Equity in evidence synthesis

Audiology (AUD) and speech-language pathology (SLP) are White-dominated fields that operate within racist systems. Systemic racism has profoundly negative impacts on students and professionals who identify as Black, Indigenous, and people of color (BIPOC). This study explored the perceptions and experiences of systemic racism in BIPOC AUD and SLP graduate students as a means to promote antiracism efforts in the fields. A national web-based survey was used to collect information from 46 graduate students. The survey included quantitative questions about systemic racism in the AUD and SLP fields as well as open-ended questions regarding the personal, professional, and client-related impacts of racism. Analyses aimed to characterize patterns first within the overall BIPOC sample and then within three disaggregated racial-ethnic groups (Asian, Black, and Latino/a) to characterize potential differences within the heterogeneous BIPOC category. On quantitative questions, a substantial majority of BIPOC students selected options consistent with perceptions of systemic racism and White privilege. Qualitative questions yielded several themes related to the personal, professional, and client-related impacts of systemic racism from the perspective of BIPOC students, including reduced access to educational opportunities as well as clinical services, experiences with appearance-based discrimination as well as overt racism, and persistent underrepresentation with accompanying feelings of otherness. Disaggregation of responses suggested some differences in response patterns across racial-ethnic groups, which may warrant further investigation. The perspectives of AUD and SLP graduate students reinforce other reports of systemic racism in the fields. Multiple actions are warranted to instigate systemic change that supports graduate students, professionals, and clients of color. https://doi.org/10.23641/asha.24171513.

12136 Background: In the thick of the ongoing global crises of the COVID-19 pandemic, uprisings against anti-Black racism and police brutality, and anti-Asian racism and violence, Black, indigenous, and people of color (BIPOC) adolescent and young adult (AYA) cancer patients may be particularly vulnerable and exploited. Whilst embroiled in sociopolitical complexity, BIPOC AYAs are increasingly called upon to contribute as patient advocates in AYA oncology research and advocacy. Researchers, clinicians, and advocates in AYA oncology must dismantle long-standing racism and create meaningful structural change. The purpose of this study is to derive vital best practices for implementing antiracist patient engagement in AYA oncology research and advocacy that are co-developed by BIPOC AYA cancer patients and oncology professionals. Methods: We utilized a modified Delphi technique with a panel of BIPOC AYA cancer patients (n = 32) to build consensus opinions on professional recommendations from a prior study ( Cheung et al., 2021 ), and to generate antiracist best practices in patient engagement. The Delphi study was comprised of three consecutive and iterative survey rounds over the course of 8 months in 2021; participants were BIPOC AYAs diagnosed with cancer between ages 15-36 years. Results: Results detail best practices for the implementation of antiracist patient engagement across all research activities within the Patient-Centered Outcomes Research Institute’s (PCORI) Framework for Patient Engagement. For example, BIPOC AYAs agreed with oncology professionals’ high priority recommendation for including BIPOC AYAs at the highest levels of decision making in research topic selection. As such, a best practice is for researchers to ensure that such representatives not only hold BIPOC AYA identity, but also hold direct experience with the particular oncology diagnosis, issue, or other outcome of interest. Additionally, BIPOC AYAs concurred with oncology professionals’ high priority for “transparency, honesty, and trust” as a core principle for best practices in patient engagement. They further explained that trustworthy relationships are especially important when collaborating with teens and young adults, who are developmentally just coming into their own. When describing successful experiences of inclusion, participants ranked “build collaborative relationships with BIPOC AYA communities and listen to patients not usually heard” and “recruit a diverse range of BIPOC patients and let them give actual input into the study” as the highest priority best practices. Conclusions: Findings from this study are instructional for AYA oncology researchers, clinicians, and advocates to prevent harmful tokenism and implement genuine antiracist inclusion to advance health equity. Future research should investigate best practices within unique clinical settings.

Collective minoritized identities such as Black, Indigenous, and People of Color (BIPOC) may promote cross-racial solidarity. However, Asian Americans occupy a racially triangulated position as the "buffer minority" stereotyped as both the model minority and perpetual foreigner, complicating their inclusion in the BIPOC identity. The present study examined how the model minority and perpetual foreigner stereotypes relate to Asian Americans' perceived belongingness and identification with the BIPOC identity and, in turn, their interracial solidarity toward Black Americans. A path analysis was conducted using cross-sectional data from a sample of 312 Asian Americans (Mage = 41.19, 69.87% college graduates, 46.79% foreign-born) to examine direct and indirect effects on Black community activism orientation (BCAO), with internalized model minority stereotype (MMS) and experiences of COVID-19 racial bias (CVRB) as exogenous predictors and perceived BIPOC inclusion and BIPOC self-identification as mediators. The BIPOC variables demonstrated a direct and positive association with BCAO. Furthermore, internalized MMS negatively related to BCAO through the sum effect of decreased perceived BIPOC inclusion and BIPOC self-identification, while experiences of CVRB positively related to BCAO through the sum effect of increased perceived BIPOC inclusion and BIPOC self-identification. Asian Americans' perceived BIPOC inclusion and BIPOC self-identification are shaped by their racially triangulated position, characterized by both the inhibiting effect of internalized MMS and the promoting effect of experiences of CVRB. This heightened or diminished BIPOC self-concept subsequently influenced their willingness to engage in interracial solidarity for Black Americans. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Merging Parallel Lines

Addressing structural racism within institutional bodies regulating research.

Enrollment of Black, Indigenous and People of Color (BIPOC) and female participants in the US diabetes trials spanning 2000 to 2020: A chronological survey

Aim/Purpose: This study aimed to compare the experiences of students who identify as Black, Indigenous, and People of Color (BIPOC) with those of White students in the same Educational Leadership doctoral program that claimed to be unapologetic in its commitment to producing racially conscious leaders. Background: This study critically assesses the doctoral program’s claims as measured by BIPOC and White doctoral students’ perceptions of their abilities as racial equity leaders and their assessments of their transformational learning. Methodology: This qualitative study employed two separate focus group interviews – one for BIPOC doctoral students (n=7) and the other for White doctoral students (n=6). The researchers could comprehend how the participants experienced an Educational Leadership Ed.D. program with curriculum, andragogy, and assessment viewed through the lens of race and how the participants perceived their growth as racial equity leaders. Contribution: This study offers several theoretical and practical applications for Educational Leadership doctoral programs that embed racial equity work. For faculty, the study informs their delivery of race-focused courses and programs to optimize their development of racially conscious leaders. For BIPOC students, the study empowers them to advocate for and demand challenging racial equity-focused curriculum and instruction. For White students, the study reinforces the necessity of a race-focused program for professional development. Findings: There was a marked difference between the BIPOC and White students’ responses. White students reported the most transformational growth in their racial awareness, their understanding of structural racism, and their recognition of where equity leadership skills could be utilized. BIPOC students were cognizant of much of this work before entering the program. However, they reported growth in understanding how best to implement effective racial equity leadership while maintaining healthy boundaries and self-care. Recommendations for Practitioners: Educational leadership doctoral programs with a focus on racial equity work need teaching faculty that espouse and demonstrate anti-racist curriculum, instruction, and assessment without relying on the racialized labor of BIPOC students to “teach” White students about racism. Recommendation for Researchers: The researchers in this study used separate focus groups – BIPOC and White. The data revealed that although the same questions were asked to each group, the BIPOC responses contained more vulnerable, personal details and yielded richer meanings. Future researchers should consider employing a more robust set of focus group questions that require more introspection and self-reflection, which might produce more significant insights. We believe they may yield more nuanced responses from all racial groups. Impact on Society: This study revealed that BIPOC and White educational leadership doctoral students have different and varying needs and challenges based on their racialized lived experiences. Educational leadership doctoral programs must provide the tools and opportunities for their students to be conversant and competent to address issues of structural racism. Future Research: Future research should use transformative learning theory to guide how BIPOC and White faculty in educational leadership doctoral programs assess their abilities to be anti-racist teachers and leaders.

Social workers are responsible for dismantling systems of oppression, promoting equity and inclusion, and creating and implementing just systems. Yet the structural inequities that disadvantage historically marginalized populations, including BIPOC (Black, Indigenous, and People of Color) populations, continue to be embedded into the very thread of social work practice, education, and research. Using critical race theory, we discuss how race and racism lead to the undervaluing of BIPOC scholarship and how BIPOC scholars with intersecting identities are doubly undervalued. We provide empirical evidence and case examples illustrating undervalued BIPOC scholarship and how it continues to oppress and disempower BIPOC scholars within academia, focused on the hiring, retention, and promotion of BIPOC faculty. We end with recommendations for addressing these areas of oppression, such as convening a multi-university effort to re-think promotion criteria for scholars engaged in diversity, equity, and disparity work. Such an effort could have implications for promoting social work scholars, many of whom are BIPOC. We hope this paper initiates a timely and essential discussions, leading to new, anti-racist practices of hiring and retaining BIPOC faculty and evaluating BIPOC scholarship and related teaching and service.

Lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) Black, Indigenous, and People of Color (BIPOC) live at the intersection of marginalized identities, resulting in unique experiences of exclusion within their various communities. Despite experiences of community exclusion, LGBTQIA+–BIPOC find ways to resist such structures to thrive in the face of adversity and strive for transformative change. The present study uses an intersectional framework to explore LGBTQIA+–BIPOC's experiences with community exclusion and acts of resistance. Fourteen LGBTQIA+–BIPOC participated in semistructured interviews to explore their experiences of exclusion and acts of resistance. Findings supported two broad categories with subthemes: (a) “on the fringes” (i.e., invalidation of LGBTQIA+–BIPOC experiences; White supremacy, colonization, and Western imperialism; “out and proud” dynamics) and (b) resistance: “we’re here, and I’m gonna let you know” (i.e., resisting intersectional oppression; intersectional identity cohesion; coalition building). Utilizing an intersectional framework, we critique larger oppressive structures that disenfranchise LGBTQIA+–BIPOC while offering implications for social justice interventions and transformational change to best serve LGBTQIA+–BIPOC.

Objectives/Goals: Research suggests that veterans identifying as Black, Hispanic/Latinx and multiracial may be at higher risk for developing posttraumatic stress disorder (PTSD). The aim of the current study was to compare PTSD treatment outcomes across racial/ethnic veteran groups. Methods/Study Population: Data from 862 veterans who participated in a 2-week cognitive processing therapy (CPT)-based intensive PTSD treatment program were evaluated. Veterans were on average 45.2 years old and 53.8% identified as male. Overall, 64.4% identified as White, Non-Hispanic/ Latino; 17.9% identified as Black, Indigenous, and People of Color (BIPOC), Non-Hispanic/Latino; and 17.7% identified as Hispanic/Latino. PTSD (PCL-5) and depression (PHQ-9) were collected at intake, completion, and at 3-month follow up. A Bayes factor approach was used to examine whether PTSD, and depression outcomes would be noninferior for BIPOC and Hispanic/Latino groups compared to White, Non-Hispanic veterans over time. Results/Anticipated Results: PTSD severity decreased for the White, BIPOC, and Hispanic/Latino groups from baseline to 3-month follow-up. The likelihood that BIPOC and Hispanic/Latino groups would have comparable PTSD outcomes was 1.81e+06 to 208.56 times greater than the likelihood that these groups would have worse outcomes than the White, Non-Hispanic veterans. Depression severity values on the PHQ-9 decreased for the White, BIPOC, and Hispanic/Latino groups from baseline to 3-month follow-up. The likelihood that BIPOC and Hispanic/Latino groups would have comparable depression outcomes at treatment completion approached infinity. At 3-month follow-up, likelihood was 1.42e+11 and 3.09e+05, respectively. Discussion/Significance of Impact: Results indicated that White, BIPOC, and Hispanic/ Latino groups experienced similarly large PTSD and depression symptom reductions. This study adds to the growing body of literature examining differences in clinical outcomes across racial/ ethnic groups for PTSD.

Challenges of Underrepresentation in LIS The underrepresentation of Black, Indigenous, and People of Color (BIPoC) within LIS poses significant challenges to the field’s efforts to advance equity, access, and representation. The statistics from the Department for Professional Employees (AFL-CIO, 2020) clearly illustrate this issue, but the challenges extend beyond numerical gaps. There are deeply embedded biases in LIS pedagogy, faculty hiring, and the overall academic culture that make it difficult for BIPoC scholars to thrive. The lack of racial diversity within LIS faculty—where many programs still have minimal BIPoC representation—creates a situation where Black and Brown students do not see themselves reflected in the curriculum, the faculty, or the research agendas of their programs. Moreover, the existing exclusionary practices within LIS academic institutions contribute to a climate where BIPoC students often feel marginalized. Research by Gibson and Hughes-Hassell (2017) highlights that Black students’ experiences at libraries are often marked by negative encounters, including feelings of unwelcomeness. These experiences not only shape students’ perceptions of LIS as a profession but also affect their investment in LIS education and careers. Furthermore, the burden of representing diversity within the LIS classroom often falls on BIPoC students, creating feelings of exploitation rather than inclusion. The gap between institutional commitment to diversity and the lived experiences of BIPoC scholars is evident in the persistent low enrollment of BIPoC students in LIS programs. The lack of representation in LIS faculty, particularly in historically White institutions, exacerbates the difficulty of recruiting new scholars from these communities. This underrepresentation underscores the importance of creating more intentional pathways for BIPoC students to enter and succeed in LIS fields. Catalysts for Change: The Spectrum Doctoral Fellowship Program Review and Impact This IMLS-grant funded program, Spectrum Doctoral Fellowship, seeks to address these systemic issues. The Spectrum Doctoral Fellowship Program has already demonstrated its effectiveness in advancing racial equity in LIS. By focusing on the recruitment of racially and ethnically diverse doctoral students, the program aims to develop a new generation of LIS faculty committed to racial equity and social justice in both teaching and research. The project builds on the success of earlier initiatives like Project Athena, which focused on cohort-based curricula, peer mentoring, and developing networks of scholars committed to anti-racist education and social justice in LIS. A majority of past Spectrum Doctoral fellows have successfully completed their doctoral degrees, and a third of these fellows have already attained positions as assistant professors or higher. These fellows represent a growing and dynamic community of BIPoC scholars who are reshaping LIS from within. The Spectrum Doctoral Fellowship Program continues to emphasize building supportive, anti-racist community spaces, which have been critical to the success of BIPoC students in LIS. Through networking, mentorship, and collective action, these spaces create an environment where fellows can build solidarity and work together to dismantle institutional barriers to racial equity in LIS education and practice. This panel will provide a platform for critical discussion on the role of diversity, equity, and inclusion in the future of Library and Information Science. It will also shed light on the impact of initiatives like the Spectrum Doctoral Fellowship Program in fostering an inclusive environment that supports BIPoC scholars and advances social justice in LIS curricula. In addition, panel will also discuss research conducted on diversity in higher education, LIS, and the impact and effectiveness of Spectrum and related BIPOC doctoral initiatives. By examining the challenges, successes, and lessons learned from these initiatives, the panel aims to contribute to the ongoing conversation about how LIS can evolve to better serve the diverse communities it aims to support.

<h3>Context:</h3> Structural factors are fundamental drivers of racial health inequity. Structural competency (SC) offers a paradigm for training health professionals to recognize and respond to the impact of structural factors. Despite national advocacy, curricula have been inconsistently implemented and evaluated. <h3>Objective:</h3> To study the incorporation of Anti-Racism structural competency curricula and how it impacts Black, Indigenous, and people of color (BIPOC) vs non-BIPOC learners. <h3>Study Design and Analysis:</h3> A cross-sectional mixed-methods study. Grounded theory analysis on the open-ended responses identified key themes. Both quantitative and qualitative analyses are by BIPOC vs non-BIPOC. <h3>Setting:</h3> Pre and post survey was disseminated using Qualtrics in the 2021-2022 academic year. <h3>Population Studied:</h3> All first year medical students at an academic medical teaching hospital. <h3>Intervention:</h3> Adapted structural competency curriculum from Bay Area Working Group. Curriculum was delivered in six 2-hour teaching sessions, involving a mix of whole-classroom presentations and self-selected racial affinity small discussion groups, and were accompanied by pre-reading, follow-up informal discussion groups, and post-session written reflective assignments. <h3>Outcome measures:</h3> Knowledge, attitudes, career choice, burnout, empowerment, and empathy. <h3>Results:</h3> 182 completed surveys: PRE: 36 BIPOC and 48 Non-BIPOC and POST: 46 BIPOC and 52 Non-BIPOC. Both groups had similar knowledge and attitudes towards the SC curriculum. Regarding more time being dedicated to these topics, the percent who responded Strongly Agree for BIPOC and Non-BIPOC increased by 36% (33 to 69%) and 22% (42 to 64%) from pre to post surveys, respectively. BIPOC students reported an increase in commitment to medicine rather than a change in career choice, and Non-BIPOC students indicated the course helped them better understand their profession. Many students noted they entered medicine because of their values related to equity and justice, though BIPOC-identified students noted more often-feeling burnout. Non-BIPOC students reported awareness of their BIPOCs’ peer burnout. Finally, we found an increase in empathy for patients and in self-empowerment across both groups. <h3>Conclusions:</h3> SC curriculum at this scale and early in the curriculum remains critical to creating a community of practice addressing racial equity in medicine.

1071 Background: Racial disparities in breast cancer incidence, mortality, and care are well documented. PAL plus endocrine therapy is indicated for patients (pts) with HR+/HER2− ABC. Findings from the PALOMA clinical trials have shown that pts receiving PAL maintained stable QoL; however, limited QoL data are available from real-world settings for BIPOC receiving PAL. Methods: POLARIS is a noninterventional, prospective, primarily US-based study in pts with HR+/HER2– ABC receiving PAL. QoL was assessed with the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 (EORTC QLQ-C30) at baseline, monthly for the first 3 mo of treatment (Tx) with PAL, and then every 3 mo. In this interim analysis, we report Tx patterns and QoL assessments at baseline and at 6 mo and 12 mo in BIPOC from POLARIS. Results: Of 1280 pts treated with PAL as November 10, 2020, 233 were included in the BIPOC subgroup of whom 159 (68.2%) completed PAL Tx for ≥6 mo and 112 (48.1%) for ≥12 mo. In the BIPOC cohort, 59.2% of pts were black, 35.2% Hispanic, 3.4% American Indian or Alaskan native, 2.1% Pacific Islander. PAL in combination with letrozole/anastrozole was received by 116 pts, 94 received PAL plus fulvestrant, 13 received PAL plus exemestane, and 10 received PAL plus another Tx; 175 pts (75.1%) received PAL as first-line Tx. Mean EORTC QLQ-C30 global health QoL and functional scales scores remained stable over the first 12 mo of PAL Tx, without any changes at or above the 10-point threshold considered clinically meaningful, and were similar to those previously reported in an earlier analysis of the entire POLARIS population (Table and Rocque et al SABCS 2019). Symptom scales scores, including nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, and diarrhea, also remained stable over 12 mo. Conclusions: In this subgroup analysis, PAL had no significant adverse impact on QOL in BIPOC with HR+/HER2– ABC, consistent with previous findings from the total POLARIS study population. Pfizer (NCT03280303). Clinical trial information: NCT03280303 .[Table: see text]

“Imposter syndrome” is a term used to describe feelings of pervasive self‐doubt despite evident success. It is the lay version of “imposter phenomenon,” a concept that was proposed as an explanation for why highly accomplished (mostly white and middle‐ to upper‐class) women persisted in believing that their success was due to luck or a mistake despite evidence to the contrary. However, the experience of imposter syndrome in genetic counseling, particularly among Black, Indigenous, and People of Color (BIPOC) individuals, remains underexplored. This study investigates the etiologies and impacts of imposter syndrome among BIPOC genetic counseling students with the aim of elucidating how the term is used and identifying potential interventions. We conducted semi‐structured interviews with 26 participants who were part of a longitudinal constructivist grounded theory study investigating the training experiences of BIPOC genetic counseling students. Using reflexive thematic analysis, we constructed themes related to self‐doubt, classroom and clinical performance, identity, and disclosing imposter syndrome feelings to others. Participants described imposter syndrome as arising from concerns that they were unprepared for their training program, less qualified than their peers, or admitted by accident or due to their BIPOC identity. Some participants attributed imposter syndrome to being a BIPOC student in a predominantly white profession. Comparisons to classmates and practicing genetic counselors, academic struggles, and anxiety about clinical rotations exacerbated imposter syndrome. Our findings underscore the multifaceted nature of imposter syndrome among BIPOC genetic counseling students and the need for a multipronged approach to mitigate its harmful effects. For BIPOC students, training programs should recognize that imposter syndrome is intertwined with racial inequities within the field that position them as imposters. We propose that supportive relationships with classmates, BIPOC mentors, and other BIPOC students can reduce imposter syndrome and enhance student well‐being and academic success.

Impact of Gender and Race on Academic Achievements for Neurology Faculty. (P5-2.001)