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2.
JAMA Netw Open ; 4(3): e213789, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33787910

RESUMEN

Importance: The COVID-19 pandemic coupled with health disparities have highlighted the disproportionate burden of disease among Black, Hispanic, and Native American (ie, American Indian or Alaska Native) populations. Increasing transparency around the representation of these populations in health care professions may encourage efforts to increase diversity that could improve cultural competence among health care professionals and reduce health disparities. Objective: To estimate the racial/ethnic diversity of the current health care workforce and the graduate pipeline for 10 health care professions and to evaluate whether the diversity of the pipeline suggests greater representation of Black, Hispanic, and Native American populations in the future. Design, Setting, and Participants: This cross-sectional study used weighted data from the 2019 American Community Survey (ACS) to compare the diversity of 10 health care occupations (advanced practice registered nurses, dentists, occupational therapists, pharmacists, physical therapists, physician assistants, physicians, registered nurses, respiratory therapists, and speech-language pathologists) with the diversity of the US working-age population, and 2019 data from the Integrated Postsecondary Education Data System (IPEDS) were used to compare the diversity of graduates with that of the US population of graduation age. Data from the IPEDS included all awards and degrees conferred between July 1, 2018, and June 30, 2019, in the US. Main Outcomes and Measures: A health workforce diversity index (diversity index) was developed to compare the racial/ethnic diversity of the 10 health care professions (or the graduates in the pipeline) analyzed with the racial/ethnic diversity of the current working-age population (or average student-age population). For the current workforce, the index was the ratio of current workers in a health occupation to the total working-age population by racial/ethnic group. For new graduates, the index was the ratio of recent graduates to the population aged 20 to 35 years by racial/ethnic group. A value equal to 1 indicated equal representation of the racial/ethnic groups in the current workforce (or pipeline) compared with the working-age population. Results: The study sample obtained from the 2019 ACS comprised a weighted total count of 148 358 252 individuals aged 20 to 65 years (White individuals: 89 756 689; Black individuals: 17 916 227; Hispanic individuals: 26 953 648; and Native American individuals: 1 108 404) who were working or searching for work and a weighted total count of 71 608 009 individuals aged 20 to 35 years (White individuals: 38 995 242; Black individuals: 9 830 765; Hispanic individuals: 15 257 274; and Native American individuals: 650 221) in the educational pipeline. Among the 10 professions assessed, the mean diversity index for Black people was 0.54 in the current workforce and in the educational pipeline. In 5 of 10 health care professions, representation of Black graduates was lower than representation in the current workforce (eg, occupational therapy: 0.31 vs 0.50). The mean diversity index for Hispanic people was 0.34 in the current workforce; it improved to 0.48 in the educational pipeline but remained lower than 0.50 in 6 of 10 professions, including physical therapy (0.33). The mean diversity index for Native American people was 0.54 in the current workforce and increased to 0.57 in the educational pipeline. Conclusions and Relevance: This study found that Black, Hispanic, and Native American people were underrepresented in the 10 health care professions analyzed. Although some professions had greater diversity than others and there appeared to be improvement among graduates in the educational pipeline compared with the current workforce, additional policies are needed to further strengthen and support a workforce that is more representative of the population.


Asunto(s)
Grupos de Población Continentales , Prestación de Atención de Salud/etnología , Grupos Étnicos , Personal de Salud , Fuerza Laboral en Salud , Pandemias , Adulto , Anciano , Estudios Transversales , Competencia Cultural , Diversidad Cultural , Femenino , Predicción , Personal de Salud/educación , Personal de Salud/estadística & datos numéricos , Disparidades en el Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Grupos Minoritarios , Estados Unidos , Adulto Joven
3.
J Nurs Adm ; 51(4): 182-184, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33734176

RESUMEN

To meet the growing demands in the US healthcare system caused by multiculturalism and the expansion of health inequities, due diligence must be given to testing the efficacy of tools used in teaching nurses to provide culturally competent care. This project assessed the utility of a free US government-developed training module. The team found an improved trend in nurse-patient communication scores and improved willingness to ask for help with cultural issues for the intervention unit. The use of no-cost, publicly available resources may be a cost-effective option for training materials.


Asunto(s)
Competencia Cultural/educación , Asistencia Sanitaria Culturalmente Competente/organización & administración , Personal de Salud/educación , Disparidades en Atención de Salud/organización & administración , Competencia Cultural/organización & administración , Diversidad Cultural , Asistencia Sanitaria Culturalmente Competente/economía , Personal de Salud/economía , Disparidades en Atención de Salud/economía , Humanos
4.
Public Health Res Pract ; 31(1)2021 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-33690789

RESUMEN

OBJECTIVE: To consider the challenges of communicating COVID-19 directives to culturally and linguistically diverse (CALD) communities in Australia, and present evidence-based solutions to influence policy and practice on promoting relevant health behaviours; to advance participatory research methodologies for health behaviour change. Type of program or service: We present a case study of a participatory research collaboration between CALD community leaders and health behaviour change scientists during the COVID-19 crisis. The goal was to better understand the role of community leaders in shaping health behaviours in their communities and how that role might be leveraged for better health outcomes. METHODS: This article is the culmination of a series of dialogues between CALD community and advocacy leaders, and health behaviour change scientists in July 2020. The academic authors recruited 12 prominent CALD community leaders, conducted five semi-structured dialogues with small groups, and worked with all participants to develop insights that were applicable to the many different CALD communities represented in the research collaboration. RESULTS: Three key findings emerged: 1) partnerships between CALD leaders, communities and government are critical for effective health communication; 2) shifting behaviour requires moving beyond disseminating information to designing tailored solutions; and 3) the diverse needs and circumstances of people and communities must be at the centre of health communication and behaviour change strategies. LESSONS LEARNT: The collaborative process we undertook in this study enabled us to identify key challenges experienced and solutions offered by CALD leaders in communicating health information throughout the COVID-19 pandemic. Partnering with communities that are subject to health messaging can reduce inequalities in healthcare communication by enabling the development of strategies that help align human behaviour with the recommendations of health experts. This - along with sustained partnership and collaboration with CALD communities, understanding the cultural context, and the appropriate tailoring and delivery of communications - will ensure health-related messages are not lost in translation. The lessons provided in this paper are applicable not only to the current pandemic but also to post-pandemic social and economic recovery.


Asunto(s)
/epidemiología , Diversidad Cultural , Conductas Relacionadas con la Salud , Comunicación en Salud/métodos , Lenguaje , Australia , Investigación Participativa Basada en la Comunidad , Información de Salud al Consumidor/métodos , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Características de la Residencia , Traducción
5.
Mol Cell ; 81(5): 885-888, 2021 03 04.
Artículo en Inglés | MEDLINE | ID: mdl-33667376

RESUMEN

As part of our commitment to amplifying the voices of underrepresented scientists, we are publishing the insights and experiences of a panel of underrepresented scientists. In this segment, we asked about support systems-the types of support that are most helpful (and less helpful), how to find a supportive network, and how institutions can better support underrepresented scientists. These are the personal opinions of the authors and may not reflect the views of their institutions.


Asunto(s)
Investigación Biomédica/ética , Grupos Minoritarios/psicología , Investigadores/psicología , Adulto , Investigación Biomédica/organización & administración , Diversidad Cultural , Femenino , Humanos , Masculino , Relaciones Raciales/psicología , Apoyo Social , Estados Unidos
7.
Front Public Health ; 9: 620060, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33643990

RESUMEN

This study is a prospective, population-based cohort of individuals with a history of SARS-CoV-2 infection and those without past infection through multiple recruitment sources. The main study goal is to track health status over time, within the diverse populations of Arizona and to identify the long-term consequences of COVID-19 on health and well-being. A total of 2,881 study participants (16.2% with a confirmed SARS-CoV-2 infection) have been enrolled as of December 22, 2020, with a target enrollment of 10,000 participants and a planned follow-up of at least 2 years. This manuscript describes a scalable study design that utilizes a wide range of recruitment sources, leveraging electronic data collection to capture and link longitudinal participant data on the current and emerging issues associated with the COVID-19 pandemic. The cohort is built within a collaborative infrastructure that includes new and established partnerships with multiple stakeholders, including the state's public universities, local health departments, tribes, and tribal organizations. Challenges remain for ensuring recruitment of diverse participants and participant retention, although the electronic data management system and timing of participant contact can help to mitigate these problems.


Asunto(s)
Estado de Salud , Salud Poblacional , Desarrollo de Programa , Adolescente , Adulto , Arizona , Enfermedad Crónica , Diversidad Cultural , Ejercicio Físico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Estudios Prospectivos , Sueño , Estrés Psicológico , Adulto Joven
9.
Hist Philos Life Sci ; 43(1): 16, 2021 Feb 04.
Artículo en Inglés | MEDLINE | ID: mdl-33538910

RESUMEN

This essay considers how scholarly approaches to the development of molecular biology have too often narrowed the historical aperture to genes, overlooking the ways in which other objects and processes contributed to the molecularization of life. From structural and dynamic studies of biomolecules to cellular membranes and organelles to metabolism and nutrition, new work by historians, philosophers, and STS scholars of the life sciences has revitalized older issues, such as the relationship of life to matter, or of physicochemical inquiries to biology. This scholarship points to a novel molecular vista that opens up a pluralist view of molecularizations in the twentieth century and considers their relevance to current science.


Asunto(s)
Historiografía , Biología Molecular/historia , Diversidad Cultural , Historia del Siglo XX
15.
Mol Cell ; 81(3): 414-417, 2021 02 04.
Artículo en Inglés | MEDLINE | ID: mdl-33545055

RESUMEN

As part of our commitment to amplifying the voices of underrepresented scientists, we are publishing the insights and experiences of a panel of underrepresented scientists. In this piece, they discuss strategies to recruit underrepresented minority students to universities and careers in science. These are the personal opinions of the authors and may not reflect the views of their institutions.


Asunto(s)
Investigación Biomédica/educación , Selección de Profesión , Diversidad Cultural , Grupos Minoritarios/educación , Selección de Personal , Investigadores , Estudiantes , Relaciones Comunidad-Institución , Humanos , Mentores , Grupo Paritario
17.
J Thorac Cardiovasc Surg ; 161(3): 733-744, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33431207

RESUMEN

BACKGROUND: Increased attention has been dedicated to gender inequity at scientific meetings. This study evaluated the gender distribution of session leaders at cardiothoracic surgery national and regional meetings. METHODS: This is a descriptive study of the gender of peer-selected session leaders at 4 cardiothoracic surgery organizations' annual meetings from 2015 to 2019. Session leaders included moderators, panelists, and invited discussants. Data from publicly available programs were used to generate a list of session leaders and organization leaders. The primary outcome measure was the proportion of female session leaders at annual meetings. Descriptive analyses were performed, including the Cochran-Armitage trend test for linear trends of proportions. RESULTS: A total of 679 sessions over 20 meetings were examined. Of the 3662 session leaders, 480 (13.1%) were women. The proportion of total female session leaders trended positively over time from 9.6% (56 of 581) in 2015 to 15.9% (169 of 1060) in 2019 (P = .001). Among specialty topic sessions, female session leaders were distributed as follows: adult cardiac, 6.9% (81 of 1172); congenital cardiac, 10.8% (47 of 437); and thoracic, 23.2% (155 of 668). The proportion of female session leaders trended significantly only for thoracic sessions (20.6% [21 of 102] in 2015 to 29.2% [58 of 199] in 2019; P = .02). More than one-half of the sessions (57.4%; 390 of 679) featured all-male session leadership. CONCLUSIONS: Women remain underrepresented in leadership roles at cardiothoracic surgery organizational meetings. This may deter female applicants and has implications for female surgeons' career trajectories; therefore, attention must be given to the potential for unconscious bias in leadership in cardiothoracic surgery.


Asunto(s)
Congresos como Asunto/tendencias , Equidad de Género , Liderazgo , Médicos Mujeres/tendencias , Cirujanos/tendencias , Cirugía Torácica/tendencias , Procedimientos Quirúrgicos Torácicos/tendencias , Procedimientos Quirúrgicos Cardíacos/tendencias , Diversidad Cultural , Femenino , Humanos , Masculino , Sexismo , Factores de Tiempo
18.
JAMA Netw Open ; 4(1): e2032550, 2021 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-33464317

RESUMEN

Importance: Accurate racial/ethnic identity measurement is needed to understand the effectiveness of outreach, recruitment, and programs to support American Indian and Alaska Native (AIAN) people becoming physicians. Objective: To examine how changes in race/ethnicity data collection by the American Medical College Application System are associated with trends in applicants, matriculants, and graduates self-reporting as AIAN. Design, Setting, and Participants: In this cohort study, interrupted time series regression was conducted using data from the American Medical College Application system identifying medical school applicants and graduates between January 1, 1996, and December 31, 2017, who identified as AIAN. The number of students identifying as AIAN was compared before and after the American Medical College Application System changed how it collected race/ethnicity data in 2002. Data analyses were conducted between December 2019 and May 2019. Exposures: Applicants could select only 1 racial identity from 1996 to 2001 and could select more than 1 racial identity from 2002 to 2017. Main Outcomes and Measures: Rates of AIAN groups before and after changing how race/ethnicity data were collected. Covariates were age, sex, and Medical College Admission Test scores. Results: The total number of individuals identifying as AIAN in the study was 8361; the mean (SD) number of applicants per year was 380.0 (89.9) overall: 257.3 (39.6) in 1996 to 2001, with a mean (SD) age of 26.6 (5.5) years and 830 (54.0%) male individuals, and 426.1 (50.1) in 2002 to 2017, with a mean (SD) age of 25.5 (5.6) years and 3441 (50.5%) female individuals. Before the change, there was a decrease of 5% per year (relative rate [RR] of 0.95; 95% CI, 0.91-0.98; P < .001) in the rate of AIAN applicants. In 2002, the change in data collection was associated with an immediate 78% relative increase in applicants (RR, 1.78; 95% CI, 1.55-2.06; P < .001). From 2002 to 2017 there was a 10% increase in applicants per year (RR, 1.10; 95% CI, 1.06-1.14; P < .001). For matriculants, yearly trends indicated a nonsignificant 3% decrease before the change, whereas the change was associated with an immediate 62% relative increase in matriculants (RR, 1.62; 95% CI, 1.35-1.95; P < .001), with no difference in trend after the change. For graduates, a nonsignificant yearly decrease of 2% was found in the mean number of graduates before the change, whereas the change was associated with an immediate 94% relative increase (RR, 1.94; 95% CI, 1.57-2.38; P < .001), followed by no change in trend after the modification. Conclusions and Relevance: Changing the method of race/ethnicity data collection captured more AIAN applicants, matriculants, and graduates. Yearly trends indicate concerning although nonsignificant differences after the change for AIAN graduates. These findings should inform diversity efforts.


Asunto(s)
/educación , Facultades de Medicina/estadística & datos numéricos , Estudiantes de Medicina , Diversidad Cultural , Femenino , Humanos , Análisis de Series de Tiempo Interrumpido , Masculino , Selección de Personal , Estados Unidos , Adulto Joven
19.
Artículo en Inglés | MEDLINE | ID: mdl-33467144

RESUMEN

Objective: To identify how Culturally and Linguistically Diverse (CALD) communities are defined in epidemiological research in Australia and provide a definition of CALD status that aids the consistency and interpretability of epidemiological studies. Methods: Peer-reviewed literature from January 2015 to May 2020 was searched via four databases (Ovid Medline combined with PubMed, Embase, Emcare, and CINAHL) to identify quantitative studies of CALD people in Australia. Results: A total of 108 studies met the criteria for inclusion in the review. Country of birth was the most commonly used CALD definition (n = 33, 30.6%), with combinations of two or more components also frequently used (n = 31, 28.7%). No studies used all the components suggested as core to defining CALD status. including country of birth, languages other than English spoken at home, English proficiency, and indigenous status. Conclusions: There was considerable inconsistency in how CALD status was defined. The review suggests that CALD status would best be defined as people born in non-English speaking countries, and/or who do not speak English at home. Additionally, indigenous peoples should be considered separately. This recommended definition will support the better identification of potential health disparity and needs in CALD and indigenous communities.


Asunto(s)
Diversidad Cultural , Prestación de Atención de Salud , Calidad de Vida , Anciano , Australia , Niño , Femenino , Humanos , Embarazo , Estudios Seroepidemiológicos , Migrantes
20.
JAMA Netw Open ; 4(1): e2030832, 2021 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-33427883

RESUMEN

Importance: The proportion of women and underrepresented racial and ethnic groups (UREGs) matriculating into general cardiology fellowships remains low. Objective: To assess a systematic recruitment initiative aimed at ensuring adequate matriculation of women and UREGs in a general cardiology fellowship. Design, Setting, and Participants: This quality improvement study took place at a large, tertiary academic medical center and associated Accreditation Council for Graduate Medical Education Cardiovascular Disease fellowship. Participants included cardiology fellowship and divisional leadership and general cardiology fellow applicants to the Duke Cardiovascular Disease Fellowship Program from 2017 to 2019. Data analysis was performed from December 2019 to May 2020. Exposure: Multipronged initiative that created an environment committed to ensuring equity of opportunity. This included the creation of a fellowship diversity and inclusivity task force that drafted recommendations, which included reorganization of the fellowship recruitment committee, and changes to the applicant screening process, the interview day, applicant ranking process, and postmatch interventions. Main Outcomes and Measures: The percentage of matriculating and overall women and UREGs before and after the interventions were recorded. Results: The fellowship received a mean (SD) of 462 (55) applications annually before the interventions (2006-2016) and 611 (27) applications annually after the interventions (2017-2019). Between the 10-year period before the interventions and the 3-year period during the interventions, there was a significant increase in the annual mean (SD) percentage of women (22.4% [2.9%] vs 26.4% [0.07%]; P < .001) and UREG applicants (10.5% [1.1%] vs 12.5% [1.9%]; P = .01) to the program. Among applicants interviewed, the percentage of women increased from 20.0% to 33.5% (P = .01) and that of and UREGs increased from 14.0% to 20.0% (P = .01). Before the interventions, a mean (SD) of 23.2% (16.2%) women and 9.7% (7.8%) UREGs matriculated as first-year fellows, whereas after the interventions, a mean (SD) of 54.2% (7.2%) women and 33.3% (19.0%) UREGs matriculated as first-year fellows. The proportion of the entire fellowship who were women increased from a 5-year mean (SD) of 27.0% (8.8%) to 54.2% (7.2%) after 3 years of interventions, and that of UREGs increased from 5.6% (4.6%) to 33.3% (19.0%). Overall, the proportion of applicants in the entire population who were either women or from UREGs increased from 27.8% to 66.7%. Conclusions and Relevance: After implementing interventions to promote equity of opportunity in the cardiovascular disease fellowship, the percentage of women and UREGs significantly increased in the fellowship over a 3-year time period. These interventions may be applicable to other cardiovascular disease fellowships seeking to diversify training programs.


Asunto(s)
Cardiología , Grupos de Población Continentales/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Becas , Cardiología/educación , Cardiología/organización & administración , Diversidad Cultural , Becas/organización & administración , Becas/estadística & datos numéricos , Femenino , Humanos , Masculino , Grupos Minoritarios/estadística & datos numéricos , North Carolina , Universidades , Mujeres
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