Minority Participants Research Articles

A Call to Analyze Sex, Gender, and Sexual Orientation in Psychopathology Research: An Illustration with ADHD and Internalizing Symptoms in Emerging Adults

We have historically ignored sex/gender and conducted sex- and gender-neutral psychopathology research. There is a clear need to analyze potential differences and similarities between individuals with various sexes, genders, and sexual orientations in psychopathology research. Specifically, we need to stop ignoring sex, gender, and sexual orientation, conduct analyses that go beyond the binary, and analyze these important variables for generalizability even when the primary research question is not about sex, gender, and sexual orientation. In the current study we examined ADHD and internalizing symptoms in a community sample to compare different ways to analyze data and better understand differences and similarities across groups. We predicted that a richer understanding of sex/gender differences would emerge when we compared sex and gender minority (SGM) participants to cisgender heterosexual women (CHW) and men (CHM) rather than conducting binary analyses. Emerging adults (N = 2,938; ages 18–29 years) completed an online survey, responding to demographic items, as well as ADHD and internalizing symptoms. Binary analyses using biological sex and gender identity yielded no differences in ADHD symptoms, and the expected female preponderance in internalizing symptoms. However, when analyzed across three groups, individuals in the SGM group reported higher levels of ADHD and internalizing symptoms compared with the other two groups. Notably, no differences emerged for internalizing symptoms across CHW and CHM when the SGM group was included. This is compelling evidence that analyzing sex, gender, and sexual orientation more systematically and precisely in psychopathology research is warranted.

Fact or Myth? Black Patients Do Not Want to Participate in Clinical Trials.

To assess strategies for optimizing participation of underserved minorities in a blood-based early CRC detection test study (PREEMPT CRC; NCT04369053) at a hospital serving primarily Black patients. Culturally sensitive, racially congruent research staff approached patients undergoing average-risk screening colonoscopy. Consent/study procedures were synchronized with clinical appointments. Enrolled and not-enrolled patient characteristics were compared. Recruitment was compared with other study sites. 247/509 eligible participants enrolled; most identified as Black (88.7%). No baseline characteristics were associated with participation. Recruitment was high compared to other sites (11th centile). Recruitment barriers for Black individuals can be overcome when easy, culturally sensitive access is facilitated.

A Systematic Review of the Literature on Risk Factors for Intimate Partner Violence From 2012 to 2023

The increasing body of studies on intimate partner violence (IPV) and its’ high prevalence worldwide signify heightened scholarly and societal interest. This is especially pertinent as IPV has recently penetrated broader contexts, including the digital world, and manifested in more diverse and complex forms. Building on Capaldi et al. (2012), this review aimed to provide a comprehensive understanding of emerging IPV risk factors by reviewing studies published from 2012 to 2023. We systematically reviewed 156 peer-reviewed articles published in English-speaking Western countries, utilizing a dynamic developmental systems perspective. The risk factors of IPV were organized into three domains: (a) contextual and demographic factors, such as age, gender, SES, and community contexts; (b) developmental characteristics, including family risk factors, history of IPV, peer-related factors, school- and work-related factors, psychological and behavioral factors, and cognition; and (c) relational characteristics, including relationship discord, conflict, and interactional patterns. This review expands on Capaldi et al.’s (2012) previous work by adopting more inclusive approaches, examining both perpetration and victimization, including sexual minority participants, incorporating technological forms of IPV, and utilizing comprehensive measures to provide a more thorough understanding of IPV. Furthermore, this review provides recommendations and future directions for practitioners, policymakers, and researchers working to address IPV.

Examining the Versatility and Misuse of Information Communication Technology in Community Policing in Malawi

Technology has modernized citizens’ social networks and interaction gaining active engagement to security management. Internet evolution popularity have revolutionized public policing through technology creating superhuman over security challenges. Paper aims to examine the versatility and misuse of technology in community policing in Malawi. This is qualitative study that purposely selected five published papers from a research “Community policing, citizen’s participation, and information communication technology in Muloza, Malawi.” Systematic review of published papers through content analysis will identify and consolidate work to date and guide future research on the topic. Data analysis followed transcription, coding, codes grouped into sub themes, sub themes into themes answering research questions. Respondents answered to (a) what are versatilities of information communication technology in security? (b) What are misuses of information communications technology in security? Through frame theory of communication, social disorganization and participatory democracy theories results indicate (1) technologies store, replicate, disseminate data for depositing evidence (2) Empower citizens to (a) communicate, share information between citizens and police, (b) be aware of rights violations, safety needs, (c) allow people’s involvement in rights violations, (d) facilitate citizen’s involvement in crime prevention, (e) maintain community dialogue and engagement, (f) help citizens look for faster emergency response times (g) promote evidence sharing with authorities. (3) Revolutionize communications allowing use SMS, WhatsApp, Telephone calls, pictures, videos, VNs, promoting wide, formal and non-formal channels improving accountability and transparency according real-time updates, responses, capacity. (4) Enhance citizens’ engagement to (i) reporting, requesting transport to police, (ii) organizing patrols (iii) mobilizing help during neighborhoods activities. (5) Encourage citizens to participate virtually allowing citizens (i) improve communications between police and community, (ii) identify a wider variety of insecurities (Transparency), (iii) promote the effective use of limited resources, (iv) move beyond the customary bureaucratic procedures, (v) improve participation of women, minorities, and vulnerable population, (vi) contribute to empowerment of the community. Technology misuse in security were; (a) some officials could inform suspects about intended ambushes (b) some citizens could fabricate false information to deceive others (d) some citizens used social media to deal with marginalized groups (e) some officials and citizens could disseminate and replicate confidential organization official client information. Other studies have concluded technology may help reduce corruption through wide formal and non-formal interactions. Currently, technology empower, revolutionize, transform citizens to get involved to fight corruption. Recommends more civic education to masses on need to adopt use of digital platform of community policing.

STANDARDS FOR THE PROTECTION OF MINORS IN THE LIGHT OF THE LAW OF 28 JULY 2023 – ASSESSMENT OF SELECTED REGULATIONS AND COMMENTS DE LEGE FERENDA (PART 3)

Pursuant to the amendment of July 28, 2023, certain provisions regarding the child’s representative were modified ‒ an institution ensuring legal protection and representation of the interests of minor participants in criminal proceedings. This institution appeared in place of the previous guardian representing the child. The project promoters justified this change by the lack of public awareness of the role and tasks of the above-mentioned function. It should be noted that already at the legislative stage, representatives of the doctrine proposed changing the name to “child’s attorney”. Unfortunately, the demand was not noticed by the legislator. This publication presents an analysis of the adopted solutions regarding the representation of minors in criminal proceedings, however, in order to deepen the considerations, the authors also referred to changes introduced in the Family and Guardianship Code and the Code of Civil Procedure.

Mental Illness Stigma in Black, Latina/o, and Asian Americans.

Mental illness stigma has significant psychiatric consequences and can impede mental health treatment seeking, especially among racial minority groups; who are understudied in stigma research and experience striking treatment disparities. Guided by a novel empirical model of racial minority stigma and treatment seeking, this study investigated stigma and its effects on treatment seeking in Black, Latina/o, and Asian American adults. Data were collected via national panel survey from 613 Black, Latina/o, and Asian American adults. Perceptions of mental illness including seriousness, treatability, causal attributions, desired social distancing, and perceived dangerousness were assessed. Data were analyzed and compared with a nationally representative sample of the U.S. public from the 2018 General Social Survey. Minority participants exhibited stronger mental illness stigma than the U.S. public, with Black, Latina/o, and Asian American participants largely perceiving mental illness as less serious, less treatable, and desiring greater social distance from individuals with major depression, who were perceived as potentially dangerous. Notably, different stigma components significantly associated with willingness to seek treatment differently across Black, Latina/o, and Asian American participants. Overall, study findings indicate that mental illness stigma is strong and associates with treatment seeking in Black, Latina/o, and Asian Americans, suggesting a need to develop culturally tailored interventions to reduce stigma and associated treatment utilization disparities in these underserved minority groups.

ACCESS TO EDUCATION FOR ETHNIC MINORITY CHILDREN IN GEORGIA (IMERETI REGION)

For representatives of ethnic minorities living in Georgia, general education and knowledge of the state language is one of the ways of civil integration, which promotes their participation in political and public life. In this process, a special role is assigned to the school. The priorities of teaching the state language for non-Georgian language schools are outlined in various international and local documents, and among them it is important to single out the "State Strategy of Civil Equality and Integration 2015-2020". This document aims to promote civic and political participation of ethnic minorities, encourage and promote cultural diversity, increase access to quality education, and improve proficiency in the state language.Ethnic minorities often face serious threats, discrimination and racism in terms of access to education, which deprives them of the opportunity to exercise the right to education on an equal footing with the majority.

Scientific Validity and Fair Subject Selection: An Empirical Analysis of Recruitment Practices in Clinical Trials

This study investigates the relationship between scientific validity and fair subject selection in clinical trials, focusing on recruitment practices. By analyzing 200 clinical trials across oncology, cardiology, and neurology, this research identifies key barriers to diversity and assesses the effectiveness of institutional policies in promoting equitable recruitment. The findings reveal that despite efforts to improve inclusivity, demographic disparities persist, particularly in terms of racial and ethnic representation. Recruitment barriers, including logistical challenges, mistrust among minority groups, and insufficient outreach resources, are prevalent, with oncology trials exhibiting the most significant issues related to minority participation. Additionally, the study highlights that stronger Institutional Review Board (IRB) policies with enforced diversity guidelines lead to higher minority representation in trials. Through a mixed-methods approach, combining systematic trial reviews, surveys of recruitment personnel, and institutional policy assessments, the study emphasizes the importance of community engagement and culturally competent recruitment strategies. The research suggests that while progress has been made, greater transparency, targeted outreach, and mandatory diversity tracking are necessary to achieve equitable and scientifically valid clinical trial outcomes. The study concludes with recommendations for future research to explore technological innovations and broader therapeutic areas, offering potential solutions for overcoming the barriers to diversity in clinical trials.

Winning hearts & minds: prostate cancer outreach and clinical trial enrollment in minority men.

Minorities participate less than White people in a variety of research settings limiting the generalizability of the research results. The driving forces behind the lower participation rates are multifactorial and vary by race. Further compounding these driving forces are past inequities and violations of trust by the healthcare system. Addressing these issues is crucial to equitably accruing within clinical trials and subsequently addressing the lack of generalizable results being produced. Despite legislation being enacted to increase the enrollment of minorities in clinical trials, the participation rates remain low with cancer clinical trials being particularly disparate in terms of equitable representation. As prostate cancer disproportionately affects Black men, it is imperative that prostate cancer clinical trials enroll an equitable number of Black men. Previous trials including the Prostate, Lung, Colorectal, and Ovarian multicenter randomized trial and the Prostate Cancer Prevention Trial both involved concerted efforts to address the relatively low participation rate of minority men, but both were not successful in that regard. To facilitate equal access and ensure the appropriate participation of minorities in prostate cancer clinical trials, various interventions from additional safety assurances to consenting patients as a family unit have been employed, depending on the community. Overall, progress is being made in equitably accruing clinical trials, but there remains more work to be done.

Reporting of participant race and ethnicity from COVID-19 randomized controlled drug and biologicals trials: a scoping review.

Racial and ethnic minorities have been disproportionally burdened by hospitalization and death due to COVID-19. Participation of individuals of diverse races and ethnicities in clinical trials, according to study-level characteristics of randomized controlled trials (RCTs) that test effectiveness of COVID-19 drugs, could be insightful for future researchers. Our objective for this scoping review was to describe the frequency of race and ethnicity reported as demographic variables and specific reporting of race and ethnicity according to COVID-19 RCT characteristics. We conducted comprehensive searches in PubMed, ProQuest, World Health Organization Database, and Cochrane Central Register of Controlled Trials, and gray literature via preprint servers from January 1, 2020, to May 4, 2022. We included RCTs on emergency- or conditionally approved COVID-19 drug interventions (remdesivir, baricitinib, and molnupiravir) with or without comparators. Self-reported race as American Indian/Pacific Islander, Asian, Black/African American, or White, ethnicity as Hispanic/Latinx, study design characteristics, and participant-relevant data were collected. In total, 17 RCTs with 17 935 participants were included. Most (n=13; 76%) reported at least 1 race and ethnicity and were US-based, industry-funded RCTs. Asian, Black, Latinx, and White participants were mostly enrolled in RCTs that studied remdesivir. Native American and Hawaiian participants were mostly assessed for progression to high-flow oxygen/noninvasive ventilation. Time to recovery was assessed predominantly in Black and White participants, whereas hospitalization or death was mostly assessed in Asian, Latinx, and multirace participants. Trialists should be aware of RCT-level factors and characteristics that may be associated with low participation of racial and ethnic minorities, which could inform evidence-based interventions to increase minority participation.

Do Social Trust and a Sense of Community Matter for the Engagement of Australian Migrants?

Previous studies have shown mixed results regarding the potential association between trust and community participation. Only a few studies comprehensively investigated the relationship between different forms of social trust. Most of the previous studies distinguished the different forms of social trust separately. This article investigated trust and a sense of community with a more comprehensive framework in a rarely investigated population, migrants in Australia. The increasing social capital approach has been gaining importance in studying the social/political participation of (ethnic) minorities as this has primarily been seen to suit 'ethnic' social capital. The article aims to fill the theoretical gap by including trust and a sense of community and examining their associations with civil engagement in society using the Household, Income and Labour Dynamics in Australia Survey data, a longitudinal survey in Australia with a particular focus on bringing the heterogeneities among groups of migrants. There has been an increasing number of people born overseas-a third of the population, according to the latest Australian Census in 2021. The results show that it is likely that the Australian-born population requires trust to engage in the community, particularly, in the case of volunteering, but this is not significant in the case of migrants. A high sense of community matters for both types of participation, political and volunteering, among Australian-born and the first generation of migrants. The results for the second generation of migrants in the context of trust and sense of community are limited, and other factors may influence their community engagement.

Ethnic disparities and lifestyle determinants in the prevalence of cardiovascular disease among Han majority and Ha Ni ethnic minority older adults in rural Southwest China

ObjectivesCardiovascular disease (CVD) is the leading cause of death in China. This study compared ethnic disparities and lifestyle determinants in the prevalence of CVD (hypertension, coronary heart disease [CHD], and stroke) among older adults of the Han majority and Ha Ni ethnic minority in rural southwest China, to provide evidence for preventing and controlling CVD among older-adult minority communities.MethodsA multi-stage stratified random sampling method was used to select 1,413 Han majority participants and 1,402 Ha Ni ethnic minority participants aged ≥ 60 years in rural Southwest China. Data on general demographic characteristics, behavioral lifestyle, and self-reported diagnostic information for patients with CHD and stroke were collected using a standardized questionnaire. The height, weight, waist circumference, and blood pressure of each participant were recorded. The relationship between lifestyle factors and CVD was analyzed using multivariate logistic regression.ResultsHan majority older adults had a higher prevalence of CHD (6.4% vs. 3.6%) and stroke (7.9% vs. 2.9%) than their Ha Ni minority counterparts (P < 0.01). Han majority participants had a markedly higher prevalence of obesity, central obesity, and physical inactivity than their Ha Ni ethnic minority counterparts (9.2%, 48.3%, and 55.1% vs. 3.4%, 19.1%, and 49.2%, respectively, P < 0.01). By contrast, Ha Ni ethnic minority participants had a higher prevalence of current drinking than Han majority participants (31.2% vs. 14.4%, P < 0.01). Among Han majority and Ha Ni ethnic minority older adults, participants with central obesity (OR = 2.09, 95% CI: 1.62–2.69 vs. OR = 2.66, 95% CI: 1.88–3.76) had a higher risk of hypertension, participants with obesity (OR = 1.99, 95% CI: 1.02–3.67 vs. OR = 3.66, 95% CI: 1.39–9.66) were more likely to suffer from CHD, and participants with physical inactivity (OR = 1.88, 95% CI: 1.18–2.98 vs. OR = 2.29, 95% CI: 1.13–4.64) had a higher probability of suffering from stroke. Furthermore, Current drinking status increased the risk of CHD (OR = 2.31, 95% CI: 1.05–5.08), but decreased the risk of stroke (OR = 0.33, 95% CI: 0.13–0.83) in Ha Ni ethnic minority participants.ConclusionCHD and stroke are more prevalent among the Han majority older adults in rural Southwest China, and lifestyle factors significantly influence CVD.

Discrimination, identity connectedness and tobacco use in a sample of sexual and gender minority young adults

IntroductionStudies show that tobacco use among sexual and gender minority (SGM) populations is disproportionately higher than heterosexual or cisgender populations. However, few studies have examined tobacco use among SGM subgroups...

Criminological Characteristics of a Person Providing Sexual Services on a Material Basis

Introduction: sexual services provided on a material basis are an ever-expanding phenomenon that can be observed in various forms around the world, which indicates the globality of this phenomenon. Sexual acts committed with the participation of minors are usually accompanied by psychological effects, both on the side of providing such services and on the consumer, which leads to the formation of unhealthy sexual attitudes, needs, and desires. The paper gives a criminological portrait of a person who provides sexual services for financial remuneration, whereby it is possible to identify the most vulnerable group of people who can become “performers” of such services and, as a result, provide the necessary psychological support. The purpose of the study is a criminological characteristic of a person providing sexual services on a material basis. Methods: a special formal logical method is used to collect, process, generalize, analyze, and interpret empirical material; the general scientific methods such as comparison and description; the general logical methods: analysis, synthesis, induction, deduction, etc. Results: an extensive description of a person providing sexual services on a material basis is presented on the basis of their socio-demographic, socio-role, and moral and psychological characteristics.

The Notarial Form of a Contract as a Way to Protect the Civil Rights of Minor Subjects in Electronic Transactions

Introduction: the notarial form of a contract is one of the ways to protect civil rights in the field of family relations, including in electronic transactions requiring special guarantees and security measures, for the subsequent neutralization of possible disputes and unfair actions. Therefore, the use of a notarial form in such cases becomes a necessary step to ensure the rights and interests of the parties. The notary, as an independent and professional expert involved in the certification of transactions, ensures the reliability and legality of documents. They check the identity of the parties, their legal capacity, as well as the correctness of the formatting and content of the contract. This eliminates the possibility of forgery or providing false data. Purpose: to determine the validity of the use of the notarial form in transactions with minor participants, to identify the advantages of using this form and to create a legal structure for maximum protection of the rights of minors in civil contracts entailing the alienation or acquisition of real estate. Methods: the methodological framework for the study consists of methods of scientific cognition, whose main ones are the methods of consistency and analysis. Results: the author analyzes the legal mechanisms and legal features in transactions involving minors, examines the main theoretical and practical problems of the legal regulation of the implementation and organization of such transactions, including with the use of digital technologies, and formulates specific proposals to improve the current legislation in this area. Conclusions: the notarial form of a contract is an effective way to protect civil rights in the field of family relations, especially in the context of electronic transactions. Its use ensures trust between the parties, the legality and execution of the agreement, and helps to prevent possible conflicts and disputes.

The Political Glass Cliff: When Ethnic, Racial and Immigration Minority Participants Choose Minority Candidates for Hard-To-Win Seats.

Atypical political candidates, such as those from ethnic, racial and immigration (ERI) minorities (vs. majority), are more likely to be chosen for hard-to-win seats than easy-to-win seats, a phenomenon known as the political glass cliff. This research aimed to uncover how the ERI status of decision makers played a role in this process. We hypothesised the emergence of a glass cliff pattern, that is, the preference for an ERI minority candidate over an ERI majority candidate for a hard-to-win seat, particularly among ERI minority participants, which are likely to perceive greater electoral potential in the ERI minority candidate compared to majority participants. Across two scenario-based experiments (Study 1: N = 264; Study 2: N = 375), ERI minority and majority participants played the role of political party leaders and made decisions regarding candidate nominations either in easy-to-win or in hard-to-win electoral districts. In Study 1, ERI minority participants, but not ERI majority participants, were more likely to choose an ERI minority (vs. majority) candidate for hard-to-win seats. Moreover, ERI minority participants made stronger attributions of change potential, competence and communion to ERI minority (vs. majority) candidates, suggesting that intra-minority solidarity could play a role in their choice. Although this result did not replicate in Study 2, exploratory analyses revealed a consistent glass cliff pattern among ERI minority men in both studies. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

Unlocking equity: assessing for gaps in cardiovascular guidelines for pregnant women

Abstract Introduction Cardiovascular disease is the primary contributor to pregnancy-related fatalities in the United States, displaying a gradual rise over the years. Pregnancy introduces unique physiological changes that can impact pre-existing cardiovascular conditions and trigger new complications. Considerable inequalities in pregnancy-related mortality built on race and ethnicity are unmistakable, with the highest rates observed in black non-Hispanic women. Purpose This study aims to evaluate current gaps in racial/ethnic minority participation in randomized control trials (RCTs) cited in major cardiology guidelines. Methods Citations in the 2018 ESC Guidelines for the Management of Cardiovascular Diseases During Pregnancy were evaluated for RCTs. The American Heart Association and American College of Cardiology guidelines were also examined. Manuscripts and supplementary data were examined for participant-level racial or ethnic data, including age, race, and ethnicity. Results Thirteen RCTs, representing 20,665 participants, spanning the period from 2002 to 2017, were reviewed. European guidelines referenced thirteen of the RCTS, while American guidelines referenced two RCTs. The average age of participants was 31 years old. Most of the trials were conducted in Europe (46%). Forty-six percent of RCTs reported race/ethnicity breakdowns, with pooled participation showing a majority of non-Hispanic white participants (76.7%), with limited representation from other racial groups (table). Eight trials focused on hypertension, two on venous thromboembolism, and one on heart failure. Conclusion Pregnant women are frequently excluded from RCTs due to concerns about potential harm to the developing fetus. Consequently, current guidelines lack robust RCTs tailored to pregnant women with various cardiovascular diseases. The underrepresentation of ethnic minorities in cardiovascular disease trials contributes to a scarcity of evidence-based recommendations for managing these conditions during pregnancy and postpartum. Future clinical practice guidelines should advocate for a more personalized and evidence-based approach to managing cardiovascular diseases in pregnancy.

Brain Health Outcomes in Sexual and Gender Minority Groups: Results From the All of Us Research Program.

Sexual and gender minority (SGM) groups have been historically underrepresented in neurologic research, and their brain health disparities are unknown. We aim to evaluate whether SGM persons are at higher risk of adverse brain health outcomes compared with cisgender straight (non-SGM) individuals. We conducted a cross-sectional study in the All of Us Research Program, a US population-based study, including all participants with information on gender identity and sexual orientation. We used baseline questionnaires to identify sexual minority (lesbian, gay, bisexual, diverse sexual orientation; nonstraight sexual orientation) and gender minority (gender diverse and transgender; gender identity different from sex assigned at birth) participants. The primary outcome was a composite of stroke, dementia, and late-life depression, assessed using electronic health record data and self-report. Secondarily, we evaluated each disease separately. Furthermore, we evaluated all subgroups of gender and sexual minorities stratified by sex assigned at birth. We used multivariable logistic regression (adjusted for age, sex assigned at birth, race/ethnicity, cardiovascular risk factors, other relevant comorbidities, and neighborhood deprivation index) to assess the relationship between SGM groups and the outcomes. Of 413,457 US adults enrolled between May 31, 2017, and June 30, 2022, we included 393,041 participants with available information on sexual orientation and gender identity (mean age 51 [SD 17] years), of whom 39,632 (10%) belonged to SGM groups. Of them, 38,528 (97%) belonged to a sexual minority and 4,431 (11%) to a gender minority. Compared with non-SGM, SGM persons had 15% higher odds of the brain health composite outcome (odds ratio [OR] 1.15, 95% CI 1.08-1.22). In secondary analyses, these results persisted across sexual and gender minorities separately (all 95% CIs > 1). Assessing individual diseases, all SGM groups had higher odds of dementia (SGM vs non-SGM: OR 1.14, 95% CI 1.00-1.29) and late-life depression (SGM vs non-SGM: OR 1.27, 95% CI 1.17-1.38) and transgender women had higher odds of stroke (OR 1.68, 95% CI 1.04-2.70). In a large US population study, SGM persons had higher odds of adverse brain health outcomes. Further research should explore structural causes of inequity to advance inclusive and diverse neurologic care.

The Participation of Ethnic Groups and Minorities in Political and Institutional Life in Kosovo

Abstract This paper explores the participation and engagement of ethnic groups and minorities in Kosovo’s political and institutional life during the post-war period (after 1999) and the post-independence phase (after 2008). The involvement of minorities in Kosovo’s institutional framework is grounded in the concept of a multiethnic state, with constitutional and legal provisions ensuring their rights. These provisions enable minorities to participate in all areas of state activity within the Republic of Kosovo. The paper addresses how circumstances and opportunities for participation have evolved, the challenges, threats, and risks faced, and what legislative measures have been enacted to ensure the political and institutional representation of ethnic groups and minorities.

‘Where is the diversity in this facility?’ Experiences of emergency care among visible minority individuals in Kingston, Ontario

ABSTRACT Introduction Visible minorities, a growing segment of Canada's population, have voiced concerns about experiencing racism while receiving care in the emergency department (ED). Understanding the ED care experiences of visible minorities is crucial to improving care and reducing health disparities. Methods From June to August 2021, we collected data from participants in Kingston, Ontario using a sensemaking approach. Individuals who had accessed emergency care or accompanied someone else to the ED in the prior 24 months were eligible to participate. After sharing a brief narrative about their care experience, participants interpreted the experience by plotting their perspectives on a variety of pre-determined questions. Here, we conducted a thematic analysis of narratives involving patients who identified as visible minorities and complemented it with quantitative analysis of the participants’ interpretative responses. This mixed-methods approach highlighted the distinct experiences of visible minority participants in relation to a comparison group. Results Of the 1973 unique participants, 117 identified as a visible minority and 949 participants did not identify with an equity-deserving group (comparison group). Visible minority participants were more likely to report that too little attention was paid to their identity and more likely to express a desire for a balance between receiving the best medical care and being treated with kindness and respect. Visible minorities’ ED experiences were also more likely to be impacted by how emergency staff behaved. Qualitative analysis revealed negative experiences of feeling uninformed and disempowered, facing judgement and discrimination, and experiencing language barriers. Positive experiences of receiving compassionate care from staff also emerged. Conclusion Visible minority perceptions of ED care were often negative and mainly focused on staff treatment. Cultural competency and language translation services are key areas for improvement to make ED care more accessible and equitable.