A Digital Music-Based Mindfulness Intervention ("healing attempt") for Race-Based Anxiety in Black Americans.

This study replicates and extends findings that "healing attempt"-a brief digital music-based mindfulness intervention-represents a feasible and potentially effective intervention for race-based anxiety in the Black community.

The lived experiences of racial bias for Black, Asian and Minority Ethnic students in practice: A hermeneutic phenomenological study.

AIM: This study explored the lived experiences of racial bias for Black, Asian and Minority Ethnic students undertaking an undergraduate or post-graduate degree in nursing, midwifery and allied health courses in the United Kingdom. BACKGROUND: Previous research indicates that students from Black, Asian and Minority Ethnic groups have fewer opportunities to succeed at university and this has brought about a race awarding gap in their degree attainment. The reasons for this awarding gap are complex and multi-factorial and it is crucial that the lived experiences of racial bias are explored from the student perspective. DESIGN: A hermeneutic phenomenological approach was adopted to elicit individual and collective experiences in the practice environment, a mandatory component of the student's degree. METHODS: A focus group and individual semi-structured interviews were conducted to collect data from sixteen participants and analysed using thematic analysis RESULTS: Three encompassing themes were identified which included a sense of not belonging, trauma impact on mental health and understanding covert and overt racism. Participants reported incidences of racism and appeared to be traumatised by their experiences within practice and the university. They also reported poor mental health and well-being as shared experiences and a lack of confidence in the university and practice to mitigate racial issues. CONCLUSIONS: Meaningful action must be taken by universities and practice partners to advance racial inequality initiatives by having robust anti-racism action plans and processes. These should be co-created with students and staff to reduce the race awarding gap.

Intergenerational Influences on Faith-based Strategies Used in Response to Racial Discrimination Among Young African American Adults.

OBJECTIVE: In this report, we used a qualitative descriptive design to explore young African American adults' intergenerationally influenced strategies to experienced racial discrimination. METHODS: The study was guided by a qualitative descriptive design using criterion and snowball sampling, and semi-structured interview questions. We also explored, quantitatively, gender differences among the racial discrimination experiences encountered and the strategies used. FINDINGS: Forty-nine participants included in this report were an average age of 29.5 (SD = 10.1). Racial discrimination experiences included daily microaggressions such as insensitive comments, stereotyping, exclusion from work and school activities, perceived low expectations, inequities in employment, and police profiling. Intergenerationally influenced strategies used in response to these experiences included religious beliefs and practices, positive reframing, and modeling behaviors used by previous generations. These intergenerationally influenced strategies enabled participants to remain calm, to express goodwill toward others, and to be patient and hopeful for a better future. CONCLUSION: Since intergenerationally influenced strategies are likely potential sources of strength and resilience for young African Americans, knowledge of these strategies might be useful to health care practitioners seeking to improve the mental health care of this population.

American Indian Researcher Perspectives on Qualitative Inquiry About and Within American Indian Communities.

It is presumed that Indigenous researchers are optimally positioned to conduct research about or within their own or other Indigenous communities. However, these researchers may still experience challenges, barriers, and distressing events that are important to identify. Qualitative inquiry may be a particularly vulnerable context for Indigenous researchers given the nature of data collection methods and an emphasis on researcher-participant relationships. This paper details the personal reflections of two American Indian (AI) researchers who carried out qualitative research focused on AI issues and/or communities. The first project examined undergraduate students' opinions of the use of AI imagery in the form of a race-based university mascot. The second was a study of the mental health needs of AI youth and families in an urban community. Several themes characterized both of their experiences and might be generalizable to others working in these contexts: (a) coping with racism and microaggressions; (b) the role and impact of identity politics; (c) community insider/outsider tension; and (d) managing personal distress associated with the research topics and process. These themes are discussed to illuminate ways that Indigenous researchers, engaged in research on Indigenous topics and/or with Indigenous communities, are challenged and affected by their work.

Health ethics and Indigenous ethnocide.

In colonial societies such as Canada the implications of colonialism and ethnocide (or cultural genocide) for ethical decision-making are ill-understood yet have profound implications in health ethics and other spheres. They combine to shape racism in health care in ways, sometimes obvious, more often subtle, that are inadequately understood and often wholly unnoticed. Along with overt experiences of interpersonal racism, Indigenous people with health care needs are confronted by systemic racism in the shaping of institutional structures, hospital policies and in resource allocation decisions. Above all, racism is a function of state law - of the unilateral imposition of the settler society law on Indigenous communities. Indeed, the laws, including health laws, are social determinants of the ill-health of Indigenous peoples. This article describes the problem of Indigenous ethnocide and explores its ethical implications. It thereby problematizes the role of law in health ethics.

Localizing Global Medicine: Challenges and Opportunities in Cervical Screening in an Indigenous Community in Ecuador.

This participatory research study examines the tensions and opportunities in accessing allopathic medicine, or biomedicine, in the context of a cervical cancer screening program in a rural indigenous community of Northern Ecuador. Focusing on the influence of social networks, the article extends research on "re-appropriation" of biomedicine. It does so by recognizing two competing tensions expressed through social interactions: suspicion of allopathic medicine and the desire to maximize one's health. Semistructured individual interviews and focus groups were conducted with 28 women who had previously participated in a government-sponsored cervical screening program. From inductive thematic analysis, the article traces these women's active agency in navigating coherent paths of health. Despite drawing on social networks to overcome formidable challenges, the participants faced enduring system obstacles-the organizational effects of the networks of allopathic medicine. Such obstacles need to be understood to reconcile competing knowledge systems and improve health care access in underresourced communities.

Aproximación crítica a las políticas públicas en salud indígena, medicina tradicional e interculturalidad en México (1990-2016) / A critical examination of public policies related to indigenous health, traditional medicine, and interculturality in Mexico (1990-2016)

RESUMEN En los últimos 26 años, el gobierno mexicano desarrolló múltiples discursos y actividades sobre la denominada "salud intercultural" dirigidos, en especial, a los pueblos originarios de México (alrededor de 62, de acuerdo al criterio lingüístico), y construyó establecimientos de salud (puestos de salud, clínicas y hospitales) en los que propuso la aplicación de indicadores de pertinencia cultural en algunos estados como Puebla, Nayarit, Oaxaca, Chiapas, Querétaro y Jalisco (mínimos e insuficientes). Sin embargo, la salud indígena y la atención médica institucional siguen siendo precarias en cuanto a recursos humanos y materiales (personal sanitario, medicamentos, etc.), y discriminatorios con relación a la forma y al contenido de la atención que se brinda. En este artículo, detallamos algunas de las intervenciones del gobierno que suponen un avance institucional sobre el tema de interculturalidad en salud pero que, en el fondo, significan la continuidad de políticas arbitrarias y excluyentes.

ABSTRACT Over the last 26 years, the Mexican government has developed a number of activities and discourses around what has been called "intercultural health," directed especially at indigenous peoples in Mexico (some 62, according to linguistic criteria). In this way, the government has built health care institutions (rural centers, clinics, and hospitals) in states like Puebla, Nayarit, Oaxaca, Chiapas, Queretaro, and Jalisco, proposing the implementation of cultural pertinence indicators (which are minimal and inadequate). Nevertheless, the health conditions among indigenous populations and the quality of health care provided by public institutions continue to be precarious in terms of human and material resources (health personnel, drugs, etc.) and discriminatory with respect to the form and content of the provided services. This paper describes some of the governmental interventions that purport to be institutional improvements in the field of interculturality, but that actually represent the continuity of arbitrary and exclusive policies.

Measurement, Education and Tracking in Integrated Care (METRIC): use of a culturally adapted education tool versus standard education to increase engagement in depression treatment among Hispanic patients: study protocol for a randomized control trial.

BACKGROUND: Significant mental health disparities exist for Hispanic populations, especially with regard to depression treatment. Stigma and poor communication between patients and their providers result in low use of antidepressant medications and early treatment withdrawal. Cultural factors which influence treatment decisions among Hispanics include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking medications. Primary care settings often are the gateway to identifying undiagnosed or untreated mental health disorders, particularly for people with co-morbid physical health conditions. Hispanics, in particular, are more likely to receive mental healthcare in primary care settings. Recent recommendations from the U.S. Preventive Services Task Force are that primary care providers screen adult patients for depression only if systems are in place to ensure adequate treatment and follow-up. METHODS: We are conducting a randomized controlled trial among 150 depressed adult Hispanics in a primary care safety net setting, testing the effectiveness of a culturally appropriate depression education intervention to reduce stigma and increase uptake in depression treatment among Hispanics, and implement a Measurement-Based Integrated Care (MBIC) model with collaborative, multidisciplinary treatment and culturally tailored care management strategies. DISCUSSION: This study protocol represents the first randomized control trial of the culturally adapted depression education fotonovela, Secret Feelings, among Hispanics in a primary care setting. The education intervention will be implemented after diagnosis using an innovative screening technology and enrolled in measurement-based integrated care for the treatment of depression, which will help build the evidence around cultural adaptations in treatment to reduce mental health disparities. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02702596. Registered on 20 March 2016.

[A critical examination of public policies related to indigenous health, traditional medicine, and interculturality in Mexico (1990-2016)]. / Aproximación crítica a las políticas públicas en salud indígena, medicina tradicional e interculturalidad en México (1990-2016).

Over the last 26 years, the Mexican government has developed a number of activities and discourses around what has been called "intercultural health," directed especially at indigenous peoples in Mexico (some 62, according to linguistic criteria). In this way, the government has built health care institutions (rural centers, clinics, and hospitals) in states like Puebla, Nayarit, Oaxaca, Chiapas, Queretaro, and Jalisco, proposing the implementation of cultural pertinence indicators (which are minimal and inadequate). Nevertheless, the health conditions among indigenous populations and the quality of health care provided by public institutions continue to be precarious in terms of human and material resources (health personnel, drugs, etc.) and discriminatory with respect to the form and content of the provided services. This paper describes some of the governmental interventions that purport to be institutional improvements in the field of interculturality, but that actually represent the continuity of arbitrary and exclusive policies.

En los últimos 26 años, el gobierno mexicano desarrolló múltiples discursos y actividades sobre la denominada "salud intercultural" dirigidos, en especial, a los pueblos originarios de México (alrededor de 62, de acuerdo al criterio lingüístico), y construyó establecimientos de salud (puestos de salud, clínicas y hospitales) en los que propuso la aplicación de indicadores de pertinencia cultural en algunos estados como Puebla, Nayarit, Oaxaca, Chiapas, Querétaro y Jalisco (mínimos e insuficientes). Sin embargo, la salud indígena y la atención médica institucional siguen siendo precarias en cuanto a recursos humanos y materiales (personal sanitario, medicamentos, etc.), y discriminatorios con relación a la forma y al contenido de la atención que se brinda. En este artículo, detallamos algunas de las intervenciones del gobierno que suponen un avance institucional sobre el tema de interculturalidad en salud pero que, en el fondo, significan la continuidad de políticas arbitrarias y excluyentes.