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1.
Article in English | MEDLINE | ID: mdl-33811676

ABSTRACT

Stigma is integral to understanding mental health disparities among racial and ethnic minority groups in the United States. We conducted a systematic review to identify empirical studies on cultural aspects of mental illness stigma (public, structural, affiliative, self) among three racial and ethnic minority groups (Asian Americans, Black Americans, Latinx Americans) from 1990 to 2019, yielding 97 articles. In comparison studies (N = 25), racial and ethnic minority groups often expressed greater public and/or self-stigma than White American groups. In within-group studies (N = 65; Asian American, n = 21; Black American, n = 18; Latinx American; n = 26), which were primarily qualitative (73%), four major cultural themes emerged: 1) service barriers including access and quality (structural stigma); 2) family experiences including concealment for family's sake, fear of being a burden, and stigma extending to family (affiliative stigma); 3) lack of knowledge about mental illness and specific cultural beliefs (public stigma); and 4) negative emotional responses and coping (self-stigma). These findings confirmed stigma has both similar and unique cultural aspects across groups. Despite this, few studies tested stigma reduction interventions (N = 7). These cultural insights can inform contextual change at the health systems and community levels to reduce stigma, and empowerment at the interpersonal and individual levels to resist stigma.

2.
Int J Technol Assess Health Care ; 37: e37, 2021 Feb 09.
Article in English | MEDLINE | ID: mdl-33557969

ABSTRACT

OBJECTIVE: The practice of public and patient engagement (PPE) in health technology assessment (HTA) has spread worldwide, yet gaps in knowledge remain. We carried out an institutional ethnography of the Canadian Agency for Drugs and Technologies in Health (CADTH) public and patient involvement in HTA. METHODS: The research took place over 15 months and included observational work in the institutional settings, text review, and interviews with individuals working for or involved with the agency. RESULTS: We found that despite demonstrated commitment to PPE, organizational history, governance structure, and practices were impediments to a unified approach to PPE. Unclear role descriptions for committee members and differences in philosophy and priority given to PPE across the organization presented challenges to effective participation. The high degree of value given to evidence-based principles at times conflicted with meaningful integration of patient input. A lack of clear goals and processes, roles, and differential treatment of evidence in PPE served to minimize the importance of patient experiences and to displace their validity. An acknowledgment of conflicts between multiple epistemic traditions at work within HTA activities may strengthen organizational approaches to PPE. CONCLUSION: HTA organizations can learn from this study by reflecting on the challenges described and the recommendations offered to address them. We suggest solidifying CADTH's commitment to PPE with clear agency-wide roles and direction, values, and outcomes, a comprehensive framework, and policy and procedures. An acknowledgment of diverse epistemic traditions, as well as leadership and expertise in PPE, will strengthen CADTH's PPE activities and sustain its leadership position in the HTA field.

3.
Front Psychiatry ; 11: 579147, 2020.
Article in English | MEDLINE | ID: mdl-33192718

ABSTRACT

Background: Cultural context substantially affects the experience and clinical expression of psychiatric diseases, while cultural factors limit both access to and effectiveness of care, especially for migrant families requiring specific types of services. We conducted a scoping review on psychiatric services adapted to cultural diversity, to compare these models of care to the French Transcultural Psychotherapy model. Methods: Systematic electronic search of databases (PubMed and PsycINFO), manual search of archives of journals dealing with transcultural psychiatry, and consultations with international experts, to identify all papers describing clinical models devoted to psychiatric care for migrants, published between January 1990 and October 2018. Narrative synthesis of the included articles. Results: The study included 29 papers. The specificities of psychiatric services for migrant families are linked to the host country's migration patterns and citizenship model. In English-speaking countries, specialized services for ethnic minorities offer ethnic matching of the therapist and patient. In Canada, indirect transcultural consultation services have existed since the late 1990s. Australia emphasizes the networking of consultation services and professional training in cultural competence, while the Nordic countries (Sweden, Finland, Norway, and Denmark) focus management on trauma. In France, psychotherapy services, with flexible numbers of therapists involved according to the situation, have existed since 1990. Discussion: Most initiatives place emphasis on training and supervision, in an indirect approach not specifically focused on the patient, or offer cultural matching of patient and therapist. The French transcultural approach, on the contrary, makes the family's culture and its cultural diversity an integral part of the therapy process.

4.
Encephale ; 2020 Oct 10.
Article in French | MEDLINE | ID: mdl-33051084

ABSTRACT

INTRODUCTION: The early identification and access to health care of toddlers with autism spectrum disorder (ASD) - or at risk of developing it - is a crucial public health issue, as care and intervention may be more effective in younger children in order to improve their development and prognosis. However, there are still disparities in identification and health care access for children with ASD despite better screening methods. Given that misdiagnosis and delayed diagnosis are often due to the cultural gap between clinician and patient in some psychiatric disorders such as depression or schizophrenia, we examined this question concerning ASD and wondered to what extent ethno-cultural or migratory status might have an impact on the age at which a child is diagnosed. The only published review looking for independent factors influencing age of diagnosis concludes that the factors that have been proved to play a role are: socioeconomic status; symptom severity; level of parental concern, and family interactions with the health and education systems prior to diagnosis. The impact of ethno-cultural or migratory status is less clear. And yet, all these factors may be interconnected: migrants have on average a lower socioeconomic status, minorities don't have the same access to health care, and cultural background can have an influence on what is expected of a child's development and health. In order to try and clarify this issue and to analyze the way in which the international literature approaches the subject, we carried out a systematic review. METHOD: Six databases were interrogated: Pubmed, Embase, Psychinfo, WebOfScience, Cochrane and Cinahl using the key words "ASD", "pervasive developmental disorder", "diagnosis", "age", "migrant", "ethnicity", "cross cultural". We narrowed neither the period of time not selected the articles by their method, as our objective was to collect the entirety of the articles written on the subject. We completed this review by including the pertinent references made in the articles. RESULTS: Twenty articles were included, all epidemiological and observational, about children diagnosed in specialized centers. Published between 2002 and 2019, they cover a 20-year research period, between 1992 and 2016. The methods are disparate: the diagnosis criteria used are from DSM IV, IV TR and ICD; data originate from medical records, phone or internet surveys, and Medicaid healthcare claims. Comparison of the age at diagnosis is the principal objective for only thirteen studies; statistical data analyses vary, especially concerning adjustments. Seventy-five percent of the articles originate from North America where the compared populations are defined by ethnic and racial categories that are not used in some other countries, notably in Europe. Only five explore the link between migratory status and age at diagnosis. The research results concerning the impact of ethnicity are contradictory, while those concerning migratory status seem to indicate that migrant children are likely to be diagnosed later. But the articles and their methods being too heterogeneous, it was difficult to make a meta-analysis and impossible to reach a scientific conclusion. CONCLUSION: Nevertheless, this review highlights the existence of a lot of confounding factors and raises many issues. It shows that the United States produces most of the studies whose conclusions cannot be generalized because of the particular history and organization of this country. In Europe, where belonging to minority groups is thought to be through migratory status, studies are rare. There is an urgent need for new research in order to clarify the connection between migratory status and socioeconomic factors, to precisely define the independent variables influencing diagnosis -such as access to healthcare- and finally to explore the possibility of different symptomatic expressions depending on cultural backgrounds. This review falls within studies currently carried out by the psychiatric service at Avicenne hospital in Bobigny, France about ASD in a transcultural context.

5.
Lima; Perú. Ministerio de Salud; 20201000. 27 p. ilus.
Monography in Spanish | LILACS, MINSAPERÚ | ID: biblio-1123122

ABSTRACT

El documento contiene las orientaciones en pertinencia cultural para la consejería del control de crecimiento y desarrollo de la niña y niño menor de cinco años de poblaciones indígenas andinas, amazónicas y población afroperuana.


Subject(s)
Population , African Continental Ancestry Group , Growth and Development , Innovation and Development Policy , Control , Indigenous Peoples , Primary Health Care
6.
BrJP ; 3(3): 253-257, July-Sept. 2020. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1132016

ABSTRACT

ABSTRACT BACKGROUND AND OBJECTIVES: There are communication barriers to assess pain in patients with consciousness and cognitive disorders. This study aimed to make the cross-cultural adaptation of the Nociception Coma Scale-Revised (NCS-R) to the Portuguese language and check the validation evidence of the content of the NCR-R Brazilian version in non-communicative patients with consciousness and cognitive disorders. METHODS: This is a methodological study to check the cross-cultural adaptation of the NCR-R, divided into two stages: cross-cultural adaptation and check of the content validity. The cross-cultural adaptation phase included an initial translation, synthesis of translations, back-translation, expert committee, and cognitive debriefing based on Beaton and Price. A second expert committee evaluated the translated and adapted version to check the content validity index RESULTS: The NCS-R scale was translated and cross-culturally adapted, presenting good evidence of content validity with a Content Validity Index of 0.86. CONCLUSION: The NCS-R is translated and transculturally adapted and has good evidence of content validity.


RESUMO JUSTIFICATIVA E OBJETIVOS: Em pacientes com desordens de consciência e distúrbios cognitivos há barreiras de comunicação para a avaliação da dor. O objetivo deste estudo foi realizar a adaptação transcultural da Nociception Coma Scale-revised (NCS-R) para a língua portuguesa e verificar as evidências de validade de conteúdo da versão brasileira da NCS-R em pacientes não comunicativos com desordens de consciência e distúrbios cognitivos. MÉTODOS: Estudo metodológico para adaptação transcultural da NCS-R dividido em duas etapas: adaptação transcultural e verificação da validade de conteúdo. A fase de adaptação transcultural incluiu a tradução inicial, síntese das traduções, retrotradução, comitê de especialista e debriefing cognitivo baseado em Beaton e Price. A versão traduzida e adaptada foi avaliada por um segundo comitê de especialistas para a avaliação do índice de validade de conteúdo. RESULTADOS: A NCS-R foi traduzida, adaptada do ponto de vista transcultural e apresentou boa evidência de validade de conteúdo com Índice de Validade de Conteúdo de 0,86. CONCLUSÃO: A NCS-R encontra-se traduzida e adaptada do ponto de vista transcultural, e possui boa evidência de validade de conteúdo.

7.
BMC Complement Med Ther ; 20(1): 182, 2020 Jun 11.
Article in English | MEDLINE | ID: mdl-32527245

ABSTRACT

BACKGROUND: African Potato (hypoxis hemerocallidea), is used for enhancing immune system in Southern Africa. It is among the plants of intense commercial and scientific interest; hence, the aim of this study was to describe its chemistry and pharmacology. METHODS: PubMed, Cochrane Controlled Trials Register (CENTRAL) and Google Scholar were searched independently for relevant literature. The last search occurred in October 2018. Other research material was obtained from Google. The following search terms were used, but not limited to: "African Potato", "hypoxis", "hemerocallidea", "rooperol." Articles that were explaining the chemistry and pharmacology of hypoxis hemerocallidea were included. RESULTS: Thirty articles from PubMed, Cochrane and Google Scholar were eligible. Three webpages were included from Google. Results showed that the tuberous rootstock (corm) of African Potato is used traditionally to treat wasting diseases, testicular tumours, insanity, barrenness, impotency, bad dreams, intestinal parasites, urinary infection, cardiac disease and enhancing immunity. The plant contains hypoxoside, which is converted rapidly to a potent antioxidant, rooperol in the gut. The corm contains sterols, sterol glycosides, stanols, terpenoids, saponins, cardiac glycosides, tannins and reducing sugars. A dose of 15 mg/kg/day of hypoxoside is reportedly therapeutic. Preclinical studies of African Potato have shown immunomodulation, antioxidant, antinociceptive, hypoglycaemic, anti-inflammatory, anticonvulsant, antibacterial, uterolytic, antimotility, spasmolytic and anticholinergic effects. The common side effects of African Potato are nausea and vomiting, which subside over time. In vitro, African Potato demonstrated inhibitory effects on CYP1A2, 2C9, 2D6, 3A4, 3A5, CYP19-metabolism and induction of P-glycoprotein. In vivo, it did not alter the pharmacokinetics of efavirenz or lopinavir/ritonavir. CONCLUSION: African Potato is mainly used as an immunostimulant. The exact mechanisms of action for all the pharmacological actions are unknown. More research is required to substantiate claims regarding beneficial effects. There are many research gaps that require investigation including pharmacokinetic interactions with conventional drugs, especially those used in HIV/AIDS.


Subject(s)
Hypoxis/chemistry , Medicine, African Traditional/methods , Plant Extracts/chemistry , Plant Extracts/pharmacology , Plants, Medicinal/chemistry , Africa , Catechols , Humans
8.
Cad. saúde colet., (Rio J.) ; 28(2): 311-324, abr.-jun. 2020. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1132960

ABSTRACT

Resumo Introdução Há crescente número de publicações brasileiras envolvendo a escala de Senso de Coerência (SOC), mas o processo de adaptação transcultural ainda não pode ser considerado definitivo. Objetivo Revisar sistematicamente estudos de adaptação transcultural da versão brasileira, sumarizando as propriedades psicométricas. Métodos Foram pesquisadas sete bases de dados eletrônicas até janeiro de 2019: LILACS, BBO, BDENF-Nursing, Index Psychology, PubMed, EMBASE e Scopus, com restrição para o Brasil ou língua portuguesa. Resultados Foram identificadas 78 referências das quais foram incluídos 15 artigos e duas teses. Versões com 13 e 29 itens foram encontradas, que deveriam possuir os seguintes domínios: compreensão, manejo e significado. Verificou-se que até o momento os estudos não consideraram todas as etapas específicas para adaptação transcultural brasileira, apesar de apresentarem etapas metodológicas para validade de conteúdo e confiabilidade. A consistência interna da escala inteira (α de Cronbach) de oito estudos para SOC-13 variou de 0,61 a 0,81, e em quatro estudos, para SOC-29 de 0,77 a 0,87. Um único estudo (SOC-29) mostrou cargas fatoriais baixas para cinco itens nas análises dos componentes principais. Conclusão Há necessidade de aprofundar as pesquisas sobre adaptação da versão brasileira, em português, da escala de SOC.


Abstract Background Brazilian publications involving the Sense of Coherence (SOC) scale has increased, however the cross-cultural adaption process is not yet definite. Objective This study aimed to review systematically the cross-cultural adaptation studies of the Brazilian version of the SOC scale, summarizing psychometric properties. Methods Seven electronic databases were searched until January 2019: LILACS, BBO, BDENF-Nursing, Index Psychology, PubMed, EMBASE and Scopus with restriction for Brazil or Portuguese Language. Results It was identified 78 references, which15 papers and 2 thesis were included. Versions with 13 and 29 items were used and items should group in three domains: comprehensibility, manageability and meaningfulness. It was verified that the studies did not consider all specific stages of cross-cultural adaptation to the Brazilian culture, despite presenting methodological steps for content validity and reliability. The internal consistency for the whole scale (Cronbach α) in eight studies for SOC-13 ranged from 0.61 to 0.81 and 4 studies for SOC-29 from 0.77 to 0.87. A single study showed low factor loadings for some items in the main component analysis on SOC-29. Conclusion It is possible to conclude that it is necessary to deepen the research on adaptation of the Brazilian version of the SOC scale.

9.
West J Nurs Res ; 43(1): 73-84, 2020 Jan.
Article in English | MEDLINE | ID: mdl-32400300

ABSTRACT

Culturally tailored interventions have been applied to provide benefits to ethnic minorities' care; however, the effectiveness of these interventions for chronic conditions is mixed. This systematic review of systematic reviews critically evaluates recent evidence of the effects that culturally tailored interventions have on health care outcomes among ethnic minorities with chronic conditions. It synthesizes results of eight English-language systematic reviews published between 2010 and 2018 and identifies four health care outcomes common to the reviews: disease knowledge, objective clinical outcomes, satisfaction, and access. Our findings suggest that culturally tailored interventions can contribute to the improvement of ethnic minorities' health care outcomes and especially improve patients' satisfaction with care. However, results overall are mixed. Further studies to better understand the value of culturally tailored interventions for ethnic minorities' care are needed.

10.
Int J Equity Health ; 19(1): 55, 2020 04 25.
Article in English | MEDLINE | ID: mdl-32334577

ABSTRACT

BACKGROUND: Reduction of health gaps between ethno-cultural groups has become a major concern for health services, with a strong emphasis on eliminating social and cultural barriers and improving accessibility for diverse populations. METHODS: The study is based on a Participatory Action Research where an involved researcher accompanied the project for a decade, as well as on eleven in-depth interviews with Bedouin women-mediators working in a perinatal health promotion project in Israel. RESULTS: The research analyzes the work of Bedouin women health mediators who mediate between their Bedouin community and institutional health services and bridge over cultural gaps. The study presents the complex task of transferring messages across cultures, dealing with socio-cultural imperatives and the intricacy of multilayered power relations. The findings reveal an evolving process, beginning with a pragmatic mediation model in which the mediators are limited to instruction of pre-defined health materials, toward a transformative model of creating a ground for encouraging the mediators to act creatively according to socio-cultural circumstances. CONCLUSION: The research elaborates on the adoption and implementation of the transformative approach in mediation and provides further understanding of the complexity of mediation role in sensitive issues such as pregnancy, birth and infant care.


Subject(s)
Arabs/psychology , Culturally Competent Care/standards , Guidelines as Topic , Health Promotion/methods , Health Services Accessibility/standards , Perinatal Care/standards , Women's Health/standards , Adult , Attitude to Health , Female , Humans , Israel , Middle Aged , Pregnancy , Young Adult
11.
Psychol Res Behav Manag ; 13: 319-330, 2020.
Article in English | MEDLINE | ID: mdl-32280289

ABSTRACT

A large body of research suggests that thin-ideal internalization is a robust predictor of eating pathology in women and, to some degree, in men. Recent research is exploring the relationships between thin-ideal internalization and culture-specific factors that may be salient to women and men who live in the US but are marginalized based on racial or ethnic background, such as acculturation. This systematic review summarizes published articles examining the relationships among thin-ideal internalization, acculturation-related constructs (including assimilation, marginalization, biculturalism, and acculturative stress), and eating pathology in US adults. Following the PRISMA method, 15 empirical studies met inclusion criteria. Although existing literature was sparse and conflicting in large part due to heterogeneity in acculturation measures, results yielded some support for positive correlational relationships between acculturative stress, thin-ideal internalization, and eating pathology for both men and women (in 4 out of 5 relevant studies). Research on other aspects of acculturation (eg, integration, assimilation) is mixed, with some existing research suggesting a positive relationship and other research finding no statistically significant relationship. Future research would particularly benefit from a gold-standard, multidimensional transcultural measure of acculturation to examine how the acculturation process relates to thin-ideal internalization and eating pathology in ethnic and racial minorities in the US.

12.
PLoS One ; 15(1): e0226938, 2020.
Article in English | MEDLINE | ID: mdl-31978050

ABSTRACT

Recent protests by athletes focused on raising awareness of social issues and injustices, such as the Black Lives Matter protests led by Colin Kaepernick of the National Football League's San Francisco 49ers, have generated a great deal of attention and debate within society. Notably, the protests conducted by these players before games in the 2016 and 2017 seasons became such a sensational topic, that extraordinary amounts of attention was paid to it by the media, consumers, and even politicians who often denounced the players as being unpatriotic. Against this backdrop, the current research examines whether fluctuations in attendance at National Football League games are associated with explicit attitudes towards race, implicit racial prejudice, and racial animus within a population. Specifically, using multiple measures of racial attitudes as part of an econometric model estimating attendance at games, the results suggest that having a higher level of implicit bias in a market leads to a decline in consumer interest in attending games. Additionally, using interaction effects, it is found that while protests generally reduced the negative effects of implicit bias on attendance, markets with lower levels of implicit bias actually had greater declines of attendance during the protests. From this, the current study advances the understanding of racial attitudes and racial animus, and its impact on consumer behavior at the regional level. That is, this research highlights that racial sentiments in a local market were able to predict changes in market behaviors, suggesting that race relations can have wide reaching impacts.


Subject(s)
Football/economics , Race Relations/psychology , Racism/economics , Adult , African Americans , Attitude , Community Participation , Consumer Behavior/economics , Humans , Political Activism , United States
13.
Mol Genet Genomic Med ; 8(2): e1099, 2020 02.
Article in English | MEDLINE | ID: mdl-31867882

ABSTRACT

BACKGROUND: Racial/ethnic minority populations in the United States are consistently underrepresented in genetic research. Large-scale public participation is required to ensure discoveries from precision medicine research are applicable to everyone. To evaluate views toward and facilitators of participation among minority populations in the United States, we conducted a systematic review of literature. METHODS: Six databases were searched for articles published from 2005 to 2018 assessing minority populations' views and/or willingness to participate in genetic research. A thematic framework was applied to extracted data to synthesize findings, and the Socio-Ecological Model was used to evaluate papers. RESULTS: Review of 2,229 titles and abstracts identified 27 papers (n = 8 qualitative, n = 19 quantitative). Themes included knowledge of genetics, engagement in research, facilitators and barriers to participation, and cultural considerations. Understanding of genetics was low, yet the majority of participants were willing to participate in genetic research among all populations included in the literature (range: 57%-97%). Recommendations for research included utilizing community-based participatory approaches, evaluating participants' informational needs, incentivizing participation, and providing direct benefits (e.g., genetic test results). CONCLUSION: Results could influence future study designs that incorporate all levels of the Socio-Ecological Model and better meet the needs of underrepresented groups, thereby ensuring precision medicine research findings are applicable to all.

14.
J Adv Nurs ; 76(1): 9-21, 2020 Jan.
Article in English | MEDLINE | ID: mdl-31566789

ABSTRACT

AIMS: To synthesize research findings regarding the coping experiences of parents following perinatal loss. DESIGN: Noblit and Hare's interpretive meta-ethnography was followed. DATA SOURCES: A comprehensive systematic search of the published literature (2013-2018) was undertaken in five databases, complemented by supplementary searches. REVIEW METHODS: Fourteen studies met the research objective and inclusion criteria. RESULTS: Five themes describe the coping strategies used by parents who experience perinatal loss. The themes were synthesized into the metaphor Staying afloat in the storm. CONCLUSION: Parents use coping strategies to manage perinatal loss and the use of these strategies is conditioned by cultural, social, and individual factors. This study has implications for evidence-based practice by showing care needs and the importance of implementing emotional and patient-centred care interventions. IMPACT: This meta-ethnography highlights the care needs of parents following perinatal loss, facilitating understanding of coping experiences. Increased knowledge about these experiences may contribute to the development and implementation of nursing and midwifery interventions that include emotional and patient-centred care.


Subject(s)
Adaptation, Psychological , Cultural Diversity , Parents/psychology , Perinatal Mortality , Female , Humans , Infant, Newborn , Male , Pregnancy
15.
Surgery ; 167(3): 661-667, 2020 03.
Article in English | MEDLINE | ID: mdl-31653491

ABSTRACT

BACKGROUND: This investigation was undertaken to define the factors determining the optimal and most productive relationship among indigenous communities, surgeons, and providers of surgical services. METHODS: A systematic literature review was conducted to identify studies reporting on the experience of indigenous communities with surgeons, medical practitioners, and the providers of surgical and other health services. The databases searched were MEDLINE, EMBASE, PubMed, Web of Science, and Google Scholar, including all literature available until the search date of April 3, 2019. The reference lists of all included articles and related review articles were searched manually to identify further relevant studies. An inductive approach was used to identify common themes. RESULTS: Thirty-three publications discussed the experiences of New Zealand Maori (n = 2), Aboriginal and Torres Strait Islanders (n = 20), North American First Nation (n = 10), and Indigenous Latin Americans (n = 1). Across all indigenous peoples, 6 themes emerged: accessible health services, community participation and community governance, continuous quality improvement, a culturally appropriate and clinically skilled workforce, a flexible approach to care, and holistic healthcare. CONCLUSION: To provide medical and surgical services in indigenous communities successfully requires a diverse range of skills and core technical and academic competencies. Many skills lie within the definition of professionalism and advocacy as well as the ability to undertake and operationalize community consultation and empowerment. If surgical services serving Indigenous communities are to be successful in addressing health disparity, specific training in these skills will need to be developed and made available.


Subject(s)
Health Services Accessibility/organization & administration , Health Services Needs and Demand , Health Services, Indigenous/organization & administration , Healthcare Disparities/organization & administration , Specialties, Surgical/organization & administration , Clinical Competence , Community Participation , Culturally Competent Care/organization & administration , Global Health , Humans , Indigenous Peoples , Latin America/ethnology , New Zealand/ethnology , North America/ethnology , Quality Improvement , Surgeons , Workforce/organization & administration
16.
J Sch Nurs ; 36(1): 19-32, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31495253

ABSTRACT

Positive father involvement is critical to the healthy social, emotional, and academic outcomes of children at all stages of development. The purpose of this integrative review was to identify, categorize, and evaluate the potential impact of fatherhood interventions on father and child outcomes. A systematic search of four major research databases yielded 44 studies published between 1988 and 2018 that met study inclusion criteria. The most effective interventions were delivered in the community, with fathers convened in groups. Content focused on promoting positive parenting, co-parenting, and father/child relationships. Consequently, father involvement and child cognitive and socioemotional development were improved. Academic settings were underutilized in the fatherhood interventions in this review. We conclude that in order to optimize healthy child development, school officials must adopt a more inclusive stance toward the involvement of fathers in their children's education. Future randomized trials of fatherhood interventions delivered within school-based settings are warranted.


Subject(s)
Child Development , Father-Child Relations , Fathers , Parenting , Academic Success , Adolescent , Adult , Aged , Child , Community Participation , Ethnic Groups , Humans , Male , Mental Health , Middle Aged , Schools
17.
Acad Med ; 95(1): 22-31, 2020 01.
Article in English | MEDLINE | ID: mdl-31365394

ABSTRACT

Medical Spanish (MS) education is in growing demand from U.S. medical students, providers, and health systems, but there are no standard recommendations for how to structure the curricula, evaluate programs, or assess provider performance or linguistic competence. This gap in medical education and assessment jeopardizes health care communication with Hispanic/Latino patients and poses significant quality and safety risks. The National Hispanic Health Foundation and University of Illinois College of Medicine convened a multidisciplinary expert panel in March 2018 to define national standards for the teaching and application of MS skills in patient-physician communication, establish curricular and competency guidelines for MS courses in medical schools, propose best practices for MS skill assessment and certification, and identify next steps needed for the implementation of the proposed national standards. Experts agreed on the following consensus recommendations: (1) create a Medical Spanish Taskforce to, among other things, define educational standards; (2) integrate MS educational initiatives with government-funded research and training efforts as a strategy to improve Hispanic/Latino health; (3) standardize core MS learner competencies; (4) propose a consensus core curricular structure for MS courses in medical schools; (5) assess MS learner skills through standardized patient encounters and develop a national certification exam; and (6) develop standardized evaluation and data collection processes for MS programs. MS education and assessment should be standardized and evaluated with a robust interinstitutional medical education research strategy that includes collaboration with multidisciplinary stakeholders to ensure linguistically appropriate care for the growing Spanish-speaking U.S. population.


Subject(s)
Clinical Competence/standards , Education, Medical/standards , Schools, Medical/standards , Consensus , Cultural Competency/education , Curriculum/standards , Education, Medical/trends , Hispanic Americans/statistics & numerical data , Humans , Interdisciplinary Studies , Learning/physiology , Physician-Patient Relations/ethics , Students, Medical/classification , United States/epidemiology
18.
Geriatr Nurs ; 41(2): 89-97, 2020.
Article in English | MEDLINE | ID: mdl-31320127

ABSTRACT

Due to low levels of planned care, older adults of underrepresented communities tend to experience higher rates of unwanted treatments at end of life (EOL). The purpose of this review was to identify factors that may explain differences in EOL care preferences and planning between older adults from the general population and ethnically diverse populations. We hypothesized that culture-specific factors may be fundamental. To describe similarities and differences, we conducted a comprehensive literature search using keywords and subject headings. Findings from 14 studies were critically examined, grouped, and compared across studies and populations. While studies on general populations showed the significance of health and sociodemographic factors, studies on underrepresented groups frequently cited the importance of spirituality, belief systems, acculturation, healthcare system distrust, and social networks.

19.
J Transcult Nurs ; 31(1): 87-99, 2020 01.
Article in English | MEDLINE | ID: mdl-31423926

ABSTRACT

Introduction: Childhood obesity remains an unrelenting public health problem disproportionately affecting ethnic minorities. Although research has examined ethnicity as a factor of childhood obesity, few studies have examined cultural influences. The purpose of this systematic review was to examine the qualitative evidence of cultural influences on childhood obesity in ethnic minority groups. Methodology: Selective sampling of studies since 2008 yielded 251 articles. Twelve articles that addressed cultural influences on childhood obesity were identified for review. The Culture Care Theory Sunrise Enabler factors were used as an a priori framework for theme coding. Results: Nine themes emerged: child feeding, family, gender roles, food, healthy child appearance, physical activity, sedentary activity, food cost, and obesogenic environment. Discussion: Cultural care practices such as traditional foods and family meals are protective factors in childhood obesity and should be encouraged by nurses caring for and working with ethnic minority populations.

20.
Health Policy Plan ; 35(1): 115-121, 2020 Feb 01.
Article in English | MEDLINE | ID: mdl-31691791

ABSTRACT

Cultural consensus analysis (CCA) is a quantitative method for determining cohesion in a specified cultural domain and cultural modelling (CM) is a method for designing and testing connections within a cultural domain based on qualitative data collection. After a description of the methods, and examples of their application, we provide a description of three main points in the programme planning, implementation and evaluation cycle at which the method can best be utilized to plan, contextualize or evaluate programmes and policies. In addition, the use of CCA and CM is not constrained to one point in time though, in order to maximize its ability to help with programme design or evaluation, it ought to be done as early as possible in the process. Through examples from research, and a broader description of the methods of CM and analysis, we provide another tool for global public health practitioners, planners and policymakers. We argue these tools can be used to great effect in a short period of time to maximize the local suitability, acceptability and quality of proposed and implemented interventions, building on existing local strengths, not just in maternal health but, more broadly.


Subject(s)
Consensus , Culture , Program Development/methods , Adult , Aged , Aged, 80 and over , Anthropology, Cultural/methods , Female , Gender Identity , Humans , Male , Middle Aged , Midwifery , Parturition/ethnology , Pregnancy/ethnology , Pregnancy Complications , Surveys and Questionnaires , Tanzania
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