Experiences of Leaders in Diversity, Equity, and Inclusion in US Academic Health Centers.

Importance: The murder of George Floyd in 2020 spurred an outpouring of calls for racial justice in the United States, including within academic medicine. In response, academic health centers announced new antiracism initiatives and expanded their administrative positions related to diversity, equity, and/or inclusion (DEI). Objective: To understand the experiences of DEI leaders at US allopathic medical schools and academic health centers, ie, the structure of their role, official and unofficial responsibilities, access to resources, institutional support, and challenges. Design, Setting, and Participants: This qualitative study used key informant interviews with participants who held formal DEI positions in their school of medicine, health system, or department. Interviews were conducted from December 2020 to September 2021. Transcripts were coded using a phenomenographic approach, with iterative concurrent analysis to identify thematic categories across participants. Data were analyzed from January to December 2021. Exposure: Formal DEI role. Main Outcomes and Measures: Questions elicited reflection on the responsibilities of the role and the strengths and challenges of the unit or office. Results: A total of 32 participants (18 of 30 [56%] cisgender women; 16 [50%] Black or African American, 6 [19%] Latinx or Hispanic, and 8 [25%] White) from 27 institutions with a mean (range) of 14 (3-43) years of experience in medical education were interviewed. More than half held a dean position (17 [53%]), and multiple participants held 2 or more titled DEI roles (4 [13%]). Two-thirds self-identified as underrepresented in medicine (20 [63%]) and one-third as first generation to attend college (11 [34%]). Key themes reflected ongoing challenges for DEI leaders, including (1) variability in roles, responsibilities, and access to resources, both across participants and institutions as well as within the same position over time; (2) mismatch between institutional investments and directives, including insufficient authority, support staff, and/or funding, and reduced efficacy due to lack of integration with other units within the school or health system; (3) lack of evidence-based practices, theories of change, or standards to guide their work; and (4) work experiences that drive and exhaust leaders. Multiple participants described burnout due to increasing demands that are not met with equivalent increase in institutional support. Conclusions and Relevance: In this qualitative study, DEI leaders described multiple institutional challenges to their work. To effectively address stated goals of DEI, medical schools and academic centers need to provide leaders with concomitant resources and authority that facilitate change. Institutions need to acknowledge and implement strategies that integrate across units, beyond one leader and office. Policymakers, including professional organizations and accrediting bodies, should provide guidance, accountability mechanisms, and support for research to identify and disseminate evidence for best practices. Creating statements and positions, without mechanisms for change, perpetuates stagnation and injustice.

Inclusive classroom norms and children's expectations of inclusion of peers with learning difficulties in their social world.

We examined whether inclusive classroom norms predicted children's reasoning and expectations about the inclusion of peers with learning difficulties from different perspectives (i.e., self, friends, and unfamiliar story protagonist). Swiss elementary school children (N = 1019; 51% girls; Mage = 10.20 years; Grades 3-6) shared their perceptions of inclusive classroom norms and answered questions regarding the inclusion of a character with learning difficulties in an academic scenario. Multilevel analyses revealed that children expected less inclusion from their friends (estimated OR = 0.14, p < .001) or the unfamiliar story protagonist (estimated OR = 0.15, p < .001) than from themselves. Inclusive classroom norms positively predicted children's own (estimated OR = 3.17, p = .041) and their friends' inclusion expectations (estimated OR = 4.59, p = .007). Moreover, individuals who perceived higher inclusive norms than the classroom average were less concerned that the inclusion of the child with learning difficulties would threaten successful group functioning (γ = - 0.19, p = .011). To target the inclusion of children with learning difficulties, school psychologists can heighten classmates' perceptions of inclusive norms and pay attention to individual differences in norm perception.

Taking Action to Promote Diversity and Inclusion: One Program's Efforts Through Pathway Opportunities, Holistic Admissions, and Curricular Changes.

AIMS: Concerted, effective, and sustainable change in healthcare education programs is a critical step towards creating more diverse, inclusive, and equitable professions. This commentary demonstrates how one entry-level physical therapist education program, through a process of reflection, prioritization, and action, is taking steps to increase diversity, equity, and inclusivity within their program. RATIONALE: This article highlights initiatives that are leveraging existing partnerships and creating new ones to reach and mentor students from diverse communities, steps taken towards a more holistic and equitable admissions process, implementation of curricular changes to intentionally discuss the social determinants of health, and engagement of faculty and students to foster personal and professional development on diversity, equity, and inclusion topics. Outcomes to track the effectiveness of the strategies being used by each initiative are shared. CONCLUSION: To create active agents of change, education programs must create a diverse and equitable space for students and guide them to become leaders who can transform society. Steps taken by an entry-level physical therapist education program to implement strategies to promote diversity, equity and inclusion can serve as a road map for other healthcare professional programs.

An Equity-Based Research Agenda to Promote Social Inclusion and Belonging for People With IDD.

Having a sense of social inclusion and belonging, typically characterized by our personal relationships and community participation, is the central essence of life for most people, yet it remains elusive for many people with intellectual and developmental disabilities (IDD). This article summarizes the work of a diverse group of researchers and advocates to propose 6 big-picture, equity-based goals to drive future research in the field: (1) understanding the role of intersectionality, (2) understanding intimate relationships, (3) promoting formation of communities of care to support social inclusion, (4) understanding life course trajectories of social inclusion, (5) understanding social inclusion in virtual spaces, and (6) understanding how to promote social inclusion in the entire research process.

[Diversity, equity and inclusion in radiation oncology : where do we stand ?] / Diversité, équité et inclusion en radiothérapie-oncologie : où en sommes-nous ?

INTRODUCTION: The promotion of diversity, equity and inclusion (DEI) is increasingly sought after in healthcare, which is why we wanted to draw up a picture of DEI in radiation oncology and give some ideas on how to contribute to its dissemination. METHOD: This article proposes a non-exhaustive review of the international literature on DEI in radiation oncology, both among health professionals and patients. In addition, this review identifies some implicit cognitive biases and proposes strategies to address them. RESULTS: Most of the proposed publications identify a lack of DEI among radiation oncology staff and document inequities in access to high-quality radiotherapy affecting patients belonging to minority groups. CONCLUSION: Significant disparities exist between genders and ethnic groups within the radiotherapy teams, and in the radiotherapy treatment of patients. Nevertheless, DEI is gaining importance, and a range of initiatives and instruments are being developed to address these disparities.

INTRODUCTION: La promotion de l'équité, de la diversité et de l'inclusion (EDI) est de plus en plus recherchée dans les soins de santé, raison pour laquelle nous avons voulu dresser un tableau de l'EDI en radiothérapie et donner des pistes pour contribuer à sa diffusion. Méthode : Cet article propose une revue non exhaustive de la littérature internationale sur l'EDI en radiothérapie, tant chez les professionnels de la santé que chez les patients. En outre, cette revue relève des biais cognitifs implicites et propose des stratégies pour y remédier. Résultats : La majorité des publications proposées identifient un manque d'EDI parmi les professionnels en radiothérapie, et documentent également des iniquités dans l'accès à une radiothérapie de haute qualité touchant les patients issus de groupes minoritaires. CONCLUSION: D'importantes disparités existent entre genres et groupes ethniques au sein des équipes de radiothérapie ainsi que dans le traitement des patients par radiothérapie. Néanmoins, l'EDI gagne en importance et toute une série d'initiatives et d'instruments pour remédier à ces disparités se développent.

Justice, Equity, Diversity, Inclusion, and Belonging (JEDI-B) in Transition to Practice Programs.

Justice, equity, diversity, inclusion, and belonging (JEDI-B) are essential for creating safe and productive professional environments. Clear definitions of JEDI-B terms are essential for collective understanding and organizational buy-in. Institutional and transition to practice program efforts should focus on the development of inclusive cultures, diverse curriculum, and data-driven evaluation of JEDI-B policies, processes, and practices. Engagement in bias recognition and the unlearning of those biases is also vital. Despite current legislative challenges, the integration of JEDI-B principles remains a vital component in enhancing health care experiences for patients and fostering inclusive workplaces. [J Contin Educ Nurs. 2024;55(6):273-275.].

Inclusão social pelo trabalho: percepções da primeira experiência de emprego em jovens de baixa renda / Social inclusion through work: perceptions of the first employment experience in low income young people / Inclusión social a través del trabajo: percepciones de la primera experiencia laboral en jóvenes de bajos ingresos

OBJETIVO: Este estudo teve como objetivo propor um modelo cognitivo/explicativo que represente as mudanças que podem ser incorporadas à vida de jovens de baixa renda, a partir de sua primeira experiência de emprego formal. MÉTODO: A amostra do estudo foi composta por 25 jovens beneficiários do Programa Primeiro Emprego/BA, que participaram de grupos focais on-line. Para a análise, as falas foram inicialmente categorizadas por meio da análise de conteúdo temática e, em seguida, visando uma sistematização e o estabelecimento de uma relação entre as categorias adotadas, foi utilizada a técnica do mapeamento cognitivo. RESULTADOS: A partir da análise das falas dos jovens, foram identificados 29 núcleos de sentidos, distribuídos em torno da tríade indivíduo- trabalho-sociedade. Entre as mudanças pessoais percebidas, destacam-se a valorização e o crescimento pessoal, assim como questões financeiras. Nas mudanças laborais, o aumento da empregabilidade como resultado da maior qualificação profissional e das novas habilidades técnicas adquiridas foi amplamente citado. Por fim, no que diz respeito às mudanças sociais, a percepção de alteração do status social ficou evidente. A maioria das mudanças observadas foram positivas e indicaram um aumento na qualidade de vida dos jovens de baixa renda. CONCLUSÃO: Conclui-se, portanto, que para uma modificação dos padrões de reprodução da força de trabalho juvenil, baseados na precarização e na subalternidade, é necessária uma transformação da realidade laboral dos seus atores.

OBJECTIVE: This study aimed to propose a cognitive/explanatory model that represents the changes that can be incorporated into the lives of low-income young people, from their first experience of formal employment. METHOD: The study sample consisted of 25 young beneficiaries of the First Employment Program/ BA, who participated in online focus groups. For the analysis, the speeches were initially categorized through thematic content analysis and, then, aiming at systematization and the establishment of a relationship between the adopted categories, the cognitive mapping technique was used. RESULTS: Based on the analysis of the young people's statements, 29 nuclei of meanings were identified, and distributed around the individual-work-society triad. Among the perceived personal changes, valorization and personal growth stand out, as well as financial issues. In terms of job changes, the increase in employability as a result of higher professional qualifications and new technical skills acquired was widely cited. Finally, with regard to social changes, the perception of change in social status was evident. Most of the changes observed were positive and indicated an increase in the quality of life of low-income youth. CONCLUSION: It is concluded, therefore, that for a change in the system, a transformation of the work reality of its actors is necessary.

OBJETIVO: Este estudio tuvo como objetivo proponer un modelo cognitivo/explicativo que represente los cambios que pueden incorporarse en la vida de jóvenes de bajos ingresos, a partir de su primera experiencia de empleo formal. MÉTODO: La muestra del estudio estuvo compuesta por 25 jóvenes beneficiarios del Programa Primeiro Emprego/BA, que participaron de grupos focales en línea. Para el análisis, los enunciados fueron inicialmente categorizados a través del análisis de contenido temático y luego, con el objetivo de sistematizar y establecer una relación entre las categorías adoptadas se utilizó la técnica del mapeo cognitivo. RESULTADOS: A partir del análisis de los enunciados de los jóvenes, se identificaron 29 centros de significado, distribuidos en torno a la tríada individuo-trabajo-sociedad. Entre los cambios personales percibidos se destacan la apreciación y el crecimiento personal, así como las cuestiones financieras. En los cambios laborales se citó ampliamente el aumento de la empleabilidad como consecuencia de una mayor cualificación profesional y de nuevas competencias técnicas adquiridas. Finalmente, en lo que respecta a los cambios sociales, se hizo evidente la percepción de cambios en el estatus social. La mayoría de los cambios observados fueron positivos e indicaron un aumento en la calidad de vida de los jóvenes de bajos ingresos. CONCLUSIÓN: Se concluye, por tanto, que para modificar los patrones de reproducción de la fuerza laboral juvenil, basados en la precariedad y la subalternidad, es necesaria una transformación de la realidad laboral de sus actores.

Centering diversity, equity, and inclusion in a regional professional nursing organization.

BACKGROUND: Professional nursing organizations can respond to threats to social justice by strengthening structures to support diversity, equity, and inclusion (DEI). PURPOSE: Describe implementation strategies and outcomes to advance DEI from the Western Institute of Nursing (WIN). METHODS: In 2019, WIN committed to prioritizing DEI by updating its vision and mission. A taskforce was assembled to conduct member surveys, focus groups, and open forums to generate recommendations on developing and implementing organizational change. DISCUSSION: These initiatives culminated in centralized efforts that include the formation of a standing committee, ongoing member surveys, selection of diverse conference topics and speakers, adoption of inclusive practices, and ongoing assessments to make recommendations to the Board to advance DEI. CONCLUSION: The work of the Committee ensures the organization remains committed to DEI. These strategies inform other nursing organizations as they advance DEI to impact research, education, policy, and practice.

Sustainable Approach to Justice, Equity, Diversity, and Inclusion Through Better Quality Measurement.

The US health care industry has broadly adopted performance and quality measures that are extracted from electronic health records and connected to payment incentives that hope to improve declining life expectancy and health status and reduce costs. While the development of a quality measurement infrastructure based on electronic health record data was an important first step in addressing US health outcomes, these metrics, reflecting the average performance across diverse populations, do not adequately adjust for population demographic differences, social determinants of health, or ecosystem vulnerability. Like society as a whole, health care must confront the powerful impact that social determinants of health, race, ethnicity, and other demographic variations have on key health care performance indicators and quality metrics. Tools that are currently available to capture and report the health status of Americans lack the granularity, complexity, and standardization needed to improve health and address disparities at the local level. In this article, we discuss the current and future state of electronic clinical quality measures through a lens of equity.

Establishing a Pediatric Health Equity, Diversity, and Inclusion Research Review Process.

Equity, diversity, and inclusion (EDI) research is increasing, and there is a need for a more standardized approach for methodological and ethical review of this research. A supplemental review process for EDI-related human subject research protocols was developed and implemented at a pediatric academic medical center (AMC). The goal was to ensure that current EDI research principles are consistently used and that the research aligns with the AMC's declaration on EDI. The EDI Research Review Committee, established in January 2022, reviewed EDI protocols and provided recommendations and requirements for addressing EDI-related components of research studies. To evaluate this review process, the number and type of research protocols were reviewed, and the types of recommendations given to research teams were examined. In total, 78 research protocols were referred for EDI review during the 20-month implementation period from departments and divisions across the AMC. Of these, 67 were given requirements or recommendations to improve the EDI-related aspects of the project, and 11 had already considered a health equity framework and implemented EDI principles. Requirements or recommendations made applied to 1 or more stages of the research process, including design, execution, analysis, and dissemination. An EDI review of human subject research protocols can provide an opportunity to constructively examine and provide feedback on EDI research to ensure that a standardized approach is used based on current literature and practice.

Medical Teacher's equity diversity inclusion policy.

Medical Teacher is a leading international journal in health professions education. The Journal recognizes its responsibility to publish papers that reflect the breadth of topics that meet the needs of its readers around the globe including contributions from countries underrepresented in the health professions education arena. This paper sets out the Journal's policy with regard to Equity Diversity Inclusion (EDI) and the steps to be taken to implement the policy in practice.

Initiatives to facilitate the social inclusion of people with intellectual disability in physical activities with others in community-based sporting, recreation and leisure activities: A scoping review.

BACKGROUND: While barriers to participation in physical activity are well documented, there is no consolidated evidence on strategies promoting participation of people with intellectual disability in physical activities. METHODS: We conducted a scoping review to examine initiatives used to facilitate the inclusion of people with intellectual disability in community-based sporting and recreation activities. We searched Medline, Embase, CINAHL+ and PsycINFO for articles published in English between 2000 and 2022. RESULTS: Eight articles were included. Initiatives included: (1) building knowledge, awareness and attitudinal change (2) organisational alliances/partnerships (3) relationship-building (4) modifications/adaptions to activities/environment (5) organisational policy (6) engagement with people with disability. Initiatives were implemented through international collaborations, in local fitness/recreational facilities and public spaces, and targeted athletes, coaches, volunteers and organisational leaders. CONCLUSION: While some increase in awareness and inclusion of people with intellectual disability was reported, no longitudinal data reported on the impact of initiatives on sustained social inclusion for people with intellectual disability.

Organizational Climate for Inclusion Among Nurses: A Mixed-Methods Analysis.

OBJECTIVE: The aim of this study was to answer the research question: What factors predict sense of belonging among nurses?The connection between inclusion (an element of diversity and equity) and a nurse's sense of belonging is poorly understood. METHODS: In this mixed-methods research, regression analysis of Climate for Inclusion Scale subscales and Sense of Belonging score plus thematic content analysis of questions assessing sense of belonging were conducted. Nurses (n = 131) attending a research conference in June to July 2022 were invited to participate; 131 (72%) participated. RESULTS: Climate for Inclusion Scale was positively associated with and predictive of sense of belonging (F3,113 = 71.7, P < 0.001). Themes reflecting actions to enhance sense of belonging were as follows: authentic leadership, embracing social justice, team unification, feeling heard, being seen, professional development, developing a healthier work environment, and integration of differences. CONCLUSIONS: Leaders can promote a sense of belonging among nurses by focusing on actions reflected in the themes.