Underrepresented Racial Groups Research Articles

A Brief Pro-Diversity Social Marketing Intervention Improves Grades and Well-Being of Students From Marginalized Groups.

Despite much research on improving intergroup relations, the evidence for long-term effects in real-world settings is mixed. We used the social marketing approach to create an "Inclusivity Page" that could be added to course syllabi. The page contained three targeted pro-diversity messages based on social norms, personal benefits, and concrete behavioral recommendations. We tested our intervention in a large randomized controlled trial in university classrooms (Nstudents = 1,799). We obtained students' course grades and overall college GPAs several years later. A subset of students also completed an outcome survey three months after the intervention. Students from underrepresented racial groups exposed to the intervention early in college had better course grades and GPAs. We also observed an enhanced sense of belonging and better emotional and physical health among students from all marginalized groups. Our research demonstrates the utility of employing a targeted approach to improve experiences of members of marginalized groups.

Single-Cell Analysis of Debrided Diabetic Foot Ulcers Reveals Dysregulated Wound Healing Environment in Non-Hispanic Blacks

Diabetic foot ulcer (DFU) is a critical complication of diabetes, but the wound microenvironment and its healing process are not completely understood. In this study, we optimized single-cell profiling from sharp debrided ulcers. Our findings demonstrate that healing-DFUs were significantly enriched with distinct fibroblasts expressing genes related to inflammation (CHI3L1, IL6) and extracellular matrix remodeling (ASPN), validating our previous studies on surgically resected ulcers. The race-focused analysis depicted lower expression of key healing-associated genes such as CHIL3L1, MMP11, and SFRP4 in fibroblasts of non-Hispanic Black (NHB) patients compared to White patients. In cellular communication analysis, healing enriched fibroblasts of NHBs exhibited upregulation of signaling pathways such as WNT while those of White showed IGF and MK pathways upregulation. Our findings advocate race as a risk marker of DFU outcomes, likely reflecting underlying disparities in environmental exposures and access to care that profoundly influence healing markers. Using sharp debrided tissues for single-cell assays, this study highlights the need for in-depth investigations into dysregulated wound healing microenvironments of under-represented racial groups.

Public opinion, racial bias and labour market outcomes in the USA.

Here we study the role of negative shifts in public opinion in the economic lives of under-represented racial groups by investigating sudden changes in views towards Asian people following the anti-Chinese rhetoric that emerged with the COVID-19 pandemic, and associated changes in employment status and earnings in the US labour market. Using data from the Current Population Survey, we find that, unlike other under-represented groups, Asian workers in occupations or industries with a higher likelihood of face-to-face interactions before the pandemic were more likely to become unemployed afterwards. While widespread along the political spectrum, negative shifts in the perceived favourability of Asian people, and not of other under-represented groups, were much stronger among those who voted for Donald Trump in 2016 and could have been more influenced by the anti-Asian rhetoric.

Stretched Thin: How a Misalignment Between Allocation and Valuation Underlies the Paradox of Diversity Achievement in Higher Education

Racial inequality is remarkably resilient in organizational and labor market contexts despite efforts to resolve it, which raises significant questions about the mechanisms underlying its persistence. We argue that organizational efforts that increase the inclusion of underrepresented racial groups in the short term may conceal an emergent mechanism that paradoxically results in exclusion over time. The emergent mechanism stems from an acute misalignment between the scope of allocation in the matching process and the scope of valuation in the evaluation process, which ultimately increases voluntary and involuntary turnover among underrepresented racial groups. We examine this paradox through a revelatory case in higher education. Drawing on comprehensive administrative and research performance data from a large (R1) U.S. public university, we find that Black assistant professors are significantly more likely than their White colleagues to be allocated to non-standard positions, i.e., formally appointed in two academic departments with shared compensation. Our results demonstrate that such non-standard appointments are associated with a significant decline in research productivity, which remains central during the evaluation process. The end result is that jointly appointed assistant professors—among whom Blacks are disproportionately represented—experience lower likelihoods of retention.

Testing the effectiveness of interactive training on sexual harassment and assault in field science

Fieldwork is a critical tool for scientific research, particularly in applied disciplines. Yet fieldwork is often unsafe, especially for members of historically marginalized groups and people whose presence in scientific spaces threatens traditional hierarchies of power, authority, and legitimacy. Research is needed to identify interventions that prevent sexual harassment and assault from occurring in the first place. We conducted a quasi-experiment assessing the impacts of a 90-min interactive training on field-based staff in a United States state government agency. We hypothesized that the knowledge-based interventions, social modeling, and mastery experiences included in the training would increase participants’ sexual harassment and assault prevention knowledge, self-efficacy, behavioural intention, and behaviour after the training compared to a control group of their peers. Treatment–control and pre-post training survey data indicate that the training increased participants’ sexual harassment and assault prevention knowledge and prevention self-efficacy, and, to a lesser extent, behavioural intention. These increases persisted several months after the training for knowledge and self-efficacy. While we did not detect differences in the effect of the training for different groups, interestingly, post-hoc tests indicated that women and members of underrepresented racial groups generally scored lower compared to male and white respondents, suggesting that these groups self-assess their own capabilities differently. Finally, participants’ likelihood to report incidents increased after the training but institutional reports remained low, emphasizing the importance of efforts to transform reporting systems and develop better methods to measure bystander actions. These results support the utility of a peer-led interactive intervention for improving workplace culture and safety in scientific fieldwork settings.Protocol registration"The stage 1 protocol for this Registered Report was accepted in principle on August 24, 2022. The protocol, as accepted by the journal, can be found at: https://doi.org/10.6084/m9.figshare.21770165.

A study on the sample representativeness of the Wisconsin Alzheimer’s Disease Research Center Clinical Core participants versus the Wisconsin state population

AbstractBackgroundUnderstanding how representative a research sample is compared to the population can help inform future recruitment planning, data analysis strategies, and interpretation of the generalizability of the findings. We compared the demographics, rural residence, neighborhood socioeconomic disadvantage, and vascular risk factors between the Wisconsin Alzheimer’s Disease Research Center (ADRC) Clinical Core participants versus the Wisconsin state adult population.MethodThe ADRC participant sample (n = 678) included all active participants as of November 30, 2021. The state population statistics were estimated using multiple national and state data sources. Differences between the sample versus the population were tested using the one‐sample z‐test, the one‐sample Wilcoxon signed rank test, the exact binomial test, and the exact Monte Carlo multinomial test. Except for age, comparisons were performed for two age groups: 45‐64 years and ≥ 65 years, separately.ResultThe ADRC participants are older than the state population. For each age group, compared to the state population, the ADRC participants include more women and greater proportions of Black and American Indians, have higher levels of educational attainment, have smaller percentages living in rural areas and more disadvantaged neighborhoods, and show lower vascular risks. The sample versus population differences are greater for the ≥ 65 years group (the group at higher risk for AD) than the 45‐64 years group for most metrics, however, are smaller for sex and neighborhood disadvantage.ConclusionThe ADRC targets recruiting middle‐aged and older adults with dementia, mild cognitive impairment, or increased risk for AD. Thus, the participants are not a suitable sample for epidemiology studies on AD prevalence. Oversampling underrepresented racial groups would alleviate the lack of statistical power associated with small or unbalanced sample sizes and increase the precision in effect size estimates for studies on racial disparities. Future recruitment should endeavor to include participants from a broader range of educational backgrounds and more residents in rural areas and disadvantaged neighborhoods. These subpopulations have inequitable access to quality health care and are at greater risk. Properly representing them in research would allow conclusions to be generalizable to these subpopulations and support policy making to meet their needs.

Real-World Use of Tafasitamab (tafa) for Relapsed or Refractory (R/R) Diffuse Large B-Cell Lymphoma (DLBCL) Among Racial and Ethnic Minorities in the United States

Introduction: Tafa, a CD19-targeting immunotherapy, received accelerated approval by the FDA in combination with lenalidomide (len) for the treatment of patients with R/R DLBCL ineligible for autologous stem cell transplantation. In a recent real-world study (RWS) of tafa for R/R DLBCL, nearly one-third of patients were from typically underrepresented racial groups (abstract submitted to ASH 2023). Research has shown that patient characteristics, risk factors, and outcomes for DLBCL can differ by race and ethnicity (Li Y, et al. Cancer Epidemiol. 2015;39:8-13; Ermann D et al. J Clin Oncol. 2022;40(suppl):7507). The purpose of this analysis is to understand the patient characteristics, treatment patterns, and outcomes observed in the tafa RWS by race and ethnicity. Methods: This was a retrospective cohort study in which participating physicians from Cardinal Health's Oncology Provider Extended Network abstracted data from eligible patients' medical records into electronic case report forms. Eligible patients were ≥18 years of age who initiated tafa for R/R DLBCL on or after Oct 21, 2020. Included patients had ≥4 months of follow-up unless the patient died during this period. Use of tafa in combination with len was not a requirement for study eligibility. Patients who received tafa as part of a clinical trial were excluded. Results were summarized by race (White, Black/African American, “Other”) and ethnicity (Non-Hispanic, Hispanic) using descriptive statistics. The “Other” racial category included patients with mixed race or a race other than White, Black/African American, or Unknown. The Kaplan-Meier method was used to measure time to tafa discontinuation. Due to limited follow-up and small sample size, effectiveness outcomes for subgroups smaller than 20 patients are not presented. Results: A total of 181 patients who initiated tafa for R/R DLBCL were included in this analysis. Table 1 shows patient characteristics, treatment patterns, and outcomes by racial and ethnic groups. The racial composition of the study population was 64% White, 22% Black/African American, 8% “Other,” and 6% Unknown (Unknown not displayed in Table), and ethnic composition was 82% non-Hispanic, 17% Hispanic, and 1% Unknown (Unknown not displayed in Table). Most physicians who participated in this study were from community oncology practices (83%). The median follow-up time from tafa initiation to data collection among all patients was 6.5 (interquartile range [IQR], 5.0-8.6) months. The majority of patients (96%) received tafa in combination with len. At the time of data collection, 144 patients (80%) were alive, among whom 121 (84%) were still receiving tafa. The median age at which tafa was initiated ranged from 70 to 72 years for all racial and ethnic groups. Among the racial groups, the White cohort had the highest percentage of patients with an ECOG PS ≥2 (53%) and Ann Arbor Stage IV (68%) at time of tafa initiation. Among the racial categories, the median time (IQR) from initial DLBCL diagnosis to initiation of tafa was longest in Black/African Americans (23.3 [12.6-34.8] months) and shortest in the “Other” group (18.0 [15.0-21.4] months). In non-Hispanics and Hispanics, the median (IQR) duration from initial DLBCL diagnosis to tafa initiation was 20.0 (12.4-35.0) and 19.0 (14.0-34.0) months, respectively ( Table 1). Among patients who had disease response data, the real-world overall response rate (95% CI) was 75.0% (66.8-83.2) and 77.5% (64.6-90.4) for the White and Black/African American cohorts, and 74.5% (67.3-81.7) and 80.8% (65.7-95.9) for non-Hispanic and Hispanic groups, respectively ( Figure 1). Conclusions: The diverse population in this RWS is reflective of the heterogeneous patient population with R/R DLBCL treated primarily at community oncology centers in the United States. In addition, the study results support the clinical benefit of tafa across racial and ethnic groups. The majority of patients were still receiving tafa at data cutoff and follow-up was limited in duration; the median follow-up time in this study was shorter than the median time to complete response observed in L-MIND (NCT02399085; Duell J, et al. Haematologica. 2021;106:2417-2426), the pivotal phase 2 trial that contributed to the accelerated FDA approval of tafa for R/R DLBCL. A longer follow-up is required to better assess long-term outcomes of tafa treatment for R/R DLBCL among racial and ethnic patient groups.

Tafasitamab for the Treatment of Relapsed/Refractory (R/R) Diffuse Large B-Cell Lymphoma (DLBCL) in the US Real-World Setting

Introduction: Tafasitamab (tafa) is a CD19-targeting immunotherapy indicated in combination with lenalidomide (len) for the treatment of adult patients with R/R DLBCL ineligible for autologous stem cell transplantation (ASCT). The 2020 FDA accelerated approval of tafa in this setting was based on findings from L-MIND, a multicenter, open-label, single-arm, phase 2 trial (Salles G, et al. Lancet Oncol. 2020;21:978-988). Since this approval, there has been a paucity of real-world studies (RWS) evaluating the outcomes of patients with R/R DLBCL who received tafa in the community setting. We conducted this RWS to describe the patient characteristics, treatment patterns, and outcomes of patients who received tafa for R/R DLBCL across practice settings in the US. Methods: A retrospective, multisite, physician-abstracted medical chart review RWS was conducted in US adults who initiated tafa (with or without len) on or after Oct 21, 2020 for R/R DLBCL outside of the clinical trial setting. Patients were required to have at least 4 months of follow-up after tafa initiation unless the patient died during this period. Participating physicians from Cardinal Health's Oncology Provider Extended Network-approximately 83% from community oncology practices-abstracted data from the medical records of patients into electronic case report forms. Data were summarized using descriptive statistics for all patients and for subgroups based on whether tafa was received as second-line (2L) or third-line (3L) therapy for R/R DLBCL. Whereas some patients received tafa as fourth-line (4L) or fifth-line (5L) therapy, data for these patients were not analyzed separately due to small numbers. Results: A total of 181 patients were included in this study, with a median follow-up time of 6.5 (range, 0.9-27.4) months since initiating tafa. Key patient characteristics, treatment patterns, and outcomes are summarized in Table 1. At initiation with tafa, the majority of patients had an Eastern Cooperative Oncology Group performance status of 0-2 (98%), Ann Arbor stage of III-IV (93%), and a revised International Prognostic Index score of 3-5 (75%). The majority of patients (72%) received tafa as 2L therapy for R/R DLBCL, whereas 24% received tafa as 3L, 3% as 4L, and 2% as 5L. The median time from initial diagnosis of DLBCL to initiation of tafa was 20 (interquartile range [IQR], 12-35) months. Prior to tafa, 12% had undergone ASCT and 3% had received chimeric antigen receptor T-cell therapy. The starting dose of concomitantly administered len varied: 68 (38%) received 25 mg; 43 (24%) received 20 mg; 29 (16%) received 15 mg; 31 (17%) received 10 mg; 2 (1%) received 5 mg; and 8 (4%) patients did not receive concomitant len. Len dose reductions were experienced during treatment by 19% of patients. Among the 60 patients who discontinued tafa, reasons for discontinuation included progression confirmed by scan (50%), progression defined clinically (17%), toxicity (15%), patient/caregiver request (3%), complete response (2%), and other reasons (13%). The real-world overall response rate for tafa was 76% (95% confidence interval [CI], 69-82%), with a real-world complete response rate of 18% (95% CI, 13-24%). The real-world progression-free survival probability at 6 months post tafa initiation was 0.8 (95% CI, 0.7-0.8). At the time of data collection, most patients were still alive (80%), among whom 84% were still receiving tafa. Conclusions: Findings from this real-world analysis support the clinical benefit of tafa when used in early lines of treatment for R/R DLBCL, as demonstrated in L-MIND. Importantly, the patient population included in this study was racially and ethnically diverse, with nearly one-third of patients from typically underrepresented racial groups and approximately one-sixth of Hispanic ethnicity. Further, this population consisted of patients treated predominantly in a community oncology setting, which is the treatment setting for the majority of patients with DLBCL in the US. Most patients were still on tafa at the time of data collection and follow-up was limited in duration; the median time to complete response in L-MIND (Duell J, et al. Haematologica. 2021;106:2417-2426) was longer than the median follow-up time in this study. Therefore, longer follow-up of these patients is warranted to better understand long-term outcomes of tafa among this diverse patient population.

Social Drivers of Health and Pediatric Extracorporeal Membrane Oxygenation Outcomes.

Relationships between social drivers of health (SDoH) and pediatric health outcomes are highly complex with substantial inconsistencies in studies examining SDoH and extracorporeal membrane oxygenation (ECMO) outcomes. To add to this literature with emerging novel SDoH measures, and to address calls for institutional accountability, we examined associations between SDoH and pediatric ECMO outcomes. This single-center retrospective cohort study included children (<18 years) supported on ECMO (2012-2021). SDoH included Child Opportunity Index (COI), race, ethnicity, payer, interpreter requirement, urbanicity, and travel-time to hospital. COI is a multidimensional estimation of SDoH incorporating traditional (eg, income) and novel (eg, healthy food access) neighborhood attributes ([range 0-100] higher indicates healthier child development). Outcomes included in-hospital mortality, ECMO run duration, and length of stay (LOS). 540 children on ECMO (96%) had a calculable COI. In-hospital mortality was 44% with median run duration of 125 hours and ICU LOS 29 days. Overall, 334 (62%) had cardiac disease, 92 (17%) neonatal respiratory failure, 93 (17%) pediatric respiratory failure, and 21 (4%) sepsis. Median COI was 64 (interquartile range 32-81), 323 (60%) had public insurance, 174 (34%) were from underrepresented racial groups, 57 (11%) required interpreters, 270 (54%) had urban residence, and median travel-time was 89 minutes. SDoH including COI were not statistically associated with outcomes in univariate or multivariate analysis. We observed no significant difference in pediatric ECMO outcomes according to SDoH. Further research is warranted to better understand drivers of inequitable health outcomes in children, and potential protective mechanisms.

The Impact of Employee Perceptions of Inclusion in a Racially Diverse Agency: Lessons From a State Government Survey

Public organizations have long sought to increase workforce diversity and employee inclusion, a goal that has only increased in recent years. The study examines a racially diverse state government agency to explore how employee perceptions of diversity and inclusion relate to workplace happiness, employee engagement, and job satisfaction. Using original survey data of over 1,800 workers, this study explores how employees perceive diversity and inclusion, how these perceptions relate to overall workplace happiness, and examines the factors that may lead to more positive perceptions of diversity and inclusion. The analysis employs principal component analysis and multilevel regression modeling. The findings underscore the connections between overall workplace happiness and positive perceptions of diversity and inclusion. The key takeaways for public organizations include the importance of senior leadership when it comes to cultivating a diverse and inclusive environment. Finally, a notable finding is the statistically significant increase in positive feelings around inclusion and diversity for historically underrepresented racial groups and that low pay for long-term employees decreases these feelings.

Racial and ethnic underrepresentation in dermatology clinical trials

Including participants of diverse racial and ethnic populations in clinical trials is important to reduce disparities and promote health care equity. To evaluate racial and ethnic representation in dermatology clinical trials. Participant data from dermatology trials completed in the United States from 2017 to 2021 from ClinicalTrials.gov were compared to census data to determine if minority groups were represented at rates that reflect population demographics. Participation was compared with prevalence rates for the most underrepresented racial group. Of 246 trials that met inclusion criteria, 87.4% (215) reported racial data. Compared to census data, Black/African American, American Indian/Alaskan Native, and 2 or more races were underrepresented. Hispanic or Latinos were an underrepresented ethnic group. The search was limited to ClinicalTrials.gov registered studies that fell within search parameters. Race reporting methods were not specified. Detailed analysis was only performed for the most underrepresented racial group. Certain minority groups were underrepresented in dermatology trials. Black/African Americans were most underrepresented and underrepresented even when accounting for prevalence rates. Trial representation that accurately reflects population demographics and subgroup prevalence rates can help reduce health inequity, improve clinical understanding, and enhance treatment access for the growing diverse population.

The role of gender expectations, stereotypes, and self-identification in rating psychopathy using the Comprehensive Assessment of Psychopathic Personality (CAPP)

This study aimed to assess the role of gender expectations, stereotypes, and self-identification when rating psychopathy using the 33-item Comprehensive Assessment of Psychopathic Personality (CAPP). Firstly, we established how laypersons conceptualize psychopathy at a general level using gender prototypicality ratings with a sample of 1054 participants. As expected, most of the CAPP items and domains were rated significantly more prototypical of male than female psychopathy. Secondly, the potential for gender bias was explored by examining if rater characteristics or differences in client presentation influenced symptom severity ratings. A sample of 596 participants was randomly assigned to one of six conditions where they read a brief vignette and completed symptom severity ratings. Two one-way MANCOVAs were performed; no main effects or interaction effects were significant after controlling for the effects of the covariates. Each vignette was rated similarly, suggesting that client presentation does not influence symptom ratings for psychopathy. Therefore, laypersons consider the symptoms of psychopathy to be more prototypical of males, but these gender expectations did not translate into bias when rating symptom severity. Self-identification as belonging to an underrepresented racial group and a greater acceptance of male gender role stereotypes were found to influence symptom ratings.

ESPO AND BUTLER-WILLIAMS SCIENTIFIC SYMPOSIUM: CAREER DEVELOPMENT TO PROMOTE DIVERSITY, DISCOVERY, AND AGING

Abstract The NIA’s Butler-Williams Scholars Program and GSA’s ESPO Section are united in providing career development opportunities in a manner that promotes leadership, diversity, and inclusivity. This year’s theme challenges our emerging scholars to embrace diversity and discovery while thinking—or rethinking—about the perspectives of older adults. Disparities in health associated with race/ethnicity, experience, sociocultural and socioeconomic factors, as well as access to and provision of health care are chief concerns of our aging population. GSA’s early career professionals and 2021 alumni of the prestigious NIA Butler-Williams Scholars Program address these issues. Dr. Matthew Farina will present on the importance of identifying life course pathways in understanding the lived experiences of older adults from underrepresented racial groups. Dr. Kacie Deters will discuss how both demographics and genetic factors contribute to cognitive performance. Dr. Mirna Arroyo-Miranda will present findings on social isolation and cognition in Hispanic/Latino older adults. The final speaker, Dr. Jamaine Davis will present on the genetic factors that may contribute to dementia in African American older adults. The featured talks by rising stars deepen our understanding of the influence of diversity and key discoveries so we can reimagine aging research.

Racial and Ethnic Cardiometabolic Risk Disparities in the Type 1 Diabetes Exchange Clinic Registry Cohort

ObjectiveTo determine whether individuals from a historically underrepresented racial group have a higher cardiometabolic risk than historically represented individuals with type 1 diabetes (T1D) considering socioeconomic deprivation. MethodsWe used the multivariable logistic and linear regression models to examine socioeconomic deprivation (upper 10th percentile) by race/ethnicity interaction for each cardiometabolic risk factor and cardiometabolic risk burden score, respectively, across 6320 zip code tabulation areas. We also determined the age-adjusted prevalence of low, moderate, and high cardiometabolic risks defined as 0, 1 to 2, and 3 or more risk factors for hypertension, obesity, dyslipidemia, and off-target glycemia for non-Hispanic White (n = 15 746), non-Hispanic Black (n = 1019), Hispanic (n = 1115), and other (n = 887), respectively. ResultsThe sample comprised 18 767 adolescents and adults with T1D. Those identifying as non-Hispanic Black were more likely to have a high cardiometabolic risk profile, including a 4.5-fold increase in the odds of off-target glycemia, a twofold increase in the odds of systolic hypertension, and 0.29 (unadjusted) and 0.46 (adjusted) increases in a higher cardiometabolic risk burden compared with non-Hispanic White individuals (P < .01). Those identifying as Hispanic had a 3.4-fold increase in the odds of off-target glycemia but were less likely to be overweight/obese or have systolic hypertension compared with non-Hispanic White. However, the lower likelihood of overweight/obesity and hypertension did not persist after considering covariates. ConclusionThere is a need to investigate additional determinants of racially/ethnically underrepresented cardiometabolic health, including structural racism and implicit bias in cardiometabolic care for individuals with T1D.

Examining racial, ethnic, and cultural diversity in occupational science research: Perspectives of persons of color

ABSTRACT Diverse sociodemographic identities, including race, culture, ethnicity, and gender, are important influences on one’s occupational patterns and choices. However, occupational science theories and research were originally driven by Western White middle-class researchers and conducted on White participants. With a focus on the Western context, we sought to identify areas for improvement in the delivery and conduct of occupational science research with considerations of race, ethnicity, culture, and occupation among underrepresented racial groups. A critical content analysis was conducted of empirical research undertaken in Western countries between 2015 and 2020 and published in the Journal of Occupational Science (JOS). This analysis asked (a) What is the stated positionality of first author? (b) What are the racial or ethnic orientations of research participants? and (c) Is there explicit discussion of a racial/ethnic phenomenon? The findings reveal a lack of scholarship on race, ethnicity, and culture. Many primary authors did not explicate their positionality in relation to the research topics and study participants. The findings reify that the current production of occupational science research continues to occur within a wider field of social relations that is characterized by the agendas, interests, and values of the dominant group. Informed by critical race theory, we urge occupational science academic journals and their contributing authors to commit to epistemological antiracism. We recommend making space for racialized perspectives; acknowledging how these identities affect engagement and choice of occupations; clarifying who regulates, narrates, and participates in occupational science research; and creating inclusive scholarly ecosystems.

September 2022 Stroke Highlights

September 2022 <i>Stroke</i> Highlights

An interim analysis of a gestational weight gain intervention in military personnel and other TRICARE beneficiaries.

Despite military fitness regulations, women in the military frequently experience overweight/obesity, excessive gestational weight gain (GWG), and the postpartum implications. This interim analysis of the Moms Fit 2 Fight study examines GWG outcomes among active-duty personnel and other TRICARE beneficiaries who received a stepped-care GWG intervention compared with those who did not receive a GWG intervention. Participants (N=430; 32% identified with an underrepresented racial group, 47% were active duty) were randomized to receive a GWG intervention or the comparison condition, which did not receive a GWG intervention. Retention was 88% at 32 to 36 weeks' gestation. Participants who received the GWG intervention gained less weight compared with those who did not (mean [SD]=10.38 [4.58] vs. 11.80 [4.87] kg, p=0.0056). Participants who received the intervention were less likely to have excessive GWG compared with those who did not (54.6% vs. 66.7%, p=0.0241). The intervention effects were significant for participants who identified as White, but not for those of other racial identities. There were no significant differences between the conditions in maternal/neonatal outcomes. The intervention successfully reduced excessive GWG, particularly among participants who identified as White. Should this intervention be found cost-effective, it may be sustainably integrated throughout the military prenatal care system.

Disparities in Student Misconduct in Higher Education for Students From Underrepresented Racial Backgrounds or Non-Citizen Visa Status

Disciplinary charges and sanctions at the K–12 level that previously demonstrated racial bias toward underrepresented racial groups (URGs) in both the severity of charge and sanction in the literature may continue to higher education; URGs received higher charges and sanctions in similar cases involving their White peers. We analyzed 4,761 disciplinary cases over seven years to determine if race, sex, or citizenships played a predictive role in severity of charge and sanction at a predominantly White institution. White students received higher charges than students from URGs. URGs received higher sanctions. URGs status predicted both higher charge and sanctions when less severe.

Internet‐based cultural competence training for White undergraduate students at a predominantly White university

AbstractCollege students from underrepresented racial groups often experience racial prejudice and discrimination from their White peers at predominantly White institutions (PWIs). White university students may be misinformed about race and unaware of their privilege. In this study, we investigated the effects of online training that aimed to increase participants' cultural competence through multicultural knowledge, awareness of their own privilege, and skills. White college students at a PWI completed a 4‐week training program adapted from a 1‐day in‐person workshop. The training provided 1‐h weekly online sessions in which White participants (n = 72) were provided resources aimed to develop cultural competence. It utilized student‐acted role plays, reflection questions, articles, and videos to create an interactive experience for students. Results demonstrated that participants showed significant increases in cultural competence and acknowledgment of their White privilege directly following the fourth training session. Further, they exhibited decreases in racial colorblindness. This study suggests that a brief, online training may increase cultural competence in undergraduates which can potentially improve the climates of university campuses.

Self-Reported Perspectives on Cultural Competence Education in Speech-Language Pathology.

Only 8% of American Speech-Language-Hearing Association (ASHA) members identify as members of an underrepresented racial group (ASHA, 2021); hence, little is known of the lived experiences and perspectives of these members. Critical investigation of cultural competence in the clinical education and training of speech-language pathologists (SLPs) can illuminate problems and solutions with existing frameworks and provide innovative pedagogical approaches to teaching and learning. The researcher's goal was to document the knowledge and lived experiences of SLPs from cross-cultural perspectives to meaningfully critique and evolve practice standards. Using self-reported perspectives in narrative case study approach, four SLPs from cross-cultural backgrounds engaged with the researcher in dialogic interviews. The interview audio recordings were transcribed and coded for themes that reflected the lived experiences and realities of the collaborators. The findings suggest that (a) this group of SLPs had critical and contrary perspectives on instruction and training in cultural competence, (b) their lived experiences through their interpersonal environments largely influence their clinical decision-making, and (c) they learned to navigate cross-cultural perspectives in their graduate education mostly through comparative framings (i.e., language difference vs. language disorder). The data gathered from the self-reported perspectives of SLPs in this study can serve as preliminary reference for future qualitative research on how curriculum and training frameworks may shift to support both underrepresented practitioners of color, the diverse populations SLPs serve and provide guidance for nuanced discussions of systemic factors that can impact research, teaching, and practice in the field.