Cultural Stigma Research Articles

Attitudes and Beliefs of African American Women Regarding Mental Health Services: A Womanist Exploration

Although studies indicate the influence of cultural beliefs on attitudes toward mental health and depression care services, there is a need to focus on the process of how culture plays a role in perceptions of mental health and depression care [1]. The purpose of this study is to explore, utilizing qualitative methods (e.g., focus groups), how cultural beliefs influence 40 African American women in their perceptions, attitudes, and beliefs about mental health services and mental health assistance-seeking behaviors, specifically regarding depression care. Participants’ narratives reveal a clear preference for service provider-client race concordance. Participants’ narratives also reveal cultural and communal stigma and gender socialization to be a “Strong Black Woman” as deterrents to mental health assistance seeking behaviors. Recommendations for incorporating the role that ethnocultural beliefs and values of different culturally-gendered groups regarding mental health and assistance-seeking behaviors be included in social work and allied health professions [2].

Willingness to use mental health counseling in diverse groups of Asian Americans.

Responding to the underutilization of mental health services in Asian American communities, we examined factors associated with their willingness to use mental health counseling. Applying Andersen's Behavioral Health Service Model, we focused on the role of mental health needs and prior use of mental health counseling in shaping the attitudes toward mental health counseling of diverse groups of Asian Americans. We conducted a secondary analysis of data from 2,609 Asian Americans aged 18 or older who participated in the Asian American Quality of Life (AAQoL) survey conducted in central Texas. Logistic regression models of willingness to use mental health counseling were tested with predisposing (age, gender, marital status, education, nativity, and English-speaking ability), mental health needs (mental distress and self-rated mental health) and enabling (prior use of mental health counseling) variables. About 67% of the overall sample indicated their willingness to use mental health counseling. Individuals who met the criteria for mental distress showed 17% lower odds of willingness to use mental health counseling. The enabling role of prior use of mental health counseling was supported; those who had used counseling were over three times more likely to be willing to use counseling in the future than their counterparts without such an experience. Given the inverse association between mental health needs and the willingness to use mental health counseling, further attention should be paid to improving Asian Americans' recognition of mental health symptoms and awareness of the benefit of mental health services. The enabling role of prior use of counseling also highlights the importance of increasing the exposure to mental health services for Asian Americans. In efforts to promote mental health literacy, reduce cultural stigma, and advocate for mental health service use, consideration of cultural and linguistic diversity within the Asian American population is imperative.

Leprosy in Children with a Focus on the Asian Region: A Narrative Review

Abstract Children are often more susceptible to contracting Mycobacterium leprae infection because of their immature immunity as well as their exposure to intrafamily interactions. The percentage of children among newly identified leprosy cases serves as a robust indicator of the ongoing transmission of the disease. Globally, the number of new cases fell by 19.3% between 2013 and 2022. A reduction of over 50% in the incidence of leprosy among children was seen, with rates declining from 10.4 cases per million children in 2013 to 5.1 per million in 2022. Children may exhibit atypical clinical symptoms, and the clinical presentation of leprosy in children can often be misdiagnosed as differential diagnoses such as pityriasis alba, nevus depigmentosus, pityriasis versicolor, among others, contributing to diagnostic difficulties. The cultural stigma surrounding leprosy may also discourage parents from seeking medical help promptly, prolonging the time to diagnosis. Furthermore, health-care systems in some regions may lack adequate training or resources for diagnosing pediatric leprosy. These challenges underscore the importance of increased awareness, early detection, and improved health-care infrastructure to effectively diagnose and treat leprosy in children. Stakeholders must give top priority in policy making and interventions to lower the prevalence of leprosy and its consequences in children and adolescents. The present article is an attempt to review the epidemiological, clinical, and therapeutic dimensions of childhood leprosy cases in Asia.

Mass Media and Promotion of Women’s Health in Capital of Jharkhand

This abstract provides an overview of a comprehensive strategy to promote women's health in the capital of Jharkhand, Ranchi, through mass media. Women's health in this region faces unique challenges, including issues related to maternal health, reproductive health, nutrition, and mental health. This abstract outline a strategic plan to address these challenges effectively. The strategy begins with identifying key health issues and collaborating with local healthcare providers, NGOs, and government agencies to gather accurate information and statistics. Educational content is then developed, encompassing articles, videos, infographics, and podcasts, which are translated into local languages for accessibility. Various media channels are leveraged, including television, radio, print media, and social media, to disseminate this content. Special attention is given to community outreach, with the organization of health camps and workshops to engage directly with the local population. The strategy aims to promote healthy behaviors, challenge cultural stigmas, and advocate for policy changes that enhance women's healthcare services, Television/print media highlighting the issues of women health and seafty. Collaboration with local influencers and the empowerment of women with knowledge about their rights and healthcare options are additional components of the plan. Continuous monitoring and evaluation ensure the impact of mass media campaigns is measured, and the sustainability of these initiatives is addressed through a long-term strategy. By adopting this comprehensive approach, mass media can become a powerful tool in promoting women's health in Ranchi, Jharkhand, leading to improved healthcare awareness, behavior, and outcomes among women in the region.

Gaps in Primary Care Suicide Screening for Asian American Adults in Honolulu Hawaii

Introduction/background: Asian Americans have experienced worsened mental health outcomes and increased rates of suicidality since the COVID-19 pandemic. Suicide screening in primary care settings need to be re-evaluated to properly screen mental health needs while accounting for barriers related to cultural norms and stigma.
 Who is it for? Asians are a fast growing racial group in the United States, and a majority racial group in the state of Hawaii. Increased cultural awareness and understanding of how suicidality presents in this group would benefit primary care providers (PCPs) to improve screening and treatment. Cultural norms, stigma, attitudes towards mental health and suicidality contribute to barriers to reporting needs to providers, and increased understanding of these barriers will support providers in regions around the world where there is an increasing Asian population assimilating with the majority cultural group.
 Who did you involve? A focus group was created to ensure the study reflects the perspectives of the Asian American community. Three individuals were recruited on the criteria of identifying as Asian, report of past or present suicidality, and having ever experienced barriers to discussing suicidality with their PCPs. The group’s responses support the design of the study in gathering personal experiences with navigating care, personal and cultural stigma of mental health and suicide, and ideas on how suicide screening could be improved to meet their needs considering their culture and values.
 What did you do? This study aims to identify the barriers that Asian Americans in Hawaii face in discussing or reporting suicidality with their PCPs through qualitative interviews with Asian individuals to assess for past or present suicidality. Those who report past or present suicidality will be interviewed further to determine whether they were able to discuss the topic with their PCP and what they feel could have improved their experience of the screening process or encouraged them to share more. Taking a person-centered approach, individual experiences are collected through a qualitative format with results to be presented as testimonials to help the audience better understand the thoughts, expectations, and needs of this community when presenting with suicidality in primary care. 
 What results did you get? It is expected that a percentage of the people interviewed will report some suicidality consistent with the national average for Asian Americans in the United States. Based on the literature review, it is expected that there will be barriers to the comfort level of reporting or discussing suicidality with PCPs and identified barriers related to limitations in language access, stereotypes or cultural stigma, settings of care delivery, and concerns with discrimination. Interviews are in process and results are expected in summer 2023.
 What is the learning for the international audience? Providers in communities where the Asian population is not the majority cultural group need to consider the unique barriers that Asian patients experience in reporting suicidality to provide effective and culturally-sensitive treatment. Identifying these gaps will provide insight for primary care practices to adapt the suicide screening process in a supportive way for Asian patients. 

Digital Mental Health Interventions: Differences in Diet Culture Intervention Framing.

Diet culture is a societal norm that ranks thin bodies as superior to other body types and has been associated with negative outcomes, such as eating disorders. Wellness has evolved into a term that is often used to promote diet culture messages. One possible way to combat diet culture is through single-session, digital mental health interventions (DMHIs), which allow for increased access to brief public health treatments. The framing of DMHIs is critical to ensure that the target population is reached. Participants (N = 397) were enrolled in a single-session DMHI, which was framed as either a Diet Culture Intervention (n = 201) or a Wellness Resource (n = 196). Baseline group differences in eating disorder pathology, body image, weight stigma concerns, fat acceptance, and demographic characteristics were analyzed. Across groups, participants reported moderately high eating disorder pathology, low-to-moderate levels of body dissatisfaction, moderate levels of fat acceptance, and either very low or very high weight stigma concerns. Participants in the Diet Culture Intervention group reported higher levels of fat acceptance than those in the Wellness Resource group (p < 0.001). No other framing group differences were identified, though post hoc analyses revealed differences based on recruitment source (i.e., social media versus undergraduate research portal). This study found that framing a DMHI as targeting diet culture or as a Wellness Resource can result in the successful recruitment of individuals at risk of disordered eating. Framing a DMHI as a Wellness Resource may increase recruitment of individuals with low levels of fat acceptance, which may be particularly important for dismantling diet culture, disordered eating, and weight stigma concerns. Future research should assess DMHI framing in other populations, such as men and adolescents.

A GREEN ACTIVITY PRESCRIPTION PROGRAM FOR CHINESE AMERICANS LIVING WITH DEMENTIA

Abstract Asian Americans account for approximately 161,000 cases of Alzheimer’s disease and related dementias (AD/ADRD) among adults ages 65 and older in the United States. Chinese Americans have among the highest incidences of AD/ADRD, and have experienced underdiagnosis, cultural stigmas, and less access to dementia care. In New York City specifically, 28.6% of Chinese American seniors live in poverty, leading to environmental racism, a lower likelihood of engagement in activities, decreased quality of life, and an increased risk of cognitive decline and developing dementia. Recommendations to support activity engagement among Chinese Americans include fostering social cohesion and linking individuals to local activity resources. Green activity prescriptions (GAPs) are one approach to achieving these objectives, and combine nature, social contexts, and meaningful activities to improve health and well-being. GAPs are co-designed with participants based on their interests, needs, and available community resources. Examples include: animal-assisted interventions, gardening, green exercise (walking), and conservation projects (composting). Past studies have provided evidence that these components have improved well-being for PLWD, supported function, and provided meaningful engagement. Yet, these early studies neglected Chinese Americans. GAPs have potential to support the health and well-being of Chinese American PLWD by addressing health inequalities and providing accessible, low-cost care, all while sustaining local green resources. Here we present the study design and implementation outcomes, including recruitment and engagement strategies, of a GAP intervention utilizing a community-based participatory approach aimed at supporting the health and well-being of Chinese American PLWD residing in lower-socioeconomic households within Brooklyn, NY.

MENOPAUSAL SYMPTOM EXPERIENCE OF MID-LIFE WOMEN FAMILY CAREGIVERS OF PERSONS LIVING WITH ALZHEIMER’S DISEASE

Abstract Midlife women experience a wide range of menopausal symptoms. Such symptoms may be different in midlife women who are family caregivers of persons living with chronic disease, particularly Alzheimer’s disease. Because the cultural stigma of dementia differs among racial/ethnic minority groups, midlife minority women tend to feel burdened with family caregiving and report negative health outcomes compared with White women. This study aimed to explore the racial/ethnic differences in menopausal symptom experienced by midlife women who were family caregivers of persons living with Alzheimer’s disease (MWPLAD). A secondary data analysis was conducted using the data of a cross-sectional online survey among 172 MWPLAD. Self-report questionnaires including the Midlife Women’s Symptom Index were used to gather the data on the women’s sociodemographic characteristics, health-related information, and menopausal symptom experience. Descriptive statistics, one-way analysis of variance and multiple linear regression were adopted for the data analysis. There were significant racial/ethnic differences in midlife women’s symptoms in the total scores (total frequencies and severity scores) and individual sub-scale scores. Psychological symptoms were reported to be more prevalent in Asian MWPLAD than in other racial/ethnic groups. After controlling for race/ethnicity, several factors were associated with the menopausal symptoms experienced by MWPLAD, such as household income, history of obstetrics and gynecology diseases, underweight, and restriction to perform daily activities. Our study findings support the racial/ethnic differences in menopausal symptoms experienced by MWPLAD. More culturally competent interventions should be established considering the significant factors that differently affect the women’s menopausal symptom experience in different racial/ethnic groups.

Transcending the classroom: (de)stigmatising foreign cultures through foreign language teaching

ABSTRACT Using intergroup contact and stigma management communication theories, this work examines the effect of cultural teaching and learning in Spanish language classes on cultural stigma, social distance, and ethnocentrism. Additionally, this study examines how individuals respond to positive and negative messages about foreigners. Survey results indicate cultural integration in the foreign language classroom was associated with increased cultural knowledge and, indirectly, decreased cultural stigma and social distance toward those from foreign cultures. The findings of this study extend prior intergroup contact work by demonstrating the potential for exposure to a culture, rather than its members, to decrease stigma.

Abstract C132: Multilevel facilitators and barriers to cancer screening programs in federally qualified health centers serving Asian American communities

Abstract Purpose: Cancer screening disparities among medically underserved Asian Americans are well documented. Assessing multilevel barriers and facilitators to cancer screening programs within safety-net settings is critical to the implementation of evidence-based strategies to improve cancer screening. This study aims to examine how community and clinic driven priorities and activities can inform multilevel processes for planning of cancer screening programs for Asian American patients within FQHCs. Methods: Academic, clinic and community partners established the Advancing Care Together (ACCT) formal network to increase knowledge, attitudes and screening behaviors among low-income Chinese, Korean and Vietnamese individuals in Orange County, California. ACCT focused on breast, cervical, and colorectal. Over three years, a series of meetings, surveys and interviews were conducted with community and clinic partners before implementing evidence-based strategies (community navigation, educational workshops) to increase cancer screening to address cultural and language barriers. We used the Implementation Research Logic Model to guide our analysis of these data and identify multilevel determinants of cancer screening with input provided by the ACCT network. Using a shared drive to gather formative data, we assembled a codebook in Excel to organize AACT activities and identify barriers and facilitators according to the Consolidated Framework for Implementation Research (CFIR). Results: Our study found barriers and facilitators that represent CFIR domains: i) Community-clinic resources can provide increased awareness of screening services (intervention characteristics); ii) patients had difficulty obtaining a provider with their preferred language (inner setting); iii) transportation issues and cultural stigma around receiving specific cancer education (outer setting); iv) clinic and patient outcomes improved as a result of ACCT activities, payers were unable to establish referrals from federally qualified health centers to comprehensive cancer centers (characteristics of individuals involved in the implementation); and v) staff turnover presented challenges to obtaining electronic medical records to evaluate screening and follow-up services (implementation process). Implications: Community-clinic-academic partnerships can facilitate increasing cancer screening and awareness, including cultural screening barriers and identification of adaptation needs for educational materials, specific to Asian American communities. Barriers identified in the cancer screening process included a lack of motivation to resolve payer-related provider networks to address patient accessibility to specialty care, high turnover among clinic quality improvement teams, and challenges of prioritizing cancer screening throughout the COVID19 pandemic. Successful implementation of evidence-based strategies to increase guideline-adherent care for Asian Americans must overcome longstanding clinic- and community-level barriers, and we believe community-clinic-academic partners hold the key. Citation Format: Samantha Garcia, Sora Tanjasiri, Cevadne Lee, Jaqueline Train, Jennifer Tsui. Multilevel facilitators and barriers to cancer screening programs in federally qualified health centers serving Asian American communities [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C132.

Barriers and facilitators to self-measured blood pressure monitoring among US-resettled Arab refugees with hypertension: a qualitative study

BackgroundMinoritized communities including refugees are at an increased risk of poorly controlled hypertension. Evidence indicates that self-measured blood pressure monitoring (SMBP) is an effective method to improve blood pressure control in patients with hypertension. However, it has not been studied among refugee populations. The objective of this study is to examine barriers and facilitators to SMBP among Arab refugees resettled in the United States (US) with diagnosed hypertension.MethodsA total of 109 participants were recruited through a Federally Qualified Health Center system that is a major provider of healthcare to refugees in San Diego, California. Participants completed a questionnaire and were interviewed using in-depth, semi-structured interviews. Interviews were transcribed and translated, and data were coded using inductive thematic analysis and organized based on the theory of care-seeking behavior.ResultsSeveral barriers to engaging in effective SMBP monitoring were identified. Clinical and sociodemographic barriers included reliance on public monitors and poor hypertension literacy. Psychosocial barriers of affect, norms, and habits included fear and anxiety from hypertension, cultural stigma of illness, and conditional SMBP with symptoms, respectively. Utility psychosocial barriers included lack of SMBP prioritization in treatment and perceived inaccuracy of home monitors. Family members’ support with home monitoring served as an important facilitator to SMBP.ConclusionsThere are several barriers to effective SMBP among the US-resettled Arab refugee population that may reflect unique cultural and care-seeking behaviors. Tailored public health and clinical interventions are needed to support refugee patients and providers to improve hypertension self-management behaviors for this unique population.

Experiencing Pain Invalidation is Associated with Under-Reporting of Pain: A Social Psychological Perspective on Acute Pain Communication

Pain invalidation involves the dismissal or lack of understanding of another’s pain, undermining their subjective experience. Frequent exposure to invalidation negatively impacts mental and physical health as well as pain-related behaviors, potentially leading people to conceal their pain from others in the future and/or withdraw from potential sources of support. It is therefore possible that experiencing pain invalidation may also impact pain-reporting behavior in clinical settings. Across 2 separate samples of emerging adults, we examined whether exposure to invalidation of one’s pain was associated with cognizant modulation of one’s subjective acute pain ratings within routine medical and dental settings. Drawing upon social psychological theories of impression management and self-presentation, we hypothesized that exposure to pain invalidation would be associated with the under-rating of one’s pain. In Study 1, previous experiences of invalidation were associated with under-rating of one’s pain when visiting the doctor and the dentist. Study 2 found that invalidation from family and medical professionals—but not from friends—was associated with under-rating pain in both settings. Findings provide further evidence for the harmful effects of pain invalidation, particularly for emerging adults, as the dismissal of one’s subjective experience may sow self-doubt while reinforcing cultural stigmas against pain, leading to alterations in pain communication that ultimately creates barriers to efficacious clinical treatment and care and increase pain-related suffering. PerspectivePain invalidation imparts harm to those who already suffer from pain, be it mentally, physically, and/or behaviorally. We show that people who have encountered invalidation are more likely to under-rate their pain when seeking care, impeding assessment and treatment, and further highlighting the importance of clinical validation of pain experiences.

Patient and Care Provider Perspectives on the Management of Fecal Incontinence: A Qualitative Rapid Review

Patient and Care Provider Perspectives on the Management of Fecal Incontinence: A Qualitative Rapid Review

Why is the screening rate in lung cancer still low? A seven-country analysis of the factors affecting adoption.

Strong evidence of lung cancer screening's effectiveness in mortality reduction, as demonstrated in the National Lung Screening Trial (NLST) in the US and the Dutch-Belgian Randomized Lung Cancer Screening Trial (NELSON), has prompted countries to implement formal lung cancer screening programs. However, adoption rates remain largely low. This study aims to understand how lung cancer screening programs are currently performing. It also identifies the barriers and enablers contributing to adoption of lung cancer screening across 10 case study countries: Canada, China, Croatia, Japan, Poland, South Korea and the United States. Adoption rates vary significantly across studied countries. We find five main factors impacting adoption: (1) political prioritization of lung cancer (2) financial incentives/cost sharing and hidden ancillary costs (3) infrastructure to support provision of screening services (4) awareness around lung cancer screening and risk factors and (5) cultural views and stigma around lung cancer. Although these factors have application across the countries, the weighting of each factor on driving or hindering adoption varies by country. The five areas set out by this research should be factored into policy making and implementation to maximize effectiveness and outreach of lung cancer screening programs.

“If we don’t speak the language, we aren’t offered the same opportunities”: Qualitative perspectives of palliative care coordination for women of color living with metastatic breast cancer.

88 Background: Black and Latina women with metastatic breast cancer (MBC) experience more severe distress, unaddressed symptom burden, and discordant provider communication relative to White women. Adequate care coordination has the potential to mitigate disparities in care access and outcomes, yet little is known regarding palliative care (PC) coordination experiences in women living with MBC. Methods: We conducted a qualitative thematic analysis of transcribed interviews of Black and Latina women with MBC (N=20) and interdisciplinary care providers (N=20). Participants were recruited from urban PC and oncology clinics, federally qualified health centers, and community organizations. Transcripts were reviewed and analyzed by a team of investigators, community scientists and community advisory board members. Themes were identified with inductive coding. Results: Barriers and facilitators of PC coordination were identified. Barriers included a) lack of communication between oncology, PC, and primary care teams, b) limited understanding and stigma surrounding PC among patients and non-PC providers, c) language and health literacy-related communication challenges, and d) racism and marginalization, including implicit bias and lack of diverse racial/ethnic representation in the supportive care workforce. Facilitators of PC coordination included a) patient-to-patient referrals, b) support groups breaking cultural stigma on topics including self-advocacy and PC, c) referrals from trusted providers, and d) community organization’s abilities to overcome challenges related to social determinants of health with logistical and financial support. Respondents reported barriers of quality PC coordination resulted in significant gaps in management of psychosocial and physical symptoms, including mental health, lymphedema, sexual health, cognitive health, and pain. Conclusions: Care coordination and patient reported PC outcomes are heavily influenced by social determinants of health and stigma surrounding PC. Patients and providers value patient-to-patient referrals, support groups, and community organizations in improving care coordination and early PC access. The results from this study will inform the design of ACCESS, a community navigator-led intervention for Black and Latina women with MBC focusing on acceptance of early PC and linkage to community and clinical resources.

Is A Therapeutic Approach Required To Treat Insomnia In Pakistan?

Insomnia, defined as difficulty falling or staying asleep, is prevalent among one-third of the general population. (1) It can give rise to various physical and mental problems, such as obesity, diabetes, anxiety, and depression. (2) While there are many effective medications for insomnia, a therapeutic approach for treating it is more likely to be dependable over time. A meta-analysis exploring the benefits of cognitive behavioural therapy (CBT) for chronic insomnia revealed an improvement of sleep onset latency by 19.03 minutes, a gain of total sleep time by 7.61 minutes, and improved sleep efficiency by 9.91%. (3)CBT has been recognized as a first-line treatment for insomnia by NIH Consensus and State of the Science Statements (4)as it is equally effective as medication for a brief treatment and is more reliable over time. One in every three persons in Pakistan is reported to have sleep problems and, a third of those take sleeping pills. (5)In developing countries like Pakistan, where people don't have resources, a therapeutic approach is likely to reduce the cost and risk of adverse effects of medications. Pakistan is a pill-oriented society, and people prefer pills over therapy. The awareness among the population to adopt treatments or shift to therapeutic interventions is close to none. The cultural stigma associated with therapy is a significant hurdle as well. Unlike medicines, therapy reduces the risk of relapse after its discontinuation. Introducing therapy in the public sector can result in more jobs for therapists and counsellors and provide a cheaper alternative to pills. The best way to introduce CBT among the population is through awareness campaigns, media, and discussions on public platforms. In addition, counsellors can provide outreach in places where additional resources are required to combat the stigma associated with psychotherapy and inform people regarding its benefits. Counsellors collaborating with other health care professionals and gaining a valuable referral source from primary care physicians can also be a meaningful strategy. It would be worth mentioning here that more studies comparing the pills to CBT should be conducted to address the issue.

Shame culture and the prevention of sexual harassment in university: A case study in Indonesia

This study aims to explore how the relationship between the culture of shame and the handling of cases of sexual violence in universities in Indonesia. The research location was conducted at three State universities with legal Entities; Universitas Negeri Malang (UM), Universitas Negeri Padang (UNP), and Universitas Sumatera Utara (USU). The data collection procedure was performed through in-depth interviews and focus group discussions (FGD). The results of the study show that the culture of shame in reporting victims is closely related to the course of the handling cases of sexual violence (PKKS) process. Shame due to social and cultural stigma also needs to be considered as a reference in forming policies to prevent and follow up on sexual harassment prevention. This means that apart from the urgency of making regulations or a special team, universities must also be able to provide space, time, and services that can guarantee the safety of victims both physically and psychologically.

Perception of Tunisian Medical Students with Chronic Conditions: Pilot Study.

Medical studies are hard to manage especially for students with specific needs. These students warrant some adaptations in studies and trainings in order to achieve learning goals. Studies showed they face structural and cultural barriers and stigma. Current efforts aim to encourage integration of these persons in order to increase diversity. This study aimed to assess perception of Tunisian medical students with specific needs. Cross-sectional study through online questionnaire including learners affiliated to the Faculty of Medicine of Tunis (students, interns, and residents) who consider they have specific needs. This questionnaire was elaborated by authors and explored barriers faced by participants, needed help, and suggested solutions. Study respected consent and confidentiality. This study included 40 participants. Most of them (n = 32) were post-graduate (interns and residents). The most reported condition was mental disability (n = 14). Main challenges faced by participants were work time schedule, unhealthy lifestyle, and negative attitudes from peers and supervisors, and 19 felt victim of stigma. Reported specific needs were adapting work schedule and psychological support from peers, from supervisors, or from mental health professionals. Almost half of the participants did never disclose their difficulties (n = 21). Suggested solutions involved to have a counseling center within the faculty. Only 8 participants knew there was a new unit helping students with specific needs in FMT. Despite efforts of the university, medical learners with chronic conditions still face many structural and cultural barriers to inclusion. Most participants suggested to have more psychological support from faculty.

Social Anxiety in University Students: Towards an Intentional Life-Skills Based Prevention Model

Research suggests that staying connected with people is very beneficial to our physical and mental well-being. Moreover, a lack of social connection is associated with poor mental and physical health, and lower overall well-being. For individuals with social anxiety, it is particularly difficult to cultivate social connections. Due to the prolonged period of social isolation during the COVID-19 pandemic, research suggests that social anxiety in university students has increased. This study employed a convergent parallel mixed method design and administered a self-reported questionnaire which included quantitative and qualitative questions. The questionnaire was administered to 301 undergraduate students to determine if feelings of social anxiety in students changed during and after the pandemic. This study also analyzed social anxiety levels across racial and ethnocultural demographics and assessed the cultural stigmas and barriers that may prevent students from accessing mental health services. Results from the quantitative analyses showed a significant difference in social anxiety scores before and after the pandemic. However, in our sample, feelings of social anxiety post-pandemic did not differ across race, or income which were our main variables of interest. In addition, there was a positive correlation between social anxiety scores and household income and fear of negative evaluation. The qualitative results showed that important barriers to accessing mental health services include fear of parents learning they are in therapy, cost of mental health services, language barriers, and concern that a therapist would not have cultural sensitivity. This study highlights the need for increased interventions to reduce social anxiety among students, and proposes a preventative approach we refer to as “Life-Skills Training” to address social anxiety.

Global viewpoints: updates on prostate cancer in Sub-Saharan Africa.

Prostate cancer (PCa) is a major health concern in Sub-Saharan Africa (SSA), with high incidence and mortality rates. However, the widely used prostate-specific antigen (PSA) screening is not readily available or affordable in SSA. Alternative screening strategies, such as risk stratification approaches and cost-effective PSA tests, are being explored to target high-risk individuals and improve access to screening. Diagnosis of PCa in SSA is challenging due to the lack of access to diagnostic tools and limited healthcare resources. Clinical evaluation and digital rectal examination are commonly used, but PSA testing, magnetic resonance imaging, and biopsy are often limited. As a result, many men in SSA are diagnosed at advanced stages of the disease. Treatment options for PCa in SSA are often limited by a lack of resources and trained healthcare providers. Surgery, radiation therapy, and androgen-deprivation therapy are available but may be inaccessible to many patients. Cultural beliefs and stigma surrounding PCa further impact treatment decisions. Improved patient and community awareness, electronic medical records, and communication between patients and healthcare professionals can enhance evidence-based decision-making and advocate for policy changes. Understanding the genetic determinants and implementing comprehensive strategies can lead to improved outcomes and better control of PCa in SSA.