Disparities in positive mental health of sexual and gender minority adults in Canada. / Disparités dans la santé mentale positive des adultes faisant partie d'une minorité sexuelle ou de genre au Canada.

INTRODUCTION: The goal of this study was to examine potential disparities in positive mental health (PMH) among adults in Canada by sexual orientation and gender modality. METHODS: Using 2019 Canadian Community Health Survey (CCHS) Annual Component data (N = 57 034), we compared mean life satisfaction and the prevalence of high self-rated mental health (SRMH), happiness and community belonging between heterosexual and sexual minority adults, and between cisgender and gender minority adults. We used 2019 CCHS Rapid Response on PMH data (N = 11 486) to compare the prevalence of high psychological well-being between heterosexual and sexual minority adults. Linear and logistic regression analyses examined the between-group differences in mean life satisfaction and the other PMH outcomes, respectively. RESULTS: Sexual minority (vs. heterosexual) adults reported lower mean life satisfaction (B = -0.7, 95% CI: -0.8, -0.5) and were less likely to report high SRMH (OR = 0.4, 95% CI: 0.3, 0.5), happiness (OR = 0.4, 95% CI: 0.3, 0.5), community belonging (OR = 0.6, 95% CI: 0.5, 0.7) and psychological well-being (OR = 0.4, 95% CI: 0.3, 0.6). Differences were not always significant for specific sexual minority groups in sexstratified analyses. Gender minority adults reported lower mean life satisfaction and were less likely to report high SRMH and happiness than cisgender adults. CONCLUSION: Future research could investigate how these PMH disparities arise, risk and protective factors in these populations, how other sociodemographic factors interact with sexual orientation and gender identity to influence PMH and changes in disparities over time.

Risk-Taking, Social Support, and Belongingness Contribute to the Risk for Cannabis Use Frequency in University Students.

Background: Cannabis use and misuse is known to be associated with a variety of negative health, academic, and work-related outcomes; therefore, it is important to study the factors that contribute to or moderate its use. Objectives: The aim of this study was to determine whether risky behavior, belongingness and social support as clustering variables play a role in cannabis use frequency. Method: In a university student sample, participant data on risky behavior, belongingness and social support were used to generate vulnerability profiles through cluster analysis (low vulnerability with low risk, low vulnerability with high belonging, moderate vulnerability, and high vulnerability). Using an analysis of variance, the vulnerability profiles were compared with respect to cannabis use frequency and quantity. Through chi-square tests we assessed whether these profiles are overrepresented in certain demographics. Results: The cluster analysis yielded four groups, which differed in their vulnerability for cannabis use. The most vulnerable cluster group had higher cannabis use frequency relative to the two least vulnerable groups. Low income vs. high income was also associated with high vulnerability group membership. International students were overrepresented in the low vulnerability with high belonging group relative to the low vulnerability with low-risk group. The opposite was observed for domestic students. Conclusions: This research adds to the expanding body of literature on cannabis use and misuse in Canada, which may contribute to public health policy and the prevention and treatment of cannabis addiction by providing new insight on who may be at risk.

Struggle and banality of belonging to Europe. Cultural Europeanization from the perspective of the Central and East European citizens.

The European Union (EU) has developed cultural policy initiatives that seek to promote cultural Europeanization with the purpose of constructing European identity narratives and facilitating citizens' sense of belonging to Europe and the EU. The article focuses on the citizens' perspective to cultural Europeanization through ethnographic research on one central action in the EU cultural policy, European Heritage Label (EHL). We analyse the interviews conducted in selected EHL sites with Central and East European (CEE) citizens who were visiting the sites as well as with cultural heritage practitioners working at three EHL sites located in CEE countries. We ask how the practitioners and the visitors engage with European identity narratives and elaborate their European belonging. We especially scrutinize how everyday encounters and experiences, such as mobility, shape identifications with 'Europe' and perceptions of what is 'European'. The interviews are interpreted in the theoretical framework of 'being' and 'becoming' European. This framework indicates a centuries-long liminal position of the Central and Eastern Europe. It enables us to scrutinize CEE citizens' sense of belonging to Europe in an intersection of dual Europeanization, i.e. cultural Europeanization and 'Europeanization' of the CEE countries to overcome this liminal position and become 'true' Europeans.

Discrimination faced by radiology residents: an analysis of experiences and mitigation strategies.

RATIONALE AND OBJECTIVES: Literature shows that discrimination has been pervasive in the field of medicine. The aim of this study was to collect experiences related to discrimination among US radiology residents, including type and source, as well as the residents' perception on lectures about discrimination and harassment. We also explored the barriers to reporting, and suggested strategies to overcome them. MATERIAL AND METHODS: Following Institutional Review Board (IRB) approval, an online survey was sent to program directors and coordinators across the US, who were asked to forward the link to their radiology residents. A reminder email was sent over a period of 4 months. The participants were reassured the survey was confidential and anonymous. RESULTS: Among the respondents, the most reported types of discrimination were based in gender, race and nationality, the majority of which not being reported. The most common perpetrators were attending radiologists, co-residents, technologists, and patients. The main barriers for reporting were fear of retaliation, confidentiality concerns, and skepticism about a positive outcome. CONCLUSION: Our study examines some experiences of discrimination shared by residents during their training, with gender and race being the most common causes. This sheds light into a hidden and unspoken issue and highlights the need for more active discussions in radiology on microaggressions and implicit bias. Our data can guide future studies as well as residency programs to build effective strategies to address discrimination, aiming for sustainable changes.

Venturing outside: Local journeying, belonging and new parenthood.

The transition to parenthood is a transformative journey marked by numerous adjustments, presenting both physical and mental health challenges. Recognising the crucial role of a sense of belonging for parental health in this transition, this study delves into the experiences of new parents, exploring the act of "journeying" within their local geographies. Through analysis of an online survey among new parents in suburban Wellington, Aotearoa New Zealand, this study highlights the multifaceted role of journeying, not only as physical movement but as a slow-creeping transformative process that affects connections with local environments, people, and places, highlighting the importance of local geographies in new parents' journey towards belonging.

Religious engagement and antibody response to the COVID-19 vaccine.

This research examined religious engagement and subsequent antibody responses to the COVID-19 vaccine. Using publicly available data from the Understanding Society survey, we employed a longitudinal design. Between January 2016 and May 2018, respondents completed measures of religious belonging, frequency of attending religious services (i.e., extrinsic religiosity), and the difference religion made to their lives (i.e., intrinsic religiosity). A COVID-19 survey wave was collected in March 2021 and measured antibody responses to the COVID-19 vaccine via blood draw. A final sample of 746 adults [462 (61.9%) females, Mage = 61.94, SD = 19.07] was achieved. Mediation analyses (PROCESS, Model 4; Hayes, Introduction to mediation, moderation, and conditional process analysis: A regression-based approach, The Guildford Press, 2022; Introduction to mediation, moderation, and conditional process analysis: A regression-based approach; The Guildford Press) revealed one pathway through which religion and antibody responses to the COVID-19 vaccine are associated, namely via extrinsic factors-attendance at religious services. In contrast, intrinsic religious factors which is the difference religion can make to one's life, was not a significant mediator. Overall, this analysis provides evidence that behavioural enactment of religion matters to the effectiveness of vaccination and the management of public health crises. It also highlights the value of social resources associated with engagement in valued social groups-and in particular religious social groups-for public health.

Students, community and belonging: an investigation of student experience across six European countries.

Despite existing empirical work that explores the multiple ways in which students develop a sense of belonging in higher education, there is a dearth of comparative research about the extent to which the concepts of community and belonging are central to what it means to be a student and how students in different national contexts (beyond Anglophone countries) construct community and belonging. Drawing on qualitative data from students from six European countries, we provide an account of conceptualisations of community and belonging. Specifically, this paper extends discussions around community and belonging in higher education through comparative inquiry. Notwithstanding the individualised and consumerist framing of students accompanied by market reforms in higher education across Europe, it shows that the notion of community and/or belonging features prominently in students' narratives. We also demonstrate how a sense of community and belonging is experienced on different levels. Crucially, the emphasis placed on community in students' sense of belonging varies by the country, pointing towards the continued influence of distinctive national traditions, structures and norms of higher education. Our analysis contributes to wider debates about the development of a European Higher Education Area and its impact on European homogenisation.

Celebrating organizational history triggers social identity threat among Black Americans.

Many mainstream organizations celebrate their historical successes. In their history, however, they often marginalized racial minorities, women, and other underrepresented groups. We suggest that when organizations celebrate their histories, even without mentioning historical marginalization, they can undermine belonging and intentions to join the organization among historically marginalized groups. Four experiments demonstrate that Black participants who were exposed to an organization that celebrated their history versus the present showed reduced belonging and intentions to participate in the organization. These effects were mediated by expectations of biased treatment in the organization. Further, when organizations had a history of Black people in power, celebrating history was no longer threatening, highlighting that the negative effects of celebrating history are most likely when organizations are or are assumed to be majority-White and have treated Black Americans poorly. Taken together, these findings suggest that emphasizing organizational history can be a source of social identity threat among Black Americans.

The Relationship between Burnout and Sense of School Belonging among the Resident Physicians in the Standardization Training in China.

BACKGROUND: As an important part in medical training in graduate school, 33-month medical residency training could be a stressful period inducing burnout (i.e. emotional exhaustion, depersonalization, and low personal accomplishment). Despite that existing literature has found that sense of belonging may have merits for residents' well-being, it has remained unclear how sense of school belonging affects burnout and the potential moderators. To address this question, a cross-sectional survey has been conducted among the residents of the physicians standardized residency training program in China. METHODS: Seven hundred (N = 700) resident physicians from different majors (i.e. clinical medicine, clinical Stomatology, and Chinese medicine) and grades have participated in the survey. Resident's sense of school belonging was assessed with the psychological sense of school membership scale (PSSM, mean = 45.12, SD = 11.14). Burnout was measured by the 22-item Maslach Burnout Inventory (MBI-HSS, mean = 65.80, SD = 15.89), including three subscales of emotional exhaustion, depersonalization, and personal accomplishment. RESULTS: The results showed that over 80% of the residents reported moderate or high level of emotional exhaustion and reduced personal accomplishment during residency training. Meanwhile, higher level of sense of school belonging was associated with lower overall burnout (B = -0.722, p < 0.001), less emotional exhaustion, reduced depersonalization, and higher personal accomplishment. In particular, the benefits of sense of belonging seem more pronounced among female and those at earlier stage of residency. No interaction effect was found between sense of belonging and major, while those from Chinese medicine reported lower scores in overall burnout and the three dimensions. CONCLUSIONS: Burnout was a prevalent issue among the resident physicians, and our findings confirmed the protective effects of sense of school belonging against burnout. Therefore, support service should be developed to cultivate resident's sense of school belonging and social connections, particularly for female and those at earlier stage of residency.

International graduate entry nursing students: A qualitative study on engagement.

AIM: This study aims to elicit graduate entry nursing students' views on factors that enable and constrain their learning engagement. BACKGROUND: Learning engagement has been associated with student retention/attrition and the achievement of learning confidence and success. While all students are subject to challenges that affect their learning engagement, those experienced by international students who are learning in a foreign and unfamiliar context are of particular concern to academics. An understanding of international graduate entry nursing students' perspectives on factors that enable and constrain their engagement can inform development of learning and teaching strategies that are more responsive to the needs of this group of students and can support their learning achievement. DESIGN: A qualitative descriptive design conducted in one Australian multi campus university School of Nursing. Participants included first and second-year international students enrolled in a graduate entry Master of Nursing course. METHODS: Data, including demographic information, was collected via a theoretically informed online survey consisting of a Likert scale and open- ended questions. This study reports participant responses to open ended questions included in the survey. A thematic analysis was used to interpret findings. FINDINGS: Analysis identified participants' perspectives on factors that influenced their learning engagement in four theme areas: 1) Availability of study support resources, 2) Opportunities for social interaction, 3) Opportunities to build a sense of belonging, and 4) Constraints on development of a sense of engagement. Opportunities for social engagement emerged as a dominant finding across all themes. CONCLUSION: This research, which focused on international students' perspectives on learning engagement, contributed to existing knowledge on student engagement in higher education graduate entry nursing courses. Opportunities for social interaction within and beyond formal course learning experiences were valued by students and identified as key to their learning engagement. These findings have implications for academics and student support services who together, can influence the context of students learning to better meet their engagement needs.

Enhancing sense of belonging in nursing student clinical placements to advance learning and identity development.

Clinical placements are considered one of the "hallmarks" of nursing education. In these settings, students can build upon their theoretical learning by applying knowledge, practicing skills, connecting with nurses and other medical professionals, and creating opportunities to work with diverse populations. As a result, students begin to hone their nurse identity, and build confidence and self-esteem. Importantly, the development of a nursing identity through clinical placement work is improved by integrating opportunities that increase belongingness. Campus climate plays a significant role in creating the environment necessary for belongingness to flourish and leads to enhanced student learning. Taking the role of positive campus climate into consideration, this article argues that instructors supervising undergraduate nursing students in clinical learning environments must create inclusive climates for their students to increase positive educational outcomes. Specific recommendations for creating inclusive clinical learning environments are provided.

Social identity, mental health and the experience of migration.

Evidence suggests that social identities, which provide purpose and a sense of belonging, enhance resilience against psychological strain and safeguard well-being. This applies to first-generation migrant populations facing adverse experiences, including prejudice and disconnection from previous identities during host country integration, negatively impacting their well-being. The importance of social identity also extends to first-generation migrant descendants, confronting dual-identity challenges and experiencing exclusion and discrimination despite being native born. Building on the social identity approach to mental health, 20 semi-structured interviews were conducted to investigate how migrants construct their social identities, their perspective on the challenges and changes they experience in relation to group memberships and ultimately, the influence this has on their psychological well-being. Findings emphasize the significance of social identity continuity and gain pathways in first-generation migrants' successful adjustment and psychological well-being. For second-generation migrants, dual-identity development is especially difficult during adolescence due to social exclusion and discrimination in schools. Even in early adulthood, pressure to maintain heritage identity can lead to negative mental health outcomes over time. The current study contributes to and strengthens the social identity approach to migrant mental health and has wider implications for psychological interventions and policy.

From classroom to life: Gender differences in the persistent effect of learning disabilities on adult depressive symptoms.

Despite the well-established link between adolescent learning disabilities (LD) and mental health, little is known about its long-term consequences. This study examines the relationship between adolescent LD and adult depressive symptoms, with a focus on gender differences and underlying mechanisms. Using a sibling sample from the National Longitudinal Study of Adolescent to Adult Health (N = 3,414), this study estimated sibling fixed effects models to account for unobserved family-level characteristics such as genes and early childhood family and social context. Sobel mediation analyses were conducted to examine social-psychological mechanisms, including the student-teacher relationship, the student-student relationship, and a sense of school belonging. LD in adolescence was positively associated with depressive symptoms in adulthood (b = 0.823, p < 0.05). This association remained robust when controlling for unobserved family-level confounders as well as educational attainment in adulthood. Gender-stratified models showed that only the association for women is statistically significant (b = 1.935, p < 0.05), and its magnitude is nearly three times that of the association for men. Sobel mediation tests indicate that a decline in a sense of school belonging mediates approximately 17% of the association between adolescent LD and adult depressive symptoms. This study's findings suggest that LD in adolescence is associated with an increase in depressive symptoms in adulthood, particularly in women, and a low sense of school belonging may be a potential mediator. Implementing interventions to improve the school integration of girls with LD could be an effective means of improving their long-term mental health.

Managers Can Support Employees in Working-Class Contexts by Promoting Growth Mindsets.

White-collar workplaces are critical "gateway" contexts. They play a crucial role in providing valuable opportunities and upward social mobility. Some groups are less likely, however, to feel they belong in these settings. For example, those with a college degree may feel relatively at ease. However, those without may be uncertain about whether they will be fully included. We examine one possibility for addressing these class-based belonging gaps. A growing education literature demonstrates the power of growth mindsets. We extend this research to the workplace and test its benefits. In two preregistered experiments (N = 1,777), we find that endorsing growth mindsets can support working-class (WK) individuals. When managers have a growth mindset, WK individuals report high sense of belonging. The effect occurred because managers with growth mindsets reduced identity threat. A preregistered survey of employees in the real world (N = 300) triangulated these findings. Sense of belonging was higher among those who believed their manager had a growth mindset. Furthermore, they reported greater job satisfaction and commitment. These findings have important implications for the growing conversation on addressing class divides.

From corners to community: exploring medical students' sense of belonging through co-creation in clinical learning.

BACKGROUND: Belonging is critical for the development and wellbeing of medical students. Belonging, particularly within a 'relational being' paradigm, presents a significant challenge for students, especially within clinical learning environments. Co-creation is a learning relationship in which students are actively involved in the education process. It is inherently relational and promotes belonging within higher education environments. Little is known about utilising co-creation in the curriculum, within medical education. The aim of this study was to explore medical students' experience of co-creation of learning resources within the clinical learning environment. METHODS: Following ethical approval, medical students were invited to become co-creators of a learning bulletin resource, within the paediatric acute receiving unit, at a paediatric teaching hospital. Interpretative phenomenological analysis (IPA) was used to enable an in-depth exploration of how medical students experienced co-creation within the clinical learning environment. Medical students participated in semi-structured interviews about their experience, which were transcribed verbatim and analysed using IPA. The analysis integrated individual lived experiences into an analytic summary. RESULTS: Nine medical students participated. Three group experiential themes were identified: identity maturation; learning community and workplace integration. The support found within this co-created learning community, along with maturation of their identity, allowed the participants to experience a challenge to their existing worldview. This shift in perspective resulted in them responding and behaving in the workplace in new ways, which enabled them to belong as themselves in the clinical learning environment. These findings were situated within the developmental concept of self-authorship, as well as contributing to a new understanding of how co-creation promoted social integration. CONCLUSIONS: Co-creation enabled students to learn in a meaningful way. The relational power of co-creation, can be harnessed to deliver participatory learning experiences, within our increasingly complex healthcare environment, to support the learning, development and integration of doctors of the future.

Exploring the use of experimental small area estimates to examine the relationship between individual-level and area-level community belonging and self-rated health.

Background: Small area estimation refers to statistical modelling procedures that leverage information or "borrow strength" from other sources or variables. This is done to enhance the reliability of estimates of characteristics or outcomes for areas that do not contain sufficient sample sizes to provide disaggregated estimates of adequate precision and reliability. There is growing interest in secondary research applications for small area estimates (SAEs). However, it is crucial to assess the analytic value of these estimates when used as proxies for individual-level characteristics or as distinct measures that offer insights at the area level. This study assessed novel area-level community belonging measures derived using small area estimation and examined associations with individual-level measures of community belonging and self-rated health. Data and methods: SAEs of community belonging within census tracts produced from the 2016-2019 cycles of the Canadian Community Health Survey (CCHS) were merged with respondent data from the 2020 CCHS. Multinomial logistic regression models were run between area-level SAEs, individual-level sense of community belonging, and self-rated health on the study sample of people aged 18 years and older. Results: Area-level community belonging was associated with individual-level community belonging, even after adjusting for individual-level sociodemographic characteristics, despite limited agreement between individual- and area-level measures. Living in a neighbourhood with low community belonging was associated with higher odds of reporting being in fair or poor health, versus being in very good or excellent health (odds ratio: 1.53; 95% confidence interval: 1.22, 1.91), even after adjusting for other factors such as individual-level sense of community belonging, which was also associated with self-rated health. Interpretation: Area-level and individual-level sense of community belonging were independently associated with self-rated health. The novel SAEs of community belonging can be used as distinct measures of neighbourhood-level community belonging and should be understood as complementary to, rather than proxies for, individual-level measures of community belonging.

Direct and indirect effects of father-child attachment on academic burnout in college students.

The study aims to investigate the multiple mediating roles of core self-evaluation and sense of school belonging in the relationship between father-child attachment and academic burnout in college students. A sample of 418 college students completed the father-child attachment scale, the scale of sense of school belonging, core self-evaluation scale, and academic burnout scale. After controlling for variables such as mother-child attachment, gender, age, and grade, the results showed: (1) father-child attachment was significantly and negatively correlated with academic burnout, and positively correlated with core self-evaluation and sense of school belonging; both core self-evaluation and sense of school belonging were significantly and negatively correlated with academic burnout. (2) The multiple mediating model of father-child attachment influencing academic burnout in college students was established. Both core self-evaluation and sense of school belonging played a partial mediating role between father-child attachment and academic burnout. The direct effect of father-child attachment on academic burnout accounts for 33.3% of the total effect. The indirect effects of core self-evaluation and sense of school belonging between father-child attachment and academic burnout account for 50.0 and 16.7% of the total effect, respectively. These findings identify the internal mechanisms through which father-child attachment affects academic burnout in college students from personal traits and interpersonal perspectives.

Immigrant Perspectives of Social Connection in a Nontraditional Migration Area.

Social connection is a core dimension of health and wellness among all populations, yet the experience of moving to and living in a new country makes social and community-level influences particularly salient for immigrants. We interviewed 38 Latino immigrants living in a nontraditional migration area to explore the social and community foundations of health and wellness. Using hybrid (inductive/deductive) qualitative analysis, we identified seven domains of social connection from the perspective of the interviewed participants: (1) lens of the individual; (2) immigrant experience; (3) interpersonal support; (4) community belonging; (5) community capital; (6) community navigation; and (7) social acceptance. Social connection domains generated by participants are consistent with the scientific literature, but this study identifies the specific social factors that immigrants describe as most salient to their own health and wellness. Our community-generated understanding of social connection can be used by healthcare providers to reduce risks and build on assets that will improve the health of immigrants living in nontraditional migration areas. Additionally, these results might serve as a foundation for a quantitative measure that can be used by providers to more accurately and comprehensively assess the social connection of their patients and by researchers to evaluate the effectiveness of community-level interventions for immigrants.

Addressing School Connectedness, Belonging, and Culturally Appropriate Care for Newly Immigrated Students and Families.

School connectedness is the degree to which students experience acceptance, inclusion, and care by school personnel and peers. A sense of belonging incorporates an emotional connection to the community. School connectedness and belonging are protective factors that promote student engagement, accomplishment, and community performance. Despite the rise in students from immigrant families in the United States, belonging and connectedness for youth from diverse cultural and linguistic experiences are understudied. School-based nurses, our term, is inclusive of advanced practice pediatric, family, and psychiatric nurse practitioners, are well-positioned to support school connectedness for youth who may encounter hurdles to health care because of cultural and linguistic differences. We present practice suggestions for language, culture, and inclusion using three health conditions experienced by youth: anxiety, asthma, and obesity. School-based nurses and other school personnel who provide linguistic and culturally appropriate care can support students in feeling connected and included in their school communities.

"I realized I was not alone": A mixed-methods investigation of the implementation of Ubuntu groups to reduce burnout and social isolation in an allopathic medical School in the Southeastern United States.

PURPOSE/BACKGROUND: Healthcare providers experience higher rates of workplace burnout, a reality highlighted by the COVID-19 pandemic. In response, small groups, inspired by South African philosophy, Ubuntu, were introduced to decrease burnout and social isolation and build community and belonging. This study examines how participation in these groups can impact these measures. METHODS: In this mixed-methods study, trained facilitators led small groups that utilized story-sharing to foster connections within the group and broader community. Quantitative and qualitative data were analyzed separately and merged to identify convergence. RESULTS: Three main qualitative themes emerged: 1) seeking and building connections and community, 2) curiosity, learning, and growing, and 3) open-hearted and thriving. These themes were linked to quantitative outcomes, showing a statistically significant decrease in social isolation among staff/faculty and students. Furthermore, faculty/staff exhibited reduced burnout compared to students, while students reported increased feelings of belonging. CONCLUSION: Participation in Ubuntu groups positively influenced students' sense of belonging, reduced faculty/staff burnout, and alleviated social isolation for all participants. Future research should explore the potential of this intervention to further promote wellness on medical campuses. Programs emphasizing the well-being of individuals, including faculty, staff, and students, are crucial for supporting the overall health of medical communities and the wider society.