African Nova Scotian nurses' perceptions and experiences of leadership: a qualitative study informed by Black feminist theory.

BACKGROUND: People of African Nova Scotian (ANS) ancestry are a culturally distinct group who experience numerous socioeconomic inequities and health disparities, secondary to structural and social determinants of health. Understanding the experiences of ANS health practitioners is important in addressing anti-Black racism in health care. We sought to critically examine the leadership experiences of ANS nurses in health care practice. METHODS: We used Black feminist theory to guide this qualitative study. We conducted 1-on-1 semistructured telephone interviews with ANS nurses and analyzed interview transcripts using Critical Discourse Analysis. RESULTS: We interviewed 18 nurses of ANS ancestry. We conceptualized study findings in 3 overarching areas: People of ANS ancestry as a distinct people, institution of care, and leadership philosophy and practice. Each area, and its corresponding themes and subthemes, illustrated an emergent understanding of factors that influence leadership among ANS nurses, such as socialization, early exposure to care and diversity in health care. Participants perceived and practised leadership in a manner that transcended formal titles or designations. INTERPRETATION: African Nova Scotian ancestry is implicated in the perception and practice of leadership among ANS nurses, who considered leadership to be a fundamental component of nursing practice that was grounded in community-oriented care. This study provides new insights that could inform recruitment, retention and representation of ANS people in nursing and other health professions.

Black nurses in the nursing profession in Canada: a scoping review.

BACKGROUND: With migration occurring over a series of centuries, dating back to the 1600's, the circumstance regarding Black people in Canada is a complex account. A plethora of social issues and the failure to adequately acknowledge and reconcile historical issues, has resulted in health inequity, disparities and knowledge gaps, related to the Black population in Canada. In nursing, historical records indicate a legacy of discrimination that continues to impact Black nurses. The profession has begun reckoning with anti-Black racism and the residual effects. This scoping review sought to chart the existing evidence on Black nurses in the nursing profession in Canada. METHODS: JBI methodology was used to search peer-reviewed evidence and unpublished gray literature. Sources were considered for inclusion based on criteria outlined in an a priori protocol focusing on: 1) Canada 2) Black nurses and 3) nursing practice. No restrictions were placed on date of publication and language was limited to English and French. All screening and extractions were completed by two independent reviewers. RESULTS: The database search yielded 688 records. After removing duplicates, 600 titles and abstracts were screened for eligibility and 127 advanced to full-text screening. Eighty-two full-text articles were excluded, for a total of 44 sources meeting the inclusion criteria. Seven sources were identified through gray literature search. Subsequently, 31 sources underwent data extraction. Of the 31 sources, 18 are research (n = 18), six are commentaries (n = 6); one report (n = 1) and six are classified as announcements, memoranda or policy statements (n = 6). The review findings are categorized into five conceptual categories: racism (n = 12); historical situatedness (n = 2); leadership and career progression (n = 7); immigration (n = 4); and diversity in the workforce (n = 4). CONCLUSIONS: This review reveals the interconnectedness of the five conceptual categories. Racism was a prominent issue woven throughout the majority of the sources. Additionally, this review captures how racism is exacerbated by intersectional factors such as gender, class and nationality. The findings herein offer insight regarding anti-Black racism and discrimination in nursing as well as suggestions for future research including the use of diverse methodologies in different jurisdictions across the country. Lastly, the implications extend to the nursing workforce in relation to enhancing diversity and addressing the ongoing nursing shortage.

Lifestyle interventions for type 2 diabetes prevention in children and adolescents of African descent in OECD countries: a systematic review protocol.

OBJECTIVES: The objectives of this review are to investigate the effectiveness of lifestyle interventions for type 2 diabetes prevention in children and adolescents of African descent in the Organisation for Economic Co-operation and Development (OECD) member countries and to attempt to ascertain what aspects of these interventions are most effective in this population. INTRODUCTION: Lifestyle interventions have been shown to prevent or delay the onset of type 2 diabetes;however, the extent to which these interventions are effective for children and adolescents of African descent is not well established. The increasing type 2 diabetes incidence and prevalence in children and adolescents of African descent in some OECD member countries underscores the need to pool available evidence to ascertain the effectiveness of lifestyle interventions for type 2 diabetes prevention in this population. INCLUSION CRITERIA: Lifestyle interventions to be considered include individual-or group-based lifestyle or behavioral modification interventions aimed at preventing or delaying the onset of type 2 diabetes in children and adolescents of African descent aged 19 years and under in OECD countries. Randomized controlled trials and non-randomized studies that assess the effectiveness of lifestyle interventions for type 2 diabetes prevention will be considered. METHODS: The databases to be searched include MEDLINE, Embase, CINAHL, PsycINFO, Social Services Abstracts, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations and Theses Global databases. There will be no language or date limits placed on the search. Two independent reviewers will conduct the title, abstract, and full-text screening, followed by critical appraisal and data extraction. Data will undergo meta-analysis where appropriate, and will otherwise be presented as narrative synthesis. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021247267.

Tackling discrimination and systemic racism in academic and workplace settings.

Racism against Black people, Indigenous and other racialized people continues to exist in healthcare and academic settings. Racism produces profound harm to racialized people. Strategies to address systemic racism must be implemented to bring about sustainable changes in healthcare and academic settings. This quality improvement initiative provides strategies to address systemic racism and discrimination against Black nurses and nursing students in Ontario, Canada. It is part of a broader initiative showcasing Black nurses in action to end racism and discrimination. We have found that people who have experienced racism need healing, support and protection including trauma-related services to facilitate their healing. Implementing multi-level, multi-pronged interventions in workplaces will create healthy work environments for all members of society, especially Black nurses who are both clients/patients and providers of healthcare.

Black nurses in action: A social movement to end racism and discrimination.

We bear witness to a sweeping social movement for change-fostered and driven by a powerful group of Black nurses and nursing students determined to call out and dismantle anti-Black racism and discrimination within the profession of nursing. The Black Nurses Task Force, launched by the Registered Nurses' Association of Ontario (RNAO) in July 2020, is building momentum for long-standing change in the profession by critically examining the racist and discriminatory history of nursing, listening to and learning from the lived experiences of the Black nursing community, and shaping concrete, actionable steps to confront anti-Black racism and discrimination in academic settings, workplaces, and nursing organizations. The Black Nurses Task Force and the RNAO are standing up and speaking out in acknowledgment of the magnitude of anti-Black racism and discrimination that exist in our profession, health system, justice system, and economic system. This social movement is demonstrating, in actions, how individuals and a collective act as change agents to drive meaningful and widespread change for our present and future Black nurses. We also acknowledge the Black nurses who have gone before us.

Out-of-pocket expenses related to aging in place for frail older people: a scoping review.

OBJECTIVE: The objective of this scoping review was to map and describe the available evidence reporting out-of-pocket expenses related to aging in place for older people with frailty and their caregivers. INTRODUCTION: As the global population ages, there has been increasing attention on supporting older people to live at home in the community as they experience health and functional changes. Older people with frailty often require a variety of supports and services to live in the community, yet the out-of-pockets costs associated with these resources are often not accounted for in health and social care literature. INCLUSION CRITERIA: Sources that reported on the financial expenses incurred by older people (60 years or older) with frailty living in the community, or on the expenses incurred by their family and friend caregivers, were eligible for inclusion in the review. METHODS: We searched for published and unpublished (ie, policy papers, theses, and dissertations) studies written in English or French between 2001 and 2019. The following databases were searched: CINAHL, MEDLINE, Scopus, Embase, PsycINFO, Sociological Abstracts, and Public Affairs Index. We also searched for gray literature in a selection of websites and digital repositories. JBI scoping review methodology was used, and we consulted with a patient and family advisory group to support the relevance of the review. RESULTS: A total of 42 sources were included in the review, including two policy papers and 40 research papers. The majority of the papers were from the United States (n = 18), with others from Canada (n = 6), the United Kingdom (n = 3), Japan (n = 2), and one each from Australia, Brazil, China, Denmark, Israel, Italy, The Netherlands, Poland, Portugal, Singapore, South Korea, Taiwan, and Turkey. The included research studies used various research designs, including cross-sectional (n = 18), qualitative (n = 15), randomized controlled trials (n = 2), longitudinal (n = 2), cost effectiveness (n = 1), quasi-experimental (n = 1), and mixed methods (n = 1). The included sources used the term "frailty" inconsistently and used various methods to demonstrate frailty. Categories of out-of-pocket expenses found in the literature included home care, medication, cleaning and laundry, food, transportation, medical equipment, respite, assistive devices, home modifications, and insurance. Five sources reported on out-of-pocket expenses associated with people who were frail and had dementia, and seven reported on the out-of-pocket expenses for caregivers of people with frailty. While seven articles reported on specific programs, there was very little consistency in how out-of-pocket expenses were used as outcome measures. Several studies used measures of combined out-of-pocket expenses, but there was no standard approach to reporting aggregate out-of-pocket expenses. CONCLUSIONS: Contextual factors are important to the experiences of out-of-pocket spending for older people with frailty. There is a need to develop a standardized approach to measuring out-of-pocket expenses in order to support further synthesis of the literature. We suggest a measure of out-of-pocket spending as a percentage of family income. The review supports education for health care providers to assess the out-of-pocket spending of community-dwelling older people with frailty and their caregivers. Health care providers should also be aware of the local policies and resources that are available to help older people with frailty address their out-of-pocket spending.

Peer doula support training for Black and Indigenous groups in Nova Scotia, Canada: A community-based qualitative study.

OBJECTIVES: The objectives of this qualitative study were to explore participant experiences of doula training programs offered by a prisoner health advocacy organization and Indigenous and Black community groups. DESIGN: This investigation employed a qualitative design. Recruitment was conducted through email. Interviews were conducted in Winter 2020. Data were analyzed using thematic analysis. SAMPLE: A total of 12 participants were recruited to participate in this study. Six participants identify as Black and six identify as Indigenous. All participants identify as women. MEASUREMENTS: Qualitative interviews were conducted using a semi-structured interview guide to elicit a breadth of information. RESULTS: Key themes included training experiences, training improvements and ''bridging the gap''. The training validated participants' experiences of birth and began to address the exclusion of Black and Indigenous people from birth work. However, participants expressed concerns about not being adequately positioned for sustained participation in birth work. CONCLUSIONS: Participants expressed receiving great value from the training programs. These trainings, which were fully subsidized, removed a financial barrier. However, these trainings do not address the exclusion of Black and Indigenous people from perinatal work or the lack or sustainable support systems for Black and Indigenous communities. This study makes several recommendations for future interventions.

The Strong Black Woman: Insights and Implications for Nursing.

OBJECTIVE: This discussion paper describes the intricacies of the strong Black woman (SBW) construct and how understanding this construct is significant and relevant within nursing. METHOD: This article is a discussion piece that provides a succinct conceptual and historical overview of the SBW construct. It then describes the impacts of this construct before presenting implications as they relate to nursing practice, education, policy, and research. RESULTS: The SBW construct is exclusively and routinely applied to Black women. Typically, the SBW construct encompasses five components, which center on independence, caring, and strength. These five components include the obligation to (1) always maintain and present an image of strength, (2) suppress emotion, (3) be self-reliant, (4) succeed despite all odds, and (5) always place the needs [especially comfort] of others above those of oneself. Moreover, the SBW construct posits Black women as possessing superhuman capabilities. The nature of this construct is complex, with some Black women using it as a survival mechanism, and others finding empowerment through this image. Nevertheless, recent research has revealed the harms associated with this image including detriment to physical, mental, and spiritual well-being, with the implications extending to Black families and communities. CONCLUSION: Understanding this topic is essential in providing support to all Black women in health care and within the Black community-including patients, nurses, faculty, staff, and students. Recognizing the implications of the SBW construct is essential toward ensuring that our care, practices, and policies are not only supportive but also antiracist.

Feminist Abolitionist Nursing.

The converging crises of COVID-19 and racist state violence in 2020 shifted public discourse about marginalization, public health, and racism in unprecedented ways. Nursing responded to the pandemic with heroic commitment and new politicization. But public engagement with systemic racism is forcing a reckoning in nursing. The profession has its own history of racism and of alliance with systems of state control with which to contend. In this article, we argue nursing must adopt an ethics of abolitionism to realize its goals for health and justice. Abolitionism theorizes that policing and prison systems, originating from systems of enslavement and colonial rule, continue to function as originally intended, causing racial oppression and violence. The harms of these systems will not be resolved through their reform but through creation of entirely new approaches to community support. Nursing as a collective can contribute to abolitionist projects through advocacy, practice, and research.

Food security in African Canadian communities: a scoping review.

OBJECTIVE: The objective of this review is to chart the evidence relating to food security among African Canadian communities to inform future research and offer insight related to food security in African Canadian communities. INTRODUCTION: Achieving food security is of global importance to meet the United Nations Sustainable Development Goals. As a social determinant of health, food security, which refers to the unrestricted physical, economic, and timely access to safe and nutritious foods, impacts more than 4 million Canadians. Yet, little is known about food security and the differential impacts of food insecurity among African Canadians. This scoping review sought to describe the current state of food security among African Canadians. INCLUSION CRITERIA: Sources were considered for inclusion if they: i) focused on Canada, ii) involved African Canadians, and iii) examined food security. METHODS: This scoping review was conducted in accordance with JBI methodology. Databases and relevant websites containing peer-reviewed, unpublished, and gray literature were searched. Ancestry searching and forward citation tracing were completed. No restrictions were placed on date of publication. Language restrictions were limited to English and French. In instances where articles were unavailable, authors of potential sources were contacted at the full-text review phase to request access to their article. Data were extracted independently by two team members, and are presented narratively and in tabular format. RESULTS: The search of databases yielded a total of 1183 records. Ancestry tracing yielded 287 records. After removing duplicates, 1075 titles and abstracts were screened for eligibility and 80 advanced to full-text screening. Seventy-five full-text articles were excluded for not meeting the inclusion criteria, leaving five articles that underwent data extraction. All five included studies involved African Canadian participants in Canada. All studies focused on adults; one study included women and men participants, while four focused exclusively on women. One study involving women participants included cisgender and transgender women as well as those identifying as queer. Study designs reflected qualitative (n = 2), quantitative (n = 1), and mixed methods (n = 2) designs. CONCLUSIONS: This review begins to fill a gap in understanding the current evidence available on food security as it impacts African Canadians. The findings of this review represent existing research, describing the type of evidence available and methodologies used, before suggesting implications for research and practice. The inclusion of only five studies reveals the limited evidence regarding the current state of food security among African Canadians. Further, included studies were exclusively conducted in urban settings and predominantly in one province. There is a need for further research in rural communities, in other provinces and territories, as well as with younger and older participants. The urgent need to collect race-disaggregated data in Canada is evident.

Mothers' Experiences with Child Protection Services: Using Qualitative Feminist Poststructuralism.

BACKGROUND: The postpartum period is often portrayed as a blissful, calm and loving time when mothers, partners and family members bond with their newborn babies. However, this time may be experienced quite differently when mothers are monitored by Child Protection Services. Having a baby under these circumstances can be very difficult and traumatizing. While all new parents require support and information to help them through the transition to parenthood and address physical and psycho-social changes, mothers who are involved with Child Protection Services require more specialized support as they encounter higher incidences of postpartum stressors and higher rates of poverty, mental illness and substance abuse. The impact of support for mothers involved with Child Protection Services is not well-understood from the perspective of mothers. AIM: The aim of the study was to understand how new mothers in Nova Scotia prioritized their postpartum needs and where they went to obtain information and support. METHODS: Feminist poststructuralism was the methodology used to understand how the experiences of five mothers who accessed a family resource center and had been involved with Child Protection Services in Nova Scotia Canada had been personally, socially and institutionally constructed. RESULTS: Themes include: (1) We are Mothers, (2) Being Red Flagged, (3) Lack of Trust, (4) Us Against Them and (5) Searching for Supportive Relationships. CONCLUSION: Personal stories from all participants demonstrated how they experienced stigma and stereotypes from healthcare workers and were often not recognized as mothers. They also struggled to find information, supports and services to help them keep or regain their babies.

Assistive technologies that support social interaction in long-term care homes: a scoping review.

OBJECTIVE: The objective of this review was to chart the literature on assistive technologies (excluding robots) that support social interaction of older adults in long-term care homes, and to advance a definition of socially assistive technologies. INTRODUCTION: Loneliness and social isolation have adverse effects on the health and well-being of older adults. Many long-term care homes provide recreational programming intended to entertain or distract residents, yet the evidence of their effectiveness is limited. Absent from the literature are comprehensive reviews of assistive technologies (other than robots) that are used to support social interaction in long-term care homes. INCLUSION CRITERIA: The review considered research studies as well as gray literature that included older adults (≥65 years) living in long-term care homes. The concept of interest was the use of assistive technologies (excluding robots) that support social interaction in long-term care homes. METHODS: The databases were searched on June 26, 2019, and included CINAHL Full Text (EBSCO), MEDLINE (Ovid), PsycINFO (EBSCO), Sociological Abstracts (ProQuest), Embase (Elsevier), and Web of Science (Clarivate). The search for gray literature was conducted in ProQuest Dissertations and Theses Databases and across 11 websites during September and October 2019. The recommended JBI approach to study selection, data extraction, and data synthesis was used. RESULTS: Twenty-five articles were included in this review, with comparable numbers of quantitative (n = 6), qualitative (n = 9), and mixed methods (n = 7) studies, with the remaining articles employing non-empirical designs (n = 3). Technologies were categorized as low (easily recognizable to everyone), medium (more electronics), or high (involves internet). Two studies reported on low-assistive technologies, including videotapes and the telephone. Medium-assistive technologies were identified in nine studies and included videophones; Nintendo Wii; tablet-based games; picture- and video-viewing tools; and CRDL (pronounced "cradle"), a special instrument that translates touch into sound. More than half (n = 14) of the included articles utilized high-assistive technologies, such as computer labs/kiosks, tablet-based applications, social media (eg, Facebook), videoconferencing, and multi-functional systems. Five studies measured whether assistive technologies had an impact on the quantity of long-term care residents' social interaction levels. Qualitative themes were related to residents' social connections and experiences after using various technologies. Four studies systematically incorporated a framework/model, and Social Structuration Theory was considered the most comprehensive. In the absence of a definition of socially assistive technologies, the definition advanced from this review is as follows: Socially assistive technologies are user-appropriate devices and tools that enable real-time connectivity to enhance social interaction. CONCLUSIONS: Included literature reported the benefits of technology use, with considerable variability in engagement and no cost estimates. We recommend that future research continue to advance our definition of socially assistive technologies, make promising assistive technologies available in long-term care homes after studies are completed, report the costs of assistive technologies, and include participants with dementia and culturally and linguistically diverse backgrounds.

Breastfeeding experiences among mothers living with food insecurity in high resource, Western countries: a qualitative systematic review protocol.

OBJECTIVE: The objectives of this review are to identify, appraise, and synthesize the qualitative evidence on the breastfeeding experiences of mothers living with food insecurity in high-resource, Western countries. INTRODUCTION: Breastfeeding and food insecurity are inter-related health issues. Globally, breastfeeding augments food security at individual, household, and community levels, but a growing body of evidence from high-resourced countries also suggests that a mother's breastfeeding practice may be negatively impacted by the additional experience of food insecurity. This protocol outlines a systematic approach to understanding the experiences of breastfeeding from the perspective of mothers living with food insecurity. Findings will provide much-needed evidence toward guiding policies and practices that support mothers to breastfeed. INCLUSION CRITERIA: The review will consider studies that explore the breastfeeding experiences of mothers aged 18 years and older who self-identify, or are classified using a screening tool, as food insecure. Papers that will be included in this review will consider all qualitative methodologies and will be limited to studies from countries identified as being within the United Nations classification of Western European and Other States Group (WEOG). METHODS: The authors will conduct a three-step search process across both published and gray literature to identify relevant studies for inclusion. A preliminary search using the PubMed database was undertaken in January 2020. Studies published in English from 1981 to 2020 will be included. The recommended JBI methodology for qualitative systematic review for study selection, critical appraisal, data extraction, and data synthesis will be followed. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020183652.

African Canadian nurses in the nursing profession in Canada: a scoping review protocol.

OBJECTIVE: The objective of this review is to synthesize the evidence on African Canadian nurses in the nursing profession in Canada. INTRODUCTION: With approximately 1.2 million people of African descent, Canada has committed to addressing the United Nations' decade for people of African descent. Intergenerational racism continues to result in multisectoral discrimination against African Canadians. Studies suggest that African Canadians are under-represented in nursing, and encountering systemic barriers to entering and advancing in the profession. Additionally, African Canadian nurses experience racism from patients and colleagues, as well as systemic racism through hiring and promotion. INCLUSION CRITERIA: This review will consider sources that include African Canadian nurses who identify as Black or as of African descent. All levels of professional nursing practice will be included (practical nurses, registered nurses, and advanced practice nurses, including nurse practitioners and clinical nurse specialists). Qualitative, quantitative, and mixed methods studies and gray literature will be searched. METHODS: This review will be conducted in accordance with the JBI methodology. Databases to be searched from inception to the present include CINAHL, MEDLINE, Embase, Sociological Abstracts, Gender Studies Database, America: History and Life, PsycINFO, Academic Search Premier, and Scopus. Studies published in English and French will be included. A comprehensive search strategy developed with a librarian will be used to retrieve relevant sources. Two independent screeners will screen titles and abstracts as well as full texts of relevant sources. Data will be extracted by two independent extractors then presented narratively, using appropriate tables and figures. SYSTEMATIC REVIEW REGISTRATION NUMBER: Open Science Framework Preregistration October 3, 2019. Open Science Framework Link for Abstract https://osf.io/6a2fe/?view_only=57d86d5b7c1d464182692d0f4bb9b396.

Commentary: Advancing Nursing in Canada: Toward the Elimination of Anti-Black Racism.

This commentary challenges historic and contemporary issues within nursing and provides direction toward a more inclusive future for nursing. This is a call-to-action for nurses, nursing students and nurse allies to advance effort toward the elimination of anti-Black racism in nursing in Canada. To achieve this, it is imperative to move beyond the performative and adopt practices that enable critical reflection and action. Addressing the manner in which exclusion is reinforced and perpetuated requires interrogation of four distinct yet interconnected processes of racial exclusion and discrimination. Notwithstanding, the future of nursing requires a critical examination of the role of nursing in and relationship with oppressive institutions, including prisons. Abolition, regarded as a radical stance, argues that beyond disproportional incarceration rates, prisons exist within a system of punishment that inflicts long-lasting irreparable mental and physical trauma upon individuals, families and communities. The effects of incarceration on mental, physical and spiritual health is a healthcare crisis that is in direct opposition to the core tenets of nursing and health.

Food security in African Canadian communities: a scoping review protocol.

OBJECTIVE: The objective of this study is to synthesize and describe the evidence relating to food security among African Canadian communities to inform future research and health policy concerning people of African descent. INTRODUCTION: Food security denotes the timely access to nutritionally and culturally appropriate foods by individuals, families, groups, and communities. In Canada, there are vulnerable groups who experience higher rates of food insecurity, including immigrant and senior populations as well as Indigenous communities. While there is evidence describing food security among these vulnerable groups, food security among African Canadian communities remains poorly understood. The African Canadian community is an integral component of the Canadian population, yet there is a limited understanding of food security among this group. INCLUSION CRITERIA: This review will focus on the African Canadian population and food security, which encompasses food access, nutrition, and culturally appropriate foods. Evidence obtained from qualitative, quantitative, mixed methods studies, as well as dissertations and gray literature will be considered for inclusion. METHODS: This scoping review will be conducted in accordance the JBI scoping review methodology. A comprehensive search strategy developed by a librarian scientist will be used to locate and retrieve relevant sources. A screening tool will be used to screen titles and abstracts as well as the full text of included sources. Data will then be extracted by two independent reviewers, synthesized, and presented narratively, including tables and figures where appropriate.

Mother-Child Programs for Incarcerated Mothers and Children and Associated Health Outcomes: A Scoping Review.

BACKGROUND: Increasing incarceration of women disrupts fertility, family formation, parenting and mother-child relationships. It is common in many jurisdictions, including Canada, to mitigate the harm of separation from the primary parent through programs allowing children to co-reside with their mothers in prison. In this scoping review, we asked the following questions: (1) What are the characteristics of residential mother-child programs in carceral facilities? (2) Who is eligible to participate? (3) How do these programs make a difference to maternal and child health outcomes? METHOD: We use the Joanna Briggs Institute methodology for systematic scoping reviews. This approach includes a three-step search strategy developed with a clinical research librarian. Databases searched include MEDLINE, CINAHL, PsycINFO, Gender Studies Abstracts, Google Scholar and ProQuest Dissertations. The search yielded 1,499 titles and abstracts, of which 27 met the criteria for inclusion. RESULTS: Conducted from 1989 to 2019, across 12 countries, the studies included qualitative and quantitative methods. None was based in Canada. The most common outcomes among the studies included attachment, development, infection, neonatal outcomes, mental health, pregnancy and general experiences. DISCUSSION: Although supporting attachment, mother-child program participation is complex and challenging. High morbidity in the incarcerated population and lack of data collection before and after program participation prevent conclusions, and wide variations in contexts prevent comparisons. BENEFITS: This scoping review illustrates the complexity of maternal and child health outcomes associated with mother-child programs. Initiation or continuation of or changes to such programs must be made with careful consideration.

Diverse Representation in Nursing Leadership: Developing a Shared Position Statement on Allyship.

Diversity initiatives are being implemented widely within academia and society more broadly; however, the School of Nursing (SoN) at Dalhousie University in Halifax, Nova Scotia, Canada, is taking an innovative approach. Faculty members recognized the need to support students at the graduate and undergraduate levels from Black, Indigenous, LGBTQ2S (Lesbian, Gay, Bisexual, Transgender, Queer, and Two-Spirit), and International communities in a student-led initiative with the mission to promote diversity, inclusion, and equity within the SoN. This coalition seeks to offer students who are often rendered invisible within the academy and society more broadly in relation to dominant cultures and normative expectations an opportunity to build relationships and expose shared histories of oppression in such a way that issues of social justice are uncovered. In response to nursing students and faculty who self-identify as members of dominant groups and who sought inclusion as allies, the leaders of the student community groups recognized a need to develop a position statement on allyship. The collaboration that transpired between the four groups of communities to develop the position statement led to the formation of the Student Equity Coalition. This article begins with the authors' definition of allyship, followed by a description of the context in which this unique initiative is taking place, the rationale behind developing a shared position statement on allyship, and the significance of this work in positioning and supporting nursing students of minority status as emerging nurse leaders.

Providing postpartum care with limited resources: Experiences of nurse-midwives and obstetricians in urban Tanzania.

BACKGROUND: Tanzania has high maternal and neonatal mortality rates. Comprehensive guidelines for postpartum care have been developed by the government as a means to improve health outcomes during the perinatal period. Despite the creation of these guidelines and the government's commitment to universal perinatal care for women and neonates, there is concern that the delivery of postpartum services may not be meeting the needs of mothers and neonates. AIM: The purpose of this feminist poststructuralist study was to explore nurse-midwives' and obstetricians' experiences of providing postpartum care in Tanzania. METHODS: This qualitative study used feminist poststructuralism to explore the personal, social, and institutional discourses of postpartum care. We individually interviewed ten nurse-midwives and three obstetricians in Dar es Salaam, Tanzania. Feminist poststructuralist discourse analysis was used to analyze the transcribed interviews after their translation from Kiswahili to English. FINDINGS: Four main themes were identified. In this paper, we present the main theme of availability of resources, and its four corresponding subthemes; (1) space, (2) equipment, (3) staffing, and (4) government responsibility. DISCUSSION: The findings from our study illustrate the need for health workforce planning to be addressed in a comprehensive manner that accounts for context, required resources and systemic challenges. These findings are consistent with findings from other studies. CONCLUSION: Understanding the resource challenges that nurse-midwives and obstetricians are facing in one low-and-middle-income-country will assist researchers, decision makers, and politicians as they address issues of mortality, morbidity, and disrespectful maternity care.