Designing the first culturally-sensitive stigma survey tailored for adolescents: RN-CSS.

AIMS: The Red Noses Culturally-Sensitive Stigma Survey (RN-CSS) contributes to the underexplored research domain of adolescents' stigmatising attitudes and behaviours towards peers with mental health difficulties and mental healthcare services. It also addresses the need for comprehensive and culturally-sensitive tools to assess stigma in this context. METHODS: Drawing on insights from focus groups and building upon the existing Stigma in Global Context-Mental Health Study, we have successfully developed and implemented the first culturally-sensitive stigma survey tailored for school-aged adolescents of different migration/cultural backgrounds. The questionnaire includes an unlabelled case vignette depicting a peer with symptoms of depression and gathers data on various domains, including (1) sociodemographic variables; (2) education-related information; (3) COVID-19; (4) perceptions of mental health difficulties and mental healthcare services (i.e. severity assessment, causal attributions, care recommendations, personal stigma, perceived stigma, and service stigma); (5) subjective wellbeing and familiarity with mental health difficulties; (6) social support; (7) school context; (8) bullying; and (9) knowledge of anti-stigma campaigns. RESULTS: Our final sample comprises 5075 pupils from 38 secondary schools in Flanders, Belgium. CONCLUSIONS: In this article, we present the study's background and rationale, the development of the questionnaire, and the sampling and recruitment methods employed. Furthermore, we provide a summary of the sample characteristics and preliminary descriptive results of the RN-CSS. Subsequent empirical studies will address the research objectives outlined in this protocol paper. The research opportunities provided by the developed materials and dataset are being discussed.

"Trying to write a story together": general practitioners' perspectives on culturally sensitive care.

BACKGROUND: Culturally sensitive care is integral to effective and equitable healthcare delivery, necessitating an understanding and acknowledgment of patients' cultural needs, preferences, and expectations. This study investigates the perceptions of cultural sensitivity among general practitioners (GPs), focusing on their intentions, willingness and perceived responsibilities in providing care tailored to cultural needs. METHODS: In-depth interviews were conducted with 21 Flemish GPs to explore their perspectives on culturally sensitive care. Data analysis followed a conventional qualitative content analysis approach within a constructivist framework. A coding scheme was developed to identify recurring themes and patterns in the GPs' responses. RESULTS: Findings reveal that culturally sensitive care provision is perceived as a multifaceted process, initiated by an exploration phase where GPs inquire about patients' cultural needs and preferences. Two pivotal factors shaping culturally sensitive care emerged: patients' specific cultural expectations and GPs' perceived responsibilities. These factors guided the process of culturally sensitive care towards three distinct outcomes, ranging from complete adaptation to patients' cultural requirements driven by a high sense of responsibility, through negotiation and compromise, to a paternalistic approach where GPs expect patients to conform to GPs' values and expectations. Three typologies of GPs in providing culturally sensitive care were identified: genuinely culturally sensitive, surface-level culturally sensitive, and those perceiving diversity as a threat. Stereotyping and othering persist in healthcare, underscoring the importance of critical consciousness and cultural reflexivity in providing patient-centered and equitable care. CONCLUSIONS: This study emphasizes the significance of empathy and underscores the necessity for GPs to embrace the exploration and acknowledgement of patients' preferences and cultural needs as integral aspects of their professional role. It highlights the importance of shared decision-making, critical consciousness, cultural desire and empathy. Understanding these nuances is essential for enhancing culturally sensitive care and mitigating healthcare disparities.

Perceived Teacher Discrimination and Depressive Feelings in Adolescents: The Role of National, Regional, and Heritage Identities in Flemish Schools.

Adolescents' identities are multiple, yet there is very little research that investigates the importance of intersecting identities, especially in relationship to teacher ethnic/racial discrimination and mental health. Multiplicity is often approached bi-dimensional (heritage and national identities) yet this study highlights the importance of regional identity. Regions are distinct socio-political contexts in relation to migration and integration dynamics. Hence, this study investigates for different combinations of national, heritage and regional identities (i.e. Flemish, Belgian and Turkish or Moroccan) the relationship between students' experiences with teacher ethnic/racial discrimination and students' depressive feelings. Latent Class Analysis of survey data involving a sample of 439 adolescents (Mage = 18, SD = 0.93; Girls = 49%) with Turkish (41%) or Moroccan origin in Flanders, shows three identification classes: full integration (35%), national integration (40%) and (weak) separation (24%). All these identity profiles had in common that heritage identification was high, yet they were highly distinct due to variation in national and regional identification. Additional, multilevel modelling showed that nationally integrated adolescents were less depressed than fully integrated adolescents. This finding illustrates the importance of adolescents' identity multiplicity for understanding their resilience in relation to teacher discrimination.

The ethnic prejudice of Flemish teachers: The role of ethnic school composition and of teachability.

OBJECTIVES: The aim of this study is to investigate the association between ethnic composition in school and the ethnic prejudice of teachers, controlling for the individual characteristics of teachers and their perceptions of pupils' teachability. METHOD: Multilevel analyses were carried out on data for 499 Flemish teachers in 44 Flemish (Belgian) secondary schools, collected through an online questionnaire. In this study, ethnic prejudice means a negative attitude to Moroccans, Turks, and Eastern Europeans. A scale was created by taking the mean scores for 18 items, with higher scores indicating greater ethnic prejudice (Quillian, 1995; Witte, 1999). RESULTS: Teachers with long-term higher education or a university diploma are shown to be less ethnically prejudiced than teachers with a lower level of education. Moreover, teachers who work at a school with a greater number of ethnic minority pupils, and at the same time evaluate their pupils as more teachable, are less ethnically prejudiced. CONCLUSIONS: These findings highlight the need for more research into the underlying processes, such as pupils' teachability, that influence the relationship between school characteristics and the ethnic prejudice of teachers. More knowledge about the context-specific factors and processes that mediate and/or moderate this relationship can increase the theoretical understanding of the development of ethnic prejudice. It can also highlight particular social characteristics, which can be the focus of social and organizational policy aimed at reducing ethnic prejudices. (PsycINFO Database Record

Perceived Ethnic Discrimination by Teachers and Ethnic Minority Students' Academic Futility: Can Parents Prepare Their Youth for Better or for Worse?

This study focuses on the interplay of perceived ethnic discrimination by teachers, parents' ethnic socialization practices, and ethnic minority students' sense of academic futility. Since discrimination creates barriers beyond control of the individual, the first research goal is to examine the association of perceived ethnic discrimination by teachers with ethnic minority students' sense of academic futility. The second research goal is to focus on the role of perceived parental ethnic socialization (e.g., cultural socialization and preparation for bias) to get a better understanding of the interaction between family level factors and the potentially negative consequences of ethnic teacher discrimination. A multilevel analysis on 1181 ethnic minority students (50.6 % girls; mean age = 15.5), originating from migration, in 53 secondary schools in Flanders (Belgium) shows that the frequent perception of ethnic discrimination by teachers is associated with stronger feelings of academic futility, and if these students also received high levels of parents' ethnic socialization, they perceive even stronger feelings of futility. The group of ethnic minority students, who perceive frequent ethnic teacher discrimination, is a group at risk, and parents' ethnic socialization does not seem able to change this.