Underrepresented Minority Groups Research Articles

Dental school pathway programs: Best practices for increasing workforce diversity.

The chronic underrepresentation of racial/ethnic minority practitioners in the U.S. health professions workforce is an oft-cited factor for disparities in health and health-care access affecting communities of color. As non-White providers are more likely to serve uninsured patients and practice in underserved areas, pathway/pipeline programs have been used for many years to increase the numbers racial/ethnic minorities in the health professions workforce. These programs target precollege, college, and postbaccalaureate students from historically underrepresented minority (HURM) groups (defined as African American/Black, Hispanic/Latino, and Native American students) to stimulate interest in health professions careers and provide academic support, mentoring, enrichment experiences, and other resources to facilitate their successful admission to and completion of health professions school and entry into the workforce. This article examines dental pathway programs to identify best practices for increasing enrollment of HURM students in dental school and their successful entry into the dental workforce-as evidenced in the academic literature.

Diversity in nursing and challenges with the NCLEX-RN

High-stakes, standardized testing has historically impeded education/career attainment for members of underrepresented minority groups and people needing testing accommodations. This study was to understand how high-stakes, standardized testing, particularly the NCLEX-RN, impacts diversity, equity, and inclusion (DEI) in nursing. This study explored the history, context, perspectives surrounding standardized testing, with a focus on the NCLEX-RN. The authors consider content, form, and delivery of testing, including accommodations. They identify available data and data collection gaps relevant to DEI and the NCLEX-RN. No nursing organization published the national data necessary to evaluate/refine the NCLEX-RN from a DEI perspective. Preliminary nursing studies and data from other professions indicated disparities in testing outcomes. Nursing must determine if prospective nurses are experiencing disparities in testing outcomes. The authors highlight opportunities to advance DEI through improved data collection, reformed licensure processes, and the reframing of standardized testing as one of many tools to determine competency.

Palliative medicine referral and end-of-life interventions among minority patients with advanced or metastatic gynecologic cancer (433)

Palliative medicine referral and end-of-life interventions among minority patients with advanced or metastatic gynecologic cancer (433)

Nutritional Challenges and Dietary Practices of Ethnic Minority (Indigenous) Groups in China: A Critical Appraisal

Indigenous food systems can affect multiple aspects of Indigenous people's health. In China, the government declared that there are no Indigenous people in China and used the term “ethnic minority groups” instead. However, to date, no attempt has been made to investigate the nutrition status and dietary practices of all 55 ethnic minority groups. To understand this pertinent issue, a systematic review is required. The main selection criteria were publications should be about nutrition status or dietary practices among ethnic minority groups in China, specify the name of the ethnic minority group, and be published within the past 10 years. For this literature review, 111 publications were selected through Wanfang Med Online for Chinese publications and Google Scholar for English publications. Linear regressions were applied to explore what factors can affect the total number of publications for an ethnic minority group. The main findings include that only 15 ethnic minority groups have dietary intake data representing the general people of the ethnic group; only seven ethnic minority groups have data for both nutrition status (anthropometric and nutrients intake/deficiency) and dietary practices (dietary intake and dietary habits); there are still 10 ethnic minority groups with a total number of population 845,420 that lack studies on both nutrition status and dietary practices; ethnic minority groups are suffering from double-burden malnutrition and consuming unbalanced diets; primary and middle school students are the most prevalent study population than any other age group due to easy access; and an ethnic minority group is likely to have more publications about nutrition status and dietary practices if they have a larger population or are unique to a region. The results indicate that more national-level programs and timely nutrition and dietary reports should be implemented to address double-burden malnutrition and unbalanced diets among ethnic minority groups in China. More studies involving maternal nutrition, targeting underrepresented ethnic minority groups and age groups, and exploring traditional food systems in China are also essential to better understand and address this issue.

Key barriers against racial and ethnic minority participation in U.S. clinical trials

<p class="abstract">Despite the United States’ (U.S.) longstanding history of promoting a melting pot nation of people from diverse racial and ethnic backgrounds all capable of achieving the American Dream, it is argued that the U.S. is failing to deliver high quality healthcare to all of its constituents equally. The widely seen health disparities of ethnic minority groups endure has extended into the parallel field of clinical research and clinical trials. There is a staggering gap between the percentage of White clinical trial participants compared to clinical trial participants of racially and ethnically diverse minority groups in U.S. clinical trials. Underrepresentation of minority groups in clinical trials dismisses opportunities to identify potential serious sub-group safety or efficacy signals, open doors to access life-saving treatments, and ultimately improve the standard of evidence-based medicine in the United States. Current literature on this issue frequently reiterates the following five key barriers underrepresented minority groups face against clinical trial participation: mistrust, lack of awareness and access, cultural and language barriers, investigator and provider bias, and financial burdens. A deeper dive into understanding each barrier will be critical in implementing changes with actions and in perspectives in order to address the issue of poor racial and ethnic representation in clinical trial populations.</p>

Social Media and the Quest for Equity and Diversity in Oncology: On Safe Spaces and the Concept of the Public Physician.

Despite their increased enrollment into medical school, women still face systemic barriers in medicine, whether in an academic or nonacademic setting. Those from Under-Represented Minority (URM) groups face similar issues, which may affect their desire to enter, pursue, and/or maintain a career in medicine. Social media provides unique opportunities for peer-to-peer support among members of URM communities and for amplification of their voices calling for social justice-here defined as a redistribution of power and the quest for equity in access to opportunities, including access to mentorship, professional development, and timely promotion in academic rank. These issues are relevant to oncologists especially as we strive for diversity, equity, and inclusion and to ensure that our patients have equal access to care, regardless of their circumstances. In this article, we review current literature that highlights issues faced by women and historically URM groups in medicine, particularly in oncology. We also discuss the physician's role as a social justice advocate and the concept of the public physician.

Encouraging Minority Groups in Higher Education: A Case Study of Druze in the IDF Academic Reserve Track

Under-representation of minority groups in the academy reflects inequality and lack of social mobilization. The Druze in Israel are a small minority, but they have a unique place in society because they have been serving in the IDF almost since its formation. The IDF maintains an academic reserve track, where young men and women complete their studies and then serve an extra number of years as professionals. Through in-depth interviews with 30 Druze participants and graduates, this study examines the effects of the academic reserve track on Druze young men, seeking to learn its impact on their future.

The Emerging Diverse Radiology Workplace: Case Studies on the Importance of Inclusion in Radiology Training Programs

Radiology remains one of the least diverse fields in medicine. With increasing understanding of the benefits of workforce diversity on health care outcomes, radiology society leadership and radiologists are engaging in necessary efforts to improve diversity, equity, and inclusion. To date, much of the initiatives have focused on pipeline development and recruitment strategies. Literature from organizational psychologists, human resources and business strategists suggest that incorporation of inclusion could overcome some of the persistent barriers to workforce diversity. Using case studies from real-life residency programs, we describe challenges associated with being a member of an underrepresented minority group in radiology. We illustrate concepts in inclusion, proposing concrete ideas for personal and institutional growth in this area, as a strategy for improving workforce diversity and team effectiveness.

Curricula, Teaching Methods, and Success Metrics of Clinician-Scientist Training Programs: A Scoping Review.

To describe the literature on clinician-scientist training programs to inform the development of contemporary and inclusive training models. The authors conducted a scoping review, searching the PubMed/MEDLINE, CINAHL, and Embase databases from database inception until May 25, 2020. Studies presenting primary research that described and evaluated clinician-scientist training programs were identified for data abstraction. On the basis of deductive and inductive methods, information about program characteristics, curricula, teaching strategies, and success metrics was extracted. The extracted variables were analyzed using descriptive statistics. From the initial 7,544 citations retrieved and 4,974 unique abstracts screened, 81 studies were included. Of the 81 included studies, 65 (80.2%) were published between 2011 and 2020, 54 (66.7%) were conducted in the United States, and 64 (79.0%) described programs that provided broad clinician-scientist training. Few programs provided funding or protected research time or specifically addressed needs of trainees from underrepresented minority groups. Curricula emphasized research methods and knowledge dissemination, whereas patient-oriented research competencies were not described. Most programs incorporated aspects of mentorship and used multiple teaching strategies, such as direct and interactive instruction. Extrinsic metrics of success (e.g., research output) were dominant in reported program outcomes compared with markers of intrinsic success (e.g., career fulfillment). Although programs are providing clinician-scientists with practical skills training, opportunities exist for curricular and pedagogic optimization that may better support this complex career path. Training programs for clinician-scientists can address contemporary issues of wellness and equity by reconsidering metrics of program success and evolving the core tenets of their education models to include equity, diversity, and inclusion principles and patient-oriented research competencies.

0067 Sleep Disparities and the Academic Achievement Gap in 1.9 Million College Students

Abstract Introduction Adults from under-represented minority groups (URM) disproportionately experience sleep disturbances. Sleep disparities can be prevalent in academic settings, however, it is still unknown whether sleep disparities directly contribute to other disadvantages in URM students, such as the academic achievement gap. Using a national database of college students collected over 20 years, we investigated whether poor sleep quality mediated the relationship between race/ethnicity and grade point average (GPA). Methods We conducted secondary analyses on American College Health Association – National College Health Assessment survey data (ACHA-NCHA). The ACHA-NCHA I, II, IIb, IIc, and III surveys were conducted between 2000 and 2020, and included approximately 1,900,000 participants. We analyzed responses to questions regarding race/ethnicity, socioeconomic status, academic achievement (GPA), daytime sleepiness, and sleep health. Non-URM students were those identifying as non-Hispanic White or Asian whereas URM students included all other racial/ethnic identifications. We calculated a sleep-problems composite score by transforming each sleep item response into a z-score and averaging across all items. Results Sleep disparities were evident amongst the college students; relative to non-URM students, URM students reported fewer days per week that they felt rested (95% CIs: 3.884–3.895 vs. 4.155–4.161) and worse sleep-problem composite scores (95% CIs: .0453–.0496 vs. -.0226 – -.0199). In addition, there was significant evidence for an academic achievement gap, such that URM students reported significantly lower GPAs than non-URM students (95% CIs: 3.162–3.166 vs. 3.344–3.346). Feeling rested and sleep problem composite scores partially mediated the relationship between race/ethnicity and academic achievement (ps < .001), explaining 4.1% and 5.1% of the variance, respectively. These results were lower in magnitude than the contribution of socioeconomic status (25.3% of the mediation variance); however, sleep problems and feeling rested continued to explain significant variance even when controlling for socioeconomic status. Conclusion Sleep disparities contribute to academic achievement gaps experienced by URM students. The current findings indicate that university-wide sleep health programs may help to remove an unnecessary barrier to academic achievement, particularly if such programs incorporate behavioral change theory and address system-level financial, sociocultural, and environmental barriers to sleep quality. Support (If Any) National Science Foundation (1920730 and 1943323)

Unheard Voices: Transformative Workplace Learning and Support Experiences of Racialized Migrant Women English Instructors in Ontario Higher Education in Canada

Racialized migrant women English instructors in higher education have been an underrepresented minority group of teaching professionals in Ontario, Canada. This study investigates highly experienced racialized migrant instructors’ workplace learning and support experiences. It aims to reveal how transformative their professional learning experiences are and how transformative their workplaces are in including them as newcomer community members. This article provides the literature review to demonstrate why this study was necessary and preliminary findings answering two research questions to display how equitable and inclusive Ontario higher education workplaces are to these understudied teaching professionals in Ontario. The study findings suggest that online professional communities can create a learning and development space for them by serving their unfulfilled needs in the workplace.

Reducing Metabolic Dysregulation in Obese Latina and/or Hispanic Breast Cancer Survivors Using Physical Activity (ROSA) Trial: A Study Protocol.

BackgroundLatina and Hispanic breast cancer survivors (LHBCS) are at increased risk for long-term complications and poorer metabolic health, including metabolic dysregulation (MetD) before and following breast cancer diagnosis. MetD can increase risk of cancer recurrence, death, and comorbid conditions by increasing inflammation and cancer cell proliferation. While exercise improves physical fitness and metabolic outcomes in breast cancer survivors, there is a lack of studies including underrepresented and disadvantaged minority groups such as LHBCS.MethodsOur 12-month randomized (exercise or attention control) controlled trial (the ROSA trial) aims to utilize a progressive combined aerobic and resistance exercise program to improve MetD, insulin resistance, and visceral adiposity among obese LHBCS. We aim to recruit 160 women with Stage I-III breast cancer who are sedentary, centrally obese, and have completed treatment (e.g., surgery, radiation, chemotherapy) prior to enrollment. Participants randomized to the exercise group receive 16-weeks of virtually supervised aerobic and resistance training, followed by 16-weeks of unsupervised home-based aerobic and resistance exercise, and 16-weeks of follow-up. The attention control group receive a 12-month home-based stretching program. Primary and secondary outcomes are measured every 4-weeks during study visits.DiscussionThe ROSA trial is the first exercise oncology trial targeting high-risk sedentary, obese LHBCS to improve MetD-related outcomes. Results of this trial will help illuminate how exercise impacts health-related outcomes, survivorship, and recurrence, and inform future exercise oncology guidelines to reduce health disparities among minority cancer survivors.

Disparities in place of death for patients with primary brain tumors and brain metastases in the USA.

Patients with primary or metastatic brain tumors often require intensive end-of-life care, for which place of death may serve as a quality metric. Death at home or hospice is considered a more "ideal" location. Comprehensive information on place of death of people with brain tumors is lacking. Using CDC Wonder Database data, those who died in the USA from a solid cancer from 2003 to 2016 were included and place of death for those with primary brain, brain metastases, and solid non-brain tumors were compared. Multivariate logistic regression tested for disparities in place of death. By 2016, 51.1% of patients with primary brain tumors and 45.2% with brain metastases died at home. 15.9% of patients with primary brain tumors and 23.6% with brain metastases died in the hospital. Black patients were least likely to die at home or hospice. For patients with primary brain tumors, being married (OR = 2.25 (95%CI 2.16-2.34), p < 0.01) and having an advanced degree (OR = 1.204 (95%CI 1.15-1.26), p < 0.01) increased odds of home/hospice death; older age (OR = 0.50 (95%CI 0.46-0.54), p < 0.01) decreased odds for home/hospice death. For patients with brain metastases, being married (OR = 2.19 (95%CI 2.11-2.26), p < 0.01) increased odds of home/hospice death and male sex (OR = 0.87 (095%CI .85-0.89), p < 0.01) and older age (OR = 0.59 (95%CI 0.47-0.75), p < 0.01) decreased odds of home/hospice death. Disparities exist in place of death in the brain tumor population. Focused interventions are indicated to increase the utilization of hospice in those with metastatic cancer, under-represented minority groups, and the elderly population.

Supporting Historically Underrepresented Groups in STEM Higher Education: The Promise of Structured Mentoring Networks

Although institutions of higher education have placed a large emphasis on increasing the number of underrepresented minority (URM) students matriculating in higher education, the disparities in STEM retention and graduation rates between URM and non-URM students emphasize the dire need for increased support to help URM students navigate challenges including stereotype threat, impostor phenomenon, and lack of social connectedness that disproportionately affect URM students in majority-dominated fields. Prior research has demonstrated that structured mentoring has the potential to generate substantial improvements in academic, social, and career outcomes for URM STEM students. In particular, network-based mentoring approaches that allow for students to receive both professional and peer mentoring, as well as the opportunity to mentor other students, have demonstrated success in this realm. In this article, we discuss how the current state of academia often fails URM STEM students and faculty, review literature regarding the ways in which structured mentoring approaches can alleviate barriers to success among URM groups in STEM fields, and offer recommendations regarding how academic institutions can successfully implement holistic student and faculty mentoring programs.

Hands-On, Virtual, Environmental Science Modules: Using Stable Carbon Isotopes as Forensic Tools for Students to Understand Environmental Chemistry From Their Homes

Engagement with the natural world is imperative to student learning in the geo- and environmental sciences. Immersion in the environment is particularly useful for complicated subjects like nutrient cycling and biogeochemistry. However, access to the outdoors is not ubiquitous, and often students living in urban and/or remote locations are unable to access geo-, bio- and environmental activities, and demonstrations, and this inaccessibility was exacerbated by the COVID-19 pandemic. We created a remote learning activity to teach the carbon cycle to high school students enrolled in the University of Michigan’s Earth Camp (summer 2020). These high school students were admitted to this summer program to facilitate their access to and inquiry of the natural world. Likewise, this program is designed to enable and encourage students from underrepresented minority groups to engage in STEM, and in particular, earth sciences. Students conducted at-home bio-centric experiments and collected hair from their pets and their pets’ foods (and for students without pets, favorite snack foods) and sent it to the University of Michigan for isotope analyses. Students recorded ingredients in their specimens and hypothesized what isotope values their specimens should have, based on C3/C4 plant distribution. The students’ results allowed them to examine how the Earth’s carbon cycle is reflected by common plants and animals living in their homes and to collect physical observations and analyze their own data. This activity received positive evaluations from students, and students felt their knowledge of isotopes and the chemistry behind their food increased from this exercise. Although Earth Camp recruitment was unrelated to student’s desired major, almost ~20% of the participants in this activity listed earth sciences as a desired major upon application to college. We have attached this activity in the supplement for future use by other earth science educators in an adapted version that does not require the ability to measure stable isotopes.

39 CAFNR Connections: Building Community for Underrepresented Students in Agriculture

Abstract College of Agriculture Food and Natural Resources (CAFNR) Connections began as a University of Missouri Animal Science upperclassmen’s desire to increase a sense of belonging and inclusion within the CAFNR for students of color in fall 2019. Open to all students across campus, the objective of CAFNR Connections is to provide opportunities for students to gather informally, engage in conversation, and build community. During its short existence, students from Animal Sciences, Natural Resources, Plant Sciences, Hospitality Management, Microbiology, Nursing, Psychology, Biological Sciences, and Spanish have come together in a space to share their personal experiences and grow personally, professionally, and academically. The establishment of a student organization by students for students from underrepresented minority groups, provides a platform for development in interpersonal communication, professional development, and philanthropic activities. The support systems developed within student organizations such as CAFNR Connections provide the necessary scaffolding for student success.

Board of Certification Examination Achievement Gaps as a Barrier to Diversifying the Athletic Training Profession.

Achievement gaps have been well documented in the medical and health professions. Previous researchers have indicated that individuals from underrepresented minority groups consistently fall short of White candidates in performance on standardized credentialing examinations. To determine the relative risk of failure by ethnicity and first-time and retake pass rates on the Board of Certification (BOC) examination. Descriptive study. Professional master's degree athletic training programs. A total of 3742 unique candidates with 4425 attempts between examination windows 1 of 2011-2012 (April) and 5 of the 2019-2020 (February) cycle of the BOC examination. Ethnicity as self-selected by the candidates, attempt number, result of each attempt, year, and testing window. Examination candidates self-identified as White (60.4%, n = 2261/3742), unknown (ie, withheld an ethnicity selection; 10.6%, n = 395/3742), Hispanic (8.6%, n = 320/3742), or African American (8.4%, n = 313/3742). On the first attempt, White candidates passed at a rate of 93.2% (2107/2261), African American candidates at 74.8% (234/313), and Hispanic candidates at 86.9% (278/320; overall first-time pass rate for this subsample = 90.5%, 2619/2894). The relative risk of first-attempt failure was higher for African Americans than for both White (relative risk = 3.706, 95% CI = 2.903, 4.730; P < .001) and Hispanic (relative risk = 1.923, 95% CI = 1.368, 2.703; P > .001) candidates. For Hispanic candidates, the relative risk of first-attempt failure was about 50% lower than for White candidates (relative risk = 0.519, 95% CI = 0.377, 0.715; P < .001). Achievement gaps existed between White candidates and those from ethnic minority groups in athletic training. Diversification of the athletic training workforce will require ensuring equity in preparation for and success on the BOC examination.

My experience at threshold and the consultation process

I had the great opportunity to take part in the Acoustical Society of America’s (ASA) 2021Summer Undergraduate Research or Internship Experience in Acoustics (SURIEA) Program. The program was designed for underrepresented minority groups in order to introduce them to the field of acoustics. After a two-week crash course I was able to experience what it was like working in an architectural acoustic consultation firm and learn the extensive consultation process at Threshold. Not only that, but learning some of the programs, the methodology, skills, and purpose of Threshold as well. The impact of the program has certainly opened my eyes to the field of architectural acoustics, and how much work has to go into a project for the best possible outcome. In essence, I found the experience to be one of the most impactful I had in my life.

HSR22-126: Key Factors Associated With Breast Cancer Clinical Trial Enrollment in Underrepresented Minority Groups

HSR22-126: Key Factors Associated With Breast Cancer Clinical Trial Enrollment in Underrepresented Minority Groups

Trends in Racial Diversity among United States Ophthalmology Residents

Underrepresented minority (URM) groups in medicine are defined as racial and ethnic populations in the medical field that are underrepresented relative to their numbers in the general population. 1 Fairless E.A. Nwanyanwu K.H. Forster S.H. Teng C.C. Ophthalmology departments remain among the least diverse clinical departments at United States medical schools. Ophthalmology. 2021; 128: 1129-1134 Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar A diverse physician workforce that reflects patient population leads to decreased health care disparities, enhanced access to care, and improved patient outcomes and satisfaction. 2 Olivier M.M.G. Forster S. Carter K.D. et al. Lighting a pathway: the minority ophthalmology mentoring program. Ophthalmology. 2020; 127: 848-851 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar However, the field of ophthalmology has not reflected the racial diversity of the country and URM groups comprise only 7.2% of practicing ophthalmologists in the United States. 3 Xierali I.M. Nivet M.A. Wilson M.R. Current and future status of diversity in ophthalmologist workforce. JAMA Ophthalmol. 2016; 134: 1016-1023 Crossref PubMed Scopus (57) Google Scholar Re: Atkuru et al.: Trends in racial diversity among United States ophthalmology residents (Ophthalmology. 2022;129:957-959)OphthalmologyVol. 129Issue 9PreviewIn their report on the demographic data of United States residents in training across multiple specialties, Atkuru et al1 reveal that ophthalmology had the lowest proportion of residents who were underrepresented in medicine (URM) in the 2019–2020 academic year. We agree with the authors’ assessment that insufficient exposure to ophthalmology during medical training may be a major contributor to the lack of diversity in the field. As specialties compete for limited teaching time within medical school curricula, it seems that ophthalmology is falling behind in the race. Full-Text PDF Racial Diversity among United States Ophthalmology Residents: A Call to ActionOphthalmologyVol. 129Issue 8PreviewThe benefits of a diverse workforce in the medical field are well known and include improved health care outcomes, improved cultural competency, and enhancement of the medical work force dedicated to serving under-resourced areas.1 Despite these well-characterized benefits, the percentage of physicians from underrepresented in medicine (URiM) groups lags well behind the overall population in the United States.1,2 In this issue, Atkuru et al3 (see page 957) used demographic data from the accreditation Council for Graduate Medical Education to compare the proportion of URiM residents between 2011–2012 and 2019–2020. Full-Text PDF