Societal Barriers Research Articles

Disability barriers autistic girls face in secondary education: A systematic review.

Autistic adolescent girls face complex and diverse challenges in the school setting, specifically mental health issues, unmet social and education needs, and social exclusion. The purpose of this review was to provide a general idea of research relating to the experiences of autistic females in secondary school settings by reporting on their experiences and the lived experiences of autistic women reflecting on their past. Based on the identified articles, the barriers girls face in the compulsory education setting centred on four themes of societal barriers grounded in gender; the institutional or physical barriers of schools; social and communicative expectations; and stigmatization. The study highlighted that there is a need to sensitize and educate widely on the topic of autism for teachers, to support staff, school psychologists and peers of autistic youth. The results call attention to the need for future research to focus on the different lived experiences and knowledge of autistic girls.

Exploring Rural, Black Women's Lived Experiences With Physical Activity and Nutrition: A Photo-Elicitation Study.

Eastern North Carolina (ENC) residents have higher rates of type 2 diabetes, lower life expectancy, less physical activity (PA), and higher food insecurity than the rest of North Carolina. Black individuals in ENC may face health disparities due to systemic and societal barriers to PA and a nutritious diet; modifiable behaviors that may improve overall health. The purpose of this study was to explore the lived experiences of rural Black women who live in ENC and who meet the criteria for overweight and obesity in the context of PA and healthful diet promotion. Photo-elicitation was used to explore this population's specific experiences with PA and nutrition, including barriers and facilitators, through photos and focus groups. Participants (N = 14; 43.5 ± 8.7 years old; body mass index (BMI) = 34.6 ± 5.9 kg/m2) were Black women in the rural Southeastern United States. Recruitment strategies included community outreach, listservs, social media, and word of mouth. Using photos submitted, our team conducted focus groups and completed content analyses to identify themes to tailor the development of a future health promotion program for Black women. Overarching themes were (a) Reframing the Mindset, (b) Accountability, and (c) Cultural Relativity. Findings demonstrate that Black women living in rural areas desire culturally relevant PA and nutrition programming focusing on healthy lifestyles versus weight loss. Future practice and research should utilize these findings to develop and examine the health impact of a health promotion program designed for Black women by Black women on PA levels, diet quality, and quality of life.

"Resilience looks like me": Community stakeholder perspectives on resilience in Black boys and young men exposed to community violence.

Black boys and young men are disproportionately burdened with navigating contexts of community violence resulting from race-based structural inequities and concentrated disadvantage. Despite this chronic adversity, many Black boys and young men thrive; however, resilience research has traditionally focused on identifying individual- and family-level factors that support resilience. Research has yet to fully examine community-level resources that facilitate processes of resilience for Black boys and young men in the contexts of trauma, violence, and poverty. Guided by ecological frameworks and using the community-based participatory method of action-oriented community diagnosis, our qualitative study examines the perspectives of diverse community stakeholders (N = 29) whose roles and influence span systems levels and shape contexts of violence and healing for Black boys and young men in Greensboro, North Carolina. Findings point toward relationship (mentoring), community (safe spaces to heal), and societal (interventions to dismantle racism) level opportunities and barriers ("terroristic territorialism") to promote resilience in Black boys and young men. Implications for research and praxis that broadens the scope of resilience research from successful adaptation to conditions of community violence to community-level intervention to promote resilience and transformation are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Barriers and Facilitators in Lactation Support for the Preterm Mother-Infant Dyad: An Integrated Approach.

Breastfeeding offers significant health benefits for both mothers and infants, particularly preterm infants, where it serves as a therapeutic strategy to reduce mortality and morbidities. However, breastfeeding practices are threatened globally by societal norms and systemic barriers at both micro and macro levels. This paper explores the complex interplay of these barriers and facilitators, focusing on the Neonatal Intensive Care Unit (NICU) setting. Preterm infants face specific feeding challenges due to immature physiological functions, yet evidence supports that strategies like cue-based feeding and individualized care can enhance feeding success and health outcomes. For mothers, initiating and maintaining lactation after preterm birth is critical but challenging, with early lactation support and achieving sufficient milk volume being key predictors of success. Partner support significantly influences lactation outcomes, although more inclusive research is needed for diverse family structures. In the NICU, a multidisciplinary approach to lactation care is vital, emphasizing the need for experienced staff and family-centered practices. NICU design, policies promoting parental presence, and adherence to Baby-friendly Hospital Initiative guidelines further support breastfeeding. This paper aims to provide directives for local breastfeeding policies through an integrated approach, considering societal attitudes and healthcare practices. The findings advocate for improved lactation support in NICUs, inclusive language and policies, and further research into diverse familial and gender roles in breastfeeding.

Navigating the challenges of public transport and urban mobility in Thohoyandou, South Africa

Background: Transport systems are an essential feature of functional urban settlements. Yet, almost all of South Africa’s secondary cities and small towns lack a true public transportation system. Because of this, quasi-public, privately operated mini-bus taxis are the main form of transport for most urban residents. Thohoyandou, Limpopo, a town of over 70 000 people, is a typical South African town in this regard.Objectives: The purpose of this research was to understand passenger experiences of mini-bus taxis in Thohoyandou, Limpopo province, South Africa.Method: This study used semi-structured interviews to explore the mobility challenges faced by the residents of Thohoyandou.Results: This study revealed several negative aspects impacting passenger experiences. Passengers consistently reported concerns regarding driver’s behaviour that compromised safety and security. This included overloading of vehicles and disregard for traffic regulations. Passengers also highlighted the challenges posed by poor transport infrastructure and a lack of reliable service. Collectively, these factors contribute to limited mobility options, increased transportation costs and a reduced quality of life. Furthermore, the shortcomings of mini-bus taxi services disproportionately affect people with disability, who already face significant societal barriers, further marginalising them within the transportation system.Conclusion: The government should increase investment in transport infrastructure, the enforcement of traffic laws and better driver training. However, a strong government combined with much political will is required if passengers and safety are to be the main priorities of the mini-bus taxi industry.Contribution: This study highlights challenges faced by public transport users in Thohoyandou, where mini-bus taxis serve as the main mode of transport. The challenges experienced by transport users not only reduce their mobility but also contribute to marginalisation of vulnerable groups, especially people with disability.

Critical Race Theory in Literature: In The Blood By Suzan-Lori Parks

This study seeks to explore the fundamental principles of Critical Race Theory (CRT) and to use it as an analytical tool in order to discuss Suzan-Lori Parks’s play, In The Blood. Through the key tenets of CRT such as the systematic racism, race as a social construct, intersectionality and power structures, it is framed a comprehensive theoretical background for a literary analysis. Relatedly, the primary focus of this study is to deeply analyze race, gender, power relations and socio-economic conditions with CRT through the playwright’s innovative representation of blackness. CRT clearly shows that racism is constructed through discriminative practices and sustained by law and institutions resulting in justification and accordingly normalization of oppression. In line with CRT’s main concerns, In The Blood embodies societal and ideological barriers and the dehumanization of black female bodies through social judgment, racial and gender discrimination, and motherhood. CRT essentially deals with how Parks reconstructs traditional narratives of guilt, shame, and femininity and claims that Hester is portrayed both as a victim of intersectional oppression and an individual struggling with the harsh conditions of life.

The Digitized Memory Clinic.

Several major challenges, including an ageing population and declining workforce and the implementation of recent breakthrough therapies for Alzheimer disease, are prompting a necessary rethink of how people with neurodegenerative dementias are diagnosed and medically managed. Digital health technologies could play a pivotal part in this transformation, with new advances enabling the collection of millions of data points from a single individual. Possible applications include unobtrusive monitoring that aids early detection of disease and artificial intelligence-based health advice. To translate these advances to meaningful benefits for people living with a disease, technologies must be implemented within a system that retains the physician expert as a central figure in decision-making. This Perspective presents a new framework, termed the Digitized Memory Clinic, for the diagnostic pathway of neurodegenerative dementias that incorporates digital health technologies with currently available assessment tools, such as fluid and imaging biomarkers, in an interplay with the physician. The Digitized Memory Clinic will manage people across the entire disease spectrum, from the detection of risk factors for cognitive decline and the earliest symptoms to dementia, and will replace the present paradigm of a pure 'brick-and-mortar' memory clinic. Important ethical, legal and societal barriers associated with the implementation of digital health technologies in memory clinics need to be addressed. The envisioned Digitized Memory Clinic aims to improve diagnostics and enable precise disease-tracking prognostication for individuals with memory disorders and to open new possibilities, such as precision medicine for prevention and treatment.

Community Provider Perspectives on an Autism Learning Health Network: A Qualitative Study.

Although autism is highly prevalent, no single care center has enough patients to produce generalizable knowledge of optimal care; this slows the pace of quality improvement research. The Autism Care Network (ACNet) is a learning health network (LHN) dedicated to developing the most effective approach to care for autistic children and adolescents through integrating clinical and research data. Given that most autistic patients receive care in the community, expanding ACNet to include community providers is essential to improve autism care. Our objectives were to: (1) understand the current data collection practices, learning needs, capacity, and overall interest of community clinicians in participating in an autism LHN; (2) identify their perspectives on participating in a LHN and ways in which their engagement and interest can be cultivated. Participants were purposively sampled from community physicians who participated in ASD-focused educational programming. In-depth semi-structured interviews were conducted. Analysis of 29 participant interviews yielded five primary themes: Navigating Administrative Challenges, Improving Data Collection Practices, Increasing Provider Confidence and Competence, Breaking Down Silos, and System and Societal Barriers to Achieving Best Practices. This study provides a rich and nuanced understanding of the experiences of community providers regarding the challenges of ASD care provision in the community. Overall, these findings suggest that LHNs have the potential to address several of the issues in community autism care highlighted by community providers.

Adapting a human sexuality curriculum for students with disabilities

Background: The US Individuals with Disabilities Education Act requires that children with disabilities receive a free appropriate public education. However, it does not specifically include the subject of health education. Currently, 30 US states require public schools to teach sexuality education as a part of the health education curriculum, but 36 do not include youth with disabilities in their sexuality education requirements. Objective: The current situation is particularly concerning due to the higher rates of unplanned pregnancy, sexual abuse, and sexually transmitted infections experienced by teenagers with disabilities. Students from across several disability groups report societal barriers, physical barriers, and poor educational outcomes with respect to sexuality education. Results: This review article sought to investigate the current state of sexuality education for students with disabilities, as well as best practices to support the learning of sexuality education content. Conclusion: Focusing sexuality education classes on practical ways so as to develop relationships, promote self-advocacy and self-determination, and incorporate privacy messages, can support students with disabilities to make healthy choices.

Personal, Institutional, and Societal Barriers to Educators’ Engagement with Datafication on Campus

Datafied digital systems have permeated higher education over the past decade. Registration, grading, financial operations, alumni communications, and often teaching take place through digital platforms that extract and collate data, about students as well as faculty and staff. At the level of these data system processes, academics may not have the knowledge or practices to fully grasp the shift in their workplace that datafication represents. However, our research suggests that educators do understand the paradigm shift that datafication represents and have strong beliefs about how institutions should proceed to protect students and academia itself. Our team conducted an in-depth Comparative Case Study (CCS) investigation of how university educators make sense of the datafied infrastructures in and on which they work. This presentation overviews the knowledge, practices, experiences, and perspectives of educators in various institutional status positions from six different countries, in relation to datafied digital tools. We will focus particularly on the barriers that participants articulated to their own engagement with data, at personal, institutional, and societal levels. We will frame ways barriers are reinforced by institutional approaches to datafication, overview participants’ concerns, and explore how datafication has altered faculty’s power position as knowers within the academy.

Barriers to accessing perinatal mental health services and suggestions for improvement: qualitative study of women of Black and south Asian backgrounds.

Maternity outcomes for women from certain ethnic groups are notably poor, partly owing to their not receiving treatment from services. To explore barriers to access among Black and south Asian women with perinatal mental health problems who did not access perinatal mental health services and suggestions for improvements, and to map findings on to the perinatal care pathway. Semi-structured interviews were conducted in 2020 and 2021 in the UK. Data were analysed using the framework method. Twenty-three women were interviewed, and various barriers were identified, including limited awareness of services, fear of child removal, stigma and unresponsiveness of perinatal mental health services. Whereas most barriers were related to access, fear of child removal, remote appointments and mask-wearing during COVID-19 affected the whole pathway. Recommendations include service promotion, screening and enhanced cultural understanding. Women in this study, an underrepresented population in published literature, face societal, cultural, organisational and individual barriers that affect different aspects of the perinatal pathway.

Lecturers' Perspectives on Disability and Inclusion in Afghan Higher Education Institutions: A Study Toward Achieving the Sustainable Development Goals

Objective: This study investigates lecturers' insights into disability and inclusive practices within Afghan Higher Education Institutions (HEIs), exploring the challenges and accommodations provided to students with disabilities (SwDs) in alignment with Sustainable Development Goal 4 (SDG 4), which promotes inclusive and equitable education. Theoretical Framework: The study is grounded in the concepts of inclusive education and disability studies. The study draws on the medical and social models of disability to analyze how faculty members perceive and implement inclusive practices. The social model aligns with SDG 4’s emphasis on removing societal barriers to provide equal educational opportunities. Method: This qualitative study uses semi-structured interviews with 27 faculty members from six Afghan HEIs. Purposeful sampling was used to select participants with knowledge of inclusive education. Data were collected through face-to-face and virtual interviews, transcribed, translated, and analyzed using thematic analysis. Results and Discussion: Lecturers demonstrate willingness to support SwDs, but barriers such as inadequate infrastructure, limited faculty training, and societal attitudes persist. The findings highlight that current practices are predominantly shaped by the medical model, limiting inclusivity. Targeted faculty development and institutional reforms are needed to align practices with SDG 4. Research Implications: This research offers critical insights for improving inclusive education in Afghanistan and other low-resource settings, informing policymaking and development of disability support services to achieve SDG 4. Originality/Value: This study is among the first to explore faculty perspectives on inclusive education in Afghan HEIs, providing recommendations for developing inclusive frameworks in conflict-affected and resource-limited contexts.

Syrian Youth with Disabilities Accessing Higher Education in Turkey: Routes and Barriers

ABSTRACT This research elaborates the nexus of disability-migration-education through a multidisciplinary investigation of intersectional barriers faced by Syrian youth with disabilities during their access to, and study at higher education (HE) institutions in Turkey. HE inclusivity for Syrian students with disabilities (SSD) is analysed in terms of the main administrative, societal, and structural barriers. The methodological design of this study applies a human rights-based approach to education, migration and disability in company with participatory action research methodology. Findings are based on data collected through semi-structured interviews, participant observations, institutional visits, and multi-stakeholder workshops addressing disability and migration-based experiences of SSD in 2018 and 2019 in Istanbul, Şanlıurfa and Gaziantep. Information and experiences are collected from SSD, NGOs in the field of migration and disability, governmental bodies, and HE institutions. Our findings showed that various legal, administrative and cultural barriers, and structural inequalities make access to HE more difficult for refugees with disabilities. Despite these, SSD have success stories in accessing HE as a result of their hard work and courage. This study provides first-hand bottom-up intersectional research about the situation of SSD in Turkey, host to the largest refugee population in the world.

Exploring comprehensive sexuality education experiences and barriers among students, teachers and principals in Nepal: a qualitative study

BackgroundComprehensive sexuality education (CSE) is essential in empowering adolescents with the knowledge and confidence to manage their sexual and reproductive health. Despite its recognized benefits, access to quality CSE remains limited, especially in low-income countries, where societal norms and structural barriers hinder effective delivery. The aim of this study is to investigate the experiences and perceptions among students, teachers, and principals in Nepal about comprehensive sexuality education.MethodsQualitative methods were used. 13 Semi-structured interviews and 1 focus group discussion were carried out with 15 teachers and principals working at higher secondary schools and two focus group discussions were conducted with a total of 13 adolescents. Thematic analysis was used to analyze the data.ResultsFour themes were developed: Resistance to Teaching and Learning, Preparation and Engagement Strategies, Taboos and Silencing and Structural Barriers. Students, teachers, principals and students reported discomfort and embarrassment when discussing sensitive topics, with gender dynamics playing a significant role. Strategies like warm-up sessions and continuous interaction with students and parents were used to create a supportive learning environment. However, socio-cultural barriers and family attitudes continued to hinder open discussions about sexuality. Structural barriers, including the lack of formal training for teachers and inadequate instructional materials, further impeded effective CSE delivery.ConclusionThe experiences of CSE in Nepal among students, teachers and principals highlight significant barriers including cultural taboos, gender dynamics and insufficient resources. Addressing these barriers through comprehensive teacher training, curriculum reform, and societal engagement is critical to ensure access to CSE.

Breast Cancer Screening in Transgender Population: Review of literature.

This literature review explores breast cancer screening practices among transgender individuals globally, emphasizing the overlooked population in Pakistan. With an overview of intersex and transgender terminology, the study delves into screening guidelines for transfeminine and transmasculine patients, considering hormone therapy and surgery. Worldwide statistics on transgender and intersex populations are provided, highlighting the unique challenges they face, particularly in Pakistan, where societal discrimination and healthcare barriers persist. Databases searched included PubMed, Scopus, and Google Scholar from the Year 2000 till todate.The review synthesizes breast cancer screening recommendations in transgender population from ACR, WPATH, UCSF, and the Canadian Cancer Society, revealing variations in guidelines. It concludes with a call for tailored screening protocols for Pakistan's transgender community and recommends a comprehensive study due to the absence of data in Southeast Asia. The unstructured abstract underscores the need for nuanced, personalized screening strategies and emphasizes the critical gap in knowledge specific to breast cancer in this marginalized population.

Unleashing Potential: How Women Entrepreneurs Drive Economic Growth in India

This study explores the dynamic role of women entrepreneurs in India’s economic growth, emphasizing their contributions across various sectors and regions. India’s economic landscape, shaped by liberalization reforms and rapid industrialization, has seen significant input from entrepreneurs, particularly women, who are pivotal in driving innovation, job creation, and GDP growth. The study examines the current landscape of women entrepreneurship, detailing statistics, key sectors of activity, and regional variations, highlighting the substantial impact of women-led enterprises on employment and economic diversification. Despite their success, women entrepreneurs face challenges, including societal biases, financial constraints, and regulatory hurdles. Government initiatives, NGOs, and educational programs play crucial roles in supporting women entrepreneurs, fostering their development and overcoming obstacles. The study also highlights emerging opportunities in digital and sustainable sectors, underscoring the importance of continued support and policy development to enhance the entrepreneurial ecosystem and drive future growth. Keywords: Women Entrepreneurs, Economic Growth, mall and Medium Enterprises (SMEs), Job Creation Innovation, Societal Barriers, Financial Constraints, Government Initiatives, Digital Economy, Sustainable Businesses Globalization, Export Potential Regional Variations, Entrepreneurship Support Systems

"Society Isn't Designed for Us to Win": Trauma and Sexual Healthcare Experiences Among Transgender Women in the Southeastern United States.

Transgender women (TGW) are disproportionately affected by sexually transmitted infections (STIs). Experienced trauma threatens TGW's commitment to sexual healthcare. Trauma-informed approaches to sexual healthcare can improve engagement. This study aimed to characterize the trauma experienced by TGW in the Southeastern US, especially related to sexual health. TGW completed in-depth individual interviews guided by the Modified Social Ecological Model (MSEM) and Minority Stress framework. Interviews explored the nature of trauma, sexual health, and their intersection in TGW's lives, and a thematic analysis was performed. Between August 2022 and January 2023, 13 TGW enrolled (69% Black, 31% White). Mental illness was common (77%). Five participants (38%) were HIV+, and seven (54%) reported lifetime STI history. Themes reflected societal (barriers to healthcare, anti-transgender legislation), community (misgendering/deadnaming), network (limited support), and individual (dysphoria, sex work, fear for physical safety, stigma, mental health conditions, race) stressors. The physical/sexual violence and resilience themes pervaded all stressor levels. Medical mistrust was exacerbated by past traumatic experiences within sexual healthcare settings. Resilience and transgender representation in healthcare settings were protective. Various experienced traumas and their cumulative effects were pervasive in the daily lives of TGW. Development of targeted interventions to improve sexual health engagement of TGW must optimize personal strengths and provide holistic support.

Parental perspectives on fertility preservation for their trans and gender-expansive children: Reflections on complexities of autonomy, support, and societal realities

Introduction Navigating fertility preservation poses unique challenges for young transgender and gender expansive (TGE) youths, who must balance short-term concerns like delaying gender-affirming hormonal treatment (GAHT) with long-term considerations of potential infertility. Parents play a crucial role in supporting their TGE children through their gender affirmation journey, which includes discussions about fertility preservation. Aim This study aimed to explore parental feelings and attitudes toward the fertility preservation of their TGE children, acknowledging the diverse perspectives shaped by societal, legal, and personal factors. Methods The study involved 82 parents who completed an online-distributed questionnaire. Participants were parents of TGE youths aged between six and twenty-five years old. The mixed-methods study utilized a tailored questionnaire comprising both open-ended and closed-ended questions. Results Descriptive analysis revealed that a significant majority of parents were aware of the effects of GAHT on fertility, with 65.3% expressing a desire for their children to have their own children in the future. However, parents shared that only 14.5% of children underwent a fertility preservation pathway, while 68.1% did not, citing barriers such as lack of services, cost, and procedural distress. Qualitative analysis identified four main themes: (1) Emotional response, (2) Parental expectations, (3) Parent-Child relationship, and (4) Structural barriers. Discussion Overall, the study underscores the multifaceted nature of parental experiences regarding fertility preservation for TGE individuals, emphasizing the importance of addressing societal norms, personal expectations, and structural barriers to ensure equitable access to reproductive healthcare services.

Climate change mitigation and women’s economic empowerment

In Pakistan, a country acutely vulnerable to climate change, this study delved into the gendered dynamics of climate sensitivity. It analyzed the correlation between gender and climate vulnerability, with a particular focus on the disproportionate influences on women and the efficacy of adaptation policies. The results showed stark gender disparities in health outcomes, with women more susceptible to the harmful effects of extreme weather events. Women in rural areas struggle to maintain their livelihoods due to water and pasture scarcity, affecting the cattle industry. Additionally, women in agriculture face economic hardships, resource constraints, and societal barriers that compound the adverse effects of climate change on their livelihoods. The paucity of food and water presents significant concerns, resulting in malnutrition and health hazards for women. Women in rural locations are compelled to depend on detrimental fuel sources due to energy shortages, which adversely affect their respiratory health. Conversely, in metropolitan settings, women have limitations in accessing vital services. The study highlights the importance of implementing policies that are sensitive to gender issues and include women in the decision-making processes related to climate change in order to establish communities that are able to withstand and recover from adverse conditions. The policy implications encompass several measures such as adapting to climate change, ensuring women's participation, investing in assistance for rural livelihoods, managing disasters, and promoting gender equality in climate governance. It is crucial to raise awareness and educate people about the gender-specific impacts of climate change in order to strengthen resilience.

A qualitative study investigating the experiences of unmet social needs for children with cerebral palsy and their families: perspectives of parents and clinicians

Purpose To explore (i) the impact of unmet social needs on children with cerebral palsy and their families; (ii) enablers-, and (iii) barriers to addressing unmet social needs. Material and methods Eligible participants attended or worked at one of the three Paediatric Rehabilitation Departments including: children with a diagnosis of cerebral palsy; parents/carers; and clinicians. One-on-one interviews were conducted with parents/carers and focus groups with clinicians. Interview and focus group transcripts were deductively thematically analysed according to the social model of disability. Results A total of 44 participants (8 parents and 36 clinicians) took part. No children consented to participate. Analysis of the qualitative data identified four main themes and 14 sub-themes. The main themes were: Unmet social needs are pervasive; An inequitable health system with no roadmap; Everyone suffers as a result of unmet social needs; and It takes a village to raise a child. Conclusion Unmet social needs have profound impacts on families. The experiences of unmet social needs are intensified by the extra complexities of raising a child with disability. Societal barriers including inequitable systems and the fragmented services are barriers impeding on families receiving support and ultimately limiting their wellbeing.