RÉSUMÉ
INTRODUCTION: Ethnic minority populations experience significant health and social care disparities; despite experiencing a greater burden of diseases, these groups are underrepresented in health and social care research. Consequently, related research can be less applicable to these population groups. The REPRESENT study aims to explore the health and social care experiences of ethnic minorities and other minoritised populations, their research interests and appropriate research practices. METHODS: Focus groups and semistructured interviews were conducted between May and September 2022 with members of a number of ethnic minority communities in England. Data were audio recorded, transcribed and thematically coded using NVivo 12. Rigour was determined through extensive sampling, iterative data collection and analysis. FINDINGS: Fifty-two ethnic minority members were engaged in group interviews and one-to-one interviews. Participants included representatives of the following groups: African Caribbean, Eastern European, Gypsy Travellers, Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual+, Refugee/Asylum Seekers, Somali and South Asian communities. Interviews were also conducted with ethnic minority healthcare providers and researchers. Three overarching categories were identified: health information, medical service experiences, health and social care concerns and health research. Health and social care services challenges were mostly attributed to discrimination, delayed services, poor cultural relevance and language and cultural barriers. The most influential information sources were local community organisations and word-of-mouth. The main health and social care concerns were chronic long-term health conditions, mental health, maternal health and child development. Recommendations for research involved understanding the motivations for participation, improving communication and empowering communities. Top research priorities were long-term health conditions, health promotion and education, early care interventions and understanding community needs. INTERPRETATION: Discrimination and bias in health and social care provision have severe implications for worsening ethnic health inequalities. Healthcare commissioning authorities and policymakers can leverage the preference of ethnic minority groups for pharmacy services and community organisations to improve access to care. Improving research interest and engagement requires understanding individual community needs, community sensitivity, research relevance and cultural appropriateness. PATIENT OR PUBLIC CONTRIBUTION: Members of ethnic minority Patient and Public Involvement and Engagement group and Community Advisory Board supported the REPRESENT study design, conceptualisation and report development.
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Groupes de discussion , Humains , Femelle , Mâle , Entretiens comme sujet , Minorités ethniques et raciales , Adulte , Royaume-Uni , Ethnies/psychologie , Minorités/psychologie , Adulte d'âge moyen , Recherche qualitative , Disparités d'accès aux soins/ethnologie , AngleterreRÉSUMÉ
BACKGROUND: Ethnic socialisation plays a vital role in the development of ethnic minority adolescents. However, the generalizability of research findings beyond the context of immigrant societies in the United States remains unclear. METHODS: Utilising a person-centred approach, this study analysed a sample of 2,600 ethnic minority adolescents in China (55.8% female, Mage = 14.93 ± 1.82) to explore ethnic socialisation patterns, and their correlations with depression. RESULTS: Latent profile analysis revealed four distinct ethnic socialisation profiles: low-frequency, moderate-frequency, high-frequency and proactive integration orientation. Adolescents with the high-frequency profile displayed the highest levels of depression, followed by those with the moderate-frequency profile, whereas adolescents with the low-frequency and proactive integration orientation profiles showed a lower risk of depression. CONCLUSIONS: Within the sociocultural context of China, ethnic minority families' ethnic socialisation practices demonstrate unique characteristics. Various ethnic socialisation messages are integrated in diverse patterns to exert influence on adolescents.
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Dépression , Humains , Chine/ethnologie , Adolescent , Femelle , Mâle , Dépression/ethnologie , Minorités ethniques et raciales/statistiques et données numériques , Minorités/psychologie , Minorités/statistiques et données numériques , Ethnies/statistiques et données numériques , Ethnies/psychologieRÉSUMÉ
It is well-established within the hate studies literature that the majority of hate crimes and incidents of targeted hostility are perpetrated by those in the "majority" society. In the UK, academic and official research consistently shows that young White, British males are most commonly the culprits of all forms of targeted victimization, especially racist hate. However, urban areas of "super-diversity" offer researchers an opportunity to understand hate crime victimization and perpetration in a more nuanced and comprehensive way. Hate studies research has slowly begun to highlight instances of people from marginalized and stigmatized groups being targeted on the basis of their identity by individuals who are also members of minority groups, sometimes even the same minority group as the victim. Very little is understood about this particular victimizing dynamic other than it appears to be an attempt by minority group members to "fit in" by adopting what they perceive to be majority group values and attitudes. By drawing from 44 qualitative in-depth interviews exploring the experiences of new migrants and refugees and observations from 20 months of grassroots engagement, this article challenges established theories of "othering" that overwhelmingly refer to binary, static majority/minority tensions. The stories of these too-often "hidden" victims of targeted hostility offer a fresh perspective on the relationships between victims of hate and perpetrators. The article also contributes new explanations as to why those who are often targeted go on to target others.
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Victimes de crimes , Haine , Hostilité , Humains , Victimes de crimes/psychologie , Mâle , Femelle , Minorités/psychologie , Adulte , Royaume-UniRÉSUMÉ
BACKGROUND: Current research has identified how ethnic minority women experience poorer health outcomes during the perinatal period. In the United Kingdom, specialist perinatal mental health services provide mental health treatment for women throughout the perinatal period. Service users have previously highlighted that perinatal services are hard to access and lack cultural sensitivity, whereas healthcare professionals have described limited opportunities and resources for developing cultural competency. OBJECTIVES: We explored the experiences of ethnic minority women with National Health Service (NHS) specialist perinatal teams and identified what culturally sensitive perinatal mental health care means to this group. DESIGN: Individual semi-structured interviews were conducted, and an interpretative phenomenological analysis framework was used to analyse the interview transcripts. SETTING AND PARTICIPANTS: Participants were recruited from NHS specialist perinatal teams and online via social media. RESULTS: Six women were interviewed. Four group experiential themes central to the experiences of participants emerged: (1) strengthening community networks and peer support; (2) valuing cultural curiosity; (3) making sense of how culture, ethnicity, race and racism impact mental health; and (4) tailoring interventions to ethnic minority women and their families. DISCUSSION AND CONCLUSIONS: The findings capture how ethnic minority women experience specialist perinatal teams and offer insights into practising culturally sensitive care. Perinatal mental health professionals can support ethnic minority women by strengthening their access to community resources and peer support; being curious about their culture; helping them to make sense of how culture, ethnicity, race and mental health interact; and applying cultural and practical adaptations to interventions. PATIENT OR PUBLIC CONTRIBUTION: A Lived Experience Advisory Group (LEAG) of women from ethnic minority groups contributed to the design and conduct of this study. The LEAG had lived experience of perinatal mental health conditions and accessing specialist perinatal teams. The LEAG chose to co-produce specific aspects of the research they felt fit with their skills and available time throughout five group sessions. These aspects included developing the interview topic guide, a structure for debriefing participants and advising on the social media recruitment strategy.
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Entretiens comme sujet , Services de santé mentale , Soins périnatals , Humains , Femelle , Adulte , Royaume-Uni , Services de santé mentale/organisation et administration , Grossesse , Soins adaptés sur le plan culturel , Recherche qualitative , Minorités/psychologie , Compétence culturelle , Ethnies/psychologie , Minorités ethniques et raciales , Médecine d'ÉtatRÉSUMÉ
BACKGROUND: Obesity in adolescence has increased in the last decades. Adolescents fail to meet the recommended guidelines for physical activity (PA) and healthy diet. Adolescents with a low socioeconomic status (SES) particularly seem to have fewer healthy lifestyle behaviours. The European Science Engagement to Empower aDolescentS (SEEDS) project used an extreme citizen science approach to develop and implement healthy lifestyle behaviour interventions in high schools. As part of this project, key stakeholders were invited to reflect on the intentions of adolescents to engage in healthy lifestyle behaviours. The aim of this study was to gain stakeholder insights into the barriers and facilitators to healthy lifestyle behaviours of adolescents from low SES areas and on the possible role of these stakeholders in facilitating healthy lifestyle behaviours. METHODS: Six semi-structured focus groups were conducted in four European countries with 28 stakeholders from different settings (schools, community, and government), like teachers, policy advisors and youth workers. The theoretical framework of focus groups was based on the Theory of Planned Behaviour. The main questions of the focus groups were centred on PA and healthy diet. The focus groups were qualitatively analysed in NVivo using thematic analysis to identify topics and themes. RESULTS: According to stakeholders, adolescents have sufficient understanding of the importance of PA and a healthy diet, but nevertheless engage in unhealthy behaviour. Parents were mentioned as important facilitators for engaging adolescents in healthy lifestyle behaviours. Stakeholders listed lack of knowledge, time, and financial resources as barriers for adolescents from low SES families to engage in healthy lifestyle behaviours. The school environment was listed as an important facilitator of adolescents' healthy lifestyle changes, but stakeholders acknowledged that current school days, curriculum and buildings are not designed to promote healthy lifestyle behaviours. External support and collaboration with community and governmental stakeholders was seen as potentially beneficial to improve healthy lifestyle behaviours. CONCLUSIONS: This study shows the variety of barriers adolescents from low SES areas face, and the need for a broader collaboration between key stakeholders to facilitate healthy lifestyle behaviours. Schools are regarded specifically as important facilitators. Currently, the school environment entails various barriers. However, when addressing those, schools can increase opportunities for healthy lifestyle behaviours of adolescents from low SES areas. TRIAL REGISTRATION: This study is registered in ClinicalTrials.gov on 12/08/2021: NCT05002049.
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Exercice physique , Groupes de discussion , Mode de vie sain , Humains , Adolescent , Mâle , Europe , Femelle , Exercice physique/psychologie , Participation des parties prenantes/psychologie , Comportement de l'adolescent/psychologie , Recherche qualitative , Régime alimentaire sain/psychologie , Minorités/psychologie , Comportement en matière de santéRÉSUMÉ
Watching movies is among the most popular entertainment and cultural activities. How do viewers react when a movie sequel increases racial minority actors in the main cast ("minority increase")? On the one hand, such sequels may receive better evaluations if viewers appreciate racially inclusive casting for its novel elements (the value-in-diversity perspective) and moral appeal (the fairness perspective on diversity). On the other hand, discrimination research suggests that if viewers harbor biases against racial minorities, sequels with minority increase may receive worse evaluations. To examine these competing possibilities, we analyze a unique panel dataset of movie series released from 1998 to 2021 and conduct text analysis of 312,457 reviews of these movies. Consistent with discrimination research, we find that movies with minority increase receive lower ratings and more toxic reviews. Importantly, these effects weaken after the advent of the Black Lives Matter (BLM) movement, especially when the movement's intensity is high. These results are reliable across various robustness checks (e.g., propensity score matching, random implementation test). We conceptually replicate the bias mitigation effect of BLM in a preregistered experiment: Heightening the salience of BLM increases White individuals' acceptance of racial minority increase in a movie sequel. This research demonstrates the power of social movements in fostering diversity, equality, and inclusion.
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Films , Racisme , Humains , Racisme/psychologie , Minorités ethniques et raciales , /psychologie , Diversité culturelle , Minorités/psychologieRÉSUMÉ
The objective of this exploratory community-based trial was to examine the usage and behavior of underserved urban residents participating in a 2-month food voucher program. $70 supermarket vouchers were provided each month for 2 months to participants enrolled in selected child daycare centers in East Harlem, New York, and receipts were collected to examine purchases. Participants were from low-income households with at least 1 child 5 years and younger (n = 113). Participants spent the most on meat, fish, poultry, and eggs (29.7%); fruits and vegetables (15.9%); and cereal and bakery products (15.1%). Fruit and vegetable purchases and dairy purchases were higher in foreign-born participants than in US-born participants. Furthermore, future models should consider the potential benefit of unrestricted vouchers in supporting differences in dietary needs and preferences.
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Supermarchés , Humains , Projets pilotes , Mâle , Femelle , Population urbaine/statistiques et données numériques , Comportement du consommateur/statistiques et données numériques , Adulte , Assistance alimentaire/statistiques et données numériques , Pauvreté/statistiques et données numériques , Pauvreté/psychologie , Minorités/statistiques et données numériques , Minorités/psychologie , Enfant d'âge préscolaire , Approvisionnement en nourriture/statistiques et données numériques , Approvisionnement en nourriture/méthodes , New York (ville) , NourrissonRÉSUMÉ
Substance use disparities among sexual and gender minority (SGM) people are attributed to minority stress, but few studies have examined minority stress and cannabis use over time or investigated differences in cannabis use trajectories by less-studied gender subgroups. We examined if longitudinal cannabis use trajectories are related to baseline minority stressors and if gender differences persisted after accounting for minority stress. Cannabis use risk was measured annually over four years (2017-2021) within a longitudinal cohort study of SGM adults in the United States (N = 11,813). Discrimination and victimization, internalized stigma, disclosure and concealment, and safety and acceptance comprised minority stress (n = 5,673). Latent class growth curve mixture models identified five cannabis use trajectories: 'low or no risk', 'low moderate risk', 'high moderate risk', 'steep risk increase', and 'highest risk'. Participants who reported past-year discrimination and/or victimization at baseline had greater odds of membership in any cannabis risk category compared to the 'low risk' category (odds ratios [OR] 1.17-1.33). Internalized stigma was related to 'high moderate' and 'highest risk' cannabis use (ORs 1.27-1.38). After accounting for minority stress, compared to cisgender men, gender expansive people and transgender men had higher odds of 'low moderate risk' (ORs 1.61, 1.67) or 'high moderate risk' (ORs 2.09, 1.99), and transgender men had higher odds of 'highest risk' (OR 2.36) cannabis use. This study indicates minority stress is related to prospective cannabis use risk trajectories among SGM people, and transgender men and gender expansive people have greater odds of trajectories reflecting cannabis use risk.
Sujet(s)
Victimes de crimes , Consommation de marijuana , Minorités sexuelles , Stigmate social , Stress psychologique , Humains , Mâle , Femelle , Minorités sexuelles/statistiques et données numériques , Minorités sexuelles/psychologie , Adulte , Études longitudinales , Stress psychologique/psychologie , Stress psychologique/épidémiologie , Consommation de marijuana/épidémiologie , Consommation de marijuana/psychologie , États-Unis/épidémiologie , Victimes de crimes/statistiques et données numériques , Victimes de crimes/psychologie , Jeune adulte , Adulte d'âge moyen , Facteurs sexuels , Adolescent , Minorités/statistiques et données numériques , Minorités/psychologieRÉSUMÉ
BACKGROUND: Participants' recruitment and retention into community-based interventions can be challenging, especially in research involving ethnic minorities and migrants. Despite known challenges, there are limited reviews that probe recruitment and retention strategies involving ethnic minorities and migrants in the Organisation for Economic Cooperation and Development (OECD) countries. This systematic review aimed to measure recruitment and retention rates and identify the barriers and facilitators to effective recruitment and retention of ethnic minorities and migrants in community-based obesity prevention Randomised Control Trials (RCTs) in OECD countries. METHODS: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases (CINAHL, Cochrane, Embase, Medline and PsychInfo) were searched from January 2000 to March 2022, in addition to Google and Google Scholar. Methodological quality and risk of bias were assessed, and pooled analysis and meta-ethnographic analysis were conducted on the included studies. RESULTS: Twenty-five studies were included in the review. The pooled analysis found a 64% rate of recruitment of ethnic minorities in RCTs, with a retention rate of 71%. Key facilitators identified were-use of multiple communication channels, incentives, recruiting community champions, participant convenience and employing culturally sensitive strategies. Key barriers to participation were limited access to study sites, time constraints, limited trust, perceived fear, and anxiety. CONCLUSION: Findings suggest the importance of undertaking culturally appropriate recruitment and retention strategies to minimise barriers and facilitate effective recruitment and retention of low-income ethnic minorities and migrants in community-based research.
Sujet(s)
Minorités ethniques et raciales , Obésité , Sélection de patients , Essais contrôlés randomisés comme sujet , Population de passage et migrants , Humains , Population de passage et migrants/statistiques et données numériques , Population de passage et migrants/psychologie , Obésité/prévention et contrôle , Obésité/ethnologie , Minorités ethniques et raciales/statistiques et données numériques , Minorités/statistiques et données numériques , Minorités/psychologie , Ethnies/statistiques et données numériquesRÉSUMÉ
BACKGROUND: Excessive weight gain can be detrimental to the health and wellbeing of both mother and child. There is evidence that women from ethnic minority groups are more likely to gain excessive weight during pregnancy. For the purpose of this review, ethnic minority women are defined as those with different national or cultural traditions from the main population. AIM: Our aim was to identify barriers and facilitators to healthy gestational weight gain in pregnant women in ethnic minority groups. METHODS: Databases searched were MEDLINE, CINAHL, PsycInfo and PsycArticles between 2011 and 2022. Inclusion criteria were empirical studies of any method considering gestational weight gain in ethnic minority women published in English. Data were extracted according to aim, participants, methods, and findings in relation to barriers and facilitators. Included papers were assessed for quality according to relevant Joanna Briggs Institute checklists. FINDINGS: Twenty-six studies were identified. Five themes were revealed: (1) knowledge and beliefs, (2) cultural and social influences, (3) confidence, (4) physical experiences, and (5) personal and environmental factors. DISCUSSION: Some barriers and facilitators were relevant to all groups and others were more specific to ethnic minority groups. The latter included social and cultural influences, which were reported extensively. Our search was comprehensive, although it is possible we may not have captured all relevant papers. CONCLUSION: We recommend that the barriers and facilitators identified here are considered in designing future, or adjusting current, health care practitioner mediated interventions to support healthy gestational weight gain in ethnic minority women.
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Prise de poids pendant la grossesse , Femmes enceintes , Humains , Femelle , Grossesse , Femmes enceintes/psychologie , Femmes enceintes/ethnologie , Adulte , Minorités/psychologie , Minorités/statistiques et données numériques , Ethnies/psychologie , Ethnies/statistiques et données numériques , NarrationRÉSUMÉ
Trust in mental health professionals and services profoundly impacts health outcomes. However, understanding trust in mental health professionals, especially in ethnic minority contexts, is lacking. To explore this within the Bedouin-Arab minority, a qualitative study conducted semi-structured interviews with 25 Bedouins in southern Israel. Participants were primarily female (60%) married (60%), averaging 34.08 years old. Employing grounded theory, three themes emerged. Firstly, concerns about confidentiality were central, eroding trust due to societal repercussions. Secondly, factors influencing confidentiality concerns and distrust were tied to Bedouin-Arab social structures and cultural values rather than professional attributes. Lastly, the consequences of distrust included reduced help-seeking. This study enriches the understanding of trust in mental health professionals among non-Western ethnic minorities, highlighting how cultural factors shape perceptions of mental health services and distrust. Addressing confidentiality worries demands Bedouin mental health professionals to acknowledge hurdles, build community ties, and demonstrate expertise through personal connections and events.
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Arabes , Services de santé mentale , Recherche qualitative , Confiance , Humains , Israël/ethnologie , Femelle , Arabes/psychologie , Mâle , Adulte , Adulte d'âge moyen , Confidentialité , Minorités/psychologieRÉSUMÉ
PURPOSE: Sexual and gender minorities (SGMs) show a heightened risk of disordered eating compared to heterosexual and cisgender people, a disparity which may be caused by exposure to minority-specific stressors, such as discrimination and violence. This systematic review aims to summarize available evidence on the role of minority stress in disordered eating and SGM-specific aspects. METHODS: Following PRISMA guidelines, scientific search engines (EBSCO, PUBMED, Web of Science) were screened up to 31st of January 2024, including English-language original research papers containing analyses of the relationship between minority stress and disordered eating. 2416 records were gathered for screening. After application of inclusion and exclusion criteria, thematic analysis was conducted regarding 4 research questions: effects of minority stress on disordered eating, mediating factors, specificities of SGMs and differences between identity categories. RESULTS: 30 studies were included. Several aspects of minority stress are reliably associated with different forms of disordered eating. The relationship between minority stressors and disordered eating is mediated by aspects such as shame, body shame, or negative affect. SGMs show several specificities, such as the presence of a role of LGBTQIA + communities and additional gender-related pressures. Bisexual people and gender minorities appear to feature comparatively higher risks, and gender-related factors shape paths leading to disordered eating risk. CONCLUSION: Minority stress is an important predictor of disordered eating, making SGM people's health particularly at risk. Institutional and organizational anti-discrimination policies are needed, as well as further research. Clinical interventions may benefit from exploring and incorporating how minority stressors impact SGM people. Evidence level I-Systematic review.
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Troubles de l'alimentation , Minorités sexuelles , Stress psychologique , Humains , Troubles de l'alimentation/psychologie , Stress psychologique/psychologie , Minorités sexuelles/psychologie , Minorités/psychologie , Femelle , MâleRÉSUMÉ
BACKGROUND: Many ethnic minorities in Hong Kong seek medical tourism after encountering inequalities in access to local healthcare because of language barriers and cultural-religious differences. The present study explored the ethnic minorities' lived experiences of medical tourism and issues arising from cross-border health-seeking relevant to this specific population. METHODS: Qualitative in-depth interviews with 25 ethnic minority informants from five South Asian countries in 2019. RESULTS: The 19 informants out of the 25 have sought assistance from their international networks for home remedies, medical advice and treatments of traditional/Western medicines, for they are more costly or unavailable in Hong Kong and for issues related to racial discrimination, language barriers, transnationalism engagement, cultural insensitivity, and dissatisfaction with healthcare services in Hong Kong. DISCUSSION: Medical tourism can relieve the host country's caring responsibilities from healthcare services, so the government might no longer be hard-pressed to fix the failing healthcare system. Consequently, it could cause public health concerns, such as having patients bear the risks of exposure to new pathogens, the extra cost from postoperative complications, gaps in medical documentation and continuum of care, etc. It also triggers global inequities in health care, exacerbating unequal distribution of resources among the affordable and non-affordable groups. CONCLUSION: Ethnic minorities in Hong Kong sought cross-border healthcare because of structural and cultural-religious issues. The surge of medical tourism from rich and developed countries to poor and developing countries may infringe upon the rights of residents in destination countries. To mitigate such negative impacts, policymakers of host countries should improve hospital infrastructure, as well as train and recruit more culturally sensitive healthcare workers to promote universal health coverage. Healthcare professionals should also strive to enhance their cultural competence to foster effective intercultural communication for ethnic minority groups.
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Tourisme médical , Acceptation des soins par les patients , Humains , Tourisme médical/psychologie , Tourisme médical/statistiques et données numériques , Mâle , Femelle , Acceptation des soins par les patients/ethnologie , Acceptation des soins par les patients/psychologie , Acceptation des soins par les patients/statistiques et données numériques , Adulte , Adulte d'âge moyen , Hong Kong , Recherche qualitative , Minorités ethniques et raciales/statistiques et données numériques , Accessibilité des services de santé , Entretiens comme sujet , Santé publique , Sujet âgé , Jeune adulte , Minorités/psychologie , Minorités/statistiques et données numériques , Ethnies/psychologie , Ethnies/statistiques et données numériquesRÉSUMÉ
This study examined the mediating role of intergroup orientation in the relationship between ethnic and national identification. Our participants were 1320 Yi minority youths from a secondary school located in the Yi ethnic autonomous prefecture of southwest China. The participants completed three self-report questionnaires measuring ethnic and national identification, and intergroup orientation, respectively. Structural equation modeling was employed to determine the relationships between ethnic and national identification and intergroup orientation, and to explore the mechanism underlying the association between ethnic and national identification. The results showed that Yi minority youths with a stronger sense of ethnic identity had a stronger sense of national identity. The results further indicated that stronger ethnic identity led to a more positive intergroup orientation, which in turn predicted a stronger national identity. Our findings may facilitate the cultivation of positive attitudes between national subgroups in multiethnic countries and help ethnic minority youth develop a stronger awareness of national identity while retaining their ethnic identity.
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Ethnies , Identification sociale , Humains , Chine/ethnologie , Mâle , Adolescent , Femelle , Ethnies/psychologie , Minorités/psychologie , Enquêtes et questionnaires , AutorapportRÉSUMÉ
The increased incidence of chronic diseases among people with HIV (PWH) is poised to increase the need for specialty care outside of HIV treatment settings. To reduce outcome disparities for HIV-associated comorbidities in the United States, it is critical to optimize access to and the quality of specialty care for underrepresented racial and ethnic minority (URM) individuals with HIV. We explored the experiences of URM individuals with HIV and other comorbidities in the specialty care setting during their initial and follow-up appointments. We conducted qualitative interviews with participants at three large academic medical centers in the United States with comprehensive health care delivery systems between November 2019 and March 2020. The data were analyzed using applied thematic analysis. A total of 27 URM individuals with HIV were interviewed. The majority were Black or African American and were referred to cardiology specialty care. Most of the participants had positive experiences in the specialty care setting. Facilitators of the referral process included their motivation to stay healthy, referral assistance from HIV providers, access to reliable transportation, and proximity to the specialty care health center. Few participants faced individual, interpersonal, and structural barriers, including the perception of individual and facility stigma toward PWH, a lack of transportation, and a lack of rapport with providers. Future case studies are needed for those URM individuals with HIV who face barriers and negative experiences. Interventions that involve PWH and health care providers in specialty care settings with a focus on individual- and structural-level stigma can support the optimal use of specialty care.
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Infections à VIH , Accessibilité des services de santé , Recherche qualitative , Orientation vers un spécialiste , Humains , Infections à VIH/psychologie , Infections à VIH/ethnologie , Infections à VIH/thérapie , Infections à VIH/épidémiologie , Mâle , Femelle , Orientation vers un spécialiste/statistiques et données numériques , États-Unis/épidémiologie , Adulte d'âge moyen , Adulte , Minorités ethniques et raciales , Entretiens comme sujet , Minorités/statistiques et données numériques , Minorités/psychologie , Stigmate social , Disparités d'accès aux soins/ethnologie , /psychologie , /statistiques et données numériquesRÉSUMÉ
During the early stages of the COVID-19 pandemic, there was a spike in the reporting of hate crimes (Human Rights Watch, 2020). However, the extent to which the pandemic affected prejudice across a general population-not merely among those disposed to hate crimes-remains unclear. Also unclear is the extent to which prejudice was restricted to specific minority groups associated with the virus, or whether prejudice spilled over to other minority groups. To address these questions, we use panel data collected from participants in a large national longitudinal (panel) study of New Zealanders before and during the early COVID-19 pandemic and systematically quantified social warmth ratings across a broad range of minority-groups (The New Zealand Attitudes and Values Study, N = 30,327, years 2018-2020). We discover reduced warmth toward Chinese, Asians (broadly defined), immigrants, Muslims, refugees, Indians, and the mentally ill. In absolute terms, warmth towards Chinese decreased the most (0.11 SD). Notably, changes in warmth were not detected toward NZ Europeans, Maori, Pacific Islanders, the overweight, or the elderly. Overall, these findings suggest that in New Zealand, pandemic prejudice may spread beyond minority groups associated with the virus to other groups perceived as non-prototypical of national identity.
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COVID-19 , Prejugé , Humains , COVID-19/épidémiologie , COVID-19/psychologie , Nouvelle-Zélande/épidémiologie , Mâle , Femelle , Adulte , Adulte d'âge moyen , Pandémies , SARS-CoV-2/isolement et purification , Haine , Sujet âgé , Études longitudinales , Minorités/psychologie , Jeune adulte , AdolescentRÉSUMÉ
PURPOSE: Despite increased clinician awareness of systemic racism, lack of substantial action toward antiracism exists within health care. Clinical staff perspectives, particularly those of racial-ethnic minorities/persons of color (POC) who disproportionately occupy support staff roles with less power on the team, can yield insights into barriers to progress and can inform future efforts to advance diversity, equity, and inclusion (DEI, also referred to as EDI) within health care settings. This qualitative study explored the perspectives of staff members on race and role power dynamics within community health clinic teams. METHODS: We conducted semistructured 45-minute interviews with staff members working in community health clinics in a large urban health care system from May to July 2021. We implemented purposeful recruitment to oversample POC and support staff and to achieve equal representation from the 13 community health clinics in the system. Interviews were audio recorded, transcribed, and analyzed over 6 months using a critical-ideological paradigm. Themes reflecting experiences related to race and role power dynamics were identified. RESULTS: Our cohort had 60 participants: 42 (70%) were support staff (medical assistants, front desk clerks, care navigators, nurses) and 18 (30%) were clinicians and clinic leaders. The large majority of participants were aged 26 to 40 years (60%), were female (83%), and were POC (68%). Five themes emerged: (1) POC face hidden challenges, (2) racial discrimination persists, (3) power dynamics perpetuate inaction, (4) interpersonal actions foster safety and equity, and (5) system-level change is needed for cultural shift. CONCLUSIONS: Understanding the race and role power dynamics within care teams, including experiences of staff members with less power, is critical to advancing DEI in health care.
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Recherche qualitative , Racisme , Humains , Femelle , Mâle , Adulte , Centres de santé communautaires/organisation et administration , Attitude du personnel soignant , Pouvoir psychologique , Personnel de santé/psychologie , Ethnies/psychologie , Diversité culturelle , Équipe soignante/organisation et administration , Minorités/psychologie , Entretiens comme sujet , Adulte d'âge moyenRÉSUMÉ
PURPOSE: Racial/ethnic minority groups and low-income students continue to be underrepresented in medicine (URiM) despite years of diversity and inclusion efforts. Post baccalaureate programs (PBP) are shown to prepare underrepresented students to successfully matriculate to medical school. However, identification of the aspects of a PBP that are key to future success in medicine from the student perspective is lacking. Therefore, this study was designed to answer the question, "What aspects of a post baccalaureate program do URiM students see as valuable to their future success?" METHODS: This is a qualitative analysis of semi-structured interviews with alumni of the UCSF PBP who completed the program between 2015-2020. Interviews were conducted via phone or video call, audio recorded, and transcribed verbatim. Names and years of attendance were removed from the transcripts prior to review to protect confidentiality. Transcripts were coded following an inductive qualitative approach using methodology rooted in grounded theory. Demographic data was collected upon enrollment in the program. RESULTS: Forty study participants were interviewed (58% of eligible subjects). Participants self-identified as Latinx (70%), African American (8%), Southeast Asian (10%), Native American (2%), Multiethnic (10%), and 60% female. The average age at enrollment was 24 years. Most participants (75%) were first-generation college students and 85% grew up with a family income <$49,999. Qualitative findings were categorized into five main themes: (1) Academic, Professional, and Personal Skills Development, (2) Supportive Student Cohort, (3) Resources, Personalized Advising, and Mentorship, (4) Gaining Confidence and a Sense of Belonging in Medicine, and (5) Redefining "Disadvantaged" Status. A novel finding was the importance of redefining the narrative of belonging to a "disadvantaged" community. During the program, the study participants reported gaining confidence and a sense of belonging in medicine as they recognized the unique qualifications and advantages they bring to medicine. CONCLUSIONS: Our findings suggest that in addition to academic preparation, PBPs for students who are underrepresented in medicine should empower students to recognize their strengths and qualifications in the field of medicine. Our study participants rejected the term "disadvantaged" as they celebrated the value of their backgrounds and what they bring to medicine.