Diverse Community Members Research Articles

“I would just like to see more acknowledgement, respect and services for the people who are in between, just Métis people”: recommendations by Métis women to improve access to health and social services in Victoria, Canada

This paper reports on recommendations made by Métis women, two-spirit, and gender diverse people for improving access to health and social services in Victoria, British Columbia. Expanding on research conducted in Toronto, Ontario, this study applied a conversational interview method to further explore and understand experiences of self-identifying Métis women, two-spirit, and gender diverse people ( n = 24) who access health and social services in Victoria. Participants provided wholistic and practical recommendations for improving access to health and social services, including (1) warm and inviting service spaces, (2) Métis-specific cultural safety training, (3) Indigenous specific clinic, (4) wholistic or integrative service delivery, and (5) non-judgemental service providers. This research demonstrates that Métis women, two-spirit and gender diverse community members hold practical solutions for improving access to health and social services for the larger Métis community.

The Meaning of Religious Moderation According to Franz Magnis-Suseno: A Phenomenological Approach

Religious moderation is necessary to guarantee social stability against the unwanted ideological force and even physical collisions in society. Social and religious lives are not isolated but must be integrated into one another. Building an educated and open-minded religious community is required to achieve this goal. The ideal religious moderation should be created through active participation from all members of diverse religious communities to achieve the same goals based on togetherness, inclusive attitude, respect, and mutual understanding related to performing certain rituals and doctrines of each religion. The variety of typologies of interfaith relations, such as exclusivism, inclusivism, and pluralism, are commonly formulated to bring these diversities into the further step of harmonious religious dialogues. This article uses the phenomenological approach in studying the meaning of religious moderation, according to Franz Magnis-Suseno. Specifically, according to Magnis-Suseno, someone just can talk about religious moderation if there is a willingness to accept and recognize plurality. That is, assuming the difference. Religious moderation means getting relatives or groups, even though their views, beliefs, and beliefs are different.

Racial equity in linkage to inpatient opioid use disorder treatment in patients that received emergency care.

Opioid use disorder (OUD) is a national epidemic, and Black and Hispanic patients are less likely to receive treatment when compared to white patients. In this study, race was used as a proxy to assess potential effects of racism on the referral process for OUD treatment. Our primary aim was to examine whether Black or Hispanic patients experienced increased barriers to inpatient OUD detoxification (detox) placement at a community-integrated, substance use disorder support program based in an emergency department (ED). Our secondary aim was to determine if Black and Hispanic patients were more likely to have >3 referrals. This retrospective cohort study was conducted at a large urban safety-net hospital and included patients seen in the ED from July 2018 to September 2019 with ICD-10 codes for an opioid-related visit and who sought placement to inpatient detox. A generalized linear mixed model controlling for multiple visits, age, sex, insurance, time, day of week, and time of year was used to assess the association between race/ethnicity and hypothesized barriers to placement. The proportion of patients with >3 visits for referral to inpatient detox was compared between Black and Hispanic patients and white patients using a chi-squared test. We identified 1733 encounters from 782 unique patients seeking connection to inpatient detox for OUD. Of the 1733 encounters, 45% were among Black and Hispanic patients. Hispanic and Black men had significantly lower odds of having a barrier to inpatient OUD detox than white men (OR = 0.734, 95% CI 0.542-0.995). No significant difference was found for Hispanic and Black women (OR = 1.212, 95% CI 0.705-2.082). More Black and Hispanic patients experienced >3 referrals to inpatient detox compared to white patients (19.2% vs 12.9%, p = 0.016). This study suggests in the context of near-universal health insurance coverage, an ED-based OUD support program staffed by diverse community members can mitigate inequities in access to inpatient detox. However, the increased number of ED visits for OUD detox placement by Black and Hispanic patients suggests racial inequities in OUD treatment exist after linkage to care. Additional research should explore the causes, specifically structural and interpersonal racism, and determine solutions to address racial inequities in detox placement as well as maintenance in treatment programs.

Making a Medical Maker's Playbook: An Ethnographic Study of Safety-Critical Collective Design by Makers in Response to COVID-19

We present an ethnographic study of a maker community that conducted safety-driven medical making to deliver over 80,000 devices for use at medical facilities in response to the COVID-19 pandemic. To achieve this, the community had to balance their clinical value of safety with the maker value of broadened participation in design and production. We analyse their struggles and achievement through the artifacts they produced and the labors of key facilitators between diverse community members. Based on this analysis we provide insights into how medical maker communities, which are necessarily risk-averse and safety-oriented, can still support makers' grassroots efforts to care for their communities. Based on these findings, we recommend that design tools enable adaptation to a wider set of domains, rather than exclusively presenting information relevant to manufacturing. Further, we call for future work on the portability of designs across different types of printers which could enable broader participation in future maker efforts at this scale.

Vaccination for Justice-Involved Youth.

Justice-involved youth are at increased risk for coronavirus disease 2019 (COVID-19) infection, and structural barriers may limit their access to vaccination. We implemented a COVID-19 vaccination initiative for justice-involved youth residing at the county juvenile detention center and enrolled in local community-based monitoring programs. Our overarching goal was to increase COVID-19 vaccine access and uptake for justice-involved youth in Allegheny County, Pennsylvania. Our efforts incorporated: a virtual forum with youth, guardians, and community partners; one-on-one outreach to guardians; motivational interviewing with youth; and coordination with organizational leaders. We collaborated with a multidisciplinary medical team to offer individualized education and counseling to parents and youth expressing vaccine hesitancy. We developed a logistical framework to ensure complete COVID-19 vaccination series for all youth, including centralized tracking and implementation of multiple community-based vaccine clinics. Through our initiative, 31 justice-involved youth have received at least 1 dose of the Pfizer-BioNTech COVID-19 vaccine. A total of 50 doses have been administered as a result of this initiative. This work has reaffirmed hypothesized barriers to vaccine access among justice-involved youth, including limited parental involvement, inadequate transportation, vaccine misinformation, and distrust rooted in histories of medical mistreatment of communities of color. Best practices for promoting equitable vaccination efforts among vulnerable subgroups include partnering closely with diverse community members; offering individualized, strengths-based counseling on vaccine safety, efficacy, and importance; and demonstrating provider trustworthiness by recognizing histories of oppression.

New Findings on Unconsented Intimate Exams Suggest Racial Bias and Gender Parity

Testimony from hundreds of medical students and numerous physicians and scholars suggests that unconsented intimate exams (UIEs) are unlikely to be rare, isolated incidents. However, much is unknown about the frequency of these exams and the circumstances in which they take place. The Community Bioethics Forum, founded and chaired by one of the authors of this commentary, is a consultative group of diverse community members who provide insights on law and policy to policy-makers and medical associations. Connecticut legislators asked the CBF to provide their views on proposed "explicit consent" legislation, and during those discussions, concerning narratives emerged about members' (and their loved ones') personal experiences with UIEs. To gain greater clarity on the demographic patterns and frequency of UIEs, we conducted the first national survey on UIEs. Data from this survey suggest that UIEs may occur under a broader range of circumstances than addressed by most law and policy. The survey resulted in nearly the exact same rate of affirmative responses between males and females in answer to whether they had received a UIE within the past five years. The survey results also showed evidence of racial disparity. Additional research is needed to understand the nature of UIEs.

Food assets for whom? Community perspectives on food asset mapping in Canada

ABSTRACT Food asset mapping is an emerging tool to promote food security and food resiliency in Canadian cities. It provides a baseline of a city’s food assets and identifies local food infrastructures that can support community food security. Mainstream food asset maps predominantly focus on the built environment, giving less consideration to the natural environment and social assets. Moreover, in the absence of community perspectives, informal, and racialized food spaces might not even be considered. Drawing upon the findings from a community focus group and food asset mapping workshop, we engaged diverse community members from the City of Vancouver (n=20) to further define and identify key food assets in Vancouver. Of note, several participants raised their discomfort with the term “asset”, especially within the context of colonialization in Vancouver, and raised the question of who gets to define what is and what is not a “food asset.”

"Just" Utility? A Bioethical Analysis of COVID-19 Resource Allocation

COVID-19 has brought into focus the bioethical challenge of resource allocation by straining healthcare delivery in limiting the availability of healthcare resources. While the bioethical principle of autonomy has typically taken precedence for medical practices, with the struggle of resource allocation, the bioethical principles emerging as front-line and conflicting have been utility and justice. Balancing these ideals has been challenging because while utility has demanded that society make decisions maximizing good and minimizing harm, justice has emphasized all people getting their due, despite if most efficient. Looking at how these principles could work without compromising each other, the question how a “just” utility, or a utility well-balanced with justice, could be attained has emerged because while utility has encouraged policies that would save the most lives in dire situations, it has inadvertently allowed for the magnification of pre-pandemic inequities disproportionately impacting the marginalized, marking an issue of justice. The conversation has proven complex when considering the ventilator crisis, showing the importance of resource allocation for public health emergencies. To grasp the scope of resource allocation challenges during COVID-19, the role of bioethical principles in making decisions, the concept of “just” utility, and the implications of resource allocation (including questions of accountability and use of innovative technologies) will be evaluated. Advocated for will be the consistent discussion of resource allocation strategies by diverse community members who take responsibility together, health officials being transparent during crisis situations, and using bioethical principles to predict and combat inequities that might be amplified during crises.

Engaging diverse community members to enhance analysis and interpretation: processing qualitative interview data

As the USA becomes more diverse, the inclusion of patients from diverse backgrounds in research becomes ever more important to ensuring a complete understanding of the patient experience in primary...

Pluralism of Identities and Major Preferences of Freshwomen and Sophomore ELT Students

This paper discusses the diversity of identities possessed by English Language Teaching (ELT) students, as prospective English language professionals, both in terms of their socio-cultural and linguistic pluralism. In addition, the complexity of the problem of determining majors that are still often encountered in the field will also be part of the discussion in this paper. By using the narrative study method, data were collected by analyzing the results of reflections carried out by the research subjects on how they view themselves as individuals and also members of diverse communities, their experiences before starting their study period as students of English education, what strategies they overcome difficulties during their study, especially since the pandemic until at the present time. Subject selection is done by purposive sampling method. This paper is expected to provide a useful reference for students and lecturers in analyzing needs at the beginning of the study period and helping students solve the problems they experience related to major preferences, with the provision of a good introduction to the identity of prospective ELT professionals. This will support their success in language education that prioritizes respect for the linguistic and cultural diversity of others as an inseparable part of this global and unpredictable era. Furthermore, the idea is expected to give valuable insights for Transformative English Studies.

11 - Creating Sustainable Learning Environments for Professional Curriculum Leadership through Information and Communication Technologies

This paper documents the processes and procedures followed by a team of two researchers and five co-researchers in the creation of sustainable learning environments at a school in the Free State province of South Af- rica. For this purpose, we used one school to illustrate how diverse school community members deliberately constructed a framework for the integra- tion of ICT in the development of its professional curriculum leadership practices. A conceptual framework driven through critical emancipatory theory is applied as the lens that propels us to create opportunities for self-empowerment. Grounded on this theoretical framing we then used a participatory action research to operationalize it. We generated relevant data through the establishment of a research team, which coalesced around a common vision collectively identified in pursuance of the aim of study. Data generated were analysed using Van Dijk’s critical discourse analysis. The findings discussed are (i) performance through reflecting on professional curriculum practices, (ii) their actions, (iii) procedures involved therein, and (iv) strategies. The contribution we made was a tested framework for the integration of ICT in a professional curriculum context. This contribution has implications for the creation of a sustainable learning environment.

The Living Alone with Cognitive Impairment (LACI) project: Bridging research and policy to expand long‐term services and supports

AbstractBackgroundThere are an estimated 4.3 million people living alone with cognitive impairment (PLACI) in the United States. The COVID‐19 pandemic and the isolation incurred by shelter‐in‐place has likely exacerbated cognitive impairment in older adults who live alone. Access to formal long‐term services and supports (LTSS) is critical to this population because they lack cohabitants to assist with activities of daily living and navigating LTSS. The Living Alone with Cognitive Impairment (LACI) Project seeks to bridge research and policy to develop actionable and timely policy recommendations to address the needs of PLACI through new expansions of LTSS.MethodSeventeen Policy Advisory Group (PAG) members were recruited, including representatives from state and local government, dementia and aging advocacy organizations, LTSS providers, and LTSS policy experts. A total of 17 individual meetings were conducted with PAG members and one webinar convening of the group.ResultThe PAG identified preliminary recommendations in three areas, including: 1) important areas of inquiry for qualitative and quantitative research to address the needs of PLACI, 2) best practices for addressing equity across diverse racial/ethnic minority groups, and 3) preliminary policy recommendations that leverage existing innovations at the state and federal level. The LACI Project team is actively incorporating the PAG feedback by: a) modifying research questions for the quantitative and qualitative research, b) convening a Community Advisory Group to ensure that the research is guided by diverse community members, and c) crafting preliminary policy recommendations based on PAG input.ConclusionEngaging the expertise of an advisory group to develop policy recommendations to increase LTSS for PLACI is a promising method of bridging research and policy. The engagement of policy experts ensures by ensuring that research is designed to address the most important policy gaps and all policy recommendations are actionable and timely.

Evaluating the benefits of inclusive community singing towards well-being: narratives of diverse community members attending an inclusive singing group

Purpose The purpose of this paper is to evaluate the benefits of an inclusive community singing group towards well-being. Design/methodology/approach This study used an exploratory qualitative study (EQS) approach. Semi-structured questions were devised and used to elicit participants’ experiences on the impact of an inclusive community singing group towards well-being. A thematic approach underpinned by the four phases of The Silences Framework was used to analyse the data. Findings This study found the following benefits of an inclusive community singing group towards well-being Connecting with others, Physical improvement, Learning new skills, Giving to others and Mindfulness. Originality/value This study concluded that inclusive community singing plays a pivotal role in enhancing the health and well-being of communities.

Informal Economy and Peacebuilding Efforts among Muslim and Christian Communities during Communal Conflicts in Ambon

Communal conflicts that happened in Ambon, eastern part of Indonesia more than 20 years ago still reserve a lot of lessons to unveil. One of the least discussed issues is the roles of economic exchanges among diverse community members in bringing peace from below. This article tries to capture the interreligious interactions (Muslim and Christian) among buyers and sellers in areas considered as border space during the conflicts from 1999 to 2004. It showcases the intertwin of everyday peacebuilding efforts through trade and the spread of peace messages among those involved in the exchange practices. This research employed qualitative research methods using ethnographic strategy with in-depth interview, observation, and library study. Data was collected from 2016-2019 including 10-month intensive fieldwork. The article discusses that social networks and cultural ties embedded in the economic drivers of trade-related activities arguably set the foundation for everyday peacebuilding. In conclusion, economic transactions allowed interethnic, intervillage, and interreligious interactions to take place, eliminated distrust among the traders, and potentially extended peace message narratives at the micro level such as among family members.

Nursing student community engagement barriers, facilitators and satisfaction: Perceptions of community champions

Nursing students could benefit professionally by participating in community engagement, but barriers to student involvement in community engagement exist. Community Champions, a nursing student-led, faculty-mentored service-learning group, promotes local outreach and engagement with a variety of community initiatives for nursing students. The purpose of this study was to examine former and current Community Champions perceptions of the barriers and facilitators to participating in community engagement initiatives, as well as their satisfaction with the community engagement initiatives. The study used a 14-item survey, consisting of both Likert-scale items and open-ended questions. Of the 130 Community Champions invited to complete the survey, 40 Community Champions responded (30.8% response rate). Quantitative responses were analyzed using descriptive statistics, and qualitative responses were reviewed for themes to generate future recommendations for program improvement. Respondents rated Community Champions highly and reported personal and professional benefits to community engagement. Reasons for program satisfaction were synthesized into “opportunities for interactions with diverse community members”, “stress relief”, and “professional development”; reasons for program dissatisfaction were summarized as “disorganization of community sites”, “competing academic priorities”, and “lack of information”. Academic student programs that engage the community can positively impact both the community partners and university students.

Perceptions of Diseases of Despair by Members of Rural and Urban High-Prevalence Communities

<h3>Importance</h3> Diseases of despair (ie, mortality or morbidity from suicidality, drug abuse, and alcoholism) were first characterized as increasing in rural White working-class populations in midlife with low educational attainment and associated with long-term economic decline. Excess mortality now appears to be associated with working-class citizens across demographic and geographic boundaries, but no known qualitative studies have engaged residents of rural and urban locales with high prevalence of diseases of despair to learn their perspectives. <h3>Objective</h3> To explore perceptions about despair-related illness and potential intervention strategies among diverse community members residing in discrete rural and urban hotspots. <h3>Design, Setting, and Participants</h3> In this qualitative study, high-prevalence hotspots for diseases of despair were identified from health insurance claims data in Central Pennsylvania. Four focus groups were conducted with 60 community members in organizations and coalitions from 3 census block group hotspot clusters in the health system between September 2019 and January 2020. Focus groups explored awareness and beliefs about causation and potential intervention strategies. <h3>Main Outcomes and Measures</h3> A descriptive phenomenological approach was applied to thematic analysis, and a preliminary conceptual model was constructed to describe how various factors may be associated with perpetuating despair and with public health. <h3>Results</h3> In total, 60 adult community members participated in 4 focus groups (44 women, 16 men; 40 White non-Hispanic, 17 Black, and 3 Hispanic/Latino members). Three focus groups with 43 members were held in rural areas with high prevalence of diseases of despair, and 1 focus group with 17 members in a high-prevalence urban area. Four themes emerged with respect to awareness and believed causation of despair-related illness, and participants identified common associated factors, including financial distress, lack of critical infrastructure and social services, deteriorating sense of community, and family fragmentation. Intervention strategies focused around 2 themes: (1) building resilience to despair through better community and organizational coordination and peer support at the local level and (2) encouraging broader state investments in social services and infrastructure to mitigate despair-related illness. <h3>Conclusions and Relevance</h3> In this qualitative study, rural and urban community members identified common factors associated with diseases of despair, highlighting the association between long-term political and economic decline and public health and a need for both community- and state-level solutions to address despair. Health care systems participating in addressing community health needs may improve processes to screen for despair (eg, social history taking) and codesign primary, secondary, and tertiary interventions aimed at addressing factors associated with distress. Such actions have taken on greater urgency with the COVID-19 pandemic.

Boundary Crossing Creativity in the Design of Digital Resources for Teaching and Learning about Climate Change

Abstract We approach creativity in educational design with teachers working together in interdisciplinary communities of practice to develop resources for teaching and learning about climate change in formal school settings. We address climate change as a socio-scientific ‘wicked problem’ and discuss the notion of creativity in educational design in a context of transformative intervention in education leading away from silo academic domain paradigms. We perceived the resources as boundary objects during the process of communication and joint design by the diverse community members. Our interest focused on studying the boundary crossing processes which facilitated creative ideas to come out, selected and transcribed into the actual resources designed. Critical episode analysis showed that boundary crossing mechanisms were employed in the interactions among the educational designers aided by and in interaction with digital media supporting collaboration. These socio-technical interactions functioned as an empowered professional learning and working milieu, within which creative processes and outcomes were nurtured. In particular, educational designers, along with trying to frame climate change as a wicked problem, attempted to address the challenging issue of designing a creative educational resource on this topic. Our research suggests that boundary crossing creativity in interdisciplinary teams of educational designers can be an answer to not only how to focus learning on addressing the grand wicked problems of our times, but also how to deal with the multiple challenges arising from educational design per se.

466-P: Cultural Adaptation of a Diabetes Self-Management Education and Support Telehealth Intervention for Rural Colorado

Diabetes impacts rural populations at higher rates compared to their urban counterparts. Diabetes self-management education and support (DSMES) is an evidence-based standard of care for people with diabetes. Yet, in rural areas, DSMES is often not available, culturally relevant, or integrated into primary care practices where many people receive diabetes care. This study uses a community-based participatory research (CBPR) approach to adapt the language, tools, and delivery of a DSMES program for use in Spanish and English-speaking populations in the High Plains Research Network in rural eastern Colorado. Boot Camp Translation (BCT) is a CBPR method that combines medical, research, and local community member expertise to create locally relevant language, messages and materials to promote discussion and action around a medical condition. For this study, community partners included 13 diverse community members (including bilingual Spanish-speakers, patients, caregivers, and healthcare providers). The group identified a particular need to increase awareness of the connection between diabetes and mental health, specifically depression, and diabetes burnout. Language and tools to address stigma and normalize the connection, talking points to initiate discussions with care teams, and calls for practices to increase screening for depression among patients with diabetes, are under development. Additional themes identified include incorporating nutrition information for food that is culturally appropriate and locally available, and integrating DSMES within the primary care practices where people with diabetes receive their care. Community engagement is crucial to support DSMES program adoption in rural communities. Disclosure T. Oser: Advisory Panel; Self; Cecelia Health, Dexcom, Inc., Advisory Panel; Spouse/Partner; Cecelia Health, Dexcom, Inc. M. L. Litchman: Research Support; Self; Abbott Diabetes. B. Kwan: None. J. Neuberger: None. K. Curcija: None. S. Burke: None. L. K. Zittleman: None. J. S. Simonetti: Consultant; Self; Rhythm Pharmaceuticals, Research Support; Self; Rhythm Pharmaceuticals . Funding National Institute of Nursing Research; National Institutes of Health (1R56NR019466-01)

Developing a university learning, teaching and research framework through practice conversations

PurposeThis project engaged faculty, students, alumni and staff in re-visioning their university's learning, teaching and research framework. An extensive consultation process allowed participants to explore, discuss and critically reflect on effective practice.Design/methodology/approachThis action research project provided a process for university community members to engage in practice conversations. In phase 1, focus groups and campus community discussions elicited the diverse perspectives of the community. The design-thinking process of discovery, ideation and prototyping aligned with the action research cycles to help a working group create a learning and teaching framework prototype based on the findings. In the second phase, surveys were used to elicit community members' responses to the prototype, which was then refined.FindingsThe prototype was organized into three overarching categories, each containing several attributes. The attributes of the “Applied and Authentic” category were: interdisciplinary and transdisciplinary; experiential and participatory; flexible and individualized; outcomes based; and openly practiced. The attributes of the “Caring and Community-Based” category were: inclusive and diverse; community-based; supportive; team-based; co-creative; and place and virtual space-based. The attributes of the “Transformational” category were socially innovative; respectful of Indigenous peoples and traditions; impactful; and reflective.Originality/valueThis article should interest higher education institutions seeking to engage faculty, staff, students and others in practice conversations to develop a learning, teaching and research strategy. This research demonstrated that fostering practice conversations among diverse community members can be a powerful process for creating a common and integrated vision of excellent learning, teaching and research practice.

Assessment of a Crowdsourcing Open Call for Approaches to University Community Engagement and Strategic Planning During COVID-19

Reimagining university life during COVID-19 requires substantial innovation and meaningful community input. One method for obtaining community input is crowdsourcing, which involves having a group of individuals work to solve a problem and then publicly share solutions. To evaluate a crowdsourcing open call as an approach to COVID-19 university community engagement and strategic planning. This qualitative study assessed a crowdsourcing open call offered from June 16 to July 16, 2020, that sought ideas to inform safety in the fall 2020 semester at the University of North Carolina at Chapel Hill (UNC). Digital methods (email and social media) were used for promotion, and submissions were collected online for 4 weeks. Participation was open to UNC students, staff, faculty, and others. Submissions were evaluated for innovation, feasibility, inclusivity, and potential to improve safety and well-being. Demographic data were collected from submitting individuals, and submissions were qualitatively analyzed for emergent themes on challenges with and solutions for addressing safety and well-being in the fall semester. Data were shared with UNC leadership to inform decision-making. The open call received 82 submissions from 110 participants, including current UNC students (56 submissions [68%]), people younger than 30 years (67 [82%]), women (55 [67%]), and individuals identifying as a racial/ethnic minority or as multiracial/ethnic (49 [60%]). Seven submissions were identified as finalists and received cash prizes with the encouragement to use these funds toward idea development and implementation. Seventeen runner-up teams were linked to university resources for further development. Thematic analysis of submissions regarding challenges with the fall semester revealed not only physical health concerns and the limitations of remote learning but also challenges that have been exacerbated by the pandemic, such as a lack of mental health support, structural racism and inequality, and insufficient public transportation. Solutions included novel ideas to support mental health among specific populations (eg, graduate students and racial/ethnic minorities), improve health equity, and increase transit access. All 24 finalists and runners-up indicated interest in implementation after being notified of the open call results. This study suggests that open calls are a feasible strategy for university community engagement on COVID-19, providing a stakeholder-driven approach to identifying promising ideas for enhancing safety and well-being. Open calls could be formally incorporated into university planning processes to develop COVID-19 safety strategies that are responsive to diverse community members' concerns.