Black, Indigenous, And People Of Color Research Articles

Exploring Cultural Competence, Inclusivity, and Diversity in Ketamine Assisted Psychotherapy: A Phenomenological Study

ABSTRACT Black, Indigenous, and People of Color (BIPOC), and other minoritized populations are insufficiently represented in research on therapeutic psychedelics. This research was a phenomenological qualitative exploration of a culturally diverse (Hispanic, African American, Asian, Native American, biracial, or LGBTQIA+) and low-income sample of 15 individuals receiving ketamine-assisted psychotherapy (KAP) at a sliding-scale fee community clinic. Participants were interviewed after a ketamine session, after a ketamine integration session, and one month later. The interviews inquired about mental and emotional state prior to treatment and the treatment context (traditionally called set and setting), preparation for treatment, experiences during the ketamine and integration sessions, barriers to treatment, perceived stigma if any, reflections on KAPs’ impact, and relevance of culture to the treatment. The current analysis, which focuses on participant comments related to diversity, equity, and inclusion that are uniquely relevant to this sample and the research goals, yielded four major themes: Insufficient Financial Resources, Race, Ethnicity, and LGBTQIA+, Stigma, and Culture and Ritual. Themes and subthemes are presented accompanied by representative quotes. Results demonstrate the high salience of culture in the KAP experience and the need to incorporate issues of race, culture, stigma, ritual, and socioeconomic status into treatment planning and outcome research.

Racial inequities and rare CFTR variants: Impact on cystic fibrosis diagnosis and treatment

Cystic fibrosis (CF) has been traditionally viewed as a disease that affects White individuals. However, CF occurs among all races, ethnicities, and geographic ancestries. The disorder results from mutations in the CF transmembrane conductance regulator (CFTR). Varying incidence of CF is reported among Black, Indigenous, and People of Color (BIPOC), who typically exhibit worse clinical outcomes. These populations are more likely to carry rare CFTR variants omitted from newborn screening panels, leading to disparities in care such as delayed diagnosis and treatment. In this study, we present a case-in-point describing an individual of Gambian descent identified with CF. Patient genotype includes a premature termination codon (PTC) (c.2353C>T) and previously undescribed single nucleotide deletion (c.1970delG), arguing against effectiveness of currently available CFTR modulator-based interventions. Strategies for overcoming these two variants will likely include combinations of PTC suppressors, nonsense mediated decay inhibitors, and/or alternative approaches (e.g. gene therapy). Investigations such as the present study establish a foundation from which therapeutic treatments may be developed. Importantly, c.2353C>T and c.1970delG were not detected in the patient by traditional CFTR screening panels, which include an implicit racial and ethnic diagnostic bias as these tests are comprised of mutations largely observed in people of European ancestry. We suggest that next-generation sequencing of CFTR should be utilized to confirm or exclude a CF diagnosis, in order to equitably serve BIPOC individuals. Additional epidemiologic data, basic science investigations, and translational work are imperative for improving understanding of disease prevalence and progression, CFTR variant frequency, genotype-phenotype correlation, pharmacologic responsiveness, and personalized medicine approaches for patients with African ancestry and other historically understudied geographic lineages.

“Being heard”: pedagogical strategies that support BIPOC students in postsecondary leadership courses

PurposeOur goals were to explore the pedagogies applied by instructors that supported Black, Indigenous and People of Color (BIPOC) student learning in a leadership course and the leadership behaviors BIPOC students identified as being applicable after the course.Design/methodology/approachThrough survey research and qualitative data analysis, three prominent themes emerged.FindingsHigh-quality, purposeful pedagogy created opportunities for students to learn. Second, a supportive, interactive community engaged students with the instructor, each other and the course material to support participation in learning. As a result, students reported experiencing big shifts, new growth and increased confidence during their leadership courses.Originality/valueWe discuss our findings and offer specific recommendations for leadership educators to better support BIPOC students in their leadership courses and classrooms and for further research with BIPOC students.

The impact of cohort relationships on BIPOC genetic counseling students: Results from a longitudinal qualitative study.

The transition to graduate school is marked by stress, with academic demands and interpersonal interactions being primary concerns for genetic counseling students. For Black, Indigenous, and People of Color (BIPOC) graduate students, additional stressors caused by the "minority tax" and microaggressions impact their sense of belonging and inclusion. This prospective longitudinal study employed a constructivist grounded theory approach to investigate the experiences of first-year BIPOC genetic counseling students as they transitioned into the first year of their graduate training. We conducted semi-structured interviews with 26 first-year genetic counseling students at three key time points during their first year and analyzed them using reflexive thematic analysis. Here, we report themes related to stressors when transitioning into the genetic counseling training environment, the role of relationships as a source of support in navigating these challenges, and the impact of cohort dynamics on the training experience. Stressors included managing academic rigor and time demands, navigating microaggressions, reactions to discussions about diversity, equity, inclusion, and justice (DEIJ), and managing mental health. Peer relationships emerge as pivotal source of support, but challenging dynamics within the cohort negatively impacted participants, highlighting the importance of fostering an inclusive training environment. Since programs have less control over the composition of each cohort with the advent of the Match system in 2018, we recommend the use of community-building and debriefing activities to strengthen healthy relationships and address problematic dynamics. We recommend that training programs be proactive in creating mentoring relationships between faculty and students rather than waiting until students ask for help. Ultimately, we advocate for a holistic approach to genetic counseling training that maintains academic rigor but also prioritizes the creation of supportive, inclusive, and culturally sensitive learning environments for all students.

Insecure attachment and eating disorder symptoms: Intolerance of uncertainty and emotion regulation as mediators.

Literature on eating disorder (ED) symptoms of Black, Indigenous, and People of Color (BIPOC) group is extremely scarce. This study aimed to understand the mechanisms underlying the associations between insecure attachment and ED symptoms and examine whether these mechanisms differed between White and BIPOC groups. The study investigated direct and indirect relationship between attachment anxiety/avoidance and ED symptoms via intolerance of uncertainty (IU) and emotion regulation strategies of suppression and reappraisal. Further, we examined whether the proposed mechanisms equally represented White versus BIPOC using Multigroup Structural Equation Model (MG-SEM). A total of 1227 college students (48.50% BIPOC and 51.50% White) completed research questionnaires. Results showed that IU and suppression mediated the relations between insecure attachment and ED symptoms for both White and BIPOC groups. Uniquely, reappraisal mediated the relations between insecure attachment and ED symptoms for the White group, but not for the BIPOC group. The implications of the findings for culturally informed practice are discussed, including targeting increasing tolerability of uncertainties and improving emotion regulation to mitigate ED symptoms for those with insecure attachment.

Brave and Transgressive Appropriations Matter: A Review of “Exploring Othello in 2020” for Red Bull Theater

This is a review of New York’s Red Bull theater's Zoom salon, entitled “Exploring Othello in 2020.” The production used a BIPOC (Black, Indigenous, and people of color) cast. This review considers the production in relationship to larger trends within premodern critical race studies and the idea that theatre can create a brave space for exploring the relationship between race and performance in Shakespeare.

Recruitment Techniques for LIS Internship Applicants of Color: Case Study of a Paid Medical Data Internship Program

Background: The recruitment of Black, Indigenous, and People of Color (BIPOC) has been an ongoing effort for specialized libraries and library programs, especially as they try to fill technical roles while combatting internalized biases and candidates’ potential self-deselection by not applying or otherwise removing themselves from the recruitment process. Introduction: This case study examines the recruitment efforts of the National Center for Data Services (NCDS) for a paid internship program for BIPOC graduate students interested in data librarianship in health sciences settings. Methods: To enhance recruitment efforts and support applicants, NCDS met with consultants on equity, diversity, inclusion, and accessibility. The recruitment process included reaching out directly to graduate programs, hiring an independent application coach who was available to consult with anyone interested in applying, holding informational sessions about the internship opportunity, and limiting the required components of the application, which included removing the need for letters of recommendation or support. Results: Although the target group was a very small pool of Library and Information Science (LIS) BIPOC students interested in medical and data librarianship, we received applications from all United States (U.S.) racial groups, except Native Hawaiian or Other Pacific Islander. The recruitment efforts led to 38 applications for 8 positions in 2022 and 59 applications for 12 positions in 2023. Conclusions: The resultant number of applications showed an interest and need for specialty programs for BIPOC LIS students and highlighted how recruitment methods impact participation in specialized programs. Further research is necessary to assess the impact of various recruitment styles for this target group and the impact of these recruitment methods.

Inclusive Science Communication Approaches Through an Equity, Diversity, Inclusion, and Social Justice (EDISJ) Lens

Science communication has taken center stage in Science, Technology, Engineering, and Math (STEM) disciplines in the context of public outreach and citizen science. Developing practical communication skills is imperative for all scientists to be highly successful in their careers and more so for underrepresented and Black, Indigenous, and People of Color (BIPOC) professionals in STEM. The program, led by the Engineering and Science Librarian at the University of Victoria (UVic) Libraries, aimed to equip students and early career scientists with critical communication skills by leveraging the unique voices and lived experiences of BIPOC speakers in STEM disciplines. Through this program, a unique toolkit with engaging modules consisting of 30 short videos, each three minutes long (30 x 3) by BIPOC speakers was created to provide broad foundational skills in verbal and visual communication, using an Equity, Diversity, Inclusion, and Social Justice (EDISJ) lens. A two-day conference offered networking and communication development opportunities to students and early-career scientists in STEM disciplines by connecting them with BIPOC STEM leaders and visionaries who promote STEM advocacy. This paper will discuss the methods used in the creation of the toolkit and conference using an EDISJ lens.

Contributing factors for career goal advancement of pharmacy learners in the Black, Indigenous, and People of Color community.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. To explore factors influencing career goals and goal attainment for pharmacy learners (eg, students, residents, fellows) who identify as part of the Black, Indigenous, and People of Color (BIPOC) community. In late 2021 and early 2022, US-based pharmacy learners were invited to participate in two focus groups. In the first focus group, participants were asked to reflect on career goal influences, barriers, and facilitators. In the second focus group, participants were asked to provide suggestions for educational institutions and healthcare organization improvement to support career goal attainment for learners in the BIPOC community. Focus group transcripts were coded using both deductive and inductive coding and thematic analysis. Fifteen learners were included in the first round of focus group, and 10 learners were included in the second. The most common career goal motivators were self-efficacy factors. Barriers and facilitators were often closely related. The most common barriers were financial, lack of representation, and lack of support. Common facilitators included mentorship and informal networking opportunities. Participants suggested multiple strategies for educational institutions and healthcare organizations to support BIPOC learner success, including genuine investment, representation, financial support, improved access to professional development opportunities, partnering with other professional organizations, and prioritizing diversity, equity, and inclusion (DEI) initiatives. Institutions should prioritize effective, positive mentoring relationships and exposure to BIPOC professionals. Training programs and associations should consider improving financial support and lowering the cost of involvement to reduce barriers. All stakeholders should prioritize DEI in their organizational culture to promote career advancement of BIPOC learners and professionals.

Racial equity facilitators of active outdoor recreation in parks and protected areas: Scale development, testing, and validation

Active outdoor recreation (AOR) can provide valuable benefits, but racial inequities can constrain participation for Black, Indigenous, and People of Color (BIPOC). Despite their potential value for park managers, limited attention has been given to assessing and understanding factors which can facilitate more equitable AOR participation. This national study included the development, testing, and validation of a new scale focused on facilitators of AOR in local parks and protected areas, including both general and racial equity oriented intrapersonal, interpersonal, and structural facilitators. The scale performed well in a racially and ethnically diverse sample, exhibiting strong fit in confirmatory factor analysis, measurement invariance by race/ethnicity, gender, income, and participation status, and expected relationships with constraints, negotiation, motivations, and participation frequency. Findings demonstrate the potential utility of the scale as a tool for identifying effective and equitable facilitation strategies and examining the unique contributions of facilitators in the constraint negotiation model.

Ethno-Racial Inequities of the COVID-19 Pandemic: Implications and Recommendations for Mental Health Professionals

The coronavirus disease-19 (COVID-19) pandemic has disproportionately impacted Black, Indigenous, and People of Color (BIPOC) communities due to systemic health disparities based on race, ethnicity, and systemic inequities. Among extent literature on BIPOC mental health and COVID-19, there is a pressing need for culturally responsive, trauma-informed treatment approaches that go beyond the broader impacts of the pandemic or immediate pandemic-related concerns and address the persisting impacts of the COVID-19 on BIPOC mental health. To this end, our article aims to equip professional counselors with the necessary tools to serve BIPOC clients more effectively by (1) understanding the ethno-racial inequities of the COVID-19 pandemic, (2) assessing the intersectional dimensions of stress and trauma associated with COVID-19, and (3) employing therapeutic approaches to promote physical and mental well-being in BIPOC clients.

Has Racial Inclusion in the Wine Industry Improved Since 2020? Results From Two Surveys of Black Wine Entrepreneurs

Black, Indigenous and People of Color (BIPOC) entrepreneurs have been underrepresented in America’s formal wine industry for centuries. It is commonly reported that Black-owned wineries represent less than one percent of the 11,000 U.S. wineries, while only two percent of wine professionals identify as Black. The events of 2020, including the video-recorded murder of George Floyd by a police officer, incited global protests for social justice, equity and inclusion. The wine industry, along with its peers in retail, finance, and others, committed to improved opportunities for Black business owners as well as employees. In the current article, the 2020 and 2023 results of the Terroir Noir survey of Black wine entrepreneurs are presented to assess the perspectives of this segment regarding inclusion and other topics.

Age, Race, Ethnicity, and Sex of Participants in Clinical Trials Focused on Chronic Pain

There is limited data on equitable inclusion in chronic pain trials. We aimed to 1) identify the frequency of reporting age, race, ethnicity, and sex in clinical trials targeting chronic pain, and 2) compare sociodemographic representation to the United States (US) population. We examined US-based intervention trials for chronic pain initiated between 2007 and 2021 and registered on ClinicalTrials.gov. We 1) assessed the frequency of reporting each demographic variable, 2) compared representation with US population estimates, and 3) explored change in reporting over time. Of 501 clinical trials, the frequency of reporting was as follows: 36.9% reported older adults, 54.3% reported race, 37.4% reported ethnicity, and 100% reported sex. Rates of race and ethnicity reporting increased, but older adult age reporting decreased over time (ps < .00001). Compared to 2020 US population estimates, there was an equitable representation of older adults, under-representation of individuals identifying as American Indian or Alaska Native (.8% vs .6%), Asian (5.6% vs 2.9%), Black or African American (12.6% vs 12.2%), with more than one race (2.9% vs 1.2%), and Hispanic/Latino (16.9% vs 14.1%). There was an over-representation of individuals identifying as Native Hawaiian or Pacific Islander (.2% vs .5%) or White (70.4% vs 72.9%), and of females (50.8% vs 68.4%). Some representation rates varied by chronic pain condition. Reporting of older adult age, race, and ethnicity was low in chronic pain trials in ClinicalTrials.gov, reinforcing the need for adhering to reporting guidelines. Representation varied across trials compared with US population data, particularly among those identifying as Hispanic/Latino and certain minority racial groups. PerspectiveDespite initiatives to increase the reporting of demographic information, doing so in clinical pain trials is far from ubiquitous. Moreover, efforts to improve diversity in these trials continue to be insufficient. Indeed, Black, Indigenous, and People of Color (BIPOC) remain under-represented in clinical pain trials.

Clinical Considerations in Working with Children and Adolescents of Color: Past, Present, and Future

Background: Systemic racism and health inequality for Children and Adolescents of Color (CAoC) and their families need to be acknowledged and addressed in the provision of mental health treatment by child and adolescent psychiatrists. The lack of parity for behavioral health drives the lack of integration of “mental” health with overall health and the lack of funding, policy, planning, and practices to support the social and emotional health of children and their families. Additionally, the unequal treatment faced by Black, Indigenous, and People of Color (BIPOC) children and their families further impacts their overall health and mental health outcomes. Implicit biases, conscious and unconscious, influence clinical judgments, lead to errors in diagnostic and treatment decisions and impair child and adolescent psychiatrists’ ability to fully partner with families to treat, advocate for, and improve the clinical and life trajectories of this diverse group of young people and families that child and adolescent psychiatrists are called to serve. Methods: Using a case vignette, this paper discusses historical examples showing how child and adolescent psychiatrists’ implicit bias may manifest when working with CAoC. Medical training and clinical practice have paid scant attention to the broader impacts of systemic racism and inequities in healthcare until recent years. Discussion: This article provides clinical recommendations for clinicians to navigate these factors through trauma-centered and patient-centered care. Viewing through the lens of intergenerational racial trauma and acknowledging one’s own bias, clinicians can better help and support CAoC as they strive toward a brighter future.

Virtual BUILD Research Collaboratory: A biomedical data science training using innovative pedagogy to address structures of racism and inequitable stress for undergraduates of color.

The unprecedented events of 2020 required a pivot in scientific training to better prepare the biomedical research workforce to address global pandemics, structural racism, and social inequities that devastate human health individually and erode it collectively. Furthermore, this pivot had to be accomplished in the virtual environment given the nation-wide lockdown. These needs and context led to leveraging of the San Francisco Building Infrastructure Leading to Diversity (SF BUILD) theories of change to innovate a Virtual BUILD Research Collaboratory (VBRC). The purpose of VBRC was to train Black, Indigenous, and people of color (BIPOC) students to apply their unique perspectives to biomedical research. These training activities were evaluated using a pre-post survey design that included both validated and new psychosocial scales. A new scale was piloted to measure culturally relevant pedagogy. VBRC scholars increased science identity on two items: thinking of myself as a scientist (+1point, p = 0.006) and belonging to a community of scientists (+1point, p = 0.069). Overall, scholars perceived stress also decreased over VBRC (-2.35 points, p = 0.02). Post VBRC, scholars had high agency scores (μ = 11.02, Md = 12, range = 6-12, σ = 1.62) and cultural humility scores (μ = 22.11, Md = 23, range = 12-24, σ = 2.71). No notable race/ethnic differences were found in any measures. Taken together, our innovative approach to data science training for BIPOC in unprecedented times shows promise for better preparing the workforce critically needed to address the fundamental gaps in knowledge at the intersection of public health, structural racism, and biomedical sciences.

Are Racial Disparities in Cesarean Due to Differences in Labor Induction Management?

While there are known racial disparities in cesarean delivery (CD) rates, the exact etiologies for these disparities are multifaceted. We aimed to determine if differences in induction of labor (IOL) management contribute to these disparities. This retrospective cohort study evaluated all nulliparous patients with an unfavorable cervix and intact membranes who underwent IOL of a term, singleton gestation at a single institution from October 1, 2018, to September 30, 2020. IOL management was at clinician discretion. Patients were classified as Black, Indigenous, and People of Color (BIPOC) or White based on self-report. Overall rates of CD were compared for BIPOC versus White race. Chart review then evaluated various IOL management strategies as possible contributors to differences in CD by race. Of 1,261 eligible patients, 915 (72.6%) identified as BIPOC and 346 (27.4%) as White. BIPOC patients were more likely to be younger (26 years interquartile range (IQR) [22-30] vs. 32 years IQR [30-35], p < 0.001) and publicly insured (59.1 vs. 9.9%, p < 0.001). Indication for IOL and modified Bishop score also differed by race (p < 0.001; p = 0.006). There was 40% increased risk of CD for BIPOC patients, even when controlling for confounders (30.7 vs. 21.7%, p = 0.001; adjusted relative risk (aRR) 1.41, 95% confidence interval (CI) [1.06-1.86]). Despite this difference in CD, there were no identifiable differences in IOL management prior to decision for CD by race. Specifically, there were no differences in choice of cervical ripening agent, cervical dilation at or time to amniotomy, use and maximum dose of oxytocin, or dilation at CD. However, BIPOC patients were more likely to undergo CD for fetal indications and failed IOL. BIPOC nulliparas are 40% more likely to undergo CD during IOL than White patients within our institution. These data suggest that the disparity is not explained by differences in IOL management prior to cesarean, indicating that biases outside of induction management may be important to target to reduce CD disparities. · The etiologies for racial disparities in cesarean are likely multifaceted.. · In this work, there were no differences by race in measures of labor induction management.. · Biases outside of induction management during labor may be targeted to reduce CD disparities..

Black indigenous and people of color arts as a premise of/for methodological theories of justice

The act of living in the world for Black, Indigenous, and people of Color (BIPOC) is a creative one. Creative acts have been a premise for BIPOC theories of survival, thriving, and movement away from entanglements with whiteness or “creative disruptions.” Creativity, we argue, is a premise for theorizing and engaging in education research. In this paper, we make a case for creativity and stitch together word and image as an exploration of the importance of BIPOC arts in theories of justice in educational research. We explore the political importance of the serious engagement of BIPOC youth arts as well as the use of arts by BIPOC scholars in their analysis and theory building. Connected to this ability to see and resist differently through art, is joy and healing. Creativity promotes healing and allows our work to persist, grow, and transform ourselves (and others) and to transform systems.

Connecting schools and communities: a look at place-based learning and equitable access in SF Bay Area outdoor environmental education

Outdoor environmental education aims to immerse students in environmental spaces and create opportunities for classroom learning to be applied in the field. However, students from Black, Indigenous, and People of Color (BIPOC) and low-income communities often have less access to these educational opportunities. This study examined the environmental education programs of nine community organizations in the San Francisco (SF) Bay Area. Through twenty-one interviews with program educators, we assessed two areas: (1) place-based learning being used as a connective tool for students and the community, and (2) ways in which access barriers to programming were addressed. Findings showed that community spaces, like gardens, brought students and the community together to reinforce the mission of place-based learning. Additionally, the findings contribute to the field of outdoor environmental education and place-based education by addressing how local organizations strategized to support equitable access through tactics like financial support and multilingual programming and materials.

Association of Client and Provider Race with Approaches Pursued by Social Workers for Reducing Firearm Access.

Social workers assess and intervene to prevent harm among clients at risk of harm to self (HTS) and harm to others (HTO) with a firearm. This study sought to assess the impact of client race on social workers' approaches to reduce firearm access when they weighed voluntary (e.g., store out-of-home) and involuntary (e.g., extreme risk protection order) removal methods. We considered the role of social workers' self-identified race as a moderator of this relationship, comparing white (single race) and Black, Indigenous, and People of Color (BIPOC) social workers. A survey was distributed to Washington state social workers (n = 9073) who were presented with two case vignettes, each randomized to view the client's race as Black or white. Logistic regression was used to assess the association between the client's race and the pursuit of voluntary or involuntary methods, stratified by social workers' race. Among the participants (n = 1306), 26% pursued at least one involuntary care plan option for the HTS client, and 59% for the HTO client. The Black client at risk of HTS had lower odds of an involuntary care plan option compared to the white client (OR = 0.69, 95% CI 0.54-0.88), while the Black client at risk of HTO had higher odds of an involuntary care plan options (OR = 1.13, 95% CI 1.07-1.66). These associations were not statistically significantly different between white (single race selected) and BIPOC social workers. This study contributes to the growing understanding of potential racial disparities in social workers' decision-making regarding firearm access reduction strategies.

BIPOC students' paths to genetic counseling: Results from a longitudinal qualitative study.

Despite diversity initiatives, the genetic counseling profession continues to exhibit limited racial and ethnic diversity, with relatively stagnant representation of Black, Indigenous, and People of Color (BIPOC) individuals. Prior research has found that BIPOC high school and college students are less likely to be aware of genetic counseling and learn about it later than their white peers. Financial barriers and familial discouragement based on a preference for medical school may disproportionately impact BIPOC applicants. Here, we report the first set of results from a longitudinal constructivist grounded theory study exploring the training experiences of BIPOC genetic counseling students. Through reflexive thematic analysis of semi-structured interviews conducted with 26 first-year BIPOC genetic counseling students, we identified five themes pertaining to participants' paths to enrolling in a genetic counseling program: (1) Deciding to pursue genetic counseling, (2) Family's reaction to genetic counseling, (3) Deciding where to submit applications, (4) Barriers during admissions, and (5) Ranking programs. Participants discovered genetic counseling later in their academic journey, often necessitating gap years to complete admissions requirements. Limited guidance from advisors was commonly cited as a barrier by first-generation college students. Family support seems to be a key factor in participants' successful pursuit of genetic counseling, but participants described challenges explaining the career, particularly to parents who did not speak English. In addition, some participants encountered resistance about changing prior plans to go to medical school. Finally, while participants prioritized cost and location in their initial decision about where to submit applications, their ranking of programs was heavily influenced by experiences during interviews, where they favored conversational interviews and evaluated if they would "fit in" at the program. These findings underscore the need for proactive measures, such as early exposure initiatives, mentorship programs, and resources to facilitate family support, to promote diversity in genetic counseling.