Determining Factors For Improved Uptake Of Harm Reduction Services In The United States: A Study Of Inclusive, Culturally Sensitive Messaging, Lauretta Ekanem Omale

Dissertations

Harm reduction refers to public health policies and programs aimed at decreasing the adverse consequences associated with drug use. While harm reduction services (e.g., syringe exchange programs) can mitigate health risks, marginalized groups face barriers to service access and utilization, partially due to ineffective messaging approaches that fail to align with cultural values and experiences. A one-size-fits-all approach to messaging can negatively impact service utilization, health outcomes, and health disparities. Ineffective communication can lead to poor adherence to treatment, poorer health outcomes, and increased adverse events.

Culturally insensitive communication contributes to stigma, mistrust, and lack of perceived relevance, discouraging service …

Effect Of Asynchronous Virtual Interviews On Ethnic Minority Matriculation Into A Doctor Of Physical Therapy Program, Conner Clark, Nanea Lagasca, Gladys Miller, Jasmine Puspos

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Methods: This study examines the impact of the use of asynchronous virtual interviews (AVIs) in the admissions process of the Doctor of Physical Therapy (DPT) program at the University of Nevada, Las Vegas (UNLV). This research aims to examine racial and ethnic subgroup differences in AVI scores, evaluate the influence of AVIs on applicant scores in the admissions process, and assess the AVI inter-rater reliability among faculty evaluators using data from the 2019-2022 admissions cycles.

Results: Significant differences were found in AVI scores among racial and ethnic groups, with Black applicants scoring highest and Asian applicants scoring lowest. Additionally, inclusion …

Understanding Medical Students' Perceived Readiness To Serve As Culturally Competent Practitioners, Michel'le Janae Bryant

Seton Hall University Dissertations and Theses (ETDs)

Background: The US population is more culturally diverse than ever. Although advancements have been made in improving the nation’s overall health, health disparities continue among different racial and ethnic groups. To promote person-centered care practices, medical students must be ready to serve diverse patient populations and provide equitable care. Despite their training, some medical students report feeling unprepared to treat diverse patient populations, potentially impacting their clinical practice and patient care outcomes.

Purpose: This study’s purpose was to explore the perceived readiness of final-year medical students in the US to provide culturally competent care utilizing the Readiness Theory and The …

The Perceptions Of Appalachian Region Doctor Of Physical Therapy Admissions Faculty On The Holistic Nature Of Their Program’S Admissions Processes And Requirements, Kwaku Kankam

Ed.D. Dissertations

Researchers have extensively investigated the quantitative relationship between various admissions requirements and their predictive capability for academic success in DPT programs; however, limited investigators have examined the perceptions of these requirements by admissions faculty. The purpose of this qualitative study was to examine the perceptions of Doctor of Physical Therapy faculty in the Appalachian region regarding their programs’ admissions processes and requirements. I investigated the Appalachian region due to its economic differences from other parts of the United States. Considering this region was more rural and impoverished, these factors could have affected students’ access to higher education. How admissions criteria …

The Together Study: Exploring The Relationship Between Ontario Undergraduate University Students’ Levels Of Resilience And Their Experiences Of Diversity And Inclusion, Manvir Ahluwalia

Electronic Thesis and Dissertation Repository

This study’s primary purpose was to assess, quantitatively, the relationship between Ontario undergraduates’ levels of resilience and experiences of diversity and inclusion, and to identify demographic factors most associated with these outcomes. The secondary purpose was to explore, qualitatively, students’ experiences of diversity and inclusion and their perspectives on how these experiences influenced their resilience. Demographic questions, three scales, and (focus group and individual) interviews were used. Undergraduates (n = 276) from 19 Ontario universities completed the survey. Pearson’s correlation revealed a positive relationship between resilience and experiences of diversity and feelings of inclusion. Demographics indicative of equity-deserving group …

Diversity, Equity, & Inclusion In Nurse Anesthesia: Bridging The Gap, Aminat Yusuff-Akinbo

Doctor of Nursing Practice Projects

The nurse anesthetist plays a crucial role in the healthcare system. Through intensive training, they provide safe and effective anesthesia care to patients across various healthcare settings. Currently, the nurse anesthesia field lacks diversity, with underrepresentation of minority groups such as Black, Hispanic, and Indigenous individuals. The United States Census revealed that there are more than 325 million residents. Yet only 10.9% of nurse anesthetists are of diverse racial backgrounds. This lack of diversity limits the cultural perspectives and experiences brought to patient care and perpetuates disparities in healthcare outcomes. An increase in diversity can improve care for individuals and …

Implementation Of Implicit Bias Training In A Doctor Of Nurse Practitioner Program, Macdana Selecon

Doctor of Nursing Practice (DNP) Projects

Background: Implicit bias in healthcare delivery refers to the unconscious mental associations healthcare providers make about patients from various social groups. Numerous studies suggest implicit bias contributes to health disparities primarily amongst marginalized groups. Furthermore, patients report a lower quality of communication from healthcare providers with higher implicit racial bias. In 2021, Assembly Bill 1407 (Nurses: Implicit Bias Courses Act) was passed to address the negative impact of bias on patient outcomes and requires California nursing schools to provide implicit bias training for nursing students.

Problem: All graduate nursing programs do not provide implicit bias (IB) training. As a result, …

Evaluation Of Effectiveness Of Cultural Competence Program Implemented As Standard Practice To Improve Nurses’ Cultural Competency (Cultural Awareness, Cultural Cultural Knowledge, Cultural Skill), Improving Patient Care In A Community Hospital, Kendra Elam

Doctor of Nursing Practice (DNP) Manuscripts

The need for a culturally competent healthcare workforce is increasing as diversity increases in the United States’ patient population. Cultural competence is necessary because it helps the healthcare provider to offer the best care to every patient while considering and incorporating their cultural diversity and the patient holistically. Healthcare providers should be culturally competent to provide compassionate, caring, patient-centered care that promotes safety and quality in healthcare, reducing healthcare disparities. Culturally competent care supports social justice and health equity; it encourages health care as a human right. There is evidence that cultural competence and humility in professional development improve providers' …

Transformational Leadership Approach For Encouraging Historically Marginalized Communities To Access Admission To Naturopathic Medicine, Baljit Khamba

The Dissertation in Practice at Western University

Many healthcare training institutions lack cultural diversity, including naturopathic medicine. One potential reason is a lack of historically marginalized individuals applying to these medical schools. Attracting communities of colour to healthcare professions, like naturopathic medicine is important for improving healthcare access and delivery across all individuals within North America. This OIP explores the lack of diversity in applicants to the naturopathic medical program at a large multi-centre institution. The role that education and mentorship of faculty members can play to improve implicit biases and eventually encourage historically marginalized individuals to apply to the program is explored. Moreover, the OIP presents …

Diversity In Nurse Anesthesia Education: Understanding The Perspective Of Racial-Ethnic Minority Nurse Anesthesia Students, Lorette Osun, Jeannette Ineza

Doctor of Nursing Practice Projects

The idea that race is not an issue, everyone is treated fairly, and the denial of racial differences is an act to refute that racism still perpetuates nursing education. Racial-ethnic minority student registered nurse anesthetists (SRNA) face unique challenges in their didactic and clinical training, including microaggressions, discrimination, and bias, all of which white students do not have to face during their educational experiences (Carter & McMillian-Bohler, 2020). Our project sought to highlight the lived experiences of ethnic minority student registered nurse anesthetists in the United States to bring awareness and effectuate change in nurse anesthesia education. Our Qualtrics survey …

Diversity, Equity, And Inclusion Efforts Among Healthcare Providers And Systems In The United States, Peyton Jobe

Health, Human Performance and Recreation Undergraduate Honors Theses

The purpose of this study was to compare patient experiences measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to healthcare provider’s diversity, equity, and inclusion efforts. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a patient survey given upon patient discharge. The results cumulate to score hospitals on patient experiences. In the sample, there were 392 hospital websites that were evaluated for the existence of policies, procedures, or statements related to diversity, equity, and inclusion efforts or stances. Of those, 121 of the hospitals received the lowest possible rating for patient experience …

Analyzing Equity Within The University Of Nevada, Las Vegas Physical Therapy Program Admissions Process, Rebecca Altman, Savanna Cathey, Michelle Dedmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose The purpose of this study was to analyze the admissions process of the University of Nevada Las Vegas Physical Therapy (UNLVPT) program through the lens of racial equity. Methods A retrospective cohort of UNLVPT applicants between 2014-2019 was obtained from the physical therapy centralized admissions system and the UNLVPT admissions office. Applicant and application characteristics were compared by racial group. Results: Our sample included 2937 total applicants with 212 (7.2%) that were admitted and matriculated into the program. Applicants identified as 49% White, 24% Asian, 13% multiracial, 6% Hispanic, 2% Black, 0.2% American Indian, and 6% did not report …

Accessibility Of Medical School To Students With Physical Disabilities, Shelby A. Cowan

Senior Theses

This thesis is an exploration of perceived and institutional barriers to matriculation into medical school for students with physical disabilities. Factors such as the lived admissions experience, available accommodations and supportive resources, and legal considerations surrounding a student's disclosure of their disability are examined; however, future work is needed to better access this population of students and empower them to become physicians and use their unique perspective to benefit patients.

Perceptions Of Women Of Color Improving Patient Outcomes Through Hospital Leadership Advancement, Benita A. Mclarin

Walden Dissertations and Doctoral Studies

Women of color have been underrepresented in hospital leadership positions and face challenges in advancing their careers. The benefit to hospitals providing women of color with training and support to move into leadership positions may be improved patient outcomes. Grounded in the interactional model of cultural diversity framework, the purpose of this basic qualitative study was to explore the perceptions of women of color advancing in leadership roles in hospitals and their impact on patient outcomes. The study participants included 16 women of color in leadership positions from hospitals in a western U.S. state. Data were collected through semi structured …

Lack Of Leadership Roles And Advancement Opportunities For Black Female Nurses, Mikela Jerilynn Jones

Walden Dissertations and Doctoral Studies

Underrepresentation is a significant issue for Black female nurses to secure nurse leadership positions in healthcare facilities. Leadership by Black female nurses is needed to provide culturally appropriate quality of care, to have a more diverse workplace, and to ensure that the needs of diverse patient populations are met. The purpose of this quantitative study was to explore the barriers and challenges faced by Black female nurses who failed to achieve their advancement goals into leadership roles.Using the National Sample Survey of Registered Nurses (NSSRN) database, the independent variables used were interpersonal differences with colleagues or supervisors, lack of good …

Perceptions Of Women Of Color Improving Patient Outcomes Through Hospital Leadership Advancement, Benita A. Mclarin

Walden Dissertations and Doctoral Studies

Women of color have been underrepresented in hospital leadership positions and face challenges in advancing their careers. The benefit to hospitals providing women of color with training and support to move into leadership positions may be improved patient outcomes. Grounded in the interactional model of cultural diversity framework, the purpose of this basic qualitative study was to explore the perceptions of women of color advancing in leadership roles in hospitals and their impact on patient outcomes. The study participants included 16 women of color in leadership positions from hospitals in a western U.S. state. Data were collected through semi structured …

Deciphering The Salivary Microbiome In Crohn’S Disease Patients With Different Factors Contributing To Dysbiosis, Hala Elzayat

Theses

Crohn’s Disease (CD) is a chronic Inflammatory Bowel Disease (IBD), common in the UAE. Microbiota is necessary to maintain a balanced gut environment which is essential for good health. Dysbiosis can predispose to many diseases including CD. The oral cavity has the second largest and most diverse microbiota after the gut harboring over 700 species of bacteria. This study aims to investigate the alterations in the salivary microbiome in patients with CD compared to Healthy controls (HC). It also aims to compare CD patients for salivary microbiome complexity and diversity according to different factors that can contribute to dysbiosis, including …

Implementing Faculty Development Modules To Increase Readiness For Addressing Social Determinants Of Health, Implicit Bias And Equity In Course Content, Claudia Ngafeeson

DNP Scholarly Projects

Implicit bias is viewed as an unconscious and involuntary attitude that lies below the surface of consciousness but can influence behavior, and cognitive processes (Maina et al., 2018). Social determinants of health are considered to be the conditions in which people are born, grow, live, work, and age; these circumstances are usually shaped by the distribution of money, power, and resources at global, national, and local levels, which in turns determines the distribution of the value of medical care. Existing literature on implicit bias has been fragmented in different fields such as; cognitive psychology, business ethics, and higher education, but …

Nurses’ Perceptions Of Culturally Competent Care At The Bedside, Judith Cox

Walden Dissertations and Doctoral Studies

The population served by health care systems in the United States is widely diversified, which requires nurses to be culturally competent in their care practices. However, studies have shown that nurses do not consistently deliver culturally competent care. This basic qualitative study was designed to explore nurses’ perceptions of cultural competence at the bedside to understand what is needed to improve cultural competency practices. Campinha-Bacote’s conceptual framework for cultural competency was used to guide this study that included face-to-face, videoconference interviews using semi structured and open-ended questions from 13 voluntary, acute care bedside nurses. Interviews were audio recorded and uploaded …

Creating A Pipeline To Increase Diversity In Executive Leadership Positions, Trarina Harris

Doctor of Nursing Practice (DNP) Projects

Background: Minority nurse leader presence at the executive leadership level is suboptimal, with insufficient pathways to increase representation. The lack of diversity in executive leadership threatens efforts to improve patient care and reduce disparities (Jerome Harris, 2021).

Local Problem: Practices to increase the diversity of executive nurse leaders at a pediatric medical center have had very little to no impact. Frontline nurses and nurse executives are not racially or ethnically representative of the increasingly minority patient populations served.

Context: As a commitment to increasing workforce diversity, the medical center developed an executive-level Racial Equity Taskforce, which aligned with the …

How To Incorporate Diversity, Equity, And Inclusion Into Physician Assistant Curriculums: An Exploratory Research Project From The Perspective Of A Prospective Pa Student, Madison Rawnsley

Honors Program Contracts

No abstract provided.

Enhancing Diversity In Nursing Education, Ellen Steidl

Nursing Capstones

Diversity in the nursing workforce lags behind the demographic of the national population; therefore, diversity of the student population must be enhanced in nursing education. While racial minority groups account for 40% and men account for 50% of the total population, only 20% of racial minority groups and 9% of men are represented in nursing. The Transcultural Nursing Theory serves as the theoretical framework for this study. A thorough review of the literature was conducted and analyzed. Several barriers to achieving diversity in nursing education exist including issues with recruitment and retention of diverse populations. Strategies for effective implementation techniques …

Investigating Barriers Experienced By Underrepresented Minorities In Becoming A Competitive Genetic Counseling Applicant, Katie Huang

Dissertations & Theses (Open Access)

Representation for both racial/ethnic and gender identity minorities in genetic counseling (GC) remains the lowest among similar healthcare professions. Barriers that underrepresented minority (URM) individuals face in becoming a competitive GC applicant have not yet been described. Academic capital (AC) is a theoretical framework describing the social processes necessary for individuals to navigate and succeed in higher education. This study aimed to characterize barriers experienced by applicants who self-identify as underrepresented and to explore how AC could identify areas for intervention. Prospective GC applicants for the 2021/2022 cycles were recruited to complete an anonymous online survey in Qualtrics through a …

Strategies For Establishing A Diverse Workforce Within A University Health System’S Department, Shanee Chantel Morgan

Walden Dissertations and Doctoral Studies

Balanced diversity in health care promotes patient satisfaction and enhances innovation. Obtaining a culturally balanced workplace requires recruitment strategies that encourage inclusiveness among team members from various backgrounds. The purpose of this doctoral study was to explore the issue of lack of diversity in a behavioral health organization’s (BHO’s) student intern program and identify strategies for creating greater diversity in the workplace. The Baldrige excellence framework, the conceptual framework that guided the research, was designed to help BHOs to improve their overall business performance to accomplish goals and increase organizational sustainability. Three themes emerged from the data analysis: diversity training, …

The Lived Experiences Of African American Nurses In South Carolina Emergency Rooms, Debra A. Dixon

Walden Dissertations and Doctoral Studies

The underrepresentation of African American (AA) nurses in South Carolina (SC) emergency rooms (ERs) may affect quality patient care for AAs and all other patients in culturally diverse populations. This qualitative interpretive (hermeneutic) phenomenological study explored the lived experiences of AA nurses in several SC ERs concerning quality patient care in culturally diverse populations. Herzberg's two-factor theory and Maslow's hierarchy of needs theory framed the study. The research question investigated the lived experiences of AA ER nurses in SC ERs concerning quality patient care in culturally diverse populations. Interpretive phenomenology was used to gain insight from a sample of 17 …

Understanding Perspectives Of Clinical And Non-Clinical Healthcare Administrators On Culture And Diversity In The Healthcare Workplace, Katherine Counts

Theses and Dissertations--Community & Leadership Development

The racial and ethnic composition of the U.S. population is becoming increasingly more diverse. The 2010 U.S. Census reported a 29% increase in minority groups other than non-Hispanic Whites. In response to these changing demographics, healthcare organizations have struggled to keep pace with these trends in their hiring of a diverse staff. Healthcare leaders appear to be lagging in their efforts to make adequate changes to increase diversity in their organizations. What factors may be contributing to this inequity? One possible explanation is a limited knowledge of healthcare leaders regarding culture and diversity within the workplace. To this end, this …

Other People’S Families: How Social Ties Shape Entrance Into The Medical Profession, Lillian Sims

Theses and Dissertations--Educational Policy Studies and Evaluation

Not enough members of low-income, rural, and minoritized populations are successfully prepared for and recruited into medical school, exacerbating issues of unequal access to healthcare and limiting access to the profession. While a multitude of factors contribute to this problem, early social exposure to others in a field can act as a key contributor to career interest and a key advantage for entering the profession. Meanwhile, students without early social exposure to healthcare may take unconventional paths to medical school or may struggle to fit into the unique culture of medicine when they do enter training, especially if they belong …

Serving Culturally And Linguistic Students Identified With A Communication Disability In The K-12 Educational Environments, Lashell Dauterman

Theses and Dissertations

As more and more students enter public schools with culturally and linguistically diverse backgrounds that require services under the Individuals with Disabilities Education Act, facilitators must be more sensitive to the needs, especially in the area of communication. Augmentative and alternative communication devices and other assistive technology are required by law to be utilized with individuals identified as disabled. However, due to the challenges that exist in properly identifying and implementing intervention plans for children who require services as English language learners and special education, communication needs are often misidentified or not provided. Another issue that exists is the lack …

Identifying Strategies To Increase The Recruitment And Retention Of Minority Males In The Public Health Workforce: A Two-State Comparative Case Study Approach, Melicent R. Miller

Electronic Theses and Dissertations

Non-White males have higher rates of morbidity and mortality from chronic health conditions as compared to Whites. An essential element for achieving success in eliminating health disparities is to increase the presence of racial/ethnic minorities (i.e., people of color) within public health careers. One of the most important competencies for a public health professional is the ability to work in culturally and racially diverse populations. Yet, individuals are significantly more likely to receive their care and experience greater satisfaction from providers that are of the same racial or ethnic background. The racial/ethnic composition of the health professions workforce continues to …

Nursing Education For Lgbtq Patients: A Literature Review, Shelley A. Jones

Honors Undergraduate Theses

In the United States (US), lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are at an increased risk for contracting sexually transmitted infections, are less likely to receive recommended health screenings, are more likely to abuse alcohol and other substances, are at a higher risk for attempting suicide, and experience greater health disparities compared to their heterosexual counterparts. Compounding these health-related problems is a significant discrepancy whereby LGBTQ people have poor or no access to health care. One approach to correct the health disparities the LGBTQ community faces is through LGBTQ-specific health education for nursing students. A review of the …