Reflective questioning to guide socially just global health reform: a narrative review and expert elicitation.

Recent research has highlighted the impacts of colonialism and racism in global health, yet few studies have presented concrete steps toward addressing the problems. We conducted a narrative review to identify published evidence that documented guiding frameworks for enhancing equity and inclusion in global health research and practice (GHRP). Based on this narrative review, we developed a questionnaire with a series of reflection questions related on commonly reported challenges related to diversity, inclusion, equity, and power imbalances. To reach consensus on a set of priority questions relevant to each theme, the questionnaire was sent to a sample of 18 global health experts virtually and two rounds of iterations were conducted. Results identified eight thematic areas and 19 reflective questions that can assist global health researchers and practitioners striving to implement socially just global health reforms. Key elements identified for improving GHRP include: (1) aiming to understand the historical context and power dynamics within the areas touched by the program; (2) promoting and mobilizing local stakeholders and leadership and ensuring measures for their participation in decision-making; (3) ensuring that knowledge products are co-produced and more equitably accessible; (4) establishing a more holistic feedback and accountability system to understand needed reforms based on local perspectives; and (5) applying systems thinking to addressing challenges and encouraging approaches that can be sustained long-term. GHRP professionals should reflect more deeply on how their goals align with those of their in-country collaborators. The consistent application of reflective processes has the potential to shift GHRP towards increased equity.

Validity of the 15-item five-facet mindfulness questionnaire among an ethnically diverse sample of university students.

OBJECTIVE: This study examines the psychometrics of the 15-item version of the Five-Factor Mindfulness Questionnaire (FFMQ-15). PARTICIPANTS: An ethnically diverse sample of 538 college students participated in this study. METHODS: The factor structure was evaluated through confirmatory factor analyses fitting 64 alternative models with and without method factors. Model fit as well as valid interpretations of the model parameters were considered in selecting the final model. Utilizing the final selected model, the relationship between mindfulness and the mindfulness facets with two related constructs, psychological inflexibility and emotional distress tolerance was examined. RESULTS: The five-facet second-order model with a single-method factor best fitted to the data and provided sound, interpretable estimates. After accounting for the single-method effect, overall mindfulness was positively correlated with emotional distress tolerance and negatively correlated with psychological inflexibility. CONCLUSIONS: The FFMQ-15 was a valid measure of mindfulness among university students when accounting for the method factor.