Raising Cultural Awareness and Addressing Barriers to Breast Imaging Care for Black Women.

Health care disparities, which are differences in the attainment of full health potential among population groups, have been documented across medical conditions, clinical settings, and diagnostic and treatment modalities. Deeply rooted health care disparities due to many factors have affected how Black women (BW) view medical care including screening mammography. This article explores health care disparities around breast cancer in BW and how patient distrust, provider biases, race, and social determinants of health continue to have negative effects on breast cancer outcomes in BW, despite medical advances in breast cancer detection and management. In addition, this article addresses the importance of culturally competent care for BW around breast cancer awareness, screening, and treatment, and offers strategies to address disparities and rebuild trust.

A Cross-Sectional Study of the Social Work Environment and Black Registered Nurses' Sleep.

INTRODUCTION: Workplace experiences may place Black nurses at higher risk for poor sleep and adverse health outcomes. This study aimed to identify poor sleep prevalence and associations of workplace discrimination and workplace social capital with sleep. METHODOLOGY: Descriptive statistics and multiple linear regression with exploratory analyses were conducted of cross sectional survey data from US Black nurses. RESULTS: On average, 63 respondents reported sleeping 6.15 h, 45 min less daily than 6.9 h reported nationally for nurses. Ninety-percent of respondents reported poor sleep quality. While no direct significance was found, respondents reporting sleep quality changes had lower workplace social capital and higher workplace discrimination. CONCLUSION: Black nurses may have higher prevalence of poor sleep than the larger nursing workforce. A potential relationship between decreased sleep quality and negative perceptions of the work environment may exist. Organizations should examine sleep and potential occupational health inequities among Black nurses when considering worker health.

Self-esteem in the context of intimate partner violence: A concept analysis.

AIM: To explore the meaning of self-esteem in the context of intimate partner violence (IPV). BACKGROUND: IPV is a preventable public health issue. The dynamic of IPV diminishes women's self-esteem. Defining self-esteem will guide the development of IPV interventions in healthcare settings. DESIGN: Walker and Avant's eight-step approach was used. DATA SOURCE: The search was conducted from Oxford Dictionary of English online, CINAHL, APA PsycInfo, PubMed, Women's Studies International, and Google Scholar. REVIEW METHODS: No limits on the year of publication were applied. RESULTS: Defining attributes of self-esteem are self-concept, self-affirmation, and self-respect. Antecedents of self-esteem are exposure to IPV and victim-blaming attitudes by healthcare professionals. Consequences include depression, substance abuse, and posttraumatic stress disorder. Empirical referents include self-worth, self-competence, self-blame, self-evaluation, self-confidence, and self-determination. CONCLUSIONS: Current literature is limited in its definition of self-esteem in the context of IPV. Women experiencing IPV with low self-esteem might not seek help for IPV from nurses. Nurses could develop culturally appropriate IPV screening tools that assess the changes in self-esteem among women from different sociodemographic and cultural backgrounds. The defining attributes could contribute to developing comprehensive IPV screening tools in healthcare settings.

Maximizing an urban secondary and post-secondary partnership to align educational expectations and student success.

Students from public urban secondary schools in the United States are often academically underprepared for post-secondary education. There are multiple social and structural factors contributing to this including living in communities where there are high rates of poverty, insufficient funding for public urban schools, and lack of rigor in their curriculum. Urban public post-secondary institutions struggle to bridge the gap to support students who are underprepared and in need of educational, financial, and social assistance. The purpose of this paper is to describe a partnership that was created between a public urban high school and a neighboring public urban university to address the issues underrepresented racially and ethnically (URE) diverse students encounter in order to not only better prepare them for the transition to post-secondary education, but to help them succeed once they arrive on campus. This partnership demonstrates that community cooperation to bridge the gap to support students who are underprepared is possible and benefits everyone involved. Preparing urban students for the successful transition to post-secondary education, particularly in the area of health professions can have a long-term impact on reducing racial inequities in health care.

The University of Cincinnati College of Nursing Case Study: Bias and Discrimination in the Nursing Learning Environment.

The purpose of this case study is to outline strategies employed by the University of Cincinnati's College of Nursing (CoN) to increase underrepresented racial and ethnic (URE), and economically and educationally disadvantaged student acceptance, presence, inclusion, and success. The case study method was used to examine strategies used at the CoN to address bias and discrimination, identify student success strategies for URE students, and outline college initiatives to facilitate an inclusive environment. CoN leadership has instituted several programs involving faculty and students in efforts to decrease bias and discrimination and promote inclusion. They continue to engage faculty and others in adding to and improving their efforts. This is a process of culture change and must involve everyone. CoN leadership is committed to both demonstrating by example and holding all accountable for progressively improved continued efforts to create a more inclusive environment.

Stress Reduction Strategies Used by Midlife Black Women to Target Cardiovascular Risk.

BACKGROUND: Midlife black women are at a high risk for cardiovascular disease and experience higher morbidity and mortality rates. Chronic life stress contributes to the existent cardiovascular-related disparities for midlife black women. OBJECTIVES: The purpose of this qualitative study was to describe stress reduction strategies relevant to midlife black women, identify barriers, and generate ideas for the development of a stress reduction wellness intervention for midlife black women. METHODS: A community advisory board consisting of 11 midlife black women from the Midwest was established and charged with exploring life stress and stress-related issues for women like themselves. The community advisory board was led through a series of focus group discussions using open-ended questions focused on stress reduction strategies used by midlife black women, what kept them from incorporating stress reduction strategies into their daily routines, and what would be helpful in a stress reduction routine. Discussions were audiotaped, transcribed, coded, and analyzed using content analysis. RESULTS: Stress reduction strategies identified included exercise, faith and prayer, self-care, sisterhood, volunteerism, and mindfulness. Barriers to adopting stress reduction behaviors included time, finances, physical limitations, health status, health insurance, and guilt. Suggested modes of delivery for an intervention included informative lectures and coaching, demonstration, team sessions, social media, and continued access. CONCLUSIONS: Findings from this study were consistent with those from a preliminary study focused on midlife black women from the West Coast. Recommendations will inform development of a stress reduction wellness intervention for midlife black women.

Leveraging Community Engagement to Develop Culturally Tailored Stress Management Interventions in Midlife Black Women.

Chronic stress is a social health determinant associated with many persistent health conditions and health disparities for midlife Black women. Midlife Black women in the United States are exposed to multiple, competing stressors, increasing their risk for adverse health outcomes. The objective of the current study was to illicit information about the key life stressors experienced by midlife Black women. Focus groups were conducted using a convenience sample of midlife Black women (N = 11, age range = 41 to 54 years). Coding and thematic analysis identified four primary sources of stress: workplace, parenting, finances, and social media. Gendered racism and discrimination and life imbalance emerged as underlying stressors linked to the Strong Black Woman persona. This persona prioritizes resilience and self-reliance while suppressing self-care. The stressors identified will inform the development of an intervention and should be considered when providing care for midlife Black women. [Journal of Psychosocial Nursing and Mental Health Services, 57(3), 32-38.].

An evaluation of forums for discussions on inclusion in a college of nursing.

BACKGROUND: The lack of diversity in the nursing profession could be an outcome of unconscious biases. Forums allowing the personal reflection and discourse of these unconscious biases are needed in order for a diverse and inclusive learning environment to exist. PURPOSE: The purpose of this study was to describe the experiences of students, staff, faculty members, and guests participating in a forum on diversity and inclusion. METHODS: An exploratory design was used to understand the experiences of college of nursing students, staff, faculty members, and guests who participated in a diversity and inclusion intervention sponsored by the college of nursing's Diversity Advisory Council. Attendees to 12 diversity book club, movie night, and speaker series' sessions completed a program evaluation tool. Responses to open-ended items were analyzed using a constant comparative analysis method.Responses from 197 participants were analyzed. Eight book club, seven movie night, and six speaker series' themes were derived from the data including Humanness is Universal, Personal Connection, The Problem, Awareness of Disparity, Make a Difference, and No Change. DISCUSSION: Participants at each session critically dialogued about their conscious and unconscious biases. The study findings show that participants also were able to document changes to their knowledge, attitudes, and behaviors in relation to the historically oppressed populations focused on during the intervention activities. CONCLUSION: Education entertainment as used in this study was a valuable mechanism for hosting conversations about diversity and inclusion.

Holistic Admissions in Nursing: We Can Do This.

UNLABELLED: Research shows that holistic admissions review practices can increase diversity across students without decreasing the workforce preparedness and academic success of students. Therefore, many disciplines have readily adopted the widespread use of holistic admissions review. Despite its proven effectiveness in addressing student diversity, nursing has been slow to implement holistic admissions review. PURPOSE: The purpose of this study was to gain a better understanding of the barriers to implementing holistic admissions review in nursing and the feasibility of adopting holistic admissions review across nursing programs. METHODS: A biphasic qualitative research study was conducted with nursing deans from across the United States. Qualitative data collection consisted of two phases of focus group discussions conducted over a 3-month period. The qualitative data were analyzed using content analysis. The categories and subcategories identified in Phase 1 informed the discussion in Phase 2. RESULTS: One overarching category from Phase 1 was identified, which was the lack of nursing schools' knowledge regarding holistic admissions review. Four subcategories also identified in Phase 1 included the need for better dissemination of evidence, the need for additional support from university leaders and administrators, the need for legal guidance to facilitate implementation of holistic admissions review, and ensuring appropriate resources to support the holistic admissions review process. Three categories emerged in Phase 2, which included everyone's buy-in is required, the need for a model, and a need for training. CONCLUSION: The adoption of holistic admissions review in nursing may be feasible. However, certain barriers need to be overcome so that nursing schools can successfully take on this process. Therefore, five recommendations have been developed to assist nursing schools in the implementation of holistic admissions review. These recommendations include increasing knowledge and understanding of holistic admissions review among nursing deans; obtaining buy-in and support for holistic admissions review and conducting a self-assessment of current admissions practices; providing nursing administrators, faculty, and staff with diversity training; and conducting further research to identify factors most critical for success in nursing. Although the transition to a holistic admissions process requires some effort, arming ourselves with the appropriate tools will mitigate barriers during implementation.

Evaluation of a Summer Bridge: Critical Component of the Leadership 2.0 Program.

BACKGROUND: Summer bridges facilitate the transition from high school to college. Although many schools employ summer bridges, few have published outcomes. This article's purpose is to share preconceptions of college by underrepresented and disadvantaged nursing students and describe important elements and long-term impact of a summer bridge, a component of the Leadership 2.0 program. METHOD: A longitudinal study design was used to collect baseline, short-term, and long-term post-summer bridge data. Methods included pre- and postsurveys, interviews, and focus groups. RESULTS: After bridge completion, students felt more prepared for the nursing program. Students ranked socialization components as most important. The summer bridge had lasting impact through the first year, where grade point average and retention of underrepresented and disadvantaged bridge students was comparable to the majority first-year students. CONCLUSION: The summer bridge was effective in preparing nursing students for the first year of college. Through holistic evaluation, unique aspects of socialization critical to student success were uncovered.

How many schools adopt interviews during the student admission process across the health professions in the United States of America?

Health profession schools use interviews during the admissions process to identify certain non-cognitive skills that are needed for success in diverse, inter-professional settings. This study aimed to assess the use of interviews during the student admissions process across health disciplines at schools in the United States of America in 2014. The type and frequency of non-cognitive skills assessed were also evaluated. Descriptive methods were used to analyze a sample of interview rubrics collected as part of a national survey on admissions in the health professions, which surveyed 228 schools of medicine, dentistry, pharmacy, nursing, and public health. Of the 228 schools, 130 used interviews. The most desirable non-cognitive skills from 34 schools were identified as follows: communication skills (30), motivation (22), readiness for the profession (17), service (12), and problem-solving (12). Ten schools reported using the multiple mini-interview format, which may indicate potential for expanding this practice. Disparities in the use of interviewing across health professions should be verified to help schools adopt interviews during student admissions processes.