DiversityNursing Blog

by Katrina Gravel

This past month, the George Washington University School of Nursing (GW) received a three-year, $1 million grant from the U.S. Health Resources and Services Administration to fund a program that aims to increase the diversity of nursing professionals, according to a press release from GW. The school’s Success in Nursing Education project focuses not only on drawing in African-American, Asian, Hispanic, and Native American students, but also male students and economically disadvantaged students from Washington, D.C., and rural Virginia. A report released by the U.S. Department of Health and Human Services (HHS) in September 2010 showed that men made up less than 10% of employed RNs licensed between 2000 and 2008, while non-white or Hispanic nurses represented only 16.8% of all registered nurses in 2008. While those percentages may have grown in years since the HHS survey, it is unlikely that the gap has become significantly smaller.

The lack of ethnic minorities, males, and economically disadvantaged nursing students does not reflect the immense diversity of the patients these students will soon be treating. As an article in GW’s student newspaper The GW Hatchet cites the school of nursing’s Dean Jean Johnson as saying, “the nursing workforce should reflect what the population at large looks like.”

GW will use the grant to launch a recruitment campaign to reach disadvantage students, as well as students who are changing careers. The program will offer both undergraduate and graduate degrees in nursing, and will utilize retention tools such as mentoring programs. The grant will also create scholarships and financial aid for some students, according to the GW press release.

Has your organization made efforts to diversify its staff? What are your thoughts on the GW program? Leave a comment and let us know!

By Anna Gorman, Los Angeles Times
August 22, 2012

Black and Latino children were more likely than white children to be obese, witness gun violence and ride in a car without a seat belt, according to a study released Wednesday.

The study, published in the New England Journal of Medicine, found wide ethnic and racial disparities in health behaviors among fifth-graders in Los Angeles, Houston and Birmingham, Ala.

“The disparities were pretty substantial across so many different health indicators,” said lead researcher Mark Schuster, a Harvard Medical School professor and chief of general pediatrics at Boston Children’s Hospital.  “The breadth of the findings was striking to us.”

The researchers examined 16 health behaviors, including cigarette smoking, alcohol use, exercise habits, terrorism fears, bike helmet use and psychological quality of life.

Many of the behaviors carry potential for lifelong health problems, Schuster said. For example, researchers found that obesity rates were twice as high among black and Latino children, placing those children at increased risk for diabetes and heart problems. Black children were also more likely to be bullied, smoke cigarettes and drink alcohol than white and Latino youths.

Parents’ education and income played a critical role in the disparities, according to the study. Researchers also found that schools had a huge influence on children’s behavior, and that there were differences among schools even in the same neighborhoods.

Researchers interviewed more than 5,000 fifth-graders and their parents between 2004 and 2006. Schuster said the team focused on 10- and 11-year-olds because there was already significant research and public awareness about risky behaviors among adolescents.

“Finding disparities this young suggests that we have to start young to try to address them,” he said. “There is a strong likelihood that these disparities will persist unless we intervene to change them.”

By definition...

Cultural competency is having specific cognitive and affective skills that are essential for building culturally relevant relationships between providers and patients. Obtaining cultural competency is an ongoing, lifetime process, not an endpoint. Becoming culturally competent requires continuous self-evaluation, skill development, and knowledge building about culturally diverse groups.

Healthcare disparities are inequalities in healthcare access, quality, and/or outcomes between groups. In the United States, these inequalities may be due to differences in care-seeking behaviors, cultural beliefs, health practices, linguistic barriers, degree of trust in healthcare providers, geographical access to care, insurance status, or ability to pay. Factors influencing these disparities include education, housing, nutrition, biological factors, economics, and sociopolitical power.

Models

Several models of cultural competency exist. In a model called The Process of Cultural Competence in the Delivery of Healthcare Services, by Campinha-Bacote, nurses are directed to ask themselves questions based on the five constructs-awareness, skill, knowledge, encounters, and desire (ASKED)-to determine their own cultural competency. According to this model, nurses need an awareness of their own cultural biases and prejudices, cultural knowledge, and assessment and communication skills. Nurses also need to be motivated to have encounters with culturally diverse groups. In its most recent form, this model suggests that these encounters are the pivotal key constructs in the process of developing cultural competency.

The Giger and Davidhizar Transcultural Assessment Model identifies six cultural phenomena nurses and other healthcare providers assess in their patients: biological variations, environmental control, time, social organization, space, and communication.

Staff should select a model that best fits your specific work setting and patient population.

Beware stereotypes

Taking it all in

You can gain helpful information by performing a cultural assessment and using a broad definition of culture that reflects the differences in healthcare besides race and ethnicity. These definitions include age, gender, disability, sexual orientation, immigration status, employment status, socioeconomic status, culture, and religion.

To avoid stereotyping, keep in mind that individuals within a particular group can vary in many respects. For example, among older adults, certain characteristics may be typical but some older adults may demonstrate attributes that differ from the group. Many believe that all older people resist the use of modern technology; however, many people who are elderly enjoy using smartphones, tablets, electronic readers, and other devices. These intracultural differences are important to consider; having group knowledge never justifies predicting behaviors of any individual members. As part of a cultural assessment, determine the specific values, beliefs, attitudes, and health needs of each patient. See Performing a cultural assessment for an example using the Giger and Davidhizar Transcultural Assessment Model.

In the United States, the healthcare system is a cultural entity with its own norms and values. Yet nurses may overlook a facility's institutional culture when they consider the impact culture has on patients' healthcare access and outcomes. Both organizational and hospital unit culture play a role in determining the quality of care a patient receives. When you can determine what interpersonal or institutional barriers exist within a particular institution, clinic, or community setting, you're better able to assist your patients in overcoming them to achieve better healthcare outcomes.

Goals and Considerations of cultural competency

How do you know whether you're providing culturally competent care? Some believe that they've reached the goal of cultural competency as they gain new knowledge or skills, or have encounters with culturally diverse groups. But while providers may meet goals, there is always room for improvement. Helpful questions and considerations when determining cultural competency include:

* What does being culturally competent mean to me and the patients I serve?

* Which cultural competency model and/or assessment tool is most useful to me, given my patient population?

* As I gain cultural knowledge and skills, how can I use that knowledge to improve my patients' healthcare outcomes and assist in reducing healthcare disparities for underserved populations?

* Did the patient demonstrate an understanding of what I was trying to convey or teach?

* What can I do to improve the quality of care I deliver to members of this group?

New CDC Campaign Aims to Stem HIV Crisis among Black Women

To combat the high toll of HIV and AIDS among black women in the United States, the Centers for Disease Control and Prevention today launched Take Charge. Take the Test., a new campaign to increase HIV testing and awareness among African-American women. The campaign – which features advertising, a website and community outreach – is being launched in conjunction with National Women and Girls HIV/AIDS Awareness Day in 10 cities where black women are especially hard-hit by the disease.

“At current rates, nearly 1 in 30 African-American women will be diagnosed with HIV in their lifetimes,” said Kevin Fenton, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. “To help reduce this toll we are working to remind black women that they have the power to learn their HIV status, protect themselves from this disease, and take charge of their health.”

The program is being launched in Atlanta; Chicago; Detroit; Fort Lauderdale, Fla.; Houston; Memphis, Tenn.; Newark, N.J.; New Orleans; Hyattsville, Md.; and St. Louis.

Take Charge. Take the Test. is part of CDC’s commitment to address the urgent HIV prevention needs of African-American women, who are far more heavily affected by HIV and AIDS than women of any other race or ethnicity in the United States. African-American women account for nearly 60 percent of all new HIV infections among women (and 13 percent of new infections overall). The rate of new infections among black women is 15 times higher than among white women.

The campaign emphasizes the importance of HIV testing as a gateway to peace of mind and better health. Campaign messages will reach black women through a variety of highly visible channels, including outdoor and transit advertising; radio ads; posters and handouts distributed in salons, stores, community organizations, and other venues; campaign ads and materials on health department and partner websites; and a dedicated campaign website,http://hivtest.org/takecharge, where women can find HIV testing locations in their communities.

In addition to promoting HIV testing, the campaign encourages African-American women to talk openly with their partners about HIV and insist on safe sex, and to bring these same messages to other women in social settings, workplaces, living rooms, and religious congregations.

Take Charge. Take the Test. reflects a strong partnership between CDC, health departments, and local organizations in the 10 participating cities, which worked together to develop local campaigns for the communities they serve. The campaign was initially piloted in Cleveland and Philadelphia, where Take Charge. Take the Test. community events were attended by nearly 10,000 women, and campaign messages were seen more than 100 million times.

“We hope to extend the reach of this campaign to multiple cities throughout the nation, help empower many more women to take control of their health, and help break the silence about HIV in their communities,” said Jonathan Mermin, M.D., director of CDC’s Division of HIV/AIDS Prevention (DHAP).

Research shows that black women are no more likely than women of other races to engage in risky behaviors. But a range of social and environmental factors put them at greater risk for HIV infection. These include higher prevalence of HIV and other sexually transmitted infections in some black communities, which increase the likelihood of infection with each sexual encounter. Limited access to health care can prevent women from getting HIV tested. Research also shows that financial dependence on male partners may limit some women’s ability to negotiate safe sex. HIV stigma, far too prevalent in all communities, may also discourage black women from seeking HIV testing.

“This campaign is just one part of the solution,” said Donna Hubbard McCree, Ph.D., associate director for health equity at DHAP. “All of us have a role to play in stopping the spread of HIV among black women – by talking to our sisters, daughters, husbands, and boyfriends about how to protect ourselves against HIV and the importance of getting tested; by speaking out against stigma; and by tackling the social inequities that place so many of us at risk for HIV.”

Take Charge. Take the Test. is the latest campaign of CDC’s Act Against AIDS initiative (http://actagainstaids.org) a five-year, $45 million national communication campaign to combat complacency about the HIV/AIDS crisis in the United States. The campaign also directly addresses the goals of the National HIV/AIDS Strategy, which calls for reducing new infections, intensifying HIV prevention efforts in communities in which HIV is most heavily concentrated, and reducing HIV-related deaths in communities at high risk for HIV infection. Other Act Against AIDS campaigns include those targeting high-risk populations such as gay and bisexual men, as well as efforts to reach health care providers and the general public.

from The CDC   

What do you think? How will the CDC Campaign work? Will it be effective? Shoot off in the comments!

Many researchers have studied patient--provider communication and documented the tensions and misunderstandings often seen in this important process. But these concerns are far greater when the patients are minorities or don't understand English well, and when healthcare providers aren't equipped to explain the intricacies of care to people whose cultural beliefs may make American medicine a mystery.

Award-winning filmmakers Maren Grainger-Monsen, M.D., and Julia Haslett explore these issues in a series of films called Worlds Apart, which document the experiences of minority Americans and patients from other countries in the U.S. health care system. This unique project, made with partial support from The Commonwealth Fund, dramatizes communication between patients and their doctors, tensions between modern medicine and cultural beliefs, and the ongoing burdens of racial and ethnic discrimination.

In this film, Alicia Mercado, a 60-year-old Puerto Rican woman, struggles to keep up with her chronic diabetes, hypertension, and asthma after being evicted from her apartment and suffering depression.

For more information on these films, please visit The Commonwealth Fund website at www.cmwf.org

Want to Learn More?

• Civil Rights Memorial Center Located in historic Montgomery, Ala., across the street from Southern Poverty Law Center, the center offers images of iconic civil-rights leaders, a 56-seat theater and the Wall of Tolerance, where visitors pledge to take a stand against hate by entering their names on an interactive wall.
• DuSable Museum of African American History This Chicago museum has been dedicated to the collection, preservation, interpretation and dissemination of the history and culture of Africans and Black Americans for more than 46 years.
• Hampton University Museum & Archives Located on the grounds of Hampton University campus, the museum, which was founded in 1868, is one of the oldest in Virginia. It features more than 9,000 objects, including African American fine arts, traditional African, Native American, Native Hawaiian, Pacific Island, and Asian art.
• Idaho Black History Museum Housed in St. Paul Baptist Church in Boise, one of the oldest buildings constructed by Idaho Blacks, the museum presents exhibits and educational outreach, including workshops, literacy programs and music.
• International Civil Rights Center & Museum This newly opened exhibit and teaching facility, located in the historic F.W. Woolworth building in Greensboro, N.C., where four N.C. A&T freshmen set off a nonviolent sit-in 50 years ago, is a recreation of what the segregated South was like during the civil-rights movement. 
• Museum of African American History in Boston Based in an African Meeting House, the oldest U.S. church built by free Blacks in 1806 has recently been restored, thanks largely to sponsorship from Walmart Foundation. It features stories of Blacks from 1638 through the Civil War.
• NAACP Interactive Historical Timeline Funded through a $500,000 grant from the Verizon Foundation, this newly launched online learning tool from the NAACP offers major milestones in Black history, biographies of legendary leaders in Black history and other educational resources. Verizon Communications is No. 22 in the 2011 DiversityInc Top 50.
• Smithsonian National Museum of African American History & Culture Although the museum is currently being built on the National Mall in the District of Columbia, not far from what were once slave markets called “Robey’s Den,” a gallery can be found on the second floor of the National Museum of American History. And thanks to a $1-million grant of technology and expertise from IBM (No. 7), you can take a virtual tour at nmaahc.si.edu.

VIDEOS

1. DiversityInc CEO Luke Visconti and National Civil Rights Museum President Beverly Robertson
2. Charles H. Wright Museum of African American History
3. African American History Museum in Boston
4. Smithsonian National Museum of African American History series
5. National Underground Railroad Freedom Center

COLLATERAL MATERIAL

• PricewaterhouseCoopers: 10 Minutes on Managing Diversity
• PricewaterhouseCoopers: Confronting the Issue brochure
• PricewaterhouseCoopers: Impact fact sheet
• PricewaterhouseCoopers: Why Diversity Why Now
• WellPoint’s Black History Month poster

The following is a Diversity Statement written and signed by numerous colleges and universities and taken from the University of Virginia's website for their Office of African American Affairs. It provides good insight into the value that diversity adds in higher education, which almost always applies to professions, like nursing, as well.

On the Importance of Diversity in Higher Education

America's colleges and universities differ in many ways. Some are public, others are independent; some are large urban universities, some are two-year community colleges, others small rural campuses. Some offer graduate and professional programs, others focus primarily on undergraduate education. Each of our more than 3,000 colleges and universities has its own specific and distinct mission. This collective diversity among institutions is one of the great strengths of America's higher education system, and has helped make it the best in the world. Preserving that diversity is essential if we hope to serve the needs of our democratic society.

Similarly, many colleges and universities share a common belief, born of experience, that diversity in their student bodies, faculties, and staff is important for them to fulfill their primary mission: providing a quality education. The public is entitled to know why these institutions believe so strongly that racial and ethnic diversity should be one factor among the many considered in admissions and hiring. The reasons include:

Diversity enriches the educational experience. We learn from those whose experiences, beliefs, and perspectives are different from our own, and these lessons can be taught best in a richly diverse intellectual and social environment.

It promotes personal growth and a healthy society. Diversity challenges stereotyped preconceptions; it encourages critical thinking; and it helps students learn to communicate effectively with people of varied backgrounds. 
It strengthens communities and the workplace. Education within a diverse setting prepares students to become good citizens in an increasingly complex, pluralistic society; it fosters mutual respect and teamwork; and it helps build communities whose members are judged by the quality of their character and their contributions. 
It enhances America's economic competitiveness. Sustaining the nation's prosperity in the 21st century will require us to make effective use of the talents and abilities of all our citizens, in work settings that bring together individuals from diverse backgrounds and cultures.

American colleges and universities traditionally have enjoyed significant latitude in fulfilling their missions. Americans have understood that there is no single model of a good college, and that no single standard can predict with certainty the lifetime contribution of a teacher or a student. Yet the freedom to determine who shall teach and be taught has been restricted in a number of places, and come under attack in others. As a result, some schools have experienced precipitous declines in the enrolment of African-American and Hispanic students, reversing decades of progress in the effort to assure that all groups in American society have an equal opportunity for access to higher education.

Achieving diversity on college campuses does not require quotas. Nor does diversity warrant admission of unqualified applicants. However, the diversity we seek, and the future of the nation, do require that colleges and universities continue to be able to reach out and make a conscious effort to build healthy and diverse learning environments appropriate for their missions. The success of higher education and the strength of our democracy depend on it.

By MICHELLE T. JOHNSON
http://michelletjohnson.com
Special writer to The Kansas City Star

September is Hispanic Heritage Month, which makes me realize how little reliable information — vs. stereotypes and inaccuracies — there is about Hispanics in the workplace.

Unfortunately, what pops into the minds of many when they think about Hispanics in the workplace is “illegal immigrants.” I’ve heard far too many people who should know better make that assumption.

This in part comes about because of what people see on television and the Internet, and because we tend to turn bits of anecdotal evidence into something we “know.”

In truth, Americans of Hispanic descent grapple with the same issues as any other group in the workforce — and like many groups battling stereotypes, their challenges are often greater than average.

For example, a recent study found that Hispanic workers were twice as likely to hold administrative or clerical entry-level jobs as “nondiverse workers,” which the study defined as white males who were not disabled, gay or transgender.

The study also found that 51 percent of the Hispanic workers surveyed were likely to be making less than $50,000 a year, compared with 31 percent for the non-diverse workers.

In terms of demographics, Hispanics have long since passed African-Americans as the largest U.S. ethnic minority, with 50 percent population growth in the last decade alone. And the most recent news is that Hispanics are the largest ethnic minority enrolled in college.

My longtime friend Mary D. Padilla says that one of the biggest misconceptions she thinks people have about Hispanics, especially in the workforce, is that they are all Mexican or of Mexican descent.

An estimated 63 percent of U.S. Hispanics are of Mexican descent, so that leaves more than a third who are not.

Diversity is about the distinctions and not just the differences. Details matter. Different groups have different cultural norms, different histories and different worldviews.

Hispanic Heritage Month is meant to remind us of that — it’s more than just having a fiesta with a feast in the lunchroom. We should recognize, celebrate and become educated about a big segment of our workforce.

Read more: http://www.kansascity.com/2011/09/05/3122994/assumptions-hurt-hispanic-workforce.html