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Nonmedical Transdisciplinary Perspectives of Black and Racially and Ethnically Diverse Individuals About Antiracism Practices: A Qualitative Study

IMPORTANCE: Overwhelming evidence that anti-Black racism is associated with health inequities is driving clinician demand for antiracism practices that promote health equity. OBJECTIVE: To investigate how nonmedical professionals address personally mediated, institutional, and internalized racism an...

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Autores principales: Shankar, Megha, Cox, Joy, Baratta, Juliana, De Leon, Gisselle, Shaw, Jonathan G., Israni, Sonoo Thadaney, Zulman, Donna M., Brown-Johnson, Cati G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8829657/
https://www.ncbi.nlm.nih.gov/pubmed/35138395
http://dx.doi.org/10.1001/jamanetworkopen.2021.47835
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author Shankar, Megha
Cox, Joy
Baratta, Juliana
De Leon, Gisselle
Shaw, Jonathan G.
Israni, Sonoo Thadaney
Zulman, Donna M.
Brown-Johnson, Cati G.
author_facet Shankar, Megha
Cox, Joy
Baratta, Juliana
De Leon, Gisselle
Shaw, Jonathan G.
Israni, Sonoo Thadaney
Zulman, Donna M.
Brown-Johnson, Cati G.
author_sort Shankar, Megha
collection PubMed
description IMPORTANCE: Overwhelming evidence that anti-Black racism is associated with health inequities is driving clinician demand for antiracism practices that promote health equity. OBJECTIVE: To investigate how nonmedical professionals address personally mediated, institutional, and internalized racism and to adapt these practices for the clinical setting. DESIGN, SETTING, AND PARTICIPANTS: Using an approach from human-centered design for this qualitative study, virtual qualitative interviews were conducted among 40 professionals from nonmedical fields to investigate antiracism practices used outside of medicine. Inductive thematic analysis was conducted to identify latent themes and practices that may be adaptable to health care, subsequently using an established theoretical framework describing levels of racism to interpret and organize themes. Convenience and purposive sampling was used to recruit participants via email, social media, and electronic flyers. MAIN OUTCOMES AND MEASURES: Antiracism practices adapted to medicine. RESULTS: Among 40 professionals from nonmedical fields, most were younger than age 40 years (23 individuals [57.5%]) and there were 20 (50.0%) women; there were 25 Black or African American individuals (62.5%); 4 East Asian, Southeast Asian, or South Asian individuals (10.0%); 3 individuals with Hispanic, Latinx, or Spanish origin (7.5%); and 3 White individuals. Participants described personally mediated, institutional, and internalized antiracism practices that may be adaptable to promote health equity for Black patients. Personally mediated antiracism practices included dialogue and humble inquiry, building trust, and allyship and shared humanity; clinicians may be able to adopt these practices by focusing on patient successes, avoiding stigmatizing language in the electronic health record, and using specific phrases to address racism in the moment. Institutional antiracism practices included education, representation, and mentorship; in the health care setting, clinics may be able to develop staff affiliate groups, focus on improving racial health equity outcomes, and conduct antiracism trainings. Internalized antiracism practices centered on authenticity; clinicians may be able to write positionality statements reflecting their identity and the expertise they bring to clinical encounters. CONCLUSIONS AND RELEVANCE: This study’s findings suggest that antiracism practices from outside the health care sector may offer innovative strategies to promote health equity by addressing personally mediated, institutional, and internalized racism in clinical care.
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spelling pubmed-88296572022-02-18 Nonmedical Transdisciplinary Perspectives of Black and Racially and Ethnically Diverse Individuals About Antiracism Practices: A Qualitative Study Shankar, Megha Cox, Joy Baratta, Juliana De Leon, Gisselle Shaw, Jonathan G. Israni, Sonoo Thadaney Zulman, Donna M. Brown-Johnson, Cati G. JAMA Netw Open Original Investigation IMPORTANCE: Overwhelming evidence that anti-Black racism is associated with health inequities is driving clinician demand for antiracism practices that promote health equity. OBJECTIVE: To investigate how nonmedical professionals address personally mediated, institutional, and internalized racism and to adapt these practices for the clinical setting. DESIGN, SETTING, AND PARTICIPANTS: Using an approach from human-centered design for this qualitative study, virtual qualitative interviews were conducted among 40 professionals from nonmedical fields to investigate antiracism practices used outside of medicine. Inductive thematic analysis was conducted to identify latent themes and practices that may be adaptable to health care, subsequently using an established theoretical framework describing levels of racism to interpret and organize themes. Convenience and purposive sampling was used to recruit participants via email, social media, and electronic flyers. MAIN OUTCOMES AND MEASURES: Antiracism practices adapted to medicine. RESULTS: Among 40 professionals from nonmedical fields, most were younger than age 40 years (23 individuals [57.5%]) and there were 20 (50.0%) women; there were 25 Black or African American individuals (62.5%); 4 East Asian, Southeast Asian, or South Asian individuals (10.0%); 3 individuals with Hispanic, Latinx, or Spanish origin (7.5%); and 3 White individuals. Participants described personally mediated, institutional, and internalized antiracism practices that may be adaptable to promote health equity for Black patients. Personally mediated antiracism practices included dialogue and humble inquiry, building trust, and allyship and shared humanity; clinicians may be able to adopt these practices by focusing on patient successes, avoiding stigmatizing language in the electronic health record, and using specific phrases to address racism in the moment. Institutional antiracism practices included education, representation, and mentorship; in the health care setting, clinics may be able to develop staff affiliate groups, focus on improving racial health equity outcomes, and conduct antiracism trainings. Internalized antiracism practices centered on authenticity; clinicians may be able to write positionality statements reflecting their identity and the expertise they bring to clinical encounters. CONCLUSIONS AND RELEVANCE: This study’s findings suggest that antiracism practices from outside the health care sector may offer innovative strategies to promote health equity by addressing personally mediated, institutional, and internalized racism in clinical care. American Medical Association 2022-02-09 /pmc/articles/PMC8829657/ /pubmed/35138395 http://dx.doi.org/10.1001/jamanetworkopen.2021.47835 Text en Copyright 2022 Shankar M et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Shankar, Megha
Cox, Joy
Baratta, Juliana
De Leon, Gisselle
Shaw, Jonathan G.
Israni, Sonoo Thadaney
Zulman, Donna M.
Brown-Johnson, Cati G.
Nonmedical Transdisciplinary Perspectives of Black and Racially and Ethnically Diverse Individuals About Antiracism Practices: A Qualitative Study
title Nonmedical Transdisciplinary Perspectives of Black and Racially and Ethnically Diverse Individuals About Antiracism Practices: A Qualitative Study
title_full Nonmedical Transdisciplinary Perspectives of Black and Racially and Ethnically Diverse Individuals About Antiracism Practices: A Qualitative Study
title_fullStr Nonmedical Transdisciplinary Perspectives of Black and Racially and Ethnically Diverse Individuals About Antiracism Practices: A Qualitative Study
title_full_unstemmed Nonmedical Transdisciplinary Perspectives of Black and Racially and Ethnically Diverse Individuals About Antiracism Practices: A Qualitative Study
title_short Nonmedical Transdisciplinary Perspectives of Black and Racially and Ethnically Diverse Individuals About Antiracism Practices: A Qualitative Study
title_sort nonmedical transdisciplinary perspectives of black and racially and ethnically diverse individuals about antiracism practices: a qualitative study
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8829657/
https://www.ncbi.nlm.nih.gov/pubmed/35138395
http://dx.doi.org/10.1001/jamanetworkopen.2021.47835
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