Distributed mixed reality learning environments for interactive public health education

Understanding a concept that people cannot observe directly in real life is always challenging in education. It could be even more difficult for public health education topics such as viruses or bacteria. However, public health education is critical for understanding the knowledge of the virus in the age of COVID-19. Thus, this paper proposes a distributed mixed reality environment to enhance public health education in the internet of things (IoT) context. We introduce the design methodology based on the mixed reality interaction characteristics, the implementation, and the initial evaluation. © 2023 Author(s).

The Institute of Medicine's call to action revisited: assuring access to public health education for U.S. college students.

The Educated Citizen and Public Health initiative promotes that an understanding of public health issues is a principal component of an educated population and is necessary to develop social responsibility and promote civic dialog. This initiative supports the Institute of Medicine's (now the National Academy of Medicine) recommendation that "all undergraduates should have access to education in public health." The purpose of our work is to examine the extent to which 2- and 4-year U.S. state colleges and universities offer and/or require a public health course. Select indicators identified include the presence and type of public health curriculum, public health course requirement, presence of public health graduate program offering, pathways to public health, Community Health Worker training, as well as demographic information for each institution. An analysis was also conducted for the historically Black colleges and universities (HBCUs), and the same select indicators were examined. The data suggest that there is an imperative need for a public health curriculum across the nation's collegiate institutions with 26% of 4-year state institutions lacking a full undergraduate public health curriculum; 54% of 2-year colleges not offering a pathway to public health education; and 74% of HBCUs not offering a public health course or degree. In the age of COVID-19, syndemics, and considering the post-pandemic phase, we argue that expanding public health literacy at the associate and baccalaureate level can help prepare an educated citizenry who is both public health literate and one that can demonstrate resilience in the face of public health challenges.

Health Outcomes, Food Accessibility, and the Social Determinants of Health: Visualizing Disparities in South Carolina Using an Active Learning Approach With Interactive Dashboards

The COVID-19 pandemic created mass disruptions throughout the world that continue to reverberate today. Among those are increasing demands for how public health information is delivered and consumed. Interactive dashboards such as the iconic Johns Hopkins University Center for Systems Science and Engineering dashboard have become a staple of the pandemic. Today, public health departments in all 50 states, many universities, school systems, and cities maintain active COVID-19 dashboards driving demand for those with skills and expertise to create new and innovative solutions to communicate critical public health information. This article describes a data visualization curriculum, learning objectives, and course activities using an active learning approach in a fully online, asynchronous undergraduate setting. The activities utilize publicly available data whereby students assemble the requisite data and develop an interactive dashboard in Tableau to analyze the intersection of food accessibility, the social determinants of health, and health outcomes in select South Carolina counties. The lesson resulted in an improved student understanding of the factors associated with dietary-related illness while enhancing data literacy and dashboard design skills. © 2023 Society for Public Health Education.

Telemedicine Management in Public Health Education at Bitung City Health Office

Objective:This study seeks to examine the planning, implementation, and assessment of Telemedicine Services in Public HealthEducation in the city of Bitung. Method(s): This study is qualitative in nature. This research was conducted at the Bitung City Health Office. This study's data source comprises of two types of sources: primary and secondary data sources. Result(s):The results indicated that the Planning of Telemedicine Services in Public Health Education in Bitung City begins with the preparation of human resources, including both resource individuals (Medical/Paramedic) and IT personnel, facilities, infrastructure, and equipment. In addition to developing health materials that will be distributed to the community, planning includes the creation of budget postings that will be utilized in telemedicine services. During the Covid-19 pandemic, the installation of telemedicine services in the form of teleconsultation went smoothly in the city of Bitung via the PSC 119 hotline number, which grew in popularity. In addition, the Bitung Digital Medical application includes a telemedicine service. In addition to utilizing existing social media such as websites, Facebook, and Instagram, the delivery of products and healthcare services also makes use of these platforms. Conclusion(s): The planning of telemedicine services as a health education attempt at the Bitung City Health Office has been carried out well, but the implementation is still not well programmed, as well as the evaluation which has not been comprehensive. The implementation of good telemedicine management can improve public health education. Hence, cross-sectoral cooperation is needed such as cooperation with the information and telecommunications service, education office and other sectors and there is a need for government regulations that can regulate the mechanism of this telemedicine service so that this telemedicine service can improve public health education.Copyright © 2023, Anka Publishers. All rights reserved.

L'ESPRIT CRITIQUE MIS À RUDE ÉPREUVE PAR LA PANDÉMIE ?

Pendant la pandémie de COVID-19, les gouvernements et les directions de santé publique à travers le monde se sont efforcés de communiquer leurs différents messages. Leur but : inciter la population à adopter les mesures sanitaires nécessaires pour stopper la propagation du virus et diminuer les comportements inadéquats. Or, il s'avère que l'exposition aux médias et l'esprit critique ont un rôle important à jouer dans l'équation.Alternate :During the COVID-19 pandemic, governments and public health departments around the world have struggled to communicate their different messages. Their goal: to encourage the population to adopt the necessary health measures to stop the spread of the virus and reduce inappropriate behavior. However, it turns out that media exposure and critical thinking have an important role to play in the equation.

The Shifting Public Health Landscape and Virtual Learning Environment: The Effectiveness of Practice-Based Teaching Delivered In-Person, Virtual, and Hybrid.

The pandemic necessitated teaching competencies that allow public health (PH) students to be immediately workforce ready. The shift to virtual learning provided an ideal time to consider pedagogies focused on applied learning opportunities, such as practice-based teaching (PBT). This multi-year, post-test evaluation of one PBT course explored differences in students' competency achievement immediately post-course with different modalities of delivery: fall 2019 in-person (n = 16), summer 2020 virtual (n = 8), and fall 2020 hybrid (n = 15). Using a variety of methods to assess across semesters, the study found virtual and hybrid learning environments resulted in equally high levels of competency achievement as in-person delivery. Regardless of course delivery, students reported, with no difference across semesters, PBT directly contributed to their workforce readiness, helped with acquisition of essential workforce skills such as problem-solving, leadership, and teamwork, and led to skill and knowledge acquisition they would not have achieved in a non-PBT course. The increased emphasis on virtual learning changed the higher education landscape and the need for students to be workforce-ready with the technical and professional skills demanded by the field and offered opportunity to redesign courses with an emphasis on applied opportunities. Virtually delivered PBT is an effective, adaptable, and sustainable pedagogy worth the investment.

Improving Youth COVID-19 Knowledge, Attitudes, and Practices Through a Novel Medical Student Driven Curriculum.

Despite widespread media coverage and public health messaging, many high school students lacked formal education about COVID-19 during the pandemic. Providing this education, particularly to underserved communities, may reduce health disparities and encourage youth to engage in the sciences. Twenty-five medical students at Emory University School of Medicine created a virtual, synchronous, COVID-19 curriculum. Learners included 25 students enrolled in a pipeline program from five high schools in metro-Atlanta. The five lesson topics included virus epidemiology, COVID-19 testing and mask-wearing, vaccine fundamentals, COVID-19 risk in communities, and mental health and wellness. Lessons were standardized through medical student-teacher practice presentations to faculty. The curriculum was evaluated with a 23-item pre- and postsurvey assessing learners' COVID-19 knowledge, attitudes, and practices. Pre- and postsurvey scores were compared using descriptive statistics and paired-samples t test. After the curriculum, learners' (N = 9) COVID-19 knowledge scores increased from 67% correct to 90% correct. Participants were better able to identify risk factors for severe COVID-19 infection, define "herd immunity," and describe how socioeconomic status can influence infection risk. In addition, after the curriculum implementation, more learners thought vaccines were safe, with 67% responding that vaccines are "very safe," compared with 0% at pretest. This initiative increased learners' COVID-19 knowledge and established bridges between medical students and underserved communities. These connections are essential to combat misinformation surrounding COVID-19, encourage participation in the sciences from underrepresented areas, and empower students to be health advocates within their communities.

Health and Equity Data to Teach the Next Generation of Public Health Leaders.

The COVID-19 pandemic restructured university learning environments while also underscoring the need for granular local health data. We describe how the University of Memphis School of Public Health used the City Health Dashboard, an online resource providing data at the city and neighborhood level for more than 35 measures of health outcomes, health drivers, and health equity for all US cities with populations >50 000, to enrich students' learning of applying data to community health policy. By facilitating students' engagement with population needs, assets, and capacities that affect communities' health-key components of the master of public health accreditation process-the Dashboard supports in-person and virtual learning at undergraduate and graduate levels and is recommended as a novel and rigorous data source for public health trainees.

Public Health Graduate Students' Longitudinal Perceptions of Remote Learning Challenges and Career Goals During an Ongoing Public Health Crisis

The ongoing COVID-19 pandemic created a shift from traditional face-to-face learning toward remote learning, resulting in students experiencing unforeseen challenges and benefits through participation in a non-traditional mode of education. Little is known regarding the impact that a shift to remote learning may have had on the learning experiences and the career goals of Master of Public Health (MPH) students. A qualitative study was conducted among a convenience sample of MPH students in the US from January to April 2021. The primary aims were (1) to describe salient challenges or benefits of learning that persisted throughout a semester of remote learning and (2) to describe how being in graduate school during the pandemic impacted students' career goals in public health. A secondary aim was to describe students' general feelings regarding their public health education, given their lived experience of remote learning during the COVID-19 pandemic. Study findings demonstrated that MPH students had mixed perceptions of how a shift to remote learning during a public health crisis impacted their learning experiences and career goals in public health over one semester. Understanding students' responses can guide public health instructors to best prepare trainees to join the workforce during ongoing and future unforeseen public health crises that continue or have the potential to disrupt learning modalities.

A Systematic Review of Whether the Use of N95 Respirator Masks Decreases the Incidence of Cardiovascular Disease in the General Population.

The usage of masks such as the N95 has increased exponentially worldwide. With the ever-increasing global rates of cardiovascular disease, it is vital that preventative measures are adopted to help tackle this crisis. N95 masks have been promoted as health prevention odysseys in the battle against viruses such as COVID-19. A systematic review was conducted on whether the N95 masks could help improve our cardiovascular health. Our data sources included PubMed, Medline and Scopus. Eleven studies met the eligibility criteria to be included in the review. N95 mask usage led to increased reports of dyspnoea, however, no significant effect was seen on blood pressure. N95 masks also showed improvement in aortic parameters. While encouraging results were yielded, further focussed studies on the use of N95 masks and the effect on various cardiovascular parameters would help strengthen the association.

Acceptability to and Engagement With a Virtual Sickle Cell Trait Education Program (SCTaware): Single-Center Prospective Study.

BACKGROUND: Public health programs are tasked with educating the community on health topics, but it is unclear whether these programs are acceptable to learners. Currently, these programs are delivered via a variety of platforms including in-person, virtually, and over the telephone. Sickle cell trait (SCT) education for parents of children with this trait is one of many education programs provided by the Ohio Department of Health. The novel SCTaware videoconference education program was developed by a research team after central Ohio's standard program transitioned from in-person to telephone-only education during the COVID-19 pandemic. OBJECTIVE: Our objectives were to investigate the acceptability of the format and engagement with the SCTaware education and assess parental worry about having a child with SCT before and after receiving SCTaware. METHODS: This was a single-center, prospective study of English-speaking parents of children <3 years of age identified to have hemoglobin S trait by newborn screening. Parents who previously received SCT education by telephone, were able to be contacted, and had access to an electronic device capable of videoconferencing were eligible to complete surveys after receiving the virtual SCTaware education program. The SCTaware educator also completed a survey to assess participant engagement. Data were summarized descriptively and a McNemar test was used to compare parental worry before and after receiving SCTaware. RESULTS: In total, 55 participants completed follow-up surveys after receiving standard SCT telephone education and then completing SCTaware. Most (n=51) participants reported that the SCTaware content and visuals were very easy to understand (n=47) and facilitated conversation with the educator (n=42). All of them said the visuals were respectful and trustworthy, helped them understand content better, and that their questions were addressed. Nearly two-thirds (62%, n=34) reported that the pictures appeared very personal and applied to them. The educator noted most participants (n=45) were engaged and asked questions despite having to manage distractions during their education sessions. Many participants (n=33) reported some level of worry following telephone-only education; this was significantly reduced after receiving SCTaware (P<.001). CONCLUSIONS: Our results suggest that SCTaware is acceptable and engaging to parents. While telephone education may make SCT education more accessible, these findings suggest that many parents experience significant worry about their child with SCT after these sessions. A study to evaluate SCTaware's effectiveness at closing parents' SCT knowledge gaps is ongoing.

Shoring Up the Frontline of Prevention: Strengthening Curricula With Community and Public Health Nursing

Hailed by some as a paradigm shift in nursing education and practice, this emphasis is not new for public health nurse educators. Since 1965, community and public health nursing content has been part of the required baccalaureate nursing curriculum.11 However, advancing the quality and augmenting the impact of community and public health nursing education, practice, and research is critical for improved local to global health outcomes. [...]we assert the need for the clinical core of the nursing curriculum to include opportunities for intervention at all levels of practice: preparing nurses to design and deliver care at the level of the individual, family, community, systems, and populations.12 To implement this directional change, essential knowledge and skills in systems awareness, change management, cost containment, resource allocation, communication, team building, equity, and inclusion are required for competent, evidence-based practice, as is the development of competencies in informatics, data science, design, and systems thinking. Additionally, effective advocacy requires consideration of the social needs of individuals, which are inextricably connected to structural determinants at the community, society, and policy level. [...]to affect the health of populations, nurses are called upon to make this broader, more integral connection between policies, systems, and environmental impact. Many community and public health nurses work in small, local public health departments unaffiliated with large academic institutions or hospitals and have limited access to evidence-based resources or financial support for professional development. Since 2017, the Nursing Experts Translating the Evidence project, an interprofessional collaborative effort between nurses and librarians, has been educating public health nurses on the acquisition, translation, and application of evidence to inform their practice.19 Through active community-academic-practice partnerships, community and public health nursing educators and governmental and nongovernmental public health agencies can build capacity for community and public health nursing practice for the future, as we continue to apply evidence-based, data-driven problem solving through the pandemic and beyond.

Mobilizing Support for the Future of Advanced Public Health Nursing Education

As a public health nurse educator, I was deeply disappointed when our advanced public health nursing (APHN) master's program shuttered in the late 2010s. I therefore found Harris et al.'s description (p. S231) of the evolution oftheir APHN program and health policy specialty at the University of California San Francisco (UCSF) to be an inspiring example that should compel nursing education leaders nationwide to consider how they can garner support for APHN education in their own institutions and communities. As evidence mounts regarding the influence of social determinants of health and our world continues to endure a time of upheaval that has magnified inequities on multiple fronts (e.g., the COVID-19 pandemic, climate change, racial injustice, violent geopolitical conflicts), our moral obligation to prepare a workforce that can effectively address structural drivers of health is stronger than ever. If nursing is to reach its potential in influencing health equity, we must teach nurses how systems outside the human bodywork (e.g., political systems) as well as how systems within the human body work (e.g., the cardiovascular system). We cannot do this without nursing faculty who have advanced preparation in public and population health nursing.1,2Although analyzing the future of APHN education is not their primary purpose, Harris et al. briefly recommend expandingthe number of APHN and policy programs nationwide. Their recommendation-which I wholeheartedly support-compels me to reflect on and amplify what others have said regardingthe state of APHN education, including our struggle within nursing to recognize the value of the APHN specialty.2,3 If nurses are to effectively step up as the systems-level practitioners that this pivotal point in history demands, we must begin by advocating for support for APHN education and the value of the specialty from both within and outside the profession.

COVID-19 and sustainable development in Somalia/Somaliland

The research aimed to understand the impact of COVID-19 and responses to it on sustainable development in Somalia and its breakaway region Somaliland. It explored how sustainable development could be protected and promoted through, during and as a method of COVID-19 response. It explored the themes of lives, livelihoods and inclusion. Due to COVID-19, it used three non-face-to-face methods: desk-based analysis of literature and secondary data;175 phone interviews;and five phone Focus Group Discussions. The research was co-produced with 40 participants, which ensured that the study was carried out with as well as for those who could potentially benefit from it. COVID-19 and responses to it have generated intense and multi-dimensional concerns and deprivation, especially among those on low incomes. Livelihoods are being destroyed but people are receiving little or no financial support. People are receiving too little help to cope with the many problems they face. Limited action to prevent COVID-19 infection is more due to structural and social factors than lack of information. Public health education is still necessary;it should include challenging stigmatisation, explaining that wearing a face covering does not mean a person is infectious, and explaining that those recovered from the virus are not still infectious. Health care is mostly unavailable, unaffordable and not trusted. There is broad and deep agreement across all major issues explored in the research, including the immediate actions needed and the fundamentals of what building back better would mean. Responses to COVID-19 have mainly had the effect of undermining the prospects for sustainable development in Somalia/Somaliland. Despite this, the existence of broad and deep agreement on the major issues explored in the research could form the basis of a new commitment to sustainable development.

The State of Public Health Education and Science During and After the Fall of the Soviet Union: Achievements, Remaining Challenges, and Future Priorities.

Objectives: In the post-COVID-19 world, when the adequacy of public health workforce education is being critically re-evaluated, this study undertakes a historical analysis of how the educational and scientific field of public health developed during and after the fall of the Soviet Union in 1991. The study intends to historically contextualize public health education and science development in former Soviet Republics. It attempts to document achievements after gaining independence and identify remaining challenges that need to be addressed for advancing public health science and education in Former Soviet Union countries to better prepare them for future pandemics and address current health challenges of the nations. Methods: The study used a mixed-methods review approach combining both a literature review, information collection from the school's websites, and secondary analysis of the quantitative data available about scientific outputs-peer-reviewed articles. Results: During communist rule and after the fall of the Soviet Union, the main historical events seem to have shaped the public health field of former Soviet countries, which also determined its eventual evolution. The international efforts post-1991 were instrumental in shifting medically oriented conceptualization of public health toward Western approaches, albeit with variable progress. Also, while scientific output has been growing from 1996 to 2019, sub-regional differences remain prominent. Conclusion: The region seems to have matured enough that it might be time to start and facilitate regional cooperation of public health schools to advance the field of public health and research. Regional and country variabilities feature prominently in the volume and quality of scientific output and call for the immediate attention of national governments and international partners.

A Rights-Based Approach to Youth Inclusion in Public Health Policy

YOUTHS' RIGHT TO HEALTH-AFFIRMING SOCIAL CONTEXTS People are embedded within neighborhoods, communities, political atmospheres, and economic systems;these contexts determine living conditions such as access to quality education, employment with living wages, adequate and appropriate health care, affordable healthy food and physical recreation, and community support. Yet youths have inherent rights to health, enumerated by the UN Convention on the Rights of the Child.2 Among these are the rights to "the highest attainable standard of health" (Article 24), and to "a standard of living adequate for the child's physical, mental, spiritual, moral and social development" (Article 27). SOCIETY'S NEED FOR POSITIVE YOUTH DEVELOPMENT Aligned with the social determinants of health framework, which situates individuals' health outcomes within social contexts, PYD regards human development as a product of youths' internal assets functioning in tandem with their environmental resources and supports.4 As a strengths-based perspective, PYD maintains that all youths have internal and external assets that make their individual development and their contributions to society unique.5 Aligned with the UN Convention on the Rights ofthe Child, PYD insists that society is responsible for fostering environments where youths have the resources they need to thrive and, importantly, for involving youths as partners in shaping their world, as contribution is both a means and an end to PYD.5 Although favorable environmental contexts are essential for positive development, Yeager identifies four internal drives that help youths develop through adolescence5: (1) to stand out: o develop a personal identity;(2) to fit in: to develop a sense of connectedness;(3) to measure up: to develop competence and find ways to achieve;and (4) to take hold: to make commitments to particular goals, activities, and beliefs. "10 In response, Maine's Department of Health and Human Services announced the establishment of the Office of Population Health Equity (OPHE) within the Maine Center for Disease Control (MCDC) to collaborate within and beyond the MCDC to achieve health justice.11 The MCDC prioritizes youth participation through its funding to the Maine Youth Action Network (MYAN), which is composed of community-based, PYDguided programs that engage youths on issues of public health education, research, and policy.

Impact of Transitioning to Remote Learning on Student Learning Interactions and Sense of Belonging Among Public Health Graduate Students

Student learning interactions and a sense of belonging are imperative to academic success within distance education settings. In March 2020, during the COVID-19 pandemic, students who intended to be educated through in-person learning environments had to shift to remote learning suddenly. In public health, a field that emphasizes experiential and interactive learning, instructors and graduate students enrolled in residential in-person programs transitioned to remote learning with limited knowledge of how this transition would impact student learning interactions and a sense of belonging. To address these gaps, we examined how remote learning impacted Master of Public Health students’ learning interactions with peers, instructors, course content, as well as their sense of belonging in an overall sample and stratified by program year. We found that students perceived challenges interacting with peers, content, and instructors, such as a lack of community and an inability to interact with instructors during course discussions. Students reported not feeling a sense of belonging when engaging with peers and instructors. Findings from this study shed light on the challenges that emerged after students transitioned to remote learning, namely disrupted student learning interactions and a decreased sense of belonging. The study provides recommendations for future remote teaching, which may be of utility to university instructors and administrators tasked with creating and implementing an interactive remote learning curriculum that provides students with a community to foster learning. © 2022 Society for Public.

Transformative Encounters: A Narrative Review of Involving People Living With HIV/AIDS in Public Health Teaching.

Objectives: To collate the experiences of involvement of people living with HIV/AIDS (PLWHA) in academic public health teaching to inform future public health education models involving people affected by long-term effects of other pandemics. Our goal is to describe interventions in a way that makes them accessible to potential public health teachers hoping to adapt patient involvement paradigms in their teaching of chronic illness brought on by infectious diseases. Methods: Narrative review based on a literature search in PubMed and Google Scholar up to September 2021. Fifteen articles that contained a description of a health educational intervention on HIV/AIDS that actively involved PLWHA were included. Results: Interventions either involved PLWHA as teachers and program/curriculum developers or incorporated experiential elements in which students have genuine contact with PLWHA. Creating safe spaces, recognizing PLWHA as experts, relating to each other differently were common transformative elements. Conclusion: Involving PLWHA in public health teaching have transformative and empowering outcomes, both for PLWHA and for learners. This finding should inform new teaching programs that will address the long-term effects of other pandemics such as COVID-19.

Critical Race Theory for Public Health Students to Recognize and Eliminate Structural Racism

Common approaches to medical and public health pedagogy that are grounded in the biomedical model and social determinants of health theory often fail to address structural racism as a root cause of health inequities.1 Structural racism refers to how societies foster discrimination through inequitable systems.2 These pedagogical approaches tend to promote reductionist views of disease, suggest that social determinants of health are immutable, and neglect the role of White power and privilege in driving unfair differences in health outcomes.1 Critical theoretical frameworks for public health education are needed to enhance understanding of how the field may be failing to address and eliminate health inequities and that contextualize health within power structures that marginalize and oppress.1 With its emphasis on the evolving practice of interrogating the roles of race and racism in society, critical race theory (CRT) is an important framework for informing how and what we teach the next generation of public health leaders to eradicate health inequities and drive social change.3 Striking racial disparities in rates of COVID-19 morbidity and mortality,4 recent surges in cases of police brutality against people of color, and public debate over teaching about racism have brought renewed attention to CRT. KEY TENETS OF CRITICAL RACE THEORY CRT provides a paradigm for equipping public health students with the knowledge and skills needed to recognize and eliminate social structures, practices, and discourses that perpetuate racism and health disparities.1,3,5 Key tenets of CRT include recognizing that race is socially constructed;understanding that racism is embedded throughout institutions, systems, structures, and policies;and embracing the lived experiences of people of color, including their experiences of oppression.1,3 Intersectionality involves conceptualizing and understanding how an individual's multiple marginalized social identities (e.g., related to gender identity, race, socioeconomic status) and intersecting structures of power and inequality shape their worldviews and lived experiences.1,8 Application of CRT to health instruction involves attending to how an individual's or group's unique "layered identities" converge with systems of oppression (e.g., racism, sexism) to better understand their health outcomes.1 APPLICATION TO PUBLIC HEALTH EDUCATION The following are our three teaching recommendations for public health faculty. Are there learning goals or objectives that are explicitly linked to antiracism and equity? A statement in the beginning of a syllabus conveying a commitment to equity and antiracism has been linked to student perceptions of a warm and supportive learning environment.8 This statement can include a proclamation of the instructor's respect for diversity, their expectations with respect to classroom climate, and a note that micro- and macroaggressions will not be tolerated.8 This statement can also be used to contextualize the course readings and materials, such as by acknowledging the subjectivity of science and the potential for overt and covert biases in course material.8,10 Similarly, we should explore how to "decolonize" our public health syllabi by disavowing those structures that reinforce superiority and exclusion, promoting critical consciousness, and centering the public health work of those from marginalized backgrounds.8 Account for Intersectionality Intersectionality is a key aspect of CRT that involves reflecting on identity and its relationship to power.11 Individuals' multiple socially constructed identities (e.g., race, sex, sexual orientation) exist within a matrix characterized by interlocking systems of oppression that may heighten their vulnerability to bias and how they experience that bias.1,8,11 We must define this concept in our course syllabi and commit to teaching approaches that promote "matrix thinking" through interrogation of how individuals' multiply marginalized identities converge with sociocultural systems that are mutable.11 Our courses must prioritize critical and multidimensional examination of how different forms of inequality, power structures, and oppression intersect to shape the health outcomes of all people and identify potential solutions to address these inequities.8,11 Wide-ranging social systems that inequitably distribute power and privilege need to be explicitly examined in all public health courses. In the field of health promotion, reflexivity provides a means of developing alternative modes of thinking related to social inequities, power dynamics, social justice, and contextually situated health issues.15 Reflexivity in action occurs when individuals engage in reflection while doing an action and adjust their practices accordingly (e.g., What am I learning about this population, and how might this learning affect the next steps of my action?);reflexivity on action occurs after an action has taken place and involves stepping back and reflecting on one's own actions (e.g., What could I have done differently?);and reflexivity underlying action involves questioning power dynamics or assumptions that underlie a field, such as public health (e.g., What power structures might this kind of practice be creating, supporting, or modifying?).15 As public health educators, we would benefit from institutional training on how to integrate this typology into our curricula to help students and ourselves become more skilled in contextualizing health decision-making and more attuned to potential biases and power imbalances.15 We can use CRT to train a legion of change agents to advance antiracismand health equity-centered programs, policies, and practices.