Anti-racist Approaches Research Articles

“Racism Happens Every Day, All the Time”: Black Families’ Outpatient Experiences of Racism Across a Large Pediatric System

ObjectiveTo qualitatively understand and characterize the experience of racism in outpatient pediatric healthcare settings from the perspectives of Black families. MethodsWe conducted focus groups with parents or guardians of Black children, recruited from academic primary care offices at a single pediatric institution. Focus groups were facilitated virtually by Black team members using an open-ended, semi-structured focus group guide. We analyzed focus group transcripts using iterative, thematic, inductive open coding performed independently by trained coders, with final codes reached by group consensus. ResultsWe conducted 6 focus groups of 3 to 5 participants each and 1 individual interview, with 24 total parents. We identified the following themes: 1) “I just felt like we was a number”: Black families perceived experiences that felt impersonal and lacked empathy; 2) “Why is the doctor treating me like I don’t matter?”: Black families perceived experiences with poor care and worse treatment; 3) Black families experience racism across socioecological levels when interacting with pediatric health systems; 4) Positive perceived experiences can guide improvement; and 5) Improvement will require antiracist efforts across the levels of racism. ConclusionsIn this qualitative study, we found that Black families have had many poor pediatric experiences, perceive racism as affecting child health broadly across socioecological levels, and recommend a multidimensional antiracist approach to improvement. Our findings underscore the importance of elevating Black family voices in developing policies that prioritize antiracism and work to eliminate the harmful impacts of racism on child health.

Negligence in biomedical research: an anti-racist approach for substance use researchers.

Racism is embedded in the fabric of society at structural, disciplinary, hegemonic, and interpersonal levels, working as a mechanism that drives health disparities. In particular, stigmatized views of substance use get entangled with racialization, serving as a tool to uphold oppressive systems. While national health institutions have made commitments to dismantle these systems in the United States, anti-racism has not been integrated into biomedical research practice. The ways in which substance use researchers use and interpret race data-without engaging in structural racism as a mechanism of health inequity-can only be described as inadequate. Drawing upon concepts from the Public Health Critical Race praxis, QuantCrit, and an anti-racism research framework, we recommend a set of guidelines to help biomedical researchers conceptualize and engage with race more responsibly in substance use research.

Nooses and Nazi swastikas on U.S. campuses: an anti-racist call for a rhetorical reframing of hate symbols as violent technologies

ABSTRACT The terrorizing placement of nooses and Nazi swastikas on U.S. college and university campuses has sustained a climate of fear, trauma, and intimidation. University administration responses often invoke protest from targeted communities over their approach. Examining news reports and university statements between 2010 and 2023, we critique universities’ use of the rhetorical framework of “symbols” (e.g., “heinous symbols of hate,” “racist symbols”). We argue that the “symbolism” framework reflects and reinforces a problem of minimization, if not dismissal, when responding to the impact of these events. Drawing on works by rhetorical studies scholars like Matsuda, Altman, Butler, and Ore, we argue that nooses and swastikas must be understood and treated in relation to their material, violent, spatial, and agential oppressive power and viewed through the relationship between the academic environment of white Christian spaces and anti-Black and anti-Jewish violence and exclusion. Coining the term, “technologies of violence,” we invite a rhetorical shift from hate speech and symbols to acts of violent doing and doing to within the context of historical and contemporary phenomena of systemic racism and antisemitism in academia and society. We offer an anti-racist approach to responding to and studying terroristic objects and acts on campuses.

Challenging anti-racism in nursing education: A moral and professional call to action

The call to implement anti-racism pedagogy in nursing education and practice is reverberating globally. Racist ideologies are foundational to systems of health inequity. An antiracist approach is critical to dismantling systemic racism and promoting optimal health outcomes in the quest for health equity. Therefore, employing an anti-racist pedagogy within nursing education that allows students and teachers to reflect on their roles in dismantling racist structures and transforming equity outcomes in practice and society, is a moral undertaking. However, for nursing education to make significant inroads in health equity, it cannot be guided by the same Eurocentric motives and value systems that continue to shape health inequities. We must transcend the boundaries of Eurocentric knowledge construction to intentionally shift how nurses think and practice within systems of inequities. Alongside the pressing and growing call for radical transformation of students and teachers through anti-racist pedagogy, we also provide directions to teaching strategies that support the uptake of anti-racism in nursing curricula and classroom engagement.

Culturally Centered Palliative Care: A Framework for Equitable Neurocritical Care.

Health disparities continue to plague racial and ethnic underserved patients in the United States. Disparities extend to the most critically ill patients, including those experiencing neurologic injury and patients at the end of life. Achieving health equity in palliative care in the neurointensive care unit requires clinicians to acknowledge and address structural racism and the social determinants of health. This article highlights racial and ethnic disparities in neurocritical care and palliative care and offers recommendations for an anti-racist approach to palliative care in the neurointensive care unit for clinicians.

A Clinic for the People: Toward an Antiracist Psychiatry at the Tuskegee Institute 1947-1965.

From 1947 until 1963, a small group of psychiatrists from the Tuskegee Veterans Administration Hospital ran a Mental Hygiene Clinic designed to provide outpatient care and education to the Black residents of Macon County, Alabama. In an analysis of the clinic and the work of its Director, Dr. Prince Barker, we see the ways that Black psychiatrists tried to develop an antiracist approach to psychiatry and to develop their own autonomy in segregated Alabama. But there were limitations to this work. Tensions between the state funding body, local politics, and the internal racism of psychiatry itself all made it difficult for Tuskegee psychiatrists to provide alternatives to care beyond the veil of the color line.

“A Wound That Was Already Festering”: The Burdens of a Racial Justice Program on Teachers of Color

Background: Research that documents the influence of anti-racism programs on teacher practice shows some desired outcomes, including developing critical consciousness to support students of color and educate others about stereotyping; understanding how racial bias affects one’s teaching and relationships with students; and implementing anti-racist approaches in schoolwide policies and practice. At the same time, research on anti-racist professional development (PD) also highlights the challenges of engaging in this work when white teachers, in particular, respond defensively or dismissively. Studies have shown how these responses can reinforce stereotyping behavior among white participants and reinscribe unequal social relationships. Research Questions: This article aims to answer the following questions: (1) How do white educators, if they do at all, display resistance to racial justice work? (2) How does resistance among white educators, if it does so at all, shape the experiences of educators of color? (3) How can schools reduce the potential burden of racial justice work on educators of color? Research Design: This article draws on data from a case study of a New York City elementary school that participated in a yearlong racial justice program. Data sources include semi-structured interviews with school and program leaders; focus groups with members of the racial equity committee and other teachers; observations of professional development sessions, racial equity committee meetings, and other program activities; and artifacts related to the implementation of the program to deepen our understanding of the program’s implementation and responses from multiple stakeholders. Recommendations: Grounded in critical race theory (CRT), the findings from this study paint a complex picture of the behaviors that white teachers may employ that derail racial justice work, the emotional and professional burden of that resistance on educators of color, and promising approaches for confronting resistance in order to advance racial equity. Beyond identifying the potential costs of engaging in racial justice work, our findings also offer schools and educators promising approaches for challenging white resistance while not perpetuating racial harm. We propose an implementation model that intentionally shields educators of color from the remonstrations of white resistors and the additional toll they can take on their time and well-being. Moreover, given what we know about the outsized role school leaders play in shaping school environments and professional cultures, it is essential that school leaders show commitment to organizational transformation, while developing the skills required to confront varying degrees of white resistance.

Equality, Discrimination and Inclusion: Lessons Learned, Challenges, and Positive Notes along the Way

This is a reflective piece on my trajectory and contributions in the field of Equality, Diversity and Inclusion (EDI) in Scotland and beyond. I start with a highlight in my career and then reflect back in order to identify what helped me get there. I want to share some insights into EDI work that I have gathered along with others over the past 23 years or so. EDI is a fertile career path and even an industry these days, partly as a result of the consciousness-raising of contemporary movements like #MeToo and Black Lives Matter. Yet, the issues raised by these movements internationally, have been well-known locally for decades and a great deal of work has been done to respond to them. What does this seemingly novel interest in, for example, intersectionality, equality, diversity, inclusion, belonging, anti-racist approaches and the decolonisation of the curriculum mean? I know where my interest stems from and, whilst sharing some reflections around these terms as buzzwords, I have rather focused in this piece on some lessons and on the processes that led me to learn them in my career in EDI. Necessarily, in this piece, I will share my EDI experience as a Mexican in Glasgow, which includes migration’s mark on my well-being, opportunities and safety in hostile anti-migrant environments. However, I also want to share what has become a life mantra of mine, a means of survival, my permanent wish to find in everything, a positive note.

A Hybrid Pragmatic and Factorial Cluster Randomized Controlled Trial for an Anti-racist, Multilevel Intervention to Improve Mental Health Equity in High Schools

Systemic racism is pervasive in US society and disproportionately limits opportunities for education, work, and health for historically marginalized and minoritized racial and ethnic groups, making it an urgent issue of social justice. Because systemic racism is a social determinant of health prevalent across multiple social and institutional structures, it requires multilevel intervention approaches using effective designs and analytic methods to measure and evaluate outcomes. Racism is a fundamental cause of poor health outcomes, including mental health outcomes; thus, mental health services and programs that address racism and discrimination are key to promoting positive mental health of racial and ethnic minority youth. While multilevel interventions are well-suited for improving outcomes like youth mental health disparities, their evaluation poses unique methodological challenges, requiring specialized design and analytic approaches. There has been limited methodological guidance provided to researchers on how to test multilevel interventions using approaches that balance methodological rigor, practicality, and acceptability across stakeholder groups, especially within communities most affected by systemic racism. This paper addresses this gap by providing an example of how to rigorously evaluate a hypothetical, theoretically based, multilevel intervention promoting mental health equity in three US school systems using an anti-racist approach intervening at the macro- (i.e., school system), meso- (i.e., school), and micro- (i.e., family and student) levels to improve mental health in adolescents. We describe the design, sample size considerations, and analytic methods to comprehensively evaluate its effectiveness while exploring the extent to which the components interact synergistically to improve outcomes. The methodological approach proposed can be adapted to other multilevel interventions that include strategies addressing macro-, meso-, and micro-levels of influence.

Using Participatory Research Methods to Foster an Anti-Racist Graduate Learning Environment

Only within the last few years has the American Psychological Association (APA) acknowledged the impact that the racist history of psychology training, research, and practice has had on people of color (APA, October 2021). As the primary governing organization of psychology, the field looks to the APA to model the possibility of an anti-racist approach to psychology. Training competencies, such as “professionalism,” have persisted as a core foundational skill, yet there is no consensus regarding the definition or essential elements of the competency (Elman et al., 2005; Grus et al., 2018). The lack of clarity in definition and essential elements has left supervising health service psychologists to form more subjective assessments that may be rooted within the field’s racist history. It is therefore unsurprising that professionalism is a concept that has long been weaponized against Black people, Indigenous people, and people of color (BIPOC) in medical and educational settings (Marom, 2019). To address this problem in a School Psychology doctoral program, participatory action research (PAR) methods were utilized to take action towards the creation of an equitable, inclusive, experiential definition of professionalism to reduce opportunities for racist and other discriminatory evaluation. Students and faculty were involved in every phase of the project, from the inception through multiple rounds of analysis and member checking. The result was a programmatic Essence Statement of professionalism, core beliefs about professionalism, and a table of professionalism competencies with definitions and behavioral exemplars, all of which are now codified in the School Psychology Program Handbook and available to all current and prospective students and faculty. The outlined methods can be implemented by professionals across disciplines and systems to actively reduce inequalities in settings where individuals with diverse and intersection identities evaluated by these systems have traditionally been excluded from the processes that impact them.

An Antiracist Approach to Social Care Integration.

An Antiracist Approach to Social Care Integration.

Microaggressions and the Complexities of Smartness in Kindergarten

ABSTRACT This study follows Mikah, an African American twice exceptional (2E-gifted and attention deficit hyperactivity disorder [ADHD]) kindergarten boy, in a U.S. classroom over the course of an academic semester, considering the research questions: How did Mikah (a pseudonym), age 5, experience microaggression in kindergarten? How were the microaggressions structured by the school/classroom and between home and school? A case study using ethnographic methods and critical discourse analysis methods was used. Data sources were collected and analyzed, including participant observation in the kindergarten classroom; interviews with teachers, children, parents, the coach, principal, and superintendent; children’s work samples; and classroom, school, and district media. The research findings showed how, across the year, Mikah switched his position from a victim of microaggressions by White people to the perpetrator of microaggressions toward Black peers and how Mikah’s White classroom teacher placed both Mikah and his father in perpetual need of disciplining because neither can completely avoid the “need” for her guidance on school-based normativity. The research indicated that racial microaggressions could spread and intensify when White teachers are not trained and committed to inclusive anti-racist approaches in the classroom, and to listening to Black children’s strengths and their parents’ wisdom.

Addressing anti-black racism in an academic preterm birth initiative: perspectives from a mixed methods case study

BackgroundGrowing recognition of racism perpetuated within academic institutions has given rise to anti-racism efforts in these settings. In June 2020, the university-based California Preterm Birth Initiative (PTBi) committed to an Anti-Racism Action Plan outlining an approach to address anti-Blackness. This case study assessed perspectives on PTBi’s anti-racism efforts to support continued growth toward racial equity within the initiative.MethodsThis mixed methods case study included an online survey with multiple choice and open-ended survey items (n = 27) and key informant interviews (n = 8) of leadership, faculty, staff, and trainees working within the initiative. Survey and interview questions focused on perspectives about individual and organizational anti-racism competencies, perceived areas of initiative success, and opportunities for improvement. Qualitative interview and survey data were coded and organized into common themes within assessment domains.ResultsMost survey respondents reported they felt competent in all the assessed anti-racism skills, including foundational knowledge and responding to workplace racism. They also felt confident in PTBi’s commitment to address anti-Blackness. Fewer respondents were clear on strategic plans, resources allocated, and how the anti-racism agenda was being implemented. Suggestions from both data sources included further operationalizing and communicating commitments, integrating an anti-racism lens across all activities, ensuring accountability including staffing and funding consistent with anti-racist approaches, persistence in hiring Black faculty, providing professional development and support for Black staff, and addressing unintentional interpersonal harms to Black individuals.ConclusionsThis case study contributes key lessons which move beyond individual-level and theoretical approaches towards transparency and accountability in academic institutions aiming to address anti-Black racism. Even with PTBi’s strong commitment and efforts towards racial equity, these case study findings illustrate that actions must have sustained support by the broader institution and include leadership commitment, capacity-building via ongoing coaching and training, broad incorporation of anti-racism practices and procedures, continuous learning, and ongoing accountability for both short- and longer-term sustainable impact.

Anti-Racist Approach to Pulse Oximetry: A Nurse Educator's Guide.

Anti-Racist Approach to Pulse Oximetry: A Nurse Educator's Guide.

Psychologists as Anti-Racist Change Agents on Campus: “What We Do Is More Important than What We Say or What We Say We Believe”

Psychologists, based on their training in the science and practice of change, are well-equipped to make vital contributions to combating inequity and embracing social justice at colleges and universities. By examining the oppressive systemic contexts of higher education and reviewing models of change, this article provides psychologists with critical perspectives and practices to ensure a more transformative and anti-racist approach to change. We consider three conceptual models to help move colleges and universities forward, employ evidence-based research and assessment strategies, and apply them at the individual, group, and organizational levels. A Black feminist critique is also utilized to further understanding of the role of resistance, coalition building, and freedom in creating change on campus.

Core components of an anti-racist approach among health professions educators: an integrative review.

This integrative literature review aimed to identify the core elements of an anti-racist approach among health professions educators. We searched five databases CINAHL (EBSCOhost), ERIC (ProQuest Dissertations & Thesis Global), EMBASE (Ovid), MEDLINE (Ovid), and Web of Science (Social Sciences Citation Index, Citation Index Expanded) in March 2021. The search strategy combined concepts related to anti-racist pedagogies in the context of health professions education by educators in any capacity. From 1,755 results, we selected 249 manuscripts published in English or French between 2008 and 2021 based on titles and abstracts. After reviewing the full texts, we selected the 48 most relevant sources. We extracted data regarding knowledge, skills, and attitudes in reference to anti-racist approaches or surrogate terms. Within each category, we grouped similar data using a conceptual map. Analysis of the selected sources revealed that, for health professions educators, engaging in an anti-racist pedagogical approach requires more than incorporating racialized perspectives and content into the classroom. It rather rests on three interrelated components: developing a critical understanding of power relationships, moving toward a critical consciousness, and taking action at individual and organizational levels. This review sheds light on knowledge, attitudes and skills that educators must deploy to adopt an anti-racist approach competently. This approach is a learned, intentional, and strategic effort in which health professions educators incorporate anti-racism into their teaching and apply anti-racist values to their various spheres of influence. This ongoing process strives for institutional and structural changes and requires whole-system actions.

A call for health justice: Striving toward health equity at a community health center.

Community health centers play a key role in promoting health justice and equity. Health justice, which is the attainment of health equity, or the fair, unambiguous, and non-arbitrary distribution of all health resources necessary for optimal health of the individual, family, and community, is necessary to optimize their wellbeing and to build healthy communities. Community-based health centers are well-positioned to lead in these efforts, as they connect with, seek to understand, and innovatively serve communities that experience complex health-related needs and are differentially impacted by structural vulnerabilities (i.e., racism). The purpose of this article is to present a nurse-led model of culturally responsive health care that is rooted in partnerships designed to address medical and health-related social needs. Current health inequities in the United States across constructs of race and socioeconomic status warrant comprehensive healthcare models that explicitly incorporate health justice, trauma-informed, and antiracist approaches into practice, especially when serving high/complex-need and under-resourced communities. Foundationally, it is imperative that these models of care strive toward equity regarding access to compassionate, affordable, culturally relevant health care; center community members' voices and guidance; promote growth and development of staff in understanding structural barriers and act to dismantle them; and create learning opportunities for students and staff to understand and address social determinants of health to provide high-quality care, with an ultimate goal to improve community health.

“Not in Our Daycare”? Commitments and Obstacles to Antiracism in Finnish ECEC

AbstractThe aim of this article is to contribute to the under-researched topic of racism in Finnish early childhood education and care (ECEC) by posing three questions: What kind of racism do ECEC teachers recognize in ECEC? How are teachers committed to opposing racism in their work? What kind of obstacles to committing to antiracism are recognized in ECEC? These questions are answered through discourse analysis on interviews with six Finnish ECEC teachers. This article demonstrates how racism is evident in many forms in early education, such as racist assumptions, all-White learning material and structures. The teachers recognized the urgency to resist racism in their work. They committed to antiracism through conscious pedagogical solutions, e.g., broadening representations in learning materials and critically reflecting on their privileges and racialised stereotypes. Yet adopting an antiracist approach in ECEC faces obstacles, such as the hectic everyday work, difficulty intervening in racist situations, and co-workers’ lack of self-reflection in multi-professional teams. Thus, it is vital to find ways to recognize racism in multi-professional teams, to improve the ability for self-reflection, and to ensure that teachers have the resources to continue their work against racism.

Critical Race Teacher Leadership: Leading Antiracist Systems Change

As attacks on critical race theory continue, anti-Black violence remains normalized, with schools often unwilling to transform toward racial healing. Sharing narratives from urban school-based practitioner projects, the authors conceptualize an applied critical race theory systems change model. After clarifying four tenets to guide teacher leadership-driven antiracist systems change, the authors identify five ongoing systemic antiracist approaches. Central to such transformation efforts are antiracist teacher leaders who are informed by voice-centric classroom instruction and an awareness of the larger school, community, and district contexts. The authors caution that antiracist systems change must continually counteract the Whiteness of schools.

Applying anti-racist approaches to informatics: a new lens on traditional frames.

Health organizations and systems rely on increasingly sophisticated informatics infrastructure. Without anti-racist expertise, the field risks reifying and entrenching racism in information systems. We consider ways the informatics field can recognize institutional, systemic, and structural racism and propose the use of the Public Health Critical Race Praxis (PHCRP) to mitigate and dismantle racism in digital forms. We enumerate guiding questions for stakeholders along with a PHCRP-Informatics framework. By focusing on (1) critical self-reflection, (2) following the expertise of well-established scholars of racism, (3) centering the voices of affected individuals and communities, and (4) critically evaluating practice resulting from informatics systems, stakeholders can work to minimize the impacts of racism. Informatics, informed and guided by this proposed framework, will help realize the vision of health systems that are more fair, just, and equitable.