Sexual and reproductive health services awareness and utilisation among young people in a semi-Urban community in Cross River State, Nigeria.

Young people's unawareness and poor utilisation of sexual and reproductive health and rights (SRHR) services is one of the contributing variables that increase the susceptibility of youths to many challenges in SRHR. This study sought to assess young people's level of awareness and utilisation of available sexual and reproductive health and rights services in Calabar South Local Government Area of Cross River State, Nigeria. The available SRHR services in the study area were identified. A community-based cross-sectional descriptive design was adopted for the study, whereby a sample of 325 youths aged 15-24 years were recruited from households within the 6 selected out of 12 political wards of Calabar Local Government Area, using a multistage sampling technique. A validated self-developed questionnaire was used for data collection which were analysed using SPSS version 22.0. Findings revealed low awareness (94.8%) of young people to available SRHR services, and the proportion of SRHR services utilisation by youths was also low (21.5%). There was a statistically significant influence of SRHR services awareness on youth's utilisation (P <0.05). Also, in the logistic regression, the P-value for all the variables showed that there is no significant influence of the predictor variables (age, religion, marital status, educational qualification, means of livelihood, mother's, and father's educational background) on the outcome variable (awareness and utilization). Limited awareness on SRHR services was a rationale for low utilisation of such services among young people. The study recommended training of health care providers on SRHR services with periodic monitoring to ensure that providers are maintaining standards of care. More community enlightenment through government-community partnership is required to strengthen the concept of SRHR, increase awareness for service utilisation and sustainable development.

Epistemic racism in the health professions: A qualitative study with Black women in Canada.

Systemic racism within health care is increasingly garnering critical attention, but to date attention to the racism experienced by health professionals themselves has been scant. In Canada, anti-Black racism may be embodied in structures, policies, institutional practices and interpersonal interactions. Epistemic racism is an aspect of systemic racism wherein the knowledge claims, ways of knowing and 'knowers' themselves are constructed as invalid, or less credible. This critical interpretive qualitative study examined the experiences of epistemic racism among 13 healthcare professionals across Canada who self-identified as Black women. It explores the ways knowledge claims and expert authority are discredited and undermined, despite the attainment of professional credentials. Three themes were identified: 1. Not being perceived or portrayed as credible health professionals; 2. Requiring invisible labour to counter professional credibility 'deficit'; and 3. Devaluing knowledge while imposing stereotypes. The Black women in our study faced routine epistemic racism. They were not afforded the position of legitimate knower, expert, authority, despite their professional credentials as physicians, nurses and occupational therapists. Their embodied cultural and community knowledges were disregarded in favour of stereotyped assumptions. Adopting the professional comportment of 'Whiteness' was one way these health care providers strived to be perceived as credible professionals. Their experiences are characteristic of 'misogynoir', a particular form of racism directed at Black women. Anti-Black epistemic racism constitutes one way Whiteness is perpetuated in health professions institutions.

Determinants of Adherence to National Infant Feeding Guidelines by Black Mothers Living with HIV.

Objective: Worldwide, 160,000 children were newly infected with HIV in 2018; half of these were infected through breastfeeding. Infant feeding guidelines are distinct depending on each country's resources and national or sub-national guidelines. Because of divergent guidelines, the best infant feeding approach to prevent mother-to-child transmission can become unclear. The purpose of this study was to examine the sociocultural and psychosocial factors related to adherence to infant feeding guidelines through a city-level, North-South comparison of Black mothers living with HIV in Nigeria, Canada, and the United States. Design: Using a cross-sectional multi-country survey, a convenience sample of 690 mothers were recruited from June 2016 - December 2019. Socio-cultural and psychosocial factors influencing infant feeding practices were measured. Results: Using binary logistic regression, infant feeding attitudes (OR = 1.10), motherhood experiences (OR = 1.08), low hyper-vigilance score (OR = .93), paternal support (OR = 1.10) and perception that the health care provider supported adherence to infant feeding guidelines (OR = 2.43) were associated with guideline adherence. Mothers who had cultural beliefs that were inconsistent with infant feeding guidelines and mothers with low incomes (OR = 2.62) were less likely adherent with their country's guidelines. Conclusion: City-level factors were not found to influence adherence to infant feeding guidelines; however, socio-cultural and psychosocial factors at community, family and individual levels were significant. Policy formulation and targeted interventions must be cognizant of cultural expectations of motherhood and mindful of psychosocial determinants of adherence to infant feeding guidelines.

"You feel you have to be made of steel": The strong Black woman, health, and well-being in Nova Scotia.

The "strong Black woman" construct has been well-documented in the United States as both an aspirational icon and a constricting burden for African-heritage women. It has not been examined among African-Canadians. Drawing on qualitative interviews and standardized measures with 50 African-heritage women in Eastern Canada, our analysis reveals their perceptions of the construct as both strongly endorsed as a source of cultural pride, yet also acknowledged to take a terrible toll on health and well-being. The construct arises from and directly benefits racism. It is imperative that health professionals understand the ways it shapes health and help-seeking behaviors.

Getting a Picture.

Delivery of care by nurses in virtual environments is rapidly increasing with uptake of digitally mediated technologies, such as remote patient monitoring (RPM). Knowing the person is a phenomenon in nursing practice deemed requisite to building relationships and informing clinical decisions, but it has not been studied in virtual environments. PURPOSE OF STUDY: The intent of this study was to explicate the processes of how nurses come to know the person using RPM, one form of telehealth technology used in a virtual environment. STUDY DESIGN AND METHOD: The study was informed by Charmaz's constructivist grounded theory and included 33 interviews and 5 observational experiences of nurses using RPM in 7 different settings. FINDINGS: Getting a Picture evolved as the core category to a theoretical conceptualization of nurses knowing the person through use of RPM and other technologies, such as telephone and electronic medical records. Getting a Picture reflected a dynamic flow and integration of seven processes, such as Connecting With the Person and Recording and Reflecting, to describe how nurses strove to attain a visualization of the person. CONCLUSIONS: While navigating disparate and disconnected information and communication technologies, Getting a Picture was important for providing safe, holistic, person-centered care.

Workforce utilization of visible and linguistic minorities in Canadian nursing.

Aim This study seeks to develop a diversity profile of the nursing workforce in Canada and its major cities. Background There is ample evidence of ethnic and linguistic segregation in the Canadian labour market. However, it is unknown if there is equitable representation of visible and linguistic minorities in nursing professions. Methods We cross-tabulated aggregate data from Statistics Canada's 2006 Census. Analyses examined the distribution of visible and linguistic minorities, including visible minority sub-groups, among health managers, head nurses, registered nurses, licensed nurses and nurse aides for Canada and major cities as well as by gender. Results In Canada and its major cities, a pyramidal structure was found whereby visible and linguistic minorities, women in particular, were under-represented in managerial positions and over-represented in lower ranking positions. Blacks and Filipinos were generally well represented across nursing professions; however, other visible minority sub-groups lacked representation. Conclusions Diversity initiatives at all levels can play a role in promoting better access to and quality of care for minority populations through the increased cultural and linguistic competence of care providers and organizations. Implications for Nursing Management Efforts to increase diversity in nursing need to be accompanied by commitment and resources to effectively manage diversity within organizations.

The substantive theory of surviving on the margin of a profession.

Using the grounded theory method, a substantive theory of surviving on the margin of a profession emerged as the core variable that explains the patterns of behavior of black nurses in Canada. Data were collected through audiotaped in-depth interviews of 20 black nurses. The three phases of this theory are realizing, surviving, and thriving and the three critical transitions points are the center, the margin, and the proving ground. The phases and transitions points, as well as the conditions that influence variations in the theory are the focus of this paper. These conditions include racism, diversity, and worklife issues such as healthy workplaces.

Participatory action research (PAR): an approach for improving black women's health in rural and remote communities.

Women are among the most disadvantaged members of any community, and they tend to be at greatest risk of illness. Black women are particularly vulnerable and more prone than White women to illnesses associated with social and economic deprivation, including heart disease and diabetes. They utilize preventive health services less often, and when they fall ill, the health of their families and communities typically suffers as well. This article discusses the process of doing innovative participatory action research (PAR) in southwest Nova Scotia Black communities. The effort resulted in the generation of a database, community action, and interdisciplinary analysis of the intersecting inequities that compromise the health and health care of African Canadian women, their families, and their communities. This particular research effort serves as a case study for explicating the key tenets of PAR and the barriers to and contradictions in implementing PAR in a community-academic collaborative research project.

Recruitment and retention of minority students: diversity in nursing education.

A culturally diverse nursing workforce is essential to meet the health needs of an increasingly diverse Canadian population. The recruitment and retention of nursing students representing diverse backgrounds are vital to the building of this diversified work force. Studies have shown that diversity within the student body benefits everyone. For example, students who study and work within a diverse environment are better able to understand and consider multiple perspectives and to appreciate the benefits inherent in diversity. This paper describes one school of nursing's project on the Recruitment and Retention of Black students into their Bachelor of Science Nursing (BScN) Program. The project goals are to increase diversity, foster student learning, and ultimately improve health care for the Black community. Presented in this paper are the project background, implementation process, challenges and outcomes. This may provide learned lessons and future directions for similar initiatives in other institutions.