Youth engagement to achieve health equity: Are healthcare organizations and leaders prepared?

Youth engagement in institutional decision-making is necessary to ensure policy and practice is responsive and relevant to youth and community needs. In particular, it is critical to engage the voices and experiences of youth of Color who have historically been marginalized by healthcare organizations. The present study used multiple methods to examine youth and adult perspectives on the facilitators and barriers to implementing a citywide youth advisory board of youths of Color for a safety net hospital. Data were analyzed using thematic analysis. The findings illustrate the need to employ an antiracist framework to ensure organizational and adult readiness to engage youth of Color in an advisory board. Organizational readiness included assessing organizational culture, clear expectation setting, and creating safe spaces for youth. Adult readiness included adult facilitators who are trained in antiracist and equity-focused practice and the youth-adult partnership model, and a recognition of the bidirectional benefits of youth engagement in decision-making. The implications and recommendations of this study are timely given the historical mistrust between healthcare organizations and communities of Color, as well as the racial health inequities that have been further exposed during the COVID-19 pandemic.

COVID-19 shines a light on health inequities in communities of color: A youth-driven photovoice inquiry.

This manuscript reports on a youth-driven health assessment engaging youth of color in identifying community health priorities during the coronavirus disease 2019 (COVID-19) pandemic. Photovoice, a participatory visual ethnographic health assessment strategy, was used to explore the question: What does health or healthiness mean to you and/or your community? Youth captured images that represented their priorities. The photos were discussed using the SHOWed framework and analyzed thematically. Four themes related to community health were identified. Additionally, youth captured their narrative of COVID-19 as "a revealing force that highlights systemic inequities, driving individuals and communities to both cultivate their resilience and take healthcare into their own hands in response to government and policy level failures." Youth are acutely aware of the historical and structural inequities that create multi-level barriers to healthcare access. Health inequities existed long before the pandemic, but the current crisis requires us to examine ways to transform the healthcare landscape moving forward.

Facing Power: Navigating Power Dynamics in a Youth Participatory Action Research Project Situated within a Healthcare Setting.

Youth Participatory Action Research (YPAR) is oftentimes cited as a method guided by social justice principles to uplift youth voice and pursue youth priorities in research. However, to uphold these principles, YPAR researchers must address how youth and adults alike negotiate power differentials to be equal partners in research and scholarship. We explore YPAR power sharing through a reflexive thematic analysis of in-depth, semi-structured interviews (n= 42) and focus groups (n=2) conducted at three timepoints (baseline, mid-point, and exit) with youth (n=8) and adult (n=6) researchers engaged in a YPAR exploring health equity at a large, safety-net hospital. Our analyses suggest that both youth and adult researchers negotiate power dynamics in a YPAR at every stage of the project. YPAR researchers made four recommendations to negotiate power: 1) preserve time for relationship building, 2) structure group expectations, 3) require training for adults working with youth of color, and 4) designate youth-only spaces. This study provides an in-depth analysis of youth and adult reflections on power across a YPAR project. Our findings indicate that YPAR requires significant investment in resources, including time to reflect on and process power, transparent and structured expectations, and ongoing training to uphold principles of YPAR.

From colorblind to systemic racism: Emergence of a rhetorical shift in higher education discourse in response to the murder of George Floyd.

We use topic modeling and exponential random graph models (ERGM) to analyze statements issued by Institutions of Higher Education (IHEs) (N = 356) in the United States in the aftermath of George Floyd's murder in May 2020. Prior research investigating discourse on race in IHEs demonstrates the prevalence of two paradigms. First, the ideology of 'colorblind racism' treats systemic racism-a form of racism where social, political, and economic institutions are organized in a way that disadvantages people of color-as having largely existed in the past. Consistent with this, IHE responses to prior race-related incidents on campus have emphasized individual prejudice, avoiding discussion of systemic racism. Second, 'diversity' orthodoxy, which treats race as a cultural identity and emphasizes the instrumental benefits of racial heterogeneity on campus, is commonplace in IHEs. Topic modeling of statements issued in 2020 reveals the prevalence of several themes including the systemic and enduring nature of racism in the United States, diversity orthodoxy, humanist responses reflecting rhetoric consistent with colorblind racism, and COVID-19 response strategies. ERGM reveals fragmentation in the discourse based on IHE attributes. Religiously affiliated IHEs and those located in Republican-voting states attend more to diversity and humanist discourse, and less to systemic racism. Elite IHEs, those in Democrat-voting states, and IHEs with high percentages of Black students are more focused on systemic racism. Overall, as compared to colorblind racism and diversity orthodoxy established in prior work, our analysis reveals two striking rhetorical shifts on race discourse in IHEs in the aftermath of George Floyd's murder: (1) from a colorblind ideology to discussing the systemic nature of racism in the United States, and (2) from acknowledging perpetrators but not the broader context of racism in on-campus incidents to acknowledging diffuse racism manifest in society but refraining from explicitly naming any wrongdoers.

Measuring Parenting Skills: Validating the Skills Assessment for Parents with Intellectual Disability.

PURPOSE: Parents with intellectual disabilities (ID) are overrepresented in the child welfare system. Valid instruments are needed to assess parenting skills in this population. This research evaluates the psychometric properties of the Skills Assessment for Parents with Intellectual Disability (SAPID), an observational instrument completed to assess parents with ID with child welfare involvement. METHOD: All clients enrolled in a prevention program for parents with ID were included in the sample (N = 133). Confirmatory factor analysis was conducted to understand the validity of the SAPID. Predictive validity was assessed by examining change over time with two outcomes: out-of-home placement and program completion. RESULTS: The validated SAPID consisted of three latent constructs: daily life skills, parent-child interaction, and overall safety. Parenting skills across all domains significantly improved for families remaining intact and those completing the program. DISCUSSION: The validated SAPID should be considered for use in assessing parenting skills for those with ID.

Dual tasking in Parkinson's disease: Cognitive consequences while walking.

OBJECTIVE: Cognitive deficits are common in Parkinson's disease (PD) and exacerbate the functional limitations imposed by PD's hallmark motor symptoms, including impairments in walking. Though much research has addressed the effect of dual cognitive-locomotor tasks on walking, less is known about their effect on cognition. The purpose of this study was to investigate the relation between gait and executive function, with the hypothesis that dual tasking would exacerbate cognitive vulnerabilities in PD as well as being associated with gait disturbances. METHOD: Nineteen individuals with mild-moderate PD without dementia and 13 age- and education-matched normal control adults (NC) participated. Executive function (set-shifting) and walking were assessed singly and during dual tasking. RESULTS: Dual tasking had a significant effect on cognition (reduced set-shifting) and on walking (speed, stride length) for both PD and NC, and also on stride frequency for PD only. The impact of dual tasking on walking speed and stride frequency was significantly greater for PD than NC. Though the group by condition interaction was not significant, PD had fewer set-shifts than NC on dual task. Further, relative to NC, PD showed significantly greater variability in cognitive performance under dual tasking, whereas variability in motor performance remained unaffected by dual tasking. CONCLUSIONS: Dual tasking had a significantly greater effect in PD than in NC on cognition as well as on walking. The results suggest that assessment and treatment of PD should consider the cognitive as well as the gait components of PD-related deficits under dual-task conditions. (PsycINFO Database Record