:An online survey was distributed to older LGBTQ adults living in the Southern US regarding appointment of a HCPoA between January-March 2018.Participants:The survey was completed by 789 older LGBTQ adults from North Carolina, South Carolina, Georgia, Alabama, Mississippi, Louisiana, and Florida in January-March 2018.Results:Overall, 61.6% of respondents had appointed a HCPoA. Respondents with an appointed HCPoA were more likely to be married (aOR = 5.04, p < .001), have larger social networks (aOR = 3.87, p < .001) and be older (aOR = 1.07, p < .001). Gender diverse respondents were less likely to have an appointed HCPoA relative to cisgender respondents (aOR = 0.39, p = .04). Overall, the majority of respondents indicated a spouse or significant other served as their HCPoA ( n = 311, 64.5%).Conclusions:Nearly 40% of older LGBTQ adults in the Southern US did not have an appointed HCPoA. Specifically, those who were more socially isolated, single, or who identified as transgender or gender non-binary were less likely to have an appointed HCPoA. These people may benefit from targeted outreach regarding advance care planning.

Advocates who work for nonprofit organizations (NPOs) that address gender-based violence (GBV) experience a wide range of psychosocial health and well-being risks due to the emotionally demanding nature of the work they engage in. Most recommendations for advocates’ self-care focus on individual-level activities, failing to hold the NPOs accountable for creating workplace cultures and practices that foster psychosocial well-being, self-care, and resilience among the advocates. The aim of this qualitative research was to further our understanding of organizational-level factors that influence psychosocial well-being and self-care practices among advocates who work for GBV-specific NPOs in a metropolitan area in the southeastern United States. We conducted in-depth interviews with 25 GBV-specific advocates. Constructivist grounded theory methods were used in coding and analyzing the data. Sixteen advocates identified as White, followed by five Black, two Hispanic, and two mixed-race/ethnicity. Mean age was 36 years. Most participants had a master’s degree ( n = 16). Analysis of the data resulted in three major themes: (a) Management and Leadership Style, (b) Interpersonal Relationship Dynamics, and (c) Culture of Self-Care. The ways in which leaders established relationships with other advocates to accomplish organizational goals, how advocates developed a sense of camaraderie with their coworkers, and shared norms around self-care shaped advocates’ willingness and ability to engage in individual and collective self-care. Findings of this study highlight the role of GBV-specific NPOs in creating workplace cultures and practices that are conducive to engaging in self-care and developing resilience among the advocates. By fulfilling this responsibility, organizations would enable the advocates to not only survive, but thrive in their work and make even greater strides in the overall mission of GBV prevention.

The number of older adults in the United States is projected to increase in coming years, including the number of lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) older adults requiring long-term care (LTC) services. We conducted an online survey of older LGBTQ+ adults living in the Southern United States between January and March of 2018 to inquire about their anticipation of discrimination in and willingness to utilize LTC services. We found that 78.6% of respondents ( N = 789) anticipated discrimination in LTC. Previous experiences with discrimination, higher educational attainment, and queer/questioning sexual orientation were associated with greater expectation of discrimination. Higher anticipation of discrimination was also associated with a greater preference for utilizing LTC services offered by LGBTQ+ providers or for LGBTQ+ older adults. These findings suggest that LTC staff and researchers may be uniquely positioned to craft outreach and policies to protect LGBTQ+ LTC residents.

Purpose:As adverse childhood experiences (ACEs) become increasingly recognized as a root cause of unhealthy behaviors, researchers, practitioners, and legislators seek to understand policy strategies to prevent and mitigate its effects. Given the high prevalence of ACEs, policies that address ACEs can meaningfully prevent disease in adulthood and improve population health. We sought to understand barriers and opportunities for policies to prevent and mitigate ACEs by exploring state legislator perspectives.Setting and Participants:Twenty-four current state legislators in South Carolina.Design:In 2018, we conducted semistructured interviews with 24 state legislators. Participants were recruited using maximum variation sampling. The researchers individually analyzed each interview transcript using focused coding qualitative techniques. A high inter-rater agreement was demonstrated (κ = .76 to .87), and discrepancies were resolved through discussion.Method:The data collection and analysis were guided by Multiple Streams Theory, which identifies 3 key components (attention to the problem, decisions about policy options, and the impact of political landscape) that can lead windows of opportunity for passing policies.Results:Legislators identified several factors that can influence the passage of legislation on ACEs: awareness of ACEs; gaps in understanding about what can be done about ACEs; the use of data and stories that contextualize the problem of ACEs; capitalizing on the bipartisanship of children’s issues; and linking to current ACEs-related issues on the policy agenda, such as school safety and violence prevention and the opioid epidemic.Conclusion:Public health researchers and practitioners should focus on the factors identified to advocate for policies that prevent ACEs and/or address their health consequences.

We examined the association between lifetime traumatic events with or without trauma response symptoms and depressive symptomatology in American Indians aged ≥ 55 years from a tribe in the Southeastern US (N = 362). Twenty-three percent of the sample experienced a traumatic event without trauma-response symptoms, whereas 14% experienced a traumatic event with at least one trauma-response symptom. After adjustment for sociodemographic characteristics and social support, participants who experienced a traumatic event with one or more trauma-response symptoms had higher odds of clinically relevant depressive symptomatology compared to (1) those who never experienced a traumatic event [odds ratio (OR) 3.2, p

In 2019, the NIH presented the results of its two-year visioning process to advance the science of minority health and health disparities. The PRISMA Health REACH Expansion (PH-REACH E) is an innovative, community-academic partnership between a hospital memory clinic, meal delivery service, research university, and low-income health clinic. The purpose is to: 1) increase the dementia capability of community-based programs, 2) offer caregivers of persons with dementia the REACH intervention, and 3) identify and connect racial minority and/or rural residents with services to promote health and well-being in older adulthood. This presentation will detail the PH-REACH E framework and present program results, which include improved caregiver outcomes (e.g., reduced burden, increased self-efficacy, reduced depression) and enhanced dementia capability (e.g., increased dementia knowledge) of partner organizations. This program illustrates some key recommendations of the NIH – community engagement in intervention adaptation, multisectoral collaboration, and promoting systems-level change to reduce health disparities.

The overall goal of the PRISMA Health - REACH (PH-REACH) project was to reduce caregiver burden and improve caregiving skills among caregivers of community-living Alzheimer's disease and related dementia patients and, as a result, improve care and quality of life for both the patients and their caregivers. This evidence-based, person-centered program emphasizes positive aspects of caregiving and provides tools to improve stress management, caregiver self-care, and coping skills for managing problem behaviors. PH-REACH provided in-home caregiver training, support, and service referral to 126 caregivers in the Greenville area. Trained coaches delivered the program to caregivers of persons with moderate to severe dementia in its original format but later adapted it to better fit the caregivers’ needs. Analysis of pre- and post-test data showed that both the standard and adapted interventions provided benefits across multiple caregiver outcomes, including reduced caregiver burden, ability to manage disruptive behaviors of the care recipient, increased caregiver self-efficacy, reduced depression, and a slight improvement in the number of chronic health conditions. This supports and expands on previous research that has demonstrated the ability of this program to translate across different community-based and clinical settings. The tailored version of PH-REACH succeeded in assisting these caregivers, meeting them where they were in their caregiving journey, and provided measurable benefits to both their mental and physical health. Overall, this project provided evidence of the utility of the PH-REACH intervention and laid the groundwork to extend caregiver training and support to other institutions, both inside and outside the health system.

Objective We examined the perspectives of child and family-serving professionals (CFSP) and state policymakers on protective factors to develop policy and program recommendations including current and needed approaches for addressing ACEs. Methods In 2018, we conducted semi-structured, in-depth interviews with 23 CFSP and 24 state policymakers in South Carolina. Data were analyzed applying the Multiple Streams Theory using thematic analyses. Results CFSPs and policymakers had varying opinions on state government involvement and primary prevention for ACEs. Three protective factors emerged from their perspectives: 1) loving, trusting, and nurturing relationships; 2) safe home environments; and 3) opportunities to thrive. For each of these protective factors, participants suggested policy options that support existing community efforts, attempt to alleviate poverty, and improve child and family serving systems. Conclusion This study suggests that CFSPs and policymakers recognize the importance of protective factors in a child’s life to buffer the effect of ACEs. More awareness is needed about the feasibility and significance of primary prevention of ACEs. The study’s findings can be used to strengthen advocacy priorities for a wide range of public health outcomes associated with ACEs and help further bridge the gap between research and policy.

With the increase in our older adult population there is a need for dementia training for informal and formal dementia caregivers. The objective of this scoping study was to assess dementia knowledge instruments utilized in educational programs and interventions intended for formal and informal dementia caregivers. Scoping review methodology was used to search PubMed, PsycInfo, CINAHL, and Web of Science with tailored database search terms. The search yielded 8,101 results, with 35 studies meeting inclusion criteria. Studies were conducted in eight countries, had varying study designs (RCTs=9, non-RCTs=6, one-group study design=20), and utilized previously published (19) and author-developed (16) instruments. Only two studies focused on minority populations. While author-developed instruments may be more relevant and time-saving, studies should strive to validate instruments or use previously published instruments to help standardize findings across studies and better understand the effects of education programs on caregiver knowledge.

Despite efforts to increase breast cancer screening (BCS) among African American women, disparities in breast cancer mortality persist. Culturally framed health communication may provide a useful strategy to address this issue. Spirituality not only represents an integral aspect of African American culture, but it has also been identified as a potential barrier to BCS among this population. Rather than continuing to focus on spirituality as a barrier, there is an opportunity to develop promotional messages that tap into the protective properties of spirituality among this population. The goals of this study were to engage a group of African American women to identify important spiritual elements to be included in health communication materials, and to subsequently develop a spiritually framed BCS message in response to their feedback. Three nominal group sessions were conducted with 15 African American women. Results revealed three important spiritual elements that can be incorporated into BCS health messages: (a) the body as a temple; (b) going to the doctor does not make you faithless; and (c) God did not give us the spirit of fear. These elements were used to draft a spiritually framed BCS message. Next, 20 face-to-face semistructured interviews were conducted to help finalize the spiritually framed BCS message for use in a future study on culturally framed health communication.