Bridging the gap, how interprofessional collaboration can support emergency preparedness for children with disabilities and their families: an exploratory qualitative study.

BACKGROUND: Children with disabilities and their families are at higher risk during emergencies and disasters, which is often attributed to the lack of disability inclusion in emergency response as well as disparities in preparedness. This disparity speaks to a need for emergency preparedness that centers children with disabilities and their families. The purpose of this study was to elicit the perspectives of health professionals (nurses, occupational therapists, social workers), disability advocates, and public safety personnel (e.g., fire fighters, police officers, emergency management administrators) on what would enable these types of professionals to support family-centered emergency preparedness for families who care for children with disabilities. One goal of this research is to provide recommendations for practice and policy to improve safety outcomes for children with disabilities and their families in emergency situations. METHODS: This study consisted of 46 qualitative interviews with nurses, occupational therapists, social workers, public safety personnel, and advocacy organization representatives about their role in emergency preparedness for families of children with disabilities. Qualitative content analysis was used to identify themes from participants' responses. RESULTS: Participants expressed interest in family-centered emergency preparedness, and stated that greater awareness, more education and training, increased networking between professions, and institutional support would enable their involvement. CONCLUSIONS: These findings have implications for the importance of interprofessional collaboration in supporting family-centered emergency preparedness for families of children with disabilities. Stronger interprofessional networks would help overcome many of the barriers identified by participants, and advocacy groups appear to be well-positioned to bridge the gap between these professionals and their areas of expertise.

Asexual-Identified Adults: Interactions with Health-Care Practitioners.

Historically, people with minority sexual and gender identities (e.g., gay, lesbian, bisexual, transgender) have been pathologized by mental and medical health practitioners. The potential for pathologization of asexuality is particularly salient considering a lack of sexual desire or interest has been studied in relationship to depression, antidepressant medication, and hypothyroidism. To explore this potential pathologization, asexual individuals were asked about their interactions with mental health and medical practitioners. The study included 136 adult participants, primarily from the U.S., who self-identified as asexual. Participants completed an online survey which contained questions about their experiences with mental health and medical practitioners. Results indicated that the majority of participants did not disclose their identity and felt uncomfortable discussing issues related to sexuality with their providers. Participants were more likely to disclose their asexual identity to mental health providers, as compared to medical providers. Participants who had positive experiences were more likely than those who had negative experiences to indicate that their practitioners were familiar with asexuality, accepted the participant's identity completely, and reacted to the disclosure in a positive and affirming manner. Positive experiences included practitioners educating themselves about asexuality, while negative experiences included practitioners disbelieving the existence of asexuality, and between one quarter and one half of participants reported that practitioners attributed their asexuality to a health condition. The findings from this study demonstrate the importance of including information about asexual identities in health education and ongoing diversity training in order to increase the cultural sensitivity of health practitioners.

Students' Risks for Out-of-School Suspensions: Indigenous Heritage and Child Protective Services Involvement.

Disproportionality in out-of-school suspensions (OSS) is a persistent social and racial justice issue. Available research indicates that Indigenous children are disproportionately represented in both OSS and the child protective services (CPS) system. This secondary data analysis followed a cohort of 3rd grade students (n = 60,025) in Minnesota public schools from 2008- 2014. It examined the relationship between CPS involvement, Indigenous heritage, and OSS. Results from a zero-inflated negative binomial regression indicated that Indigenous students had two times the odds of suspension compared to white students (OR = 2.06, p < .001). Furthermore, there was a significant interaction between CPS involvement and Indigeneity on frequency of OSS (OR = 0.88, p < .05). Indigenous students showed a much higher odds ratio of OSS compared to white students, but the distance between the odds ratios of the two groups decreased as the number of child maltreatment allegations increased. Indigenous students may experience relatively high levels of both CPS and OSS due to systematic racism. We discussed implications for practice and policy to reduce discipline disparities.