Cultural Competency Training Research Articles

Inclusive School Policies and Practices and the Well-Being of LGBTQ + Students in Portugal

Abstract Introduction The school context can be particularly problematic for youth who identify as lesbian, gay, bisexual, trans, and queer or who hold other sexual and gender-minoritized identities (LGBTQ +). To address this issue, LGBTQ + inclusive policies and practices have been implemented in many schools around the world. Methods A cross-sectional sample of 989 LGBTQ + and cisheterosexual high school students residing in Portugal completed an anonymous online survey in 2020/21. Participants were asked about their perceptions of LGBTQ + inclusive policies and practices in their school, namely, an inclusive curriculum, comprehensive policies, and information and support regarding sexual orientation and gender identity in their school. We further examined associations between these perceptions and LGBTQ + student well-being (depression, resilience, and self-esteem). Results Perceptions of the existence of an inclusive school curriculum were lower among LGBTQ + students compared to their cisheterosexual peers. In addition, LGBTQ + students who perceived the curriculum as less inclusive were more likely to report higher levels of depression and lower levels of resilience and self-esteem. Conclusions The findings suggest that LGBTQ + students perceive the school curriculum to be less inclusive, and this is associated with poorer well-being. Policy Implications Concrete policies and practices that improve school climate and promote the well-being of LGBTQ + students are paramount. These may include awareness-raising activities for students and discussion of LGBTQ + issues in the classroom. Therefore, cultural competency training for school staff is essential.

Strategic Treatment and Assessment for Youth (STAY): A Theoretically-Driven, Culturally-Tailored MBC Approach.

Racial and ethnic minoritized (REM) youth are at greater risk for depression and suicide than their White peers. Despite this, REM youth are much more likely than their White peers to prematurely dropout of treatment. Culturally tailored and scalable engagement models to improve mental health treatment retention among REM youth with depressive symptoms and suicidal thoughts and behaviors (STB) are urgently needed. Strategic Treatment Assessment for Youth (STAY) is a theoretically-driven, culturally tailored measurement-based care (MBC) approach to treatment engagement for REM youth with depressive symptoms and suicide risk. Specifically, STAY uses MBC feedback processes to reduce perceptual barriers to treatment, thus improving treatment retention and ultimately, client outcomes among REM youth. In addition to standard MBC components, STAY includes a greater emphasis on providing a client-centered rationale for MBC which includes assessing and discussing treatment expectations, the use of individualized progress measures and alliance measures, and cultural competence training. The goal of this manuscript is to describe the STAY model based on initial theoretical development and preliminary clinician-informed refinements. Further, a case example of STAY is presented with a particular focus on the use of feedback processes. Finally, the current and future directions to empirically examine STAY as a treatment retention strategy with REM populations are provided.

School administrators’ and teachers’ pedagogical responses to demographic change based on their meaning-making of multicultural students in South Korea

ABSTRACT Public schools in South Korea have faced unprecedented changes because of demographic shifts, particularly the influx and growth of three types of ‘multicultural students’: children of married migrant women, foreign workers, and North Korean refugees. In this situation, teachers are challenged to implement educational policies and a standardised national curriculum for those unfamiliar with the Korean language, culture, and education system. This study, conducted between Fall 2022 and Summer 2023, involved interviews with 16 elementary and secondary school administrators and teachers from urban and rural regions. It revealed that teachers’ perceptions and biases about multicultural students significantly influenced their educational practices, resulting from interpretive processes and problematic framing. The data indicate that teachers’ meaning-making and pedagogical responses to multicultural students are insufficient for systematically addressing the structural inequalities and social injustices faced by these students. Ultimately, these teachers’ responses and practices fell short of providing equitable education that South Korea’s multicultural education policies aim for. The study concluded that comprehensive teacher training in cultural competence and bias awareness is essential for bridging the gap between policy and practice. It recommends the development of reflective practices, continuous professional development, and the creation of supportive school environments to enhance multicultural education’s effectiveness.

Student experiences of cultural competence encounters during MPharm placements and foundation year training

Abstract Introduction Cultural competence is the ability of a healthcare professional to work effectively with clients from different backgrounds. With 18.3% of the UK population identifying with non-white1, pharmacists need to be culturally competent as they have a patient-facing role. Having a multicultural society would require culturally competent pharmacists to effectively deliver healthcare services to patients of different cultures. Exploring pharmacy students' experiences of CC encounters during their MPharm placements and foundation year training is crucial as it helps identify the challenges and barriers they may face when providing healthcare to diverse populations. Understanding these experiences can inform the development of effective training programs to enhance cultural competence among future pharmacists and highlight the impact of cultural factors on patient care and outcomes. Ultimately, this exploration contributes to the overall goal of improving healthcare delivery and promoting patient-centred, culturally sensitive pharmacy practice. Aim This study aimed to explore experiences of student regarding cultural competence encounters during placements and training. Methods A qualitative study was conducted between Oct – Dec 2023. All currently enrolled students in Parts 3, 4 and the foundation year were eligible to participate. Convenience sampling was used. Semi-structured interviews were conducted online using a pilot-tested script. Interviews were audio and video recorded and held online through a Microsoft Teams account, where an automatic electronic transcript was generated. Initial codes were generated from each transcript, to create themes and sub-themes. The researcher scrutinised the themes before defining and naming them. Ethical clearance was obtained. Results A total of 15 students (8 males and 7 females) participated in the study. Four participants were from year 3, five were from year 4, and six were from the foundation year. Six participants were from Asian backgrounds, four were Black, and three were White. All students had a placement in hospital, while 14 had a placement in community pharmacy in addition to hospital, and 8 had a placement in a GP surgery in addition to the hospital and community pharmacy. Key themes identified were 1) Impact of culture on patient health including language barriers and ethnic diversity, 2) Influence of personal culture on practice during placements and training such as using patient’s language to communicate, personal cultural awareness, and the influence of religious teachings, 3) Recommendations for improving cultural competence training in MPharm programme such as having more case studies. Conclusion This study provides a unique exploration into the experiences of pharmacy students and shows the importance of immersing in diverse cultural groups during placements and foundation training. There is a need to enhance pharmacy students’ training through curricular reforms that build on theoretical knowledge to instil confidence during placements and training. This approach will equip future pharmacists to navigate complex cultural dynamics, to meet the demands of an inclusive healthcare system. Ultimately this research extends beyond the current reforms to the MPharm curriculum, and advocates for an equitable and inclusive healthcare system to reduce health disparities. The predominance of participants from Asian backgrounds may limit the generalisability of the findings. Reference 1. Office for National Statistics. Measuring equality: A guide for the collection and classification of ethnic group, national identity and religion data in the UK. Office for National Statistics 2021 https://www.ons.gov.uk/methodology/classificationsandstandards/measuringequality/ethnicgroupnationalidentityandreligion. Accessed 20 Dec 2023.

The Missing Voices, an exploration of what healthcare-related research would matter to Global Ethnic Majority Women in Aberdeenshire, Scotland

Abstract Introduction In multicultural communities, such as the UK, published evidence has indicated that patients from marginalised backgrounds experience healthcare inequality and inequity with regards to accessibility and safety.1 The lack of appropriate ethnic representation in healthcare-related research, has been identified as a potential causation of some of these disparities and poorer health outcomes.2,3 The focus of this project was the marginalised communities identified by the NIHR to have poorer health outcomes, such as Global Ethnic Majority (GEM) women. Aim To explore what healthcare research matters to marginalised communities with a focus on lived and perceived experiences on access to healthcare for GEM women in Aberdeen city and Aberdeenshire, Scotland. Methods This pilot project captured real world data through an inclusive community engagement approach of reaching within rather than reaching out. A framework of 5Cs (Connect, Collaborate, Consult, Co-create and Circulate) was used to establish a diverse panel of ten GEM women. All panel members had a passion for equality and wellbeing as well as diverse lived experiences. The method used to establish the panel is presented elsewhere. Based on a review of literature, open-ended, flexible, thought-provoking questions for the discussions were developed and circulated to all panel members for approval. These questions were used to guide both in-person and virtual open discussions with aforementioned stakeholders to capture narratives and perspectives around barriers and facilitators to equitable healthcare access in the area. As the public members were research partners and not participants, no ethical approval was required as advised by a professor of pharmacy research and the school’s ethics convenor. The project had three main objectives. This submission will only report on objective three that aimed to Identify and prioritise research questions relating to equitable access to healthcare and the needs of marginalised minority ethnic communities. Results The objective was met. A list of emergent themes from the pre-panel questions and a list of panel-approved research questions were devised with a focus on access to healthcare. The emergent themes were around accessibility and equity of maternal/reproductive healthcare, lack of early screening for high-risk GEM groups and culturally appropriate approaches to mental healthcare. Solution focused recommendations included the design of an inclusive healthcare curriculum, compulsory EDI and cultural competency training for healthcare professionals who practice in diverse communities, additional screening programmes tailored to specific GEM groups based on prevalence and risk factors and the development of localised culturally appropriate and inclusive community programmes, especially for those who support new immigrants. Mistrust and lack of inclusive language were mentioned as potential barriers to participating in research. Discussion / Conclusion This pilot offered the historically under-represented and usually silent communities an equal voice within a trusting and collaborative environment. Over ten years after the enaction of the UK Equality Act (2010) inequity in healthcare access and poor outcomes are still evident. The outcomes of this small pilot study highlight that GEM-specific projects should be driven by that community.

Towards cultural inclusion for older adults from culturally and linguistically diverse communities: A commentary on recent aged care reforms.

Due to the high and increasing number of older people from culturally and linguistically diverse (CALD) backgrounds in Australia, it is essential to ensure that the upcoming Support at Home program and other new initiatives incorporate culturally responsive aged care provision. Failing to address these challenges perpetuates inequalities in access to quality care for CALD older adults. This paper reviews recent reforms and initiatives in aged care, identifies culturally responsive provisions and proposes new approaches for upcoming reforms that focus on CALD older people and their support networks. We summarise current standards of cultural appropriateness in aged care to identify areas for improvement. There are instructive interactions between cultural responsiveness and standardising or mainstreaming provision in recent aged care policies and initiatives. We argue that culturally adapting the aged care assessments and Support at Home frameworks through co-production collaborations in the Aged Care Data and Digital Strategy (2024-2029) is not just beneficial but necessary. These actions involve (i) developing culturally tailored assessment tools that consider linguistic and cultural factors, such as using bilingual questionnaires and incorporating culturally responsive communication materials, and (ii) incorporating cultural competence training. Implementing these changes, though complex, will enable equitable and inclusive aged care. It involves overcoming language and cultural barriers that impede effective communication and care. We advocate for ongoing testing and evaluation of these approaches to determine their feasibility for integration into digitisation plans within the aged care sector.

Vaccine literacy and cultural competence training of Professional FOR health to improve the vaccination offer

Abstract Background It is essential that healthcare institutions have a high level of organizational vaccine literacy so that they can support Newly Arrived Migrants (NAM) to navigate, understand and make informed decisions on vaccinations in an effort to make uptake equitable. Developing training material for Professional-FOR-health (PfH) working with NAM, i.e. health and non-health workers, can improve the vaccination offer for NAM. Objectives A holistic training framework for PfH was designed to increase capacity building skills and cultural sensitivity of the healthcare system in promoting active immunization of NAMs. The blended training should cover four topics: “Vaccine Literacy”, “Cultural awareness/migrant sensitivity”, “Health promotion tools with community-based approach” and “Entitlement to vaccination for NAMs/NAMs profile”. As learners cannot be seen as mere recipients of notions, their needs, motivations, and experiences should be put right at the center of the training process. Therefore, a training guide and materials were shared to Consortium Countries to be adapted and implemented in their context. Training sessions were conducted in the summer of 2023. Results A total of 180 participants showed an average increase of 8.2% in correct answers from pre- to post-raining. Notably, 112 participants experienced more than a 10% increase in correct answers. Significant increases were observed across all topics, particularly in Vaccine Literacy (A1) and NAM Profile (A4), with increases of 52% and 74%. The training was evaluated positively with an overall index of 4.2 out of 5. All items analyzed from the satisfaction questionnaire yielded positive evaluations, with an average rating of 4 out of 5. Conclusions The evaluation underscores the effectiveness of training in meeting educational needs of participants. This type of training can be the groundwork for the changes needed to make the NAMs vaccination process more guaranteed and inclusive.

10.O. Scientific session: Breaking Barriers: Advancing Vaccine Access for Newly Arrived Migrants in Europe

Abstract Health disparities are particularly evident in Europe among Newly Arrived Migrants (NAM), in accessing healthcare systems and navigating vaccination services. The AcToVax4NAM project emerged as a pioneering initiative aimed at identifying solutions to overcome system barriers, following a life-course approach. These solutions consist of a broader strategy to promote organisational vaccination literacy and enhance vaccine uptake among NAM. Employing a participatory approach, the project engaged with professionals FOR health (PFH) and ΝΑΜ to ensure the relevancy of the practices developed, along with the widespread acceptance of proposed solutions and tools tackling access to vaccination services. This workshop is not just about showcasing the outcomes and impact of the AcToVax4NAM project; it’s about equipping PFH with practical tools and strategies that are immediately applicable and will ultimately increase vaccine literacy and uptake. By delving into the challenges encountered, strategies employed, and recommendations formulated, the workshop offers invaluable insights for professionals seeking to address similar issues in their respective contexts. We believe that by sharing our experiences and best practices, we can empower others to make a real difference in their communities. The workshop will contain 5 presentations that follow the functional structure of the project, starting with a presentation on the General Conceptual Framework, the foundational element guiding project activities. Following this, we will discuss the development of a migrant-centered and migrant-sensitive tool aimed at improving the communication skills of PFH by providing definitions of vaccine-related terms in an easily digestible way. The third presentation will detail the development of action-oriented flowcharts across consortium countries validated through focus group discussions with PFH; the flowcharts are linked to a comprehensive repository of 359 tools. The workshop will then explore the consortium’s efforts in providing vaccine literacy and cultural competency training to more than 200 healthcare professionals. Finally, the outcomes of the pilots implemented in consortium countries will be presented, and recommendations will be made that summarize the evidence-based accumulation of improved access to vaccinations for NAM and, consequently, increase vaccine uptake. This workshop fosters dialogue among stakeholders and showcases collaborative efforts to promote vaccination literacy and uptake among NAMs in Europe. Sharing experiences and best practices empowers PFH to address similar challenges in their communities, offering insights into effective strategies for improving healthcare access and promoting health equity. Finally, insights from the presentations and discussions can inform evidence-based policymaking and shape the development of immunization public health strategies at the local, national, and European levels, inspiring real change in communities. Key messages • Equipping Professionals for Health with strategies to Enhance Vaccine Access for Newly Arrived Migrants. • Equity through Collaborative Efforts in Promoting Vaccination among Newly Arrived Migrants.

Exploring Perceptions of Communication among Culturally Diverse Nurses in Saudi Arabia.

Cultural diversity among nurses in the Kingdom of Saudi Arabia poses problems in communication management to ensure optimal patient care. This study explored and described the perceptions of communication among nurses in a culturally diverse workforce. A qualitative approach was used; a sample of seventeen (n=17) nurses was purposively selected. Data obtained from semi-structured interviews were analyzed using Braun and Clarke's six steps of thematic qualitative analysis. Key themes were (1) nurses' perceptions of communication in a culturally diverse workforce, (2) barriers to communication in a culturally diverse workforce, and (3) facilitators of effective communication in a culturally diverse workforce. Nurses have recognized the importance of communicating in a culturally diverse environment to provide optimal care. Strategies such as cultural competence training, open communication forums, and mentorship programs are recommended to improve cross-cultural understanding and collaboration in care teams.

Job Satisfaction Among First-Generation Migrant Physicians in Anesthesiology and Intensive Care Medicine in Germany.

This study examines job satisfaction, burnout, and well-being among first-generation migrant physicians in anesthesiology and intensive care medicine in Germany, comparing them to their native German counterparts. A cross-sectional survey design was utilized, collecting data from 513 physicians, 110 of whom identified as having a migration background. Job satisfaction was measured using the Warr-Cook-Wall (WCW) Job Satisfaction Scale, burnout was assessed with the Copenhagen Burnout Inventory (CBI), and well-being was evaluated using the WHO-5 Well-Being Index. The job satisfaction ratings revealed no significant differences between migrant and German physicians in most dimensions, including physical workload, freedom to choose work methods, satisfaction with colleagues, responsibility, income, skill utilization, and variety in work tasks. However, migrant physicians reported significantly higher satisfaction with recognition received for their work and lower dissatisfaction with working hours. Burnout assessments showed that migrant physicians experienced higher psychological strain, perceiving every work hour as more exhausting and having significantly less energy for family and friends. Migrant physicians reported higher difficulty and frustration in working with patients. Well-being items indicated that migrant physicians felt less energetic and active but found their daily life more filled with interesting activities. Notably, the multivariate analyses of the total scale scores did not show significant associations between migration background and the overall outcome scales. The findings indicate unique challenges faced by migrant physicians, particularly in terms of recognition and patient-related burnout. These results highlight the need for targeted interventions to support migrant physicians, including cultural competence training and flexible working hours to enhance their job satisfaction and overall well-being. Addressing these issues is crucial for maintaining the quality of patient care and the occupational health of migrant physicians in Germany.

Cultural Competency in Dental Practice: Navigating the Experiences and Perspectives of Dentists in South Punjab, Pakistan.

Introduction Cultural competence in healthcare embraces the principles of equal access and nondiscriminatory services in healthcare delivery. Dentists as significant healthcare professionals should definitely have the skills needed to diagnose and treat patients' conditions, but it is crucial to also address nontechnical skills such as cross-cultural communication, the ability to empathize, and inclusive-mindedness. Globally, cultural competency training has been included in healthcare educational programs; however, national practices reportedly have revolved around patients' clinical competencies and thus entailed overlooking the cultural dimensions of dental education that include diverse sociocultural factors that influence how dental practices are taught, learned, and delivered. These dimensions encompass elements such as language, communication styles, attitudes toward healthcare, and culturally specific oral health beliefs and behaviors. Therefore, the aim of this study is to explore the experiences and perspectives of dentists practicing in South Punjab regarding cultural competency. Methodology The study employed a qualitative phenomenological approach. Data was collected through purposive sampling techniques utilizing semistructured interview guides. The participants recruited were licensed dentists practicing in dental institutions in South Punjab, Pakistan. A total of 18 dentists were recruited in the study. The interviews were focused on the different aspects of cultural competency by exploring the perspectives of dentists. Thematic analysis was carried out utilizing the Bran and Clarkes framework to categorize data into key themes and subthemes utilizing inductive coding. Results The study revealed that dentists lack awareness and understanding of cultural competency; they also faced significant problems due to limited cultural proficiency while dealing with diverse patients. Major challenges included inadequate training, communication barriers, and cultural bias in dentists while dealing with such diverse populations. Patients recognized the benefits of cultural competency and highlighted facilitators like institution support, peer support, mentorship support, and patient trust.Participants suggested incorporating cultural competency in dentistry curricula, continuous professional development, and community outreach programs for the development of cultural competency among dentists. Conclusions The study highlighted perspectives and experiences of dentists regarding cultural competency. The findings demonstrated key problems due to limited or lack of cultural proficiency that included communication and language barriers and unconscious cultural bias among dentists. The study also highlighted facilitators of cultural competency like institutional facilitation, mentoring opportunities from peers and seniors, and patient trust. Facilitating cultural competency among dentists may result in improved patient satisfaction, enhanced patient care, and an increase in compliance, hence overall enhancing the quality of care.

Exploring cultural competence barriers in the primary care sexual and reproductive health centres in Catalonia, Spain: perspectives from immigrant women and healthcare providers

BackgroundImmigrant populations, especially women, continue facing challenges in accessing quality healthcare, particularly sexual and reproductive health services (SRH). Poor cultural competent health systems contribute to communication challenges between immigrant women and healthcare providers perpetuating health disparities. This exploratory study describes these communication barriers from the perspective of Moroccan and Pakistani immigrant women and healthcare providers within the Catalan health system and its implications to ensure an equitable provision of SRH services.MethodsAn exploratory-descriptive qualitative study was conducted in various municipalities of Barcelona with high concentration of immigrants. Eight focus groups (N = 51) and semi-structured interviews (N = 22) with Moroccan and Pakistani immigrant women were combined with key informant interviews (N = 13) with healthcare professionals. Thematic analysis and data triangulation were performed primarily using an inductive approach.ResultsLanguage barriers and cultural differences in health needs, expectations, care-seeking behaviours and understanding of quality healthcare provision hindered the ability of immigrant women and providers to interact effectively. Limited availability of intercultural mediators and inadequate cultural competence training opportunities for health staff were also identified. Findings suggest a lack of minority representation in the Catalan health workforce and leadership roles.ConclusionThis study reinforces the evidence of persistent inequities in accessing healthcare among immigrant populations by focusing on the cultural competence barriers of the Catalan health system in the provision and access to SRH services. The regularization of adequately trained intercultural mediators, quality training in cultural competence for health staff and a commitment to increase workforce diversity would contribute to improve intercultural communication between immigrant patients and providers. An urgent call to action in this direction is needed to ensure an equitable access to SRH services among immigrant women.

A survey of obstetrical anesthesia health equity practices at academic centers in the United States (US)

BackgroundLimited research has explored obstetrical anesthesiologists' perceptions of healthcare disparities associated with labor and delivery. The objective of this study was to evaluate the perception of obstetrical anesthesia related healthcare disparities, drivers of disparities, and potential solutions. MethodsAn online survey was emailed to division leads at Accreditation Council for Graduate Medical Education (ACGME) accredited obstetrical anesthesiology programs in the United States. The survey included a mixture of yes/no, select all that apply, and free-text questions. Descriptive statistics were used to characterize variable distribution. Free text responses were categorized into themes by selective coding. Results149 surveys were delivered, 74 surveys were conducted (50 %), and 57 were completed entirely (38 %). Fifty-seven percent of participants reported perceived presence of obstetrical/obstetrical anesthesia related healthcare disparities. Most participants reported that they consider a patient's cultural preferences during clinical management, collect race/ethnicity data, implement specific practices to address disparities, and analyze outcome data by social determinants of health. The majority of participants reported using additional relevant practice features, including translator services, quality improvement practices, provider rounds, standardized protocols, and cultural competency or diversity training. Thematic analysis of free text responses into drivers of disparities mapped to 6 themes: language barriers, racism or bias, socioeconomics or social determinants of health, access or quality of care, patient-provider interactions or cultural sensitivity, and individual patient factors. ConclusionMost academic obstetrical anesthesia center division leads reported perceived presence of obstetric anesthesia related health care disparities. Efforts should be made to devise targeted solutions to this multifaceted, pervasive problem.

“I Do Not Believe We Should Disclose Everything to an Older Patient”: Challenges and Ethical Concerns in Clinical Decision-Making in Old-Age Care in Ethiopia

Clinical decision-making in old-age care is a complex and ethically sensitive process. Despite its importance, research addressing the challenges of clinical decision-making in old-age care within this cultural context is limited. This study aimed to explore the challenges and ethical concerns in clinical decision-making in old-age care in Ethiopia. This qualitative study employed an inductive approach with data collected via semi-structured interviews with 20 older patients and 26 health professionals recruited from healthcare facilities in Ethiopia. Data were analysed using reflexive thematic analysis. Our analysis identified three key themes. First, participants highlighted perceptions that older patients’ religious beliefs interfere with the clinical decisions both older patients and health professionals make. Second, older patients often receive limited information from health professionals about their diagnosis and treatment. Third, families of older patients appear to strongly influence clinical decisions made by older patients or health professionals. This research enhances the understanding of clinical decision-making in old-age care within Ethiopia, a context where such research is scarce. As a result, this study contributes towards advancing the deliberation of ethical dilemmas that health professionals who work with older patients in Ethiopia might face. A key implication of the study is that there is a need for more ethics and cultural competence training for health professionals working with older patients in Ethiopia.

A review of multicultural communication dynamics in the U.S.: Highlighting challenges and successful strategies in a diverse society

This study presents a comprehensive analysis of multicultural communication dynamics in the United States, focusing on the challenges and strategies pertinent to diverse societal contexts. The main objectives were to explore theoretical frameworks, historical evolution, and current trends in multicultural communication, alongside identifying key challenges and effective strategies. The methodology encompassed a systematic review of literature, including peer-reviewed journal articles, conference papers, and reports, with a focus on themes of anti-racism, equity, inclusion, and social justice in multicultural communication. Content and thematic analysis was employed to assess publication productivity and identify major themes. Key findings revealed the significance of various theoretical frameworks in understanding multicultural dynamics, with a historical shift from monolithic to inclusive communication approaches. Major challenges identified include language barriers, cultural misunderstandings, and differing communication styles. Effective strategies highlighted include cultural sensitivity training, inclusive policies, and leveraging technology. The study also underscored the role of policy and regulation in shaping multicultural communication practices. The study emphasizes the complexity of multicultural communication in the U.S., suggesting practical recommendations for enhancing communication in diverse environments. These include implementing cultural competency training, adopting inclusive communication policies, and leveraging technology for barrier reduction. Future research directions proposed focus on longitudinal studies of communication strategies, the impact of emerging technologies, and cross-cultural comparative studies. This comprehensive analysis aims to contribute to a more inclusive and understanding society through improved multicultural communication practices.

Healthcare professionals’ experiences of delivering pain science education to adults from ethnically minoritised groups

BackgroundPain Science Education (PSE) seeks to increase patients understanding of their pain, to improve clinical outcomes. It has been primarily developed and tested within western cultures. There is a lack of research exploring its use with people from ethnically minoritised groups. ObjectiveTo explore Healthcare Professionals (HCPs) experiences of delivering PSE to people with persistent pain from ethnically minoritised groups. MethodsIn this qualitative study semi-structured interviews were carried out with a convenience sample of 14 HCPs who routinely deliver PSE to patients from ethnically minoritised groups. The interviews were analysed using reflexive thematic analysis. ResultsThree themes were identified: 1) Biomedical model or disengagement, 2) Pain is a taboo topic, and 3) The importance of cultural competence. Participants believed that people from ethnically minoritised groups disengaged with PSE sooner in comparison to non-ethnically minoritised groups and this was rooted in a strong biomedical understanding of pain and preference for biomedical treatments. Addressing patients’ beliefs was deemed difficult as participants felt that pain was considered a taboo amongst some ethnically minoritised groups and HCPs lacked sufficient training in cultural competency to confidently address their pain-related misconceptions. ConclusionsOverall, HCPs found that many people from ethnically minoritised groups held strongly biomedical views and/or a cultural reluctance to discuss pain. These factors made pain discussions challenging leading to disengagement from PSE and a preference for passive care. Cultural competency training and access to culturally competent PSE resources may facilitate engagement with PSE for people from ethnically minoritised background.

Abstract B067: A mixed-methods health services analysis of disparities and social vulnerabilities in childhood cancer survivors’ long-term follow-up care

Abstract Pediatric cancer affects >15,000 US children annually. Treatment advances have led to an increase in those surviving the disease, and these patients must be managed to control their long-term comorbidities. Unfortunately, a majority are nonadherent to post-treatment care guidelines and become lost to follow-up. This is especially true for those from underserved backgrounds, including survivors who are Black and Latine. To help understand this disparity, we studied the organization and delivery of pediatric cancer survivorship care at an urban comprehensive cancer center. Research included: 1) a qualitative study exploring healthcare barriers and facilitators of survivors’ adherence to long-term follow-up care, as determined by N=31 key informants (pediatric oncology care providers, administrators), and; 2) a retrospective cohort study (2007- 2020) among N>350 survivors (10% Black, 28% Latine, 12% Asian; 47% from vulnerable neighborhoods) assessing social determinants of health (SDoH) and its cofactors, adjusted for vital status. Interviews were recorded, transcribed, and thematically analyzed using software (K>.70). Three major themes emerged in survivors’ adherence: 1) healthcare system-level influences (69%), SDoH (25%), and intra/interpersonal factors (16%). At the system-level, informants noted opportunities to strengthen adherence, especially for survivors from underserved backgrounds, including the provision of greater social support (14%), easing appointment scheduling (11%), offering high-quality ambulatory and specialty care within the system upon entering young adulthood (12%), and cultural competency training for staff (6%). Among SDoH, informants noted transportation and geographic challenges in accessing the healthcare system (25%), insurance coverage for follow-up care (17%), and strengthening trust with marginalized communities (17%). For intra/interpersonal factors, time- and age-related changes in survivors’ medical needs were acknowledged as barriers to be overcome (28%), along with providing greater patient education (11%) and heightened salience of follow-up care (17%). Conversely, the provider-patient relationship was noted as a strength in promoting adherence (23%). Retrospective cohort results revealed that survivors’ attendance at dedicated clinics was suboptimal (52% >= 2 years off-therapy), as were rates of system-wide ambulatory care encounters 3+ and 5+ years post-therapy. At the bivariate level, non-Hispanic Black survivors (68%), adolescents (58%), and those with CNS tumors (81%) had the lowest likelihood of survivorship clinic attendance (p<.05)–underscoring qualitative findings on SDoH. Area-level SDoH indices were unrelated to the cohort’s adherence, highlighting qualitative findings on intra/interpersonal barriers and facilitators. These data lend insights into transformations possible within the organization and delivery of healthcare to young survivors, especially those from underrepresented backgrounds, including greater attention to SDoH and strengthening cultural competence among health system employees. Citation Format: Marcelo Sleiman Jr, Tara Suntum, Nina Kadan-Lottick, Brianna Miller, Mary R Yockel, Arnold Potosky, Chiranjeev Dash, Adil Alaoui, Burton Appel, Ken Tercyak. A mixed-methods health services analysis of disparities and social vulnerabilities in childhood cancer survivors’ long-term follow-up care [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B067.

Contraceptive access and use among women with migratory experience living in high-income countries: a scoping review

BackgroundWomen who have migrated often encounter difficulties in accessing healthcare and experience inequitable sexual and reproductive health outcomes in destination countries. These health inequities include contraceptive access and use. To better understand what influences contraceptive access and use, this scoping review set out to synthesize the evidence on contraceptive access and use and on associated interventions among women with migratory experience in high-income countries (HICs) in Europe, North America and Australasia.MethodsThe scientific databases PubMed, Web of Science and CINAHL were searched for peer-reviewed quantitative, qualitative and mixed method articles published between January 2000 and June 2023. Articles were included if they reported on studies exploring contraceptive use to prevent pregnancies among women of reproductive age with migratory experience living in HICs. Two researchers independently screened and extracted data from the articles. Findings were categorized by patient and health system level factors according to Levesque et al.’s framework of access to health care.ResultsA total of 68 articles were included, about half (n = 32) from North America. The articles focused on the individual level rather than the health system level, including aspects such as women’s contraceptive knowledge, the influence of culture and religion on accessing and using contraception, partner involvement, and differing health insurance coverage. On the health system level, the articles highlighted lack of information on contraceptive services, cultural (in)adequacy of services and communication aspects, contraceptives’ side effects, as well as geographic availability and cost of services. The review further identified three articles reporting on interventions related to contraceptive counselling.ConclusionsThere is a lack of knowledge regarding how health systems impose obstacles to contraceptive services for women with migratory experience on an organizational level, as research has focused heavily on the individual level. This review’s findings may serve as a foundation for further research and advances in policy and practice, specifically recommending early provision of health system related information and contraceptive education, engagement of male partners in contraceptive discourses, cultural competency training for healthcare professionals, and strengthening of interpretation services for contraceptive counselling.

Analyzing the Relationship between Cultural Identity and Health Professional Perspectives

Having a systematicseize of cultural diversity is necessary for health professionals to present culturally competent treatment, enhance patient satisfaction and recover healthcare outcomes. To better recognize how cultural identity (CI) affects the attitudes, communication preferences and decision-making processes of health professionals, this research looks at how cultural competency is integrated into healthcare education and strategy.This study examines the influence of CI on the perspectives and practices of health professionals and its impact on patient care. People's behaviors and self-perceptions are greatly influenced by their concept of culture, which is defined by shared norms, language, and ethical principles. This research includes 281 health professionals from diverse contexts utilizing the Cultural Competence Assessment Questionnaire (CCAQ). Interpersonal relationships, professional development, communication skills, cultural sensitivity, competence and patient-centered care are all significantly correlated, according to the data. This finding suggests that for improved patient relationship and liberty of health, there should be specialized cultural competency training. Implications for practice: promote continued professional development about cultural sensitivity in health events, and conferences. This article also puts forward the use of CI as one method to guide and support the approach of health professionals and capture the attention of communications and cultural competencies to help develop patient results.

The unique social-emotional challenges that bright immigrant youth face

This paper explores the social-emotional challenges faced by bright immigrant youth. We incorporate Bronfenbrenner’s ecological systems theory to identify complexities across the model’s 5 layers. In the microsystem, cultural heritage conflicts with assimilation, disrupting support networks, suggesting the need for culturally sensitive support in schools, peer networks, and family involvement. The mesosystem highlights language and cultural barriers in family-school cooperation, recommending enhanced communication, curricular adjustments, and language support. The exosystem reveals immigration policies and discrimination exacerbate challenges, advocating for equitable educational access and cultural competence training. The macrosystem addresses societal perceptions and the recognition of giftedness, promoting equality, diversity, and positive cultural climates. Finally, the chronosystem indicates that policy changes impact developmental trajectories. Understanding these 5 socio-cultural layers and implementing targeted interventions can effectively support the social-emotional well-being and academic success of immigrant youth.