Experiences Of Discrimination Research Articles

Examining critical anti-racism action as a buffer of the link between discrimination and mental health outcomes

Youth in the U.S. must navigate intersecting systems of oppression as they develop. One potentially adaptive approach to navigating oppressive systems is through engagement in informed action to promote greater justice (“critical action”). This study examined whether a particular kind of action, anti-racism critical action, has protective mental health effects on Black and White U.S. adolescents. The study also examined whether experiences of discrimination such as feeling that one is treated worse than others are associated with greater engagement in anti-racism critical action. We find that, for both Black youth and White youth, experiences of discrimination are associated with anti-racism critical action. Black youth are equally likely to engage in anti-racism critical action if they attribute their discrimination to their race as if they attribute it to other causes. We also find that, for White youth but not for Black youth, some forms of anti-racism critical action attenuate the link between experiences of discrimination and mental health outcomes. We suggest that future research attend to the nuanced ways in which experiences of discrimination may shape engagement in anti-racism critical action as well as other forms of critical action, whether for the benefit of oneself and for others.

Perceived discrimination, political efficacy, and political participation in American Indian adults

IntroductionPsychological factors linked to political participation are largely understudied in American Indians. Prior work notes relatively low levels of participation compared to other racial and ethnic groups and suggests that identification with being American Indian is linked to overall levels of civic engagement in part through perceptions of group discrimination.MethodsIn the current work, in a sample of 727 American Indian adults, we created two groups: Group 1 (N = 398) reported perceived discrimination related to race, and Group 2 (N = 329) reported perceived discrimination not related to race or ethnicity. We investigated the relationships between individual experiences of everyday discrimination related to race, levels of political efficacy, and political participation (Group 1), and individual experiences of everyday discrimination not related to race or ethnicity, political efficacy, and political participation (Group 2).ResultsWe found that greater experiences of everyday discrimination related to race was associated with higher levels of political participation through increased levels of internal and collective efficacy. In contrast, greater experiences of everyday discrimination related to race was associated with higher levels of political participation through lower external political efficacy. For Group 2, we found that greater experiences of everyday discrimination not related to race or ethnicity was not directly associated with political participation, but mediation analyses revealed a relationship with lower levels of political participation through decreased internal and collective efficacy. The indirect effect through external political efficacy was not significant.DiscussionGiven low levels of American Indian political participation, political efficacy could be a target for interventions aiming to increase participation in the political system.

Abstract 4837: Perceived discrimination, medical mistrust, and their associations with ovarian cancer mortality among women in the African American Cancer Epidemiology Study

Abstract Background: There are pronounced racial disparities in ovarian cancer mortality wherein Black women are on average 30% more likely to succumb to their disease than White women. Factors that contribute to these disparities are complex and multifactorial. Racial discrimination is hypothesized to affect cancer health disparities through three distinct pathways including the impact on socioeconomic inequities, chronic stress, and restricted access to goods and services. In this study, we examined the role of perceived discrimination and medical mistrust on all-cause mortality among ovarian cancer patients. Methods: Using data from the African American Cancer Epidemiology Study (AACES), we included 592 ovarian cancer patients who self-identified as Black or African American and completed a telephone interview. Perceived discrimination was measured with a modified version of the 5-question Williams Everyday Discrimination scale. Medical mistrust was measured with the Trust in Physician scale (ranged 0-48 based on a combination of 12 questions). We used Cox proportional hazard models to compute hazard ratios (HR) and 95% confidence intervals (CIs) associating perceived discrimination and medical mistrust with all-cause mortality, adjusting for age, stage, and histotype. Results: Nearly two-thirds of the cohort passed away by the end of follow-up (mean follow-up 5.5 years, ranging 0.5-12 years). We observed that 231 participants patients (39%) reported experiencing discrimination in at least one of the domains assessed. Reporting any experience of discrimination was associated with lower all-cause mortality (HR=0.78, 95% CI: 0.62, 0.97). In multivariable adjusted models, higher trust in physicians (above vs. below the median of 35) was associated with a decreased risk of mortality (HR=0.87, 95% CI: 0.70, 1.08). Conclusion: In our preliminary results, we observed an association between any experience of discrimination and better survival, and that a higher trust in physicians was associated with better survival. Further work on this project will try to understand the paradoxical association with perceived discrimination, and evaluate the associations of discrimination and medical mistrust with ovarian cancer treatment, leading to more insight into drivers of racial disparities in ovarian cancer mortality. Citation Format: Lindsay Jane Collin, Courtney Johnson, Maxwell Akonde, Mary Kan, Elisa V. Bandera, Lauren Peres, Anthony Alberg, Theresa Hastert, Joellen Schildkraut. Perceived discrimination, medical mistrust, and their associations with ovarian cancer mortality among women in the African American Cancer Epidemiology Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4837.

Racial discrimination is associated with food insecurity, stress, and worse physical health among college students

BackgroundStudents of color disproportionately experience racial discrimination and food insecurity, which both lead to poor academic and health outcomes. This study explores the extent to which the location of racial discrimination experienced is associated with food insecurity, stress, physical health and grade point average among college studentsMethodsA cross sectional study design was implemented to survey 143 students from a racially diverse public university. Logistic regression models assessed if discrimination at various locations was associated with food insecurity and linear models assessed how racial discrimination was associated with physical health, stress and grade point averageResultsStudent’s experiencing food security had an average discrimination score of 2.3 (1.23, 3.37), while those experiencing food insecurity had a statistically significant (P < 0.001) higher average discrimination score 7.3 (5.4, 9.21). Experiencing any racial discrimination was associated with increased odds of experiencing food insecurity when experienced from the police (OR 11.76, 95% CI: 1.41, 97.86), in the housing process (OR 7.9, 95% CI: 1.93, 32.34) and in the hiring process (OR 6.81, 95% CI: 1.98, 23.48) compared to those experiencing no racial discrimination after adjusting for race, gender, age and income.ConclusionThe location in which a student experienced racial discrimination impacted the extent to which the racial discrimination was associated with food security status. Further research is needed to explore potential mechanisms for how racial discrimination may lead to food insecurity.

Early and current experiences of weight-based discrimination are associated with eating psychopathology, depression, and poor general health in adulthood.

Early and current experiences of weight-based discrimination are associated with eating psychopathology, depression, and poor general health in adulthood.

Interpersonal ethnic-racial discrimination and tobacco products: The moderating role of critical action.

The present study aimed to understand the role of critical action, sociopolitical participation, an essential form of consciousness in the relationship between interpersonal discrimination and the use of tobacco products. The present study was part of a more extensive longitudinal study on students' genetic and environmental experiences. To examine these associations, 164 racially minoritized college students (Mage = 19.86, SD = 0.28) were surveyed for this study. Findings indicated that the relation between interpersonal ethnic-racial discrimination (IERD) and tobacco products was moderated by critical action. Specifically, IERD was associated with greater use of tobacco products when students had low critical consciousness-critical action. The relation between IERD and the use of tobacco products became nonsignificant when students had high critical action. Critical action was protective in mitigating increased tobacco use in the context of discrimination experiences. Research, clinical, and policy implications are discussed in efforts to reduce tobacco-related disparities among racially minoritized college students. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Discrimination and sense of purpose: Taking an intergenerational lens

Given the developmental benefits associated with higher sense of purpose, past work has aimed to understand how experiences of adversity relate to sense of purpose. With a specific focus on experiences of adversity that may impact individuals from marginalized groups, past work has found that discrimination is related to lower sense of purpose in life, but that these effects are weaker for Black adults relative to White adults. The current research aims to extend past work by examining how and for whom discrimination is related to sense of purpose in life. Moreover, the current work also aimed to understand the extent to which sense of purpose spans across generations and whether there are generational differences in the relationship between discrimination and sense of purpose. Using data from the St. Louis Personality and Aging Network study, 822 parents (G1 participants) and 654 children (G2 participants) completed measures for sense of purpose, major experiences of discrimination, and personality traits. Results found mixed evidence for a relationship between discrimination and sense of purpose, with little evidence for consistent moderators. In addition, while the current work found no evidence of intergenerational associations for sense of purpose, results showed that discrimination was positively associated across generations, suggesting a potential for an intergenerational cycle of marginalization.

Abstract P228: Baseline Characteristics of a Pilot Randomized Controlled Trial of a Self-Management Program for Depressed Black Women at Risk for Hypertension

Introduction: Black women have the highest prevalence of hypertension (HTN) compared to other racial/ethnic groups. Depression impacts women on a 2:1 ratio and increases cardiovascular risk. Black women are less likely to receive evidence-based care for depression and face barriers to engaging in healthy behaviors. In the current descriptive analysis, we examined baseline data from an ongoing pilot randomized controlled trial aimed to assess the efficacy of a group self-management program to decrease depression and HTN risk. Hypotheses: We assessed the hypothesis that a well-characterized sample of 30 depressed Black women would have high levels of physical and psychosocial risk factors for cardiovascular disease, low levels of treatment engagement, and that depression severity would correlate with experience of discrimination, stress, and perceived lack of social support. Methods: Inclusion criteria were Black women between the age of 18-49 with moderate depression (PHQ-9 of ≥10) and at least one risk factor for HTN. Social determinants of health (SDOH), discrimination, stress, and social support were assessed using validated measures. Results: The sample consisted of 30 Black females; mean age=34.27, SD= 8.60, and mean years of education=13.97, SD=1.79. Mean depression=15.10, SD=3.16, 33.33% endorsed thoughts of self-harm, and 36.67% reported currently receiving treatment for depression. Of those, 72.7% were in therapy and 54.5% were taking medication. Forty percent reported a history of physical abuse and 36.7% reported a history of sexual abuse. Salient cardiovascular risk factors included mean BMI=37.47, SD=5.84 (29/30 met BMI&gt;30 criteria), 26.67% smoker, 6% diabetes, 13% high cholesterol, and 46.67% other chronic health conditions. Mean discrimination score was 27.23, SD=10.96 indicating moderate exposure to discrimination and 75% identified race as the main source of discrimination. Additionally, 26.67% scored above the threshold on violence as measured by a SDOH screener and perceived stress averaged in the moderate range. Depression severity was significantly correlated with discrimination ( r =.43, p &lt;.05), stress, ( r =.55, p &lt;.01) and trended with social support ( r =-.39, p =.076). Conclusion: In conclusion, given the high rates of CVD risk factors, multiple psychosocial stressors, and low rates of treatment engagement, to improve cardiovascular health in Black women, we must be aware of and address a more comprehensive set of socio-emotional risk factors. Self-management interventions that simultaneously provide social support, address mental health needs, and are led by peers are likely to increase engagement and improve health outcomes.

Abstract P240: Association of Perceived Lifetime Discrimination With COVID-19 Infection, Hospitalization and Death: The Collaborative Cohort of Cohorts for COVID-19 Research (C4R) Study

Rationale: Perceived discrimination adversely impacts individual and population health. However, limited studies have examined associations between discrimination and COVID-19 severity in a diverse cohort of adults. We investigated the association between lifetime discrimination and risk of severe COVID-19. Methods: This study included Black, Chinese, Hispanic, and White participants (45-84 years of age) from the Multi-Ethnic Study of Atherosclerosis (MESA). Lifetime discrimination (experiences of unfair treatment in 6 domains) was assessed at baseline (2000-2002). Incident COVID-19 was ascertained by the Collaborative Cohort of Cohorts for COVID-19 Research (C4R) via questionnaires, serosurvey, and medical records in 2020-2023. Hospitalized and fatal cases were defined as severe; all other cases were defined as non-severe. Associations of lifetime discrimination and incident severe and non-severe COVID-19 were examined via Fine-Gray proportional sub-distribution hazards models, adjusting for covariates. Effect modification by sex, race/ethnicity, and educational attainment was tested. Results: Of 3,441 participants (mean age 76 years, 54% female, 13% Chinese, 20% Hispanic, 25% Black, 41% White), there were 248 cases of non-severe COVID-19 and 83 cases of severe COVID-19. Individuals reporting lifetime discrimination in ≥2 domains (vs none) had a two-fold higher hazard of severe COVID-19. Effect modification was observed by sex (P=.003) and educational attainment (P=.072), but not by race/ethnicity (P=.24). In stratified models, associations of lifetime discrimination and severe COVID-19 were stronger in women versus men and in participants with lower versus higher educational attainment ( Table ). Conclusion: Lifetime discrimination was associated with greater risk of severe COVID-19, particularly in women and persons with lower educational attainment. Further research is needed to understand mechanisms underlying these associations and to inform prevention and risk mitigation.

O2: The development of anti-bullying, discrimination, and harassment guidance: A survey among the association of surgeons in training (ASiT) council members

Abstract Introduction Surgical trainees have a reasonable expectation to feel safe and valued in their workplace. Previous reports proved that poor behaviour and misconduct existed in national health system. We aimed to conduct a survey among ASiT council members to identify the need of guidance to report bullying, discrimination, and harassment for trainees who experienced any type of poor behaviour at workplace. Methods Data among executive and council members was collected. Questions were related to trainee demographics, level of training, specialities, experienced, witnessed, or reported poor behaviours including bullying, discrimination and harassment. We asked if participants lacked direction when experienced poor behaviours, if support strategies were needed such as a standardised guidance for reports. Results A total of 58 survey responses were received, 55.17% of participants experienced bullying, 77.58% witnessed it and 67.25% did not report. While 37.93% experienced discrimination, 62.07% witnessed it and 68.97% did not report. A total of 24.14% experienced sexual harassment, was witnessed in 29.69%, 72.41% did not report. Over eighty percent mentioned they need more guidance to support trainees. Almost all participants (98%) agreed that surgical trainees should be made aware of routes for reporting, and 88% agreed that ASiT should develop the guidance to support trainees against poor behaviours. Conclusion Most of the trainees who experienced or witnessed poor behaviours did not report the incidents. A new standardised anti-bullying, anti-discrimination, and anti-harassment guidance was developed based on our study results. We envisage that its use may play a role in eliminating misconducts in surgical training.

Black Americans suppress emotions when prejudice is believed to stem from shared ignorance.

Past research examining lay theories of the origins of prejudice has focused on white Americans and has not considered how Black Americans' lay theories of prejudice may impact emotion regulation following discrimination. Across three samples of Black Americans (N = 419), the present research examined relationships between endorsement of two lay theories of prejudice origins (1, beliefs that prejudice stems from shared social ignorance and 2, that prejudice stems from malice). Stronger beliefs that prejudice stems from shared ignorance were associated with greater expression suppression following experiences of racial discrimination (studies 1b and 2), which was, in turn, associated with psychological distress (study 2). By centering the beliefs and experiences of Black Americans in response to discrimination events, the present research has implications for understanding how emotion regulation following racial discrimination is impacted by marginalized groups' conceptualizations of prejudice. Future research should investigate how these factors impact health disparities.

Impacts of vocational training for persons with disabilities: Experimental evidence from Cambodia

This paper examines the impacts of vocational training for persons with disabilities (PWDs). In heavily mined areas of rural Cambodia, adults with limb amputation or paralysis were randomly assigned to either a treatment group (invited to participate in an intensive training program in mechanics and services) or a control group (not invited to participate). Over 30% of PWDs in the treatment group participated in the program and none in the control group did so. Although being assigned to the treatment group greatly increased PWDs’ employment and earnings, experiences of discrimination reported by them and their disability stigma (self-stigmatization) also increased. The paper shows suggestive evidence for skill acquisition and networking for employment and negative self-stereotyping leading to stigma.

청년 아르바이트생의 차별경험과 진로미결정의 관계

Objectives In this study, we tested the mediating effect of belief in a just world in the relationship between young part-time workers' experiences of discrimination and career indecision.&#x0D; Methods An online survey was conducted targeting young people aged 15 to 34 with part-time work experience. The final 259 copies were used for statistical analysis. Descriptive statistical analysis, reliability analysis, correlation analysis, and regression analysis were performed using the SPSS 23.0 statistical program. And to verify the mediation effect, bootstrapping was performed to verify statistical significance.&#x0D; Results The average experience of discrimination was 3.06, the average career indecision was 2.32, and the average belief in a fair world was 3.77. and the average belief in a just world was 3.77. There was a positive correlation that the more discrimination experiences young part-time workers had, the higher their career indecision. There was a negative correlation between the experience of discrimination and overall belief in a just world, distributive justice belief, and procedural justice belief. It was confirmed that belief in a just world had a full mediating effect on the impact of youth discrimination experiences on career indecision. In addition, the partial mediating effect of distributive justice belief and the full mediating effect of procedural justice belief, which are subvariables of belief in a just world, were confirmed.&#x0D; Conclusions This study emphasizes the need to consider the cognitive variable of belief in a just world in the relationship between young part-time workers' experiences of discrimination and career indecision. Based on this, we laid the foundation to reduce the career indecision of young part-time workers who are experiencing discrimination and provide education and counseling opportunities to help young people enter the labor market.&#x0D;

Discrimination, Drinking to Cope, Protective Behavioral Strategies, and Alcohol-Related Consequences Among University Students.

University students who experience more discrimination typically report more negative consequences from alcohol use. The study aimed to assess whether drinking to cope and protective behavioral strategies for alcohol use would help explain the relationship between everyday discrimination and alcohol-related consequences among university student drinkers. Data were collected in Fall 2020, and the sample included 707 undergraduate and graduate students from a large public institution in the Northeast who reported consuming alcohol in the past month. Participants identified predominantly as women (71.7%; 24.6% men) and White (65.1%; 7.9% Black/African American; 7.2% Asian/Asian American; 7.1% Hispanic/Latinx). A cross-sectional serial mediation analysis using structural equation modeling was conducted using Mplus. When we controlled for alcohol use, results supported a serial partial mediation model. More experiences of discrimination predicted a significant increase in alcohol-related consequences, above and beyond the increase attributed to drinking to cope. More frequent use of protective behavioral strategies significantly increased the odds of reporting no alcohol-related consequences. Drinking to cope and protective behavioral strategies for alcohol use may help explain why university students who report frequent discrimination are more likely to experience alcohol-related consequences, independent of how much alcohol they consume. Findings can inform clinical and prevention practice, advocacy, and training.

From identity-based distress to thinking “I am better off being dead:” Minority stress, posttraumatic cognitions, and suicidal ideation

BackgroundSuicidal ideation (SI) disproportionately impacts individuals with minoritized race/ethnicity, gender, and sexual orientation. Minority stress – i.e., traumatic, insidious distress that results from acts of discrimination – may lead to the formation of posttraumatic cognitions that may generalize to suicidal ideation, elevating SI risk in minoritized populations. The current study aimed to test this potential relationship by examining whether minority stress and posttraumatic cognitions accounted for the association between discrimination and SI. MethodsSeries of structural equation models, including multigroup confirmatory factor analyses conducted to test invariance of latent constructs, were estimated on cross-sectional data collected from minoritized young adults (n = 337). ResultsResults supported the hypothesized model: experience of discrimination indirectly associated with SI via correlations shared between minority stress and posttraumatic cognitions. Experiences of discrimination lacked a significant correlation with SI while accounting for minority stress and posttraumatic cognition variance. Invariance testing conducted to account for applicability of the model across race, ethnicity, sexual orientation, and plurality of minoritized identities all demonstrated that the model was applicable across these identity dimensions. LimitationsGranular inspection of identity dimensions was infeasible due to sample size and causal inferences cannot be drawn given cross-sectional nature of the data used. ConclusionsPosttraumatic cognitions within the context of discrimination may be effective treatment targets for minoritized individuals who present with minority stress and SI. Future studies should aim to replicate such findings longitudinally to infer temporality.

Medical student non-modifiable risk factors and USMLE Step 1 exam score

ABSTRACT For diversity to exist in the medical graduate workforce, students from all backgrounds should have equitable opportunities of employment. Specialties have utilized a minimal threshold for USMLE Step 1 score when screening applicants for residency interviews. The OHSU SOM class of 2021 completed a 14-question voluntary survey on their Step 1 score and the following non-modifiable risk factors: Adverse Childhood Experience score (ACEs), sex, gender, Underrepresented in Medicine status (URiM), family income during adolescence, highest degree held by a guardian, discrimination experience during medical school, federal/state assistance use, and rural versus urban primary home. Descriptive statistics and unadjusted risk ratios were applied to study the relation between Step 1 score and non-modifiable risk factors as well as certain non-modifiable risk factors and ACEs ≥ 3. The mean Step 1 score was 230 (213, 247). Of the students, 28.2% identified ACEs ≥ 3, 13.6% were considered URiM, and 65.4% were female. URiM were 2.34 (1.30, 4.23), females were 2.77 (1.06–7.29), and those who experienced discrimination in medical school were 4.25 (1.85, 9.77) times more likely to have ACEs ≥ 3. Students who had ACEs ≥ 3 were 3.58 (1.75, 7.29) times less likely to meet a minimal threshold for residency interviews of 220. These are the first results to demonstrate a relationship between Step 1 score and ACEs. Those who identified as URiM, females, and those who experienced discrimination in medical school were at a higher risk of ACEs of ≥ 3. Step 1 transitioned to pass/fail in January 2022. However, the first application cycle that residencies will see pass/fail scoring is 2023–2024, and fellowships will continue to see scored Step 1 until, at the earliest, the 2026–2027 application cycle. These data contribute to a foundation of research that could apply to Step 2CK testing scores, and help to inform decisions about the diversity and equity of the residency interview process.

Multiple Discrimination and Substance Use Intention in Late Childhood: Findings From the Adolescent Brain Cognitive Development (ABCD) Study

PurposeThe study aimed to investigate longitudinal, bidirectional associations between discrimination due to multiple reasons (race/ethnicity, sexual orientation, weight; termed multiple discrimination) and substance use (SU) intention in late childhood. These associations were compared across youth with no, single, and multiple (i.e., intersecting) marginalized identities based on race/ethnicity, sexual orientation, and overweight status. MethodsData were drawn from a national sample of youth in the Adolescent Brain Cognitive Development study (N = 8,530; 9–12 years old). Youth reported both their experiences of multiple discrimination (the number of forms of discrimination youth experienced) and SU intention at one-year and two-year follow-ups. Theoretically relevant covariates were included. ResultsCompared to non-marginalized youth (n = 2,689) and youth with single marginalized identities (n = 3,399), youth with intersecting marginalized identities (n = 2,442) reported the highest SU intention and multiple discrimination across waves. Only for this last group, multiple discrimination predicted stronger SU intention subsequently (β = 0.07, 95% confidence interval [0.02, 0.11]), whereas stronger SU intention predicted lower levels of multiple discrimination over time (β = −0.06, 95% confidence interval [-0.09, −0.02]). Sensitivity analyses yielded similar patterns with some nuances among subgroups of youth with varying intersecting marginalized identities. DiscussionMultiple discrimination predicted stronger SU intention over time in late childhood, particularly among youth with intersecting marginalized identities. Policies and practices should consider addressing multiple discrimination to reduce SU disparities among diverse youth.

Emotional impacts of racial discrimination on caregiver-child dyads: Can mentalizing-focused parenting groups buffer against racism-related stress?

Black and Latinx caregivers face high risk for parenting stress and racism-related stress due to experiences of racial discrimination (RD). This study aimed to explore the associations between RD, parenting stress, and psychological distress in caregiver-child dyads, as well as the impact of a mentalizing-focused group intervention on caregivers' experiences of RD distress. Ethnoracially minoritized caregivers of children aged 5-17 years old participated in a non-randomized clinical trial (N = 70). They received either a 12-session mentalizing-focused group parenting intervention or treatment-as-usual in outpatient psychiatry. We assessed self-reported frequency and distress related to RD, parenting stress, and psychological distress at baseline (T1) and post-intervention (T2). Caregiver- and self-reported child psychological distress were also measured. The results showed that greater RD frequency and greater RD distress separately predicted higher overall parenting stress and parental role-related distress. Greater RD distress was linked to increased psychological distress in caregivers. Similarly, greater RD frequency and distress among caregivers were associated with higher caregiver-reported, but not self-reported, child psychological distress. No significant changes in RD distress were observed between T1 and T2 for either of the treatment groups. These findings highlight the exacerbating role of RD on parenting stress and psychological distress among ethnoracially minoritized caregivers and their children.

Health-related quality of life over chemotherapy course among individuals with early-stage breast cancer: the association of social determinants of health and neighborhood socioeconomic disadvantage.

This study aimed to examine relationships between health-related quality of life (HRQOL), social determinants of health, and neighborhood socioeconomic disadvantage in individuals with early-stage breast cancer (ESBC) during chemotherapy. This is a longitudinal study that recruited Black and White women with ESBC receiving chemotherapy. Participants completed questionnaires recording their sociodemographic information at baseline and the Functional Assessment of Cancer Therapy-General (FACT-G) to report their HRQOL before each chemotherapy cycle. Linear mixed modeling was employed to examine the associations between FACT-G scores, self-reported race, and area deprivation index (ADI) before and at the last chemotherapy cycle, with the duration of chemotherapy treatment as a covariate. A total of 84 Black and 146 White women with ESBC completed the surveys. Linear mixed modeling results suggested that women with ESBC who reported being Black experienced significantly worse physical well-being than those who reported being White throughout chemotherapy, with a 0.22-point lower average (p = 0.02). Both Black and White women with ESBC experienced decreased functional well-being over the chemotherapy, and Black women consistently reported lower scores than White women, with the change in functional well-being over time differing between racial groups (p = 0.03). Participants' ADI national percentiles were not significantly associated with their HRQOL throughout chemotherapy. These findings underscore possible racial differences in some dimensions of HRQOL during chemotherapy among women with ESBC. Future research should consider further assessing life stressors and past experiences of discrimination and racism that may contribute to these disparities and guide proactive interventions.

Immigrant nurses' experiences of discrimination by patients and nursing home residents: a narrative review

Immigrant nurses' experiences of discrimination by patients and nursing home residents: a narrative review Abstract: Background and aim: Immigrant nurses are filling the shortage of skilled workers in many countries. Studies suggest that they may face discrimination in their destination countries. This paper aims to provide an overview of the experiences of immigrant nurses with regard to discrimination in their interactions with patients. Methods: A systematic literature review was performed by searching the databases PubMed and CINAHL. Additional articles were identified through a search in Google Scholar and by reviewing reference lists. Studies published between 1/2013 and 3/2023 were included. Results: The literature search yielded 103 studies, 18 of which were included in the narrative review. The review showed that immigrant nurses may experience discrimination in the form of rejection, questioning of their qualifications, unequal treatment, derogatory remarks, threats, as well as violence from patients. Discrimination is based on their ethnicity, country of origin, external characteristics, language, and accent. Conclusions: Overall, available data is insufficient. The results of this review can serve as a basis for further studies and help managers and policy makers to better understand discrimination against immigrant care workers, to develop strategies to support them and to implement appropriate prevention measures.