RESUMEN
BACKGROUND AND OBJECTIVES: Addressing the issues of workplace advancement, resilience, and retention within medicine is crucial for creating a culture of equity, respect, and inclusivity especially towards women and nonbinary (WNB) providers including advanced practice providers (APPs), most notably those from marginalized groups. This also directly impacts healthcare quality, patient outcomes, and overall patient and employee satisfaction. The purpose of this study was to amplify the voices on challenges faced by WNB providers within a pediatric academic healthcare organization, to rank workplace interventions addressing advancement, resilience, and retention highlighting urgency towards addressing these issues, and, lastly, to provide suggestions on how to improve inclusivity. METHODS: Participants were self-identified WNB providers employed by a pediatric healthcare organization and its affiliated medical university. An eligibility screener was completed by 150 qualified respondents, and 40 WNBs actually participated in study interviews. Interviews were conducted using a semi-structured interview guide to rank interventions targeted at improving equity, with time allotted for interviewees to discuss their personal lives and how individual circumstances impacted their professional experiences. RESULTS: WNB providers called for efficient workflows and reducing uncompensated job demands. Support for family responsibilities, flexible financial/compensation models, and improved job resources all were endorsed similarly. Participants ranked direct supervisor and leader support substantially lower than other interventions. Conclusions: Career mentorship and academic support for WNB individuals are recognized interventions for advancement and retention but were not ranked as top priorities. Respondents focused on personal supports as they relate to family, job resources, and flexible compensation models. Future studies should focus on implementing realistic expectations and structures that support whole lives including professional ambitions, time with family, personal pursuits, and self-care.
RESUMEN
Findings are presented from focus group data collected during a larger study describing factors that inhibit, support, and sustain women's abilities to leave and stay out of abusive relationships. A subset (n = 24) of the larger study sample (N = 40) participated in one of four focus groups. Participants had left or were currently in abusive intimate relationships. Women reported diverse experiences and were in various stages of abusive relationships. Ages ranged from 21 to 51; 67% were Caucasian, and 20% African American. Most women (71%) had at least a high school education and were employed (60%), but 83% reported annual incomes less than $20,000. NVIVO software facilitated content analysis of transcriptions. After initial synthesis of data, 20 women participated in one of two confirmatory focus groups. Four primary themes emerged from the content analysis: (1) Living an Unnatural Experience included maladaptive physical and emotional responses to chronic violence; (2) The Experience of Telling included multiple intrapersonal, interpersonal, and societal barriers to disclosure; (3) The Experience of Leaving included descriptions of acute and long-term experiences and difficulties; and (4) Reducing Barriers included participant ideas on ways to reduce barriers to assistance. Recommendations are made to improve community interventions and programs that will facilitate the choices and enhance the successes of women who have experienced domestic violence.