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Cheng SM, McKinney CC, Hurtado-de-Mendoza A, Chan S, Graves KD. Confidence, Connection & Collaboration: Creating a Scalable Bias Reduction Improvement Coaching Train-the-Trainer Program to Mitigate Implicit Bias across a Medical Center. TEACHING AND LEARNING IN MEDICINE 2024; 36:381-398. [PMID: 37074228 DOI: 10.1080/10401334.2023.2201289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 03/08/2023] [Indexed: 05/03/2023]
Abstract
Problem: Academic medical centers need to mitigate the negative effects of implicit bias with approaches that are empirically-based, scalable, sustainable, and specific to departmental needs. Guided by Kotter's Model of Change to create and sustain cultural change, we developed the Bias Reduction Improvement Coaching Program (BRIC), a two-year, train-the-trainer implicit bias coaching program designed to meet the increasing demand for bias training across a university medical center. Intervention: BRIC trained a cohort of faculty and staff as coaches during four quarterly training sessions in Year 1 that covered 1) the science of bias, 2) bias in selection and hiring, 3) bias in mentoring, and 4) bias in promotion, retention, and workplace culture. In Year 2, coaches attended two booster sessions and delivered at least two presentations. BRIC raises awareness of bias mitigation strategies in a scalable way by uniquely building capacity through department-level champions, providing programming that addresses the 'local context,' and setting a foundation for sustained institutional change. Context: In a U.S. academic medical center, 27 faculty and staff from 24 departments were trained as inaugural BRIC coaches. We assessed outcomes at multiple levels: BRIC coach outcomes (feedback on the training sessions; coach knowledge, attitudes, and skills), departmental-level outcomes (program attendee feedback, knowledge, and intentions) and institutional outcomes (activities to sustain change). Impact: After Year 1, coaches reported high satisfaction with BRIC and a statistically significant increase in self-efficacy in their abilities to recognize, mitigate, and teach about implicit bias. In Year 2, attendees at BRIC coach presentations reported an increase in bias mitigation knowledge, and the majority committed to taking follow-up action (e.g., taking an Implicit Association Test). Coaches also launched activities for sustaining change at the broader university and beyond. Lessons Learned: The BRIC Program indicates a high level of interest in receiving bias mitigation training, both among individuals who applied to be BRIC coaches and among presentation attendees. BRIC's initial success supports future expansion. The model appears scalable and sustainable; future efforts will formalize the emerging community of practice around bias mitigation and measure elements of on-going institutional culture change.
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Affiliation(s)
- Susan M Cheng
- Department of Family Medicine, Senior Associate Dean for Diversity, Equity, and Inclusion, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Caleb C McKinney
- Department of Rehabilitation Medicine, Graduate and Postdoctoral Training & Development, Biomedical Graduate Education, Georgetown University Medical Center, Washington, District of Columbia
| | | | - Samuel Chan
- Office of Diversity, Equity & Inclusion, Georgetown School of Medicine, Washington, District of Columbia, USA
| | - Kristi D Graves
- Department of Oncology and Associate Dean for Faculty Development, Georgetown University Medical Center, Washington, District of Columbia, USA
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Hill Weller L, Rubinsky AD, Shade SB, Liu F, Cheng I, Lopez G, Robertson A, Smith J, Dang K, Leiva C, Rubin S, Martinez SM, Bibbins-Domingo K, Morris MD. Lessons learned from implementing a diversity, equity, and inclusion curriculum for health research professionals at a large academic research institution. J Clin Transl Sci 2024; 8:e22. [PMID: 38384906 PMCID: PMC10879992 DOI: 10.1017/cts.2024.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/12/2023] [Accepted: 01/03/2024] [Indexed: 02/23/2024] Open
Abstract
Objective Despite advances in incorporating diversity and structural competency into medical education curriculum, there is limited curriculum for public health research professionals. We developed and implemented a four-part diversity, equity, and inclusion (DEI) training series tailored for academic health research professionals to increase foundational knowledge of core diversity concepts and improve skills. Methods We analyzed close- and open-ended attendee survey data to evaluate within- and between-session changes in DEI knowledge and perceived skills. Results Over the four sessions, workshop attendance ranged from 45 to 82 attendees from our 250-person academic department and represented a mix of staff (64%), faculty (25%), and trainees (11%). Most identified as female (74%), 28% as a member of an underrepresented racial and ethnic minority (URM) group, and 17% as LGBTQI. During all four sessions, attendees increased their level of DEI knowledge, and within sessions two through four, attendees' perception of DEI skills increased. We observed increased situational DEI awareness as higher proportions of attendees noted disparities in mentoring and opportunities for advancement/promotion. An increase in a perceived lack of DEI in the workplace as a problem was observed; but only statistically significant among URM attendees. Discussion Developing applied curricula yielded measurable improvements in knowledge and skills for a diverse health research department of faculty, staff, and students. Nesting this training within a more extensive program of departmental activities to improve climate and address systematic exclusion likely contributed to the series' success. Additional research is underway to understand the series' longer-term impact on applying skills for behavior change.
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Affiliation(s)
- LaMisha Hill Weller
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
- Office of Diversity and Outreach, University of California, San Francisco, CA, USA
| | - Anna D. Rubinsky
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Starley B. Shade
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Felix Liu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Georgina Lopez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Asha Robertson
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Jennifer Smith
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Kristina Dang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Christian Leiva
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Susan Rubin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Suzanna M. Martinez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Meghan D. Morris
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
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Polston PM, Matthews DD, Golden SD, Golin CE, Hall MG, Saint-Phard E, Lightfoot AF. Institutional Reform to Promote Antiracism: A Tool for Developing an Organizational Equity Action and Accountability Plan. Prev Chronic Dis 2023; 20:E50. [PMID: 37319342 DOI: 10.5888/pcd20.220368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
Racism is a public health problem. Systems, structures, policies, and practices perpetuate a culture built on racism. Institutional reform is needed to promote antiracism. This article describes 1) a tool used to develop an equity action and accountability plan (EAAP) that promotes antiracism in the Department of Health Behavior at the University of North Carolina at Chapel Hill's Gillings School of Global Public Health, 2) strategies that were developed, and 3) short-term outcomes and lessons learned. A study coordinator, not affiliated with the Department of Health Behavior, was hired to collect qualitative data that documented the lived experiences of students and alumni of color (ie, racial and ethnic minority students) over time in the department. Seeking action from faculty and departmental leadership, students engaged in collective organizing covered the department chair's office door with notes describing microaggressions, and visited faculty one-on-one to demand action. In response, 6 faculty members volunteered to form the Equity Task Force (ETF) to explicitly address students' concerns. The ETF identified priority areas for action based on 2 student-led reports, gathered resources from other institutions and the public health literature, and examined departmental policies and procedures. The ETF drafted the EAAP, solicited feedback, and revised it according to 6 priority strategies with actionable steps: 1) transform culture and climate, 2) enhance teaching, mentoring, and training, 3) revisit performance and evaluation of faculty and staff, 4) strengthen recruitment and retention of faculty of color, 5) increase transparency in student hiring practices and financial resources, and 6) improve equity-oriented research practices. This planning tool and process can be used by other institutions to achieve antiracist reform.
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Affiliation(s)
- Patsy M Polston
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
- Rosenau Hall, Room 302, Campus Box 7440, 135 Dauer Dr, Chapel Hill, NC 27599-7440
| | - Derrick D Matthews
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Shelley D Golden
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill
| | - Carol E Golin
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill
- Carolina Population Center, University of North Carolina at Chapel Hill
| | - Emmanuel Saint-Phard
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Alexandra F Lightfoot
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
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de la Rocha P, Sudhinaraset M, Jones NV, Kim C, Cabral A, Amani B. A Qualitative Analysis on Sexual and Reproductive Health Needs and Issues During COVID-19 Using a Reproductive Justice Framework. Ethn Dis 2022; 32:357-372. [PMID: 36388866 PMCID: PMC9590595 DOI: 10.18865/ed.32.4.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The COVID-19 pandemic exacerbated existing health inequities, further exposing the challenges in meeting the sexual and reproductive health (SRH) needs, particularly for Black, Indigenous and People of Color (BIPOC). We interviewed 11 key informants through three focus groups to explore barriers and pathways to SRH care for BIPOC during COVID-19 in the United States. Reimagining reproductive health practices requires holistic practices and multisector pathways, a comprehensive reproductive justice approach. This includes interventions across the sexual and reproductive health continuum. Using a deductive-dominant approach grounded in reproductive justice values, we explore themes around SRH during COVID-19. Five themes for advancing reproductive justice were identified: "supremacy of birth"; police violence as a determinant of SR mental health; addressing quality of care outside of hospital settings; digital redlining; and centering joy, liberation, and humanity.
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Affiliation(s)
- Patanjali de la Rocha
- Department of Global Health, University of Washington, Seattle, WA, Address correspondence to Patanjali de la Rocha MSW, MPH; Charles Drew University & UCLA COVID-19 Task Force on Racism and Equity;
| | - May Sudhinaraset
- Fielding School of Public Health, University of California, Los Angeles, CA
| | - Nicole V. Jones
- Fielding School of Public Health, University of California, Los Angeles, CA
| | - Catherine Kim
- Fielding School of Public Health, University of California, Los Angeles, CA
| | - Alejandra Cabral
- Fielding School of Public Health, University of California, Los Angeles, CA
| | - Bita Amani
- Charles R. Drew University of Medicine and Science, Los Angeles, CA
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Manalo-Pedro E, Mackey A, Banawa RA, Apostol NJL, Aguiling W, Aguilar A, Oronce CIA, Sabado-Liwag MD, Yee MD, Taggueg R, Bacong AM, Ponce NA. Learning to love ourselves again: Organizing Filipinx/a/o scholar-activists as antiracist public health praxis. Front Public Health 2022; 10:958654. [PMID: 36062092 PMCID: PMC9437515 DOI: 10.3389/fpubh.2022.958654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/02/2022] [Indexed: 01/24/2023] Open
Abstract
A critical component for health equity lies in the inclusion of structurally excluded voices, such as Filipina/x/o Americans (FilAms). Because filam invisibility is normalized, denaturalizing these conditions requires reimagining power relations regarding whose experiences are documented, whose perspectives are legitimized, and whose strategies are supported. in this community case study, we describe our efforts to organize a multidisciplinary, multigenerational, community-driven collaboration for FilAm community wellness. Catalyzed by the disproportionate burden of deaths among FilAm healthcare workers at the onset of the COVID-19 pandemic and the accompanying silence from mainstream public health leaders, we formed the Filipinx/a/o Community Health Association (FilCHA). FilCHA is a counterspace where students, faculty, clinicians, and community leaders across the nation could collectively organize to resist our erasure. By building a virtual, intellectual community that centers our voices, FilCHA shifts power through partnerships in which people who directly experience the conditions that cause inequities have leadership roles and avenues to share their perspectives. We used Pinayism to guide our study of FilCHA, not just for the current crisis State-side, but through a multigenerational, transnational understanding of what knowledges have been taken from us and our ancestors. By naming our collective pain, building a counterspace for love of the community, and generating reflections for our communities, we work toward shared liberation. Harnessing the collective power of researchers as truth seekers and organizers as community builders in affirming spaces for holistic community wellbeing is love in action. This moment demands that we explicitly name love as essential to antiracist public health praxis.
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Affiliation(s)
- Erin Manalo-Pedro
- Data and Research Committee, Filipinx/a/o Community Health Association, Los Angeles, CA, United States
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Andrea Mackey
- Data and Research Committee, Filipinx/a/o Community Health Association, Los Angeles, CA, United States
| | - Rachel A. Banawa
- Data and Research Committee, Filipinx/a/o Community Health Association, Los Angeles, CA, United States
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
- UCLA Center for Health Policy Research, Los Angeles, CA, United States
| | - Neille John L. Apostol
- Data and Research Committee, Filipinx/a/o Community Health Association, Los Angeles, CA, United States
| | - Warren Aguiling
- Data and Research Committee, Filipinx/a/o Community Health Association, Los Angeles, CA, United States
- Division of General Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Arleah Aguilar
- Data and Research Committee, Filipinx/a/o Community Health Association, Los Angeles, CA, United States
| | - Carlos Irwin A. Oronce
- Data and Research Committee, Filipinx/a/o Community Health Association, Los Angeles, CA, United States
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
- VA Advanced HSR Fellowship, Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Melanie D. Sabado-Liwag
- Data and Research Committee, Filipinx/a/o Community Health Association, Los Angeles, CA, United States
- Department of Public Health, California State University, Los Angeles, Los Angeles, CA, United States
| | - Megan D. Yee
- Data and Research Committee, Filipinx/a/o Community Health Association, Los Angeles, CA, United States
- Medical College of Wisconsin, Milwaukee, WI, United States
| | - Roy Taggueg
- Data and Research Committee, Filipinx/a/o Community Health Association, Los Angeles, CA, United States
- Bulosan Center, University of California, Davis, Davis, CA, United States
| | - Adrian M. Bacong
- Data and Research Committee, Filipinx/a/o Community Health Association, Los Angeles, CA, United States
- Stanford University Center for Asian Health Research and Education, Palo Alto, CA, United States
| | - Ninez A. Ponce
- Data and Research Committee, Filipinx/a/o Community Health Association, Los Angeles, CA, United States
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
- UCLA Center for Health Policy Research, Los Angeles, CA, United States
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Cerceo E, Zimmerman M, DeLisser HM. Diversity, Equity, and Inclusion: Moving from Performance to Transformation Through the Arts and Humanities. J Gen Intern Med 2022; 37:944-946. [PMID: 34993859 PMCID: PMC8904695 DOI: 10.1007/s11606-021-07225-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 10/19/2021] [Indexed: 11/26/2022]
Abstract
Effective engagement on issues of diversity, equity, and inclusion (DEI) requires activities that promote deep introspection and group conversations that serve to complement and build upon formal DEI presentations. The arts and humanities by their nature allow for intentional and sustained reflection and have the potential to be transformative of thinking. We therefore propose that the next phase of institutional pro-equity/anti-racism efforts includes arts- and humanities-based initiatives to facilitate reflection and that serve to complement and build upon formal DEI didactic presentations, implicit bias workshops, and anti-racism training.
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Affiliation(s)
- Elizabeth Cerceo
- Department of Hospital Medicine, Cooper Medical School of Rowan University, Cooper University Healthcare, Camden, NJ, USA.
| | | | - Horace M DeLisser
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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