Anti-racism Initiatives Research Articles

Navigating the Unseen Strain: The Hidden Challenges of Black Nursing Faculty in the Fight Against Anti-Black Racism.

As Black faculty members of a majority-White nursing school, we reflected on our unique experiences as part of a Black community engagement project, aimed at addressing anti-Black racism in nursing education. Our positionality created a complex scenario as we navigated emotionally heavy discussions, grappled with our ability to manage competing interests and care for our own well-being. The invisibility of the undue burden of anti-racism work is discussed. Recommendations for alleviating the burden are proposed based on this lived experience. Nursing schools must recognize the uniqueness of Black faculty members' experiences. Proposed strategies include creating mechanisms and resources for emotional support and incorporating anti-racism initiatives into the nursing school's values and strategic plan.

Efforts to Reduce Bias in Clerkship Evaluations: A CERA Study.

As the number of medical students who identify as underrepresented in medicine (URiM) increases, the disparities related to gender and URiM status persist. This study examines the current initiatives within family medicine clerkships to reduce bias in evaluations. Our 10-item survey was included as a module in the 2022 Council of Academic Family Medicine Educational Research Alliance national survey of family medicine clerkship directors. Our survey questions asked about whether programs had strategies to reduce bias in student evaluations, antiracism initiatives, perceptions on effectiveness of the initiatives, and type and cadence of faculty development on evaluations for preceptors. The overall response rate for the survey was 59.12% (94/159); all respondents completed our module. Seventy percent said they had implemented strategies to reduce bias in evaluations, 60% felt these were effective, and 80% felt that reducing bias in evaluations was a priority. The majority, 89/91(95%), indicated that their medical schools had a current social justice, diversity, or antiracism initiative. We identified a positive association between specific antibias medical school initiatives and clerkship directors undertaking practices to reduce bias in evaluations (P=.005). Most programs had implemented strategies to reduce bias and felt that doing so was a priority. Community-based preceptors were less likely to have faculty development around reducing bias compared to those in academics. Further improvements may need to prioritize including community preceptors in educational efforts to reduce bias.

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

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). 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. 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. Formal DEI role. Questions elicited reflection on the responsibilities of the role and the strengths and challenges of the unit or office. 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. 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.

SAGES White Paper on the importance of diversity in surgical leadership: creating the fundamentals of leadership development (FLD) curriculum.

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper. The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback. The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations. The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery.

COVID-19-related direct and vicarious racial discrimination: Associations with psychological distress among U.S. college students

BackgroundThe COVID-19 pandemic has been accompanied by a myriad of racist incidents targeting minorities in the U.S. Young adults are susceptible to direct and vicarious (indirect) pandemic-related racial discrimination. We sought to examine associations between both types of discrimination experiences and psychological distress among college students across different racial groups. MethodsWe analyzed self-reported data from 64,041 undergraduate students from the Spring 2021 American College Health Association-National College Health Assessment. Logistic regression examined odds of severe distress based on self-reported exposure to direct and vicarious racial discrimination. ResultsEven after controlling for sociodemographic characteristics and prior mental health diagnoses, there was a significant association between direct discrimination and distress among Asian (AOR: 1.3, p < 0.001), Hispanic (AOR: 1.6, p < 0.001), and Multiracial (AOR: 1.4, p < 0.001) students. Vicarious discrimination was significantly associated with distress among White (AOR: 1.4, p < 0.001), Asian (AOR: 1.4, p < 0.001), Hispanic (AOR: 1.5, p < 0.001), and Multiracial (AOR: 1.3, p < 0.001) students. Further analysis considering distress as a continuous measure revealed a significant association between vicarious discrimination and distress for Black participants (β = 0.9, p < 0.001). LimitationsSelf-reported variables are susceptible to recall bias. Minority racial group analyses may be underpowered. ConclusionsOur findings reveal an overall link between both direct and vicarious racial discrimination and distress across several racial groups. Further studies should examine effective mental health interventions and anti-racism initiatives to support students who have experienced direct or vicarious discrimination due to COVID-19.

Integrating Critical, Engaged, and Abolitionist Pedagogies to Advance Antiracist Social Work Education

The intersecting coronavirus, racism, and economic pandemics electrified U.S. social work organizations into creating long overdue antiracism initiatives. This necessary shift includes the Council on Social Work Education specifying that curriculums must consist of frameworks and practices that eliminate racism. Social work educators will need to incorporate antiracism into their teaching. We argue that critical, engaged, and abolitionist pedagogies contain frameworks and practices that align with antiracism. One of our fundamental assumptions is that liberation, which is a collective state of freedom from racism and other intersecting structures of domination, is the end goal of antiracism. We integrate concepts developed by critical pedagogy scholars, Black feminists, and abolitionist activists with our experiences to share ten lessons we learned through decades of collective praxis as social justice educators committed to liberation.

'Good Intentions' that 'Do Harm': Canada's state multiculturalism policy in the case of Black Canadians.

This essay identifies Canada's recognition of the United Nations Declaration for People of African Descent (UNDPAD) as a multiculturalist iteration. In this scope, the essay discusses the Community Support, Multiculturalism and Anti-Racism Initiatives (CSMARI) program as a central element of state multiculturalism, through which Canada plans to meet commitments to Black Canadians-and by extension, the UNDPAD. Although the CSMARI program is well intended, it causes harm to Black Canadians by reinscribing stereotyped material lack and other forms of racialized scarcity. Rather than address longstanding social-economic histories that sustain racialized poverty, state multiculturalism policy inadvertently reinforces these. The CSMARI program's focus on material lack as opposed to the systemic aspects that underpin these, amplifies Canada's multicultural myth of inclusivity while leaving unquestioned the cultural barriers that block Black citizens. State multiculturalism policy maintains the status quo by commodifying and depoliticizing anti-racism, while also neutralizing the language of naming experiences of exclusion. This essay adapts an anti-Black racism feminist theory to recast state multiculturalism as, implicitly, a cause of harm. The paper questions 'good intentions' that 'do harm' as a critical reflection that speaks to the dissonance expressed by Black Canadians, despite state multiculturalism policy.

The Perceived Role and Expectations of Diversity and Inclusion Trainers

In this study, “critical allyship” is defined as a critical approach to implementing strategies that promote the awareness, attitudes, and actions needed to support individuals and communities subjected to an ongoing history of marginalization and discrimination. This concept was used to examine the perceived roles and expectations of diversity and inclusion (D&I) trainers who self-identify as White and work for a corporate organization. The data consisted of 16 in-depth interviews analyzed using an interpretative phenomenological analysis (IPA) approach. The findings suggested that the participants’ racial identity and job responsibility present challenges and opportunities to practice critical allyship on an individual and organizational level. The participants described challenges concerning how the performance of diversity and inclusion trainers are evaluated, and how diversity and inclusion work is different from antiracism initiatives. The participants also explained how their personal development and ongoing journey of understanding White privilege and White supremacy has helped them guide the learning and development of their White colleagues. The teaching and support the participants receive from their Black, Indigenous, and other People of Color (BIPOC) colleagues was also acknowledged as an invaluable resource to help build their confidence and competence as a White ally and D&I trainer. In addition to the insights disclosed by the participants, this study also offers recommendations for future studies related to race-conscious diversity, equity, and inclusion outcomes in the workplace.

Teaching Undergraduate Social Determinants of Health: “Bad” Neighborhoods, “Those” People, and Dispelling the Stereotypical Portrayal of Poor, Urban Communities

The current racial climate, the subsequent protests taking place in the state of Minnesota, and the social spotlight that followed, brought forth the importance of creating anti-racism initiatives in higher education. This article describes a significant curriculum redesign of an undergraduate social determinants of health (SDOH) course to include a module on examining social and community context with an emphasis on racism, discrimination, and violence. Course materials focused on a notorious urban housing project subject to media scrutiny, and a corrupt political system that resulted in policies perpetuating generational segregation, poverty, and violence. SDOH factors are presented in an upstream public health approach from the lens of individuals, and their perceptions of top down, uncontrollable institutional level forces that impact their quality of life. This module aims to disrupt students’ deep-rooted understanding about underserved urban populations and introduces them to a nuanced understanding of intersectionality around five key SDOH. The module incorporates an intersectional analysis within the praxis of public health and sociology to explore discrimination, institutional racism, and segregation beyond public health data driven indicators that examine race and disparate health outcomes. We found that preconceived notions of student knowledge, behavior, and belief systems contribute to the stereotypical views of urban, poor minority populations. Students discovered that despite neighborhood dysfunction, residents created strong social cohesive networks, were political advocates for change, and sought promised governmental economic opportunities. Students are better informed about “those” people in “bad” neighborhoods that struggle to overcome decades of institutionally designed obstacles created from subversive policies.

Tackling the Minority Tax: A Roadmap to Redistributing Engagement in Diversity, Equity, and Inclusion Initiatives.

Academic medical centers striving to implement diversity, equity, and inclusion (DEI) and antiracism initiatives often ask faculty to volunteer substantial time to committee work, recruitment, mentoring, community, and administrative responsibilities. These requests are not in lieu of current workload and seldom count toward scholarship; the service may go unrecognized, unrewarded, and uncompensated. URiM faculty (underrepresented in medicine) providing such service thus pay a minority tax when precious time is syphoned away from career-advancing activities and personal growth. The resulting strain on available resources has social, psychological, and monetary ramifications that can undermine the long-term objectives of DEI initiatives. We examine the facets of the minority tax, consider the current state of diversity, and present a roadmap to redistribute, reform, and reduce URiM taxation through shared engagement in DEI initiatives. Key interventions include ascribing value to DEI efforts, implementing evidence-based policies to reduce bias, and promoting mentorship, sponsorship, and allyship.

Diversity, Equity, and Inclusion in Research Teams: The Good, The Bad, and The Ugly

Since the murder of George Floyd on May 25, 2020, and the racial justice protests that followed, many institutions, including the academy, pledged their support for policies and practices that combat on-going racial injustice. Social justice and anti-racism initiatives abound on college campuses, including programming, hosting speakers, and proposing required ‘diversity’ classes for all students. For all this rhetoric, college and university administrators have remained silent when it comes to diversity, equity, and inclusion practices as they relate to research. And yet, extant research documents the ways in which racial and gender biases have consistently shaped every level of research from the development of the research question, to the diversity (or not) of the sample, the availability of funding, and the probability of publishing. In this paper we focus on one aspect of the research process: the assembling (or not) of diverse research teams. We explore the benefits that diversity in research teams brings to the integrity of the data as well as the obstacles to both assembling a diverse research team and managing it successfully. Specifically, this paper focuses on the myriad ways in which diversity in research teams is treated as a set of boxes to check, rather than an epistemology that underscores positionality and power. We present a series of case examples that highlight the ways in which diversity, equity, and inclusion are successfully and unsuccessfully achieved in research teams, both in terms of outcomes and experiences. These case examples focus specifically on power relations along all forms of diversity, including race and gender as well as rank. The case examples also serve to unpack the ways in which research teams can rely on positionality as a tool for addressing power at three distinct levels: in conducting social science research generally, between the researcher and the “researched,” and among the research team itself.

How to appear fully committed to doing nothing at all about structural and systemic racism: A modest proposal for health and higher education services.

How to appear fully committed to doing nothing at all about structural and systemic racism: A modest proposal for health and higher education services.

Moving Beyond Implicit Bias in Antiracist Academic Medicine Initiatives.

The concept of implicit bias has arguably laid the groundwork for uncomfortable discussions surrounding race in academic medicine, but its effectiveness in changing racist behavior and systems remains unclear. Terms like implicit bias, while perhaps more palatable than other concepts to some, may result in confusion and divert time from meaningful reconceptualization and creation of effective antiracism initiatives. This Invited Commentary contends that the term implicit bias is inadequate for addressing racism because it is too broad; does not necessarily lead to a change in racist behaviors; assumes that racism is unconscious, aggressor-centered, and individual-focused; and implies that everyone suffers equally in a racist system. The authors illustrate why terms like implicit bias are inadequate in combatting racism in medicine and suggest alternate terminology to use while engaging in antiracism work in academic medicine.

Kicking It Out? Football Fans’ Views of Anti-Racism Initiatives in English Football

This article explores the views of 906 football fans (96% of whom selfidentified as White), collected via an online survey from May-June 2019, regarding the impact of the leading equality and inclusion organization, Kick It Out, in delivering initiatives to challenge the multifaceted expressions of racism by some White English football fans. Whilst fans recognize the importance of raising awareness of racial discrimination, nearly three quarters of White fans do not engage with any Kick It Out initiatives. In the face of new challenges, including the largely unregulated space of social media, and a socio-political climate that has facilitated the resurgence of overtly expressed bigoted, colour and cultural-based racisms, the article stresses that the English football authorities must support the work of anti-racism organizations to increase their potency amongst White fans if racial discrimination is to be more effectively challenged in the future.

Strategies to Reduce Bias and Racism in Nursing Precepted Clinical Experiences.

Nursing programs are tasked with ensuring diverse, equitable, and inclusive (DEI) learning environments for all student learners. With calls to diversify the nursing workforce, engaging nursing preceptors in program-wide DEI initiatives are crucial. Preceptors lacking commitment to DEI could result in poor patient-preceptor communication, tense learning environments, or biased evaluations of students. Suggestions for successful strategies to include the preceptor in nursing program's antiracism initiatives are based on the current literature. Best practices include providing antiracism training for preceptors, decreasing potential for bias in student evaluations, inquiring about observed racism in clinical sites, and equipping students to be upstanders for antiracism and DEI interventions. Dismantling racism and bias in nursing education requires a multilevel strategy. Nursing programs and nurse educators have a responsibility for ensuring a bias-free learning environment and should include the preceptor in antiracism strategic planning. [J Nurs Educ. 2021;60(12):697-702.].

Antiracism in the LIS Profession: Not Just Lip Service

AbstractWith rising cases of brutality, gun violence, and racial injustice towards particularly the Black and AAPI (Asians, Asian Americans, Pacific Islanders) communities, racism is being recognized and declared as an emergency and public health threat. Diversity, equity, and antiracism are core to the Library and Information Science (LIS) profession as we strive to uphold the principle of “libraries serve humanities” and the motto of “free to all.” During this extended period of “racial‐injustice as a public crisis”, what are the roles of LIS professionals in battling racism, violence, and other systems of oppression? This panel session features experienced LIS professionals and educators who specialize in DEI, reporting their activities, stories, and thoughts on antiracism. A breakout room activity is envisioned following panelists' presentations, with participants discussing and sharing their antiracism initiatives. Participants will also brainstorm the next course of action in the LIS profession's journey in battling racism.

Exclusion, Minimization, Inaction: A Critical Review of Ireland's Policy Response to Gender-Based Violence as It Affects Migrant Women

This critical review of Ireland's policy response to gender-based violence as it affects migrant women contributes to recent literature that focuses on how states' legal and policy regimes can be part of the problem, in this case adding to rather than reducing GBV related vulnerabilities experienced by migrant women. Through a review of key policy, law and NGO documents, the report foregrounds the significance of context-specific framing and interpretation of influential ideas in shaping the horizons of possible policy action. The review is contextualized in relation to developments in Ireland concerning migration, citizenship and racialisation and more broadly vis-a-vis the nexus of migration governance and gender based violence. The authors trace the development of dominant ideas that shape policy practice with a focus on their interpretation in the Irish context—namely, vulnerability, intersectionality, and interculturalism. Four particular areas of policy response are identified, which reveal a pattern of policy failure on the part of the Irish state characterized by exclusion, minimization, and/or inaction. These relate to assessment of vulnerability of applicants for international protection; addressing gender-based violence in the context of direct provision accommodation; identification and referral of trafficking victims; and response to domestic violence linked to dependent migration status. The authors find that the pattern of failure identified is linked to the current dominance of an ever narrowing and individualized framing of vulnerability found in EU migration regulations, a lack of application of an intersectional gender perspective, the diminished influence of indivisible human rights norms requiring attention to economic, social and cultural rights, as a well as a wider national context of declining resource allocation to addressing gender-based violence and integration, including anti-racism initiatives, for over a decade.

Diabetes And Race

Diabetes And Race

A time to act: Anti-racist paediatric research

Research offers the potential for new treatments, programs and services, and underlies decisions about funding that can have profound implications for people’s lives. When racism in research is not addressed, children and their families will be unjustly impacted by systemic discrimination, exclusion, and inequity. With a growing acknowledgement that racism is a social determinant of health, and as COVID-19 reveals staggering racial disparities, we believe now is the time for intentional anti-racism initiatives throughout the research ecosystem to prevent further harms in patient care and the lives and futures of children. We aim to highlight this need for justice, and conclude with a series of practical recommendations, ranging from the collection and use of race-based data, to equity, diversity, and inclusion (EDI) education, to mentorship opportunities.

From Intention to Action: Operationalizing AGA Diversity Policy to Combat Racism and Health Disparities in Gastroenterology

From Intention to Action: Operationalizing AGA Diversity Policy to Combat Racism and Health Disparities in Gastroenterology