Socioecologies in shaping migrants and refugee youths' sexual and reproductive health and rights: a participatory action research study.

OBJECTIVE: This study explores socioecological factors facilitating the sexual and reproductive health and rights (SRHR) experiences of migrant and refugee youth (MRY) in Greater Western Sydney, Australia. MRY may be at higher risk for poorer SRH outcomes due to cultural, linguistic, and systemic barriers. METHODS: Using participatory action research, 17 focus groups were conducted with 87 MRY aged 15-29 from diverse cultural backgrounds. Data were analysed thematically, using socioecological framework. RESULTS: Key facilitators of MRY's SRHR were identified at the microsystem and exosystem levels, including (1) Peer dynamics and support, with friends serving as trusted confidants and sources of advice; (2) Safety and contraceptive choices, highlighting the importance of access to contraception and STI prevention; and (3) Digital platforms for SRHR information access, with online resources filling knowledge gaps. CONCLUSION: Findings suggest the need for SRHR interventions to leverage peer support networks, expand access to contraceptive options, and develop culturally appropriate digital resources for MRY. Further research is needed to identify and enhance facilitators across all socioecological levels to comprehensively support MRY's SRHR needs.

Migrants and refugee youth often struggle to access sexual and reproductive health information and services in their new countries. This study is an attempt to understand what helps young migrants and refugee maintain their sexual and reproductive health and rights in Greater Western Sydney, Australia. Our aim was to identify the positive factors in their environment that make it easier for them to access and use sexual health resources. We talked to 87 migrants and refugee youth aged 15­29 from various cultural backgrounds, conducting 17 group discussions about their experiences with sexual health. Our main results show three important factors that help these young people. The results were, that (1) Many young people trust their friends for advice and information about sexual health, (2) Having choices about contraception and ways to prevent sexually transmitted infections was important, and (3) The internet, especially social media and search engines, is a major source of sexual health information for young people. Understanding these helpful factors can guide better support for young migrants and refugees. It shows sexual health programs need to use peer support in sexual health programs, make sure young people can easily access contraception and protection and create trustworthy online resources about sexual health that are culturally appropriate. Our findings show more research is needed to find other ways to support young migrants and refugees with their sexual and reproductive health. This will help create better health services and education programs for these young people.

Parental perceptions of an oral health promotion program in early childhood education and care settings: A qualitative study.

OBJECTIVES: Early Childhood Caries is a global health problem. The Bright Smiles Bright Futures (BSBF) program seeks to equip educators, children, and parents with skills and knowledge about oral health promotion habits early in life. The aim of this study was to examine parental perceptions of the BSBF program and identify key facilitators and barriers for its implementation. METHODS: Twelve mothers of children who participated in the BSBF program in five Early Childhood Education and Care (ECEC) settings in NSW, Australia were recruited in this qualitative study. Data were collected via focus groups and interviews, transcribed verbatim and coded to categorize for inductive thematic analysis. RESULTS: Five major themes emerged: Promoters of the BSBF oral health program, barriers to the BSBF oral health program implementation and participation, online resources, impact of the BSBF oral health program, and strategies for enhancing the BSBF oral health program. While participants reported that the program encouraged their children's toothbrushing, they found issues with the program's materials, ECEC center attendance, and communication about the oral health program with their children. The program improved message retention, attitudes, routines, and family perceptions toward oral health. Participants recommended oral health literacy, changed delivery formats, increased dental access, and inclusion of interactive elements to enhance the program. CONCLUSIONS: The findings from this study provide insight to improve parents' experiences and engagement in oral health promotion. This can help to raise awareness of the importance of child oral health among policymakers, healthcare professionals, and the public to inform public health policy discussions.

Twelve tips for strengthening global equity in health professions education publication.

Despite recent calls to engage in scholarship with attention to anti-racism, equity, and social justice at a global level in Health Professions Education (HPE), the field has made few significant advances in incorporating the views of the so-called "Other" in understanding the nature, origin, and scope of knowledge as well as the epistemic justification of knowledge production. Editors, authors, and reviewers must take responsibility for questioning existing systems and structures, specifically about how they diffuse the knowledge of a few and silence the knowledge of many. This article presents 12 recommendations proposed by The Global South Counterspace Authors Collective (GSCAC), a group of HPE professionals, representing countries in the Global South, to help the Global North enact practical changes to become more inclusive and engage in authentic and representative work in HPE publishing. This list is not all-encompassing but a first step to begin rectifying non-inclusive structures in our field.

A Qualitative Study of Preschool Children's Perspectives on an Oral Health Promotion Program in New South Wales, Australia.

In Australia, dental caries are observed in almost half of children starting school. Oral health promotion programs are being implemented in early childhood education and care (ECEC) settings to promote oral health. This study examined children's perceptions of one such program, the Bright Smiles Bright Futures (BSBF) program in ECEC settings in New South Wales, Australia. Data were collected using focus group discussions from 15 children aged 3-5 years, transcribed verbatim, and analysed through inductive thematic analysis. Three themes were identified as follows: (i) oral health knowledge of children, (ii) oral hygiene practices routine and skills development, and (iii) evaluation of the oral health promotion kit and opportunities for improvement. Children's perspectives highlight the BSBF program's success in communicating key messages to promote oral health. The integration of family-centric approaches, acknowledgement of children's preferences, and the use of interactive tools collectively enhance the overall effectiveness of the oral health promotion program.

Migrant and Refugee Youth's Sexual and Reproductive Health and Rights: A Scoping Review to Inform Policies and Programs.

Objectives: Migrants and refugee youth (MRY) in Western nations are less likely to participate in sexual reproductive health (SRH) services. Consequently, MRY are more likely to encounter adverse SRH experiences due to limited access to and knowledge of SRH services. A scoping review was conducted to examine MRY's understanding of and the implications for inclusive sexual and reproductive health and rights (SRHR) programs and policies. Methods: A systematic search of literature across seven academic databases was conducted. Data were extracted following Partners for Dignity and Rights' Human Rights Assessment framework and analysed using the thematic-synthesis method. Results: 38 literature (peer-reviewed, 24 and grey, 14) were considered eligible for inclusion. The findings highlighted significant barriers and the under-implementation of SRHR support and services by MRY. Key policy implications include a need for programs to support MRY's SRHR education, diversity, equity and inclusiveness and privacy protections. Conclusion: The review shows that the emerging evidence on MRY SRHR suggests gaps in practices for resourcing policies and programs that promote sustainable SRH for vulnerable populations. Policies for MRY's SRHR should prioritise programs that focus on diversity, equity and inclusion with targeted education and community resourcing strategies for sustainability.

Gamified innovation to teach patient disadvantage.

BACKGROUND: Disadvantages such as social distress, safety, economic status and educational levels can significantly impact health risk factors, health care access and health outcomes. Teaching of disadvantage is critical for medical students to understand impact of disadvantages on patient health and facilitate patient-centred care. Disadvantage was initially taught through one tutorial to third year medical students. Students often narrowly focused on financial disadvantage and failed to consider other disadvantages. In 2019, an innovation to teach disadvantage to first year students was developed and evaluated. APPROACH: A 'trio of learning activities' was designed that combined gamification and experiential learning. The first activity was the gamified Treasure Hunt where students overcame multiple disadvantages to collect 'treasure'. The workshop introduced the topic and potential impacts of disadvantages on health. The second activity included placements at general practices where students observed patient disadvantages. The third activity was the end-of-semester tutorial during which students debriefed their learning on disadvantage throughout the semester. EVALUATION: Students completed the sentence 'Disadvantage is …' after the Treasure Hunt workshop and after the tutorial. Seventy-six percent of the 146 students participated in the evaluation. Responses were thematically analysed. Post-workshop data indicated improvement in students' understanding of disadvantage including its different types, invisible nature of some disadvantages and people's lack of control over disadvantages. Post-tutorial data indicated additional learning about intersectionality, clinical impacts and doctors' ability to address patient disadvantage. IMPLICATIONS: Combining gamification and experiential learning provided an effective and engaging way to teach about disadvantage in a limited time. Positive evaluation of the innovation indicates this approach can be utilised to teach social determinants of health.

LGBTIQ CALD People's Experiences of Intimate Partner Violence: A Systematic Literature Review.

BACKGROUND: Experience of surviving intimate partner violence (IPV) is well documented in research, policing practices, newspapers, and awareness campaigns domestically and internationally. Arguably, those who have survived IPV and have their experiences reflected within society undergo a transformative experience of empowerment. As society recognises and validates their experience has occurred, and responds to it, accordingly, as some survivors have targeted services and interventions to assist in this transformation. However, for LGBTIQ-identifying peoples, experiences of IPV are poorly understood in contemporary society, which is further exacerbated for LGBTIQ-identifying CALD people as they continue to remain hidden. AIM AND OBJECTIVE: The systematic literature review aims to explore the experiences of this group in their development of resilience following an abusive and violent relationship. METHODS: Of the potential 230 identified studies, 5 studies met the eligibility criteria. In line with the eligibility criteria, these studies were first reviewed by title, then by abstract and then by full text. Of those studies which the research team deemed relevant for inclusion, their reference lists where also reviewed to determine if any further relevant studies could be identified using this strategy. As a result of the above process, five (5) studies met the eligibility criteria and were included in the study. RESULTS: From data extraction, three major themes emerged: Intimate Partner Violence as Experienced by LGBTIQ survivors, Marginalised Identity and Types of Survivorship. While refined, these themes capture a more robust set of sub-themes that identify the diverse ways in which LGBTIQ survivors experience responses to their victimised status as experienced in IPV situations. CONCLUSIONS: Overall, the review found that resilient outcomes for LGBTIQ CALD survivors remain misunderstood and missing within the literature. There is a propensity to focus on negative coping strategies and an exclusive focus on LGBTIQ CALD vulnerabilities. Future research requires investigation into strategies and support that move beyond coping to include resilient outcomes and support systems that allow manifestations of resilience.

Barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings and primary schools: a systematic review.

BACKGROUND: Untreated dental caries negatively impacts a child's quality of life including overall health and wellbeing, growth and development, social interaction ability, and school attendance. School-based toothbrushing programs have been recognised as an effective intervention to reduce the burden of dental caries. However, limited information is available to understand the real-world enablers and challenges in the implementation and sustainability of toothbrushing programs. This review aims to understand the barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings and primary schools. METHODS: Five electronic databases [i.e., CINAHL (EBSCO), Medline (EBSCO), EMBASE (Ovid), Web of Science, and PsycINFO] and backward citation chasing were performed. The last updated databases searches were conducted in May 2022. Studies reporting on barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings or primary schools were included in the review. The methodological quality of included studies was assessed by using Joanna Briggs Institute [JBI] and mixed methods appraisal tool [MMAT] critical appraisal tools and results were reported in accordance with PRISMA guidelines. RESULTS: A total of six studies met the eligibility criteria and were included in the review. Toothbrushing programs in early childhood settings and primary schools were mostly implemented under the supervision of staff and teachers. A positive attitude of the staff, the flexibility of toothbrushing sessions, involvement of community volunteers and parents were a few of the identified enablers. However, the timing of the communication of the program, inadequate transfer of information among staff, frequent staffing turnover, lack of parental support, and staff feeling overburdened while acting as pseudo parents were frequently reported as barriers. CONCLUSION: The results of this systematic review identify key enablers and barriers for toothbrushing programs in early childhood settings and primary schools which need to be considered for developing oral health promotion initiatives.

Twelve tips for engaging students and community partners in medical education.

There is increasing evidence on the positive outcomes of engaging students and community partners in medical education, especially in achieving social accountability. However, less is known about the steps through which these engagements are established. This paper outlines twelve tips on establishing a robust and enduring partnership with students and community partners in medical education, using examples from the Western Sydney University School of Medicine. While context is paramount in any engagement program, these tips are formulated to be transferable to medical education settings in different countries, education systems, and the broader context of health professional education.

Exploring Tertiary Health Science Student Willingness or Resistance to Cultural Competency and Safety Pedagogy.

There is an increasing body of literature that considers the relevance and experiences of cultural competency and safety training in health professional students. However, less is written about Australian tertiary learners' experiences of engaging with cultural competency training. The aim of this study is to explore tertiary students' willingness or resistance to cultural competency and safety pedagogy. Qualitative student feedback to a teaching unit was collected and triangulated with data from focus groups with tutors. Results were thematically analyzed. Willingness and resistance to cultural competency and safety teaching emerged as two key themes. Willingness to engage with the unit was largely due to student interest in the content, teaching environment and relevance of cultural competency to students' future practice. Resistance was linked to the students feeling personally attacked, or culturally confronted, with tutors noting the topics around sexuality and white privilege being more resisted. Acknowledging reasons for student resistance and developing strategies to reduce resistance can facilitate more student engagement with cultural competency topics, ultimately leading to their future provision of culturally competent healthcare.

Medicine in Context: ten years' experience in diversity education for medical students in Greater Western Sydney, Australia.

Objective: This paper describes the Western Sydney University School of Medicine (WSUSoM) diversity education program, Medicine in Context (MiC). MiC implements community-engaged learning and partnership pedagogy in teaching diverse social determinants of health to first clinical year medical students. Central to MiC content and delivery methods is the local region's diversity which is also reflected in the student population and MiC staff. Methodology: This is a descriptive report about how the WSUSoM staff with community and General Practice (GP) partners have co-designed, co-delivered, co-assessed and co-evaluated the MiC program in 2009-2018. In keeping with the community-engaged learning and partnership pedagogy, the report is co-authored by a cross section of MiC stakeholders: the WSUSoM staff members, community partners and an alumna. Results: Ten weeks' immersion in community-based services, with debriefing and scaffolding in tutorials and workshops, exposes students to the complex interplay between social determinants of health and clinical practice. Sharing of experiences, insights and reflections in safe environments enables students to overcome the uneasiness of diversity education. Quality assurance reviews identified positive trends in students' quality of learning and satisfaction in the program following evidence-based continuous improvements of the program design and delivery. Conclusion: Implementation of community-engaged learning and partnership pedagogy in the MiC program, supported by ongoing commitment from the WSUSoM and its community and GP partners, has been successful in engaging students in diversity education. The synthesis of diversity education and clinical learning throughout the MiC program is an important step toward building competency in patient-centred care.

Blended learning to teach gender in medical school.

BACKGROUND: Teaching gender and sexuality in medical school is critical to prepare students for future clinical practice. Yet curriculum gaps exist in teaching these topics in medical schools. To address this, medical schools are integrating gendered perspectives into their curricula. CONTEXT: Acknowledging the need to teach gender and sexuality, Western Sydney University School of Medicine introduced a lecture on 'Gendered Perspectives on Health' in 2015. However, the delivery of the content took more time than anticipated, as some students lacked a basic understanding of gender and sexuality. Engagement with the didactic teaching method was low. INNOVATION: Using blended learning techniques, a flipped classroom workshop on gender and sexuality was developed in 2016. The workshop had online components that gave basic information on gender and sexuality, which students viewed prior to the face-to-face session. Students then discussed specific gender-related topics with expert facilitators using a timed multi-station approach during the face-to-face session. A plenary session provided students with the opportunity to address any remaining questions. Evaluation suggests that the workshop increased the students' self-reported knowledge on gender and sexual health topics and services. Students also found the workshop useful and engaging. Teaching gender and sexuality in medical school is critical to prepare students for future clinical practice IMPLICATIONS: The workshop provided an engaging and informative way for students to discuss gender and sexuality. The workshop also created a safe learning environment for students to clarify their perceptions of gender and sexuality. Increasing students' knowledge and understanding of gender and sexuality promoted a gender-sensitive approach to patient care, which can help students to avoid stereotyping and to provide comprehensive care to gender-diverse groups.