From Early Intervention to Graduate Education-- to CSD Leadership...Robert Augustine

An interview with Robert Augustine, American Speech-Language-Hearing Association (ASHA) 2023 president, is presented. Among the issues he discussed include his experience of growing up in Livingston, Illinois, what drove his decision to expand his scope beyond communication sciences and disorders (CSD) to graduate program administration, and issues among the association's priorities that he wants to emphasize.

Rural Psychology and the COVID-19 Pandemic: Highlighting Strengths and Future Directions

The Coronavirus disease (COVID-19) pandemic has dramatically impacted Canadians' mental health, including those who live in rural areas. Rural psychologists have long faced unique challenges associated with practice related to accessibility, isolation, and technology. They also have extensive experience in practicing with flexibility, creativity, and complex ethical considerations such as competency (generalist vs. specialist, cultural competence vs. content competence). Therefore, they may have adapted relatively rapidly to the dramatic changes that came along with the pandemic and be well positioned to lead their urban colleagues and organizations as we move forward. Whereas new and pre-existing challenges have been exacerbated by the pandemic, strengths of rural psychologists (e.g., managing geographical isolation, familiarity with telehealth) have emerged. This article looks at the strengths embedded in rural psychology that facilitated service provision during the pandemic. It also reviews future directions to build upon within the rural Canadian context. La pandémie causée par le coronavirus (COVID-19) a eu d'importantes répercussions sur la santé mentale de la population canadienne, y compris dans les régions rurales. Les psychologues des régions rurales doivent composer depuis longtemps avec des difficultés particulières dans leurs pratiques en matière d'accessibilité, d'isolement et de technologie. Ils possèdent une vaste expérience d'une pratique caractérisée par la flexibilité, la créativité et des considérations éthiques complexes, telles que les champs de compétence (généraliste vs spécialiste, compétence culturelle vs compétence relative au contenu). Ainsi, ils ont peut-être pu s'adapter relativement rapidement aux importants changements suscités par la pandémie et sont peut-être bien placés pour diriger leurs confrères, consoeurs et organismes des villes pour la suite des choses. Étant donné que des difficultés nouvelles et existantes ont été exacerbées par la pandémie, les forces des psychologues des régions rurales ont été mises en relief, par exemple, la gestion de l'isolement géographique et leur connaissance préalable des consultations à distance. Cet article examine les forces inhérentes aux services psychologiques en région rurale qui en ont facilité l'accès durant la pandémie. De plus, il présente les orientations futures sur lesquelles s'appuyer dans le contexte rural au Canada.

Effective and respectful interaction with Māori: How the regulators of health professionals are responding to the Health Practitioners Competence Assurance Amendment Act 2019

AIMS: To ascertain the response of registered health professional regulators to the legislated requirement under the Health Practitioners Competence Assurance Amendment Act 2019 (HPCA Amendement Act) that practitioners are culturally competent and, specifically, enabling "effective and respectful interaction with Māori". METHOD: A document analysis of the extent to which the culturally competent requirement is indicated in information about professional competencies within publicly available information of the 17 responsible authorities (RAs) that govern health practitioners under the Health Practitioners Competence Assurance legislation. RESULTS: Three years after the amendment to the original Act (HPCA Act) requiring health professionals to be culturally competent specifically in relation to interacting with Māori, only four of the 17 RAs fully reference the amended requirement, and only two RAs link this specific cultural competence to the requirements of the amended Act (HPCA Amendment Act). The majority of the RAs have yet to integrate references to engaging with Māori in this way into their professional competencies. CONCLUSIONS: Culturally competent practice is only meaningful once it is enacted by individual practitioners in their interactions with others. It is imperative for RAs to include the cultural competence requirement into their published information about professional competencies as this would signal to the profession, practitioners, and wider community that effective and respectful interaction with Māori is a fundamental expectation of all health practitioners in this country. Other issues identified during the analysis suggest an emphasis on administration and bureaucracy. This presents an opportunity for consolidating the practice of RAs including how key functions are expressed and promulgated.

Community health needs bus tour: understanding social determinants of health and racism

Purpose of Study: Racism, the social system in which certain groups of people are afforded opportunity while others are limited, based on race, is a social determinant of health (SDOH) that contributes greatly to health inequity. An interactive Community Health Needs Bus Tour at Arkansas Children's Hospital served to: (1) increase intern knowledge of SDOH and racially-driven health inequity, while providing context to the patients and community we serve;and (2) connect residents to the organizations working to overcome these disparities. Methods Used: Key SDOH were identified including food and housing insecurity, education, literacy, community and personal violence, and racism. Community organizations and landmarks were identified as "tour stops" to illustrate each SDOH and its impact. Each stop connected residents to a place where they would soon be referring patients with such needs in the future. A detailed script was developed. At each tour stop residents were given demographic data that highlighted the impact of health inequity. They also learned the positive impact of the organization. At "Hop On" tour stops, speakers from the individual organizations were invited on board the bus to share the specific impact of their work. The tour was also designed with two "Hop Off" stops, chosen to illustrate how Little Rock's unique history and racial division created much of the health inequity of today. At the Mosaic Templars Cultural Center, residents toured exhibits to learn and celebrate African American history and culture. At the Central High School Visitor Center, residents studied the history of the "Little Rock 9." These stops highlighted the impact of public policy and racism and sought to expand residents' cultural competency. The tour took place during Intern Orientation in June 2019 and 2022, with a gap due to COVID. Summary of Results: All participants were surveyed anonymously at the conclusion of the bus tour. 96% felt that the experience met its core objectives. 100% of all participants agreed or strongly agreed that they can apply what they learned on the Bus Tour to their work as a resident. Further, 100% of all participants agreed or strongly agreed that they had identified an organization or person they can collaborate with in the future. One resident reported the tour led to "better understanding the history and current socioeconomic context that may color interactions with future patients." Another resident reflected the experience was a "great reminder to keep in mind that regardless of patients' background, they all deserve the same standard of care." Conclusion(s): This type of interactive, community-based programming is effective in teaching SDOH, raciallydriven health inequity, and connecting residents to the patients and communities they serve. Further study could identify if these experiences specifically impact residents' perception on racism, health inequity, and bias. Copyright © 2023 Southern Society for Clinical Investigation.

Diversity Impacts of Coronavirus Disease 2019.

This article describes how coronavirus disease 2019 (COVID-19) health disparities relate to the social determinants of health and reviews the importance of a diverse nursing workforce prepared to advance social justice. The article reviews recommendations from the National Academy of Medicine and highlights practical strategies to promote diversity and social justice, including mentoring nurses from underrepresented backgrounds, amplifying diverse nursing voices, and leveraging the power of coalitions. In highlighting the interwoven impact of COVID-19 and demand for social change throughout 2020 to 2022, the article strives to move beyond the acute COVID-19 crisis to sustained social justice in health care.

Developing an Equitable COVID-19 Pandemic Response: Lessons Learned From a Multisectoral Public Health Partnership in Guadalupe, Arizona

The COVID-19 pandemic has disproportionately impacted communities that are medically underserved across the United States, including the 6,700 Hispanic and Pascua Yaqui residents of Guadalupe, Arizona. In May 2020, Guadalupe experienced new COVID-19 cases at a rate 13.9 times as high as its surrounding county, urging town leadership to establish the Guadalupe Community Response Team (GCRT), a multisectoral network of community, academic, and public health partners. The objectives of the GCRT were to: (a) increase access to health and support services;(b) develop novel and intensive outreach efforts;and (c) build partnerships to strengthen public health capacity. From June 2020 to December 2021, the GCRT provided door-to-door case investigation and resource provision, coordinated testing and vaccination events, created public health communications, and developed COVID-19 guidance for cultural gatherings. These interventions were implemented in an effort to reduce community transmission of SARS-CoV-2 and increase equitable access to testing, vaccination, and social support resources. Cultural leaders, such as promotores de salud and Yaqui Cultural Specialists, were integral in building trust among community members. The GCRT provides valuable lessons learned on the importance of implementing a culturally grounded approach to COVID-19 mitigation to increase equitable access to health services during a public health emergency. [ FROM AUTHOR]

Understanding Physical Distancing and Face Mask Use Across High-Risk African American Subgroups During the COVID-19 Pandemic: Application of Health Belief Model.

Physical distancing and face masks remain frontline prevention strategies due to suboptimal vaccine uptake and the highly infectious COVID-19 variants. Communities of color are disproportionately impacted by a chronic disease burden that places them at higher risk of severe COVID-19 disease. Therefore, they can greatly benefit from face mask use and physical distancing, especially if the individual(s) have not received the vaccine. We applied the Health Belief Model to explore barriers and motivators influencing physical distancing and face mask use among high-risk, Black American subgroups during the early COVID-19 pandemic stages. We conducted 62 semi-structured interviews among four Black American subgroups: young adults, individuals with underlying medical conditions, essential workers, and parents. Thematic analysis, guided by the Health Belief Model, yielded six themes: (1) Knowledge on Face Mask Use and Physical Distancing, (2) Perceived Susceptibility and Severity Varies by Subgroup, (3) Experience with and Perceived Self-Efficacy to Engage in Preventive Behavior, (4) Perceived Benefits to engaging in preventive behaviors, (5) Perceived Barriers to engage in preventive behaviors, and (6) Cues to action to increase participation. Each subgroup's unique experience informed multilevel, tailored approaches that can be used by health promotion practitioners to improve face mask use and physical distancing among uniquely vulnerable Black American subgroups in the current and future pandemic.

Transforming Transitions: Developing Cultural Competence in Supporting Caregivers of Children and Youth Growing up with Autism Spectrum Disorder

BACKGROUND: Transition to adulthood is a stressful time for caregivers of children and youth with Autism Spectrum Disorder (ASD). Anecdotally, we know that cultural perspectives can directly influence decisions made around ASD diagnosis, treatment, and transition to adulthood. However, there is a paucity of research into these cultural perspectives and how they may affect illness trajectories. OBJECTIVE(S): 1.Through open-ended responses, identify cultural values that play a role in decision making around health care and life course planning during transition to adulthood in ASD. 2.Identify criteria for success in adulthood from parents of children and youth with ASD in a culturally diverse population. 3.Identify systemic barriers that prevent families from accessing culturally sensitive care 4.Educate health care workers on any unique cultural perspective that may impact transition planning. DESIGN/METHODS: In-depth interviews (IDIs) were conducted with caregivers (i.e., parents/guardians) of children and youth with autism. Interviews were recorded, transcribed, and coded using deductive and inductive coding methods by two independent coders, with inter-rater reliability confirmed by Cohen's kappa coefficient. RESULT(S): A total of 12 IDIs were conducted. The main themes that were discussed included caregivers' understanding of adulthood for their child with ASD, barriers to accessing services, the importance of culture and religion/spirituality to their child's future, recommendations to improve current services and programming and the impact of the COVID-19 pandemic on decision-making. Caregivers expressed their desire for their child to be independent as they transition to adulthood. They also described how cultural or religious/spiritual practices are integrated into their child's life and the importance of maintaining their cultural identity. Caregivers emphasized the lack of culturally tailored resources as their child transitions to adulthood to maintain that sense of community. CONCLUSION(S): Caregivers' cultural perspectives are an integral part of their identity and an important aspect of their environment that should be taken into consideration as children and youth with ASD transition to adulthood.

Evaluation of primary care during the COVID-19 pandemic in a Peruvian región

Introducción: La atención primaria es el pilar fundamental de un sistema de salud efectivo;el incumplimiento de los atributos esenciales podría contribuir al colapso de los sistemas de salud en eventuales pandemias. Objetivo: Evaluar el cumplimiento de los atributos de la atención primaria y sus factores asociados, según perspectiva del usuario externo en el contexto de la pandemia por COVID-19, en una región del Perú. Método: Estudio transversal, que incluyó 1064 usuarios externos, seleccionados aleatoriamente. Utilizando la Encuesta se recogieron características sociodemográficas y de salud. El cumplimiento de los atributos de la atención primaria fue valorado con la versión modificada del instrumento PCAT-A10. Se realizó un análisis descriptivo y multivariado mediante modelos lineales generalizados de la familia Poisson para evaluar ciertos factores asociados al incumplimiento de los atributos de la atención primaria. Resultados: De los participantes, el 76,6% perciben que los atributos básicos esenciales se incumplen;asimismo, en el primer contacto (74,7%), continuidad (87,8%), coordinación (95,7%), globalidad (88,3%) y competencia cultural (75,9%). La condición de estudiante (p<0,001), autopercepción de salud regular (p=0,010), adulto de 30 a 59 años (p<0,001) y la condición de usuarios del centro de salud Subtanjalla (p=0,001), Parcona (p<0,001) y Guadalupe (p<0,001), se encuentran asociados a mayor percepción de incumplimiento de los atributos de la atención primaria. Conclusiones: Desde la perspectiva de los usuarios externos los atributos esenciales son incumplidos en los centros de atención primaria;existen factores asociados a mayor probabilidad de percibir que estos atribuidos son incumplidos.Alternate :Introduction: Primary care attention is the fundamental pillar of an effective health system;a failure to comply with its essential attributes could contribute to the collapse of the health systems in the event of pandemics. Objective: To evaluate the compliance of the primary attention's attributes and its associated factors, according to the external user's perspective in the context of the COVID-19 pandemic in a Peruvian region. Method: Cross-sectional study, which included 1064 randomly selected external users. Also, the sociodemographic and health characteristics were collected using the survey. And the compliance of the primary care attributes was valued using the modified version of the PCAT-A10 instrument. Finally, a descriptive and multivariate analysis was performed using generalized linear models of the Poisson family to evaluate certain factors associated with noncompliance with the attributes of primary care. Results: 76.6% of the participants perceive that the essential basic attributes are not met;likewise, in the first contact (74.7%), continuity (87.7%), coordination (95.7%), globality (88.3%) and cultural competence (75.9%). The student condition (p<0,001), self-perception of regular health (p=0.010), adult from 30 to 59 years old (p<0.001), and the condition of users of Subtanjalla (p=0.001), Parcona (p<0.001) and Guadalupe (p<0.001) health centers were associated with a greater perception of noncompliance with the attributes of primary health care. Conclusions: From the external user's perspective the essential attributes are met in primary care centers;there are factors associated with a greater probability of perceiving that these attributes are not met.

The Perception of Nurses about Migrants after the COVID-19 Pandemic: Close Contact Improves the Relationship.

Nurses have faced during the COVID-19 pandemic a tough professional situation in which they have had to work in a resource-limited context and with a high probability of COVID-19 transmission. In today's multicultural societies, care for immigrant patients is also included. In our study, we have delved into the perception of hospital nurses towards migrant people in the context of the COVID-19 pandemic. We used a qualitative methodology with a phenomenological approach. Semi-structured interviews were conducted with 16 nurses. Seven categories emerged and were distributed in the three blocks of the interviews: (a) perception before the pandemic: prejudices make a mark and communication problems; (b) perception after the pandemic: prejudices weaken and communication worsens; and (c) how to improve care: improve communication, more nurses, and no need for training. The approach in the interpersonal relationship between nurses and patients during the pandemic has improved health care. Proposals arise to overcome the language barrier such as the incorporation of intercultural translators-mediators and professionals of foreign origin. There is a lack of awareness of the need for training in cultural competence on the part of the nurses in the study.

Career adaptability of international hospitality management students during the COVID-19 pandemic: Focus on the role of language communication competence

In addition to dealing with language, communication and cultural barriers, international students in hospitality management were suddenly confronted with bleak career prospects in a sector crippled by the COVID-19 pandemic. Yet, little is known about how international students in hospitality management mobilize personal resources to cope with sudden career shock events. We address this question by developing and testing a model of career adaptability of international hospitality management students during the COVID-19 pandemic that focuses on the role of language communication competence. We draw from communication theory to argue that language communication competence enables international hospitality management students to appraise COVID-19 as presenting career opportunities that in turn motivate career adaptability contingent on cultural distance. Our results, based on a sample (n = 290) of international hospitality management students in Australia during the COVID-19 pandemic, support our contention. The theoretical and practical implications of our findings of the role of communicative behavior and cultural competence for coping with career transitions in periods of crises are fully discussed.

Creating a culture of clinical research in the clinic: Integrating clinical trials into the care of patients with lupus

620 Table 1Clinician-focused opportunities and approaches to cultivate a culture of clinical research in lupus clinical careStrategy Strategies to cultivate a culture of clinical research in clinical care Future directions and opportunities Provide training opportunities for trainees and clinicians • Provide subspecialty fellows/trainees with formal training, practical experience/apprenticeship, and mentorship opportunities to gain experience in clinical trials investigation • Develop and integrate formal training programs throughout medical training and continuing education to develop and strengthen skills and expertise in having effective clinical trial conversations (e.g., verbal and nonverbal skills training, cultural competence and implicit bias training) • Adopt/integrate existing programs such as Materials to Increase Minority Involvement in Clinical Trials (MIMICT), an online accredited CME program through the ACR that focuses on improving clinician knowledge about referring diverse patients to lupus clinical trials21 • Engage diverse stakeholders, including patients, throughout all phases of the development, evaluation, and dissemination of training products Adopt a ‘Universal Precautions' Approach to Educate All Patients About Clinical Trials • Present clinical trial opportunities to all potentially eligible patients (e.g., regardless of beliefs or implicit biases around a patient's willingness to participate or ‘fit' for a trial)• Advocate for consideration of participation, rather than participation11• Offer additional resources for patients to support informed decisions about clinical trial participation• Incorporate teach-back methods to train research personnel as well as to reinforce patient education and understanding• Develop clinical trials materials (including consent forms) in languages other than English • Explore patient preferences for conversations with clinicians about lupus clinical trials• Develop culturally competent, health literate lupus clinical trial-specific information and research materials to support patients in making informed decisions• Diversify clinical research personnel (e.g., bilingual research staff, etc.) Provider Outreach • Engage, exchange information, and build partnerships with rheumatologists, as well as primary care physicians and subspecialists who are closely involved in the care of patients with lupus, as well as health care and research teams • Conduct outreach to create communication and partnerships between academic a d private- practice settings• Encourage outreach to and partnerships with community organizations and stakeholders ReferencesFalasinnu T, Chaichian Y, Bass MB, Simard JF. 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Factors associated with participation in rheumatic disease–related research among underrepresented populations: a qualitative systematic review. Arthr tis Care & Research. 2020;72(10):1481–9. https://doi.org/10.1002/acr.24036.Patel S, Pelletier-Bui A, Smith S, Roberts MB, Kilgannon H, Trzeciak S, et al. Curricula for empathy and compassion training in medical education: A systematic review. PLOS ONE. 2019;14(8): e0221412. doi: 10.1371/journal.pone.0221412.Sneed RS, Mason M, Williams JN, Sinnette C Taber K, Mancera-Cuevas K, et al. Using critical race theory to understand trial participation among black individuals with systemic lupus erythematosus: a qualitative study of patients and caregivers. Arthritis Care & Research. 2021;73(10):1387–95. https://doi.org/10.1002/acr.24635.Georgopoulou S, Prothero L, D'Cruz DP. Physician–patient communication in rheumatology: a systematic review. 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Improving Perioperative Communication During the COVID-19 Pandemic: The Official Voice of Perioperative Nursing

Perioperative communication can be ineffective and result in delays or adverse events. Coronavirus disease 2019 (COVID-19) has placed demands on health care leaders and personnel to integrate information quickly and accurately. When caring for patients diagnosed with COVID-19 or whose infection status was unknown, perioperative personnel at one facility discovered communication gaps associated with the environmental cleaning process and hand-over reports. A project team comprising perioperative nurses created five tools to provide critical information to help diverse team members share the same mental model. The project team created one tool in English and Spanish to meet the needs of environmental services personnel whose primary language was Spanish. The team created another tool to support communication with central processing department personnel and facilitate prioritization of case cart cleaning when needed. The development and implementation of the communication tools helped to provide a safe working environment during the COVID-19 pandemic.

Teaching multicultural psychology as a cultural competence intervention: An empirical evaluation of course components

Previous research has shown that a semester-long multicultural psychology course can effectively increase students' cultural competence-related attitudes when students complete the class in-person and online. Cultural competence refers to the knowledge, awareness, and skills required to appreciate, recognize, and effectively work with members of other cultural groups. This dissertation examined several components of a multicultural psychology course: ethical grading, skill development, and intergroup contact. The first paper discussed techniques used to minimize grading bias and examined whether cultural competence shifts impacted grading. Students' cultural competence scores did not relate to or predict their grades in the course, which supported the notion instructors can grade fairly and objectively regardless of students' attitudes and values. The second paper highlighted the importance of social justice competence in addition to cultural competence, as well as the importance of targeting skill development in addition to knowledge and awareness. This study investigated the impact of adding a skills-focused Difficult Dialogues group assignment to the course on students' shifts in cultural competence-related attitudes and social justice orientation and also discussed of implementation considerations for instructors. Results suggested that the Difficult Dialogues project had a particular impact on improving students' social justice behavioral intentions. The third paper focused on the impact of intergroup contact with diverse others. The multicultural psychology course typically requires direct contact by attending at least three cultural events every semester. However, due to the COVID-19 pandemic, this requirement was shifted to indirect contact activities. This study examined differential shifts on students' cultural competence-related attitudes in sections where students were required to engage in direct intergroup contact versus students who were allowed to engage in indirect intergroup contact due to taking the course during the COVID-19 pandemic. Results suggest that indirect contact contributed to positive shifts in cultural competence equally as well as direct intergroup contact. These studies advance the evidence-based teaching of multicultural psychology by empirically examining specific course components. The manuscripts provide useful information for educators, administrators, advocates, and policymakers about the impact of multicultural education, the efficacy of cultural competence training, and feasibility of ethical implementation in the classroom. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Editorial

[...]we have two more special issues lined up! A Human Rights Approach to Mental Health Services, policy and legislation will be edited by Guest Editor Michael Elnemais Fawzy, MD Consultant Psychiatrist at the Al Abbassia Mental Health Hospital, Cairo, Egypt. Do front-line employees in the Chinese commercial banks have the rights to experience psychological well-being? aims to understand the relationship between job autonomy, transformational leadership and psychological well-being mediated by job satisfaction among front-line employees in Chinese commercial banks. Employees with a high level of job satisfaction and psychological well-being benefit both their own health and organisational performance in the long run.

Improving Access and Health Outcomes in Palliative Care through Cultural Competence: An exploration of opportunities and challenges in India.

People who belong to ethnic, racial and cultural minorities often have less access to healthcare and have poorer health outcomes when compared to the majority population. In the COVID pandemic, too, health disparities have been observed. Similar disparities have been noted in patients with advanced disease and suffering from pain, with minority patients having less access to or making less use of palliative care. In the US, a range of solutions has been proposed to address the issue of inequality in access to healthcare, with cultural competence figuring prominently among them. This study explores whether and how cultural competence may be applied to palliative care in India to improve access and health outcomes. In the literature, it is argued that, in diverse societies, cultural competence is an essential part of the solution towards equitable healthcare systems. Solutions to problems of healthcare disparities must go beyond an increase in financial resources as more financial resources will not necessarily make the healthcare system more equitable. A culturally competent system recognises and integrates at all levels the culture as a significant component of care, which is particularly relevant at the end of life. If efficiently implemented, cultural competence will lead to higher patient satisfaction, better follow-up and patient compliance and an improved reputation of palliative care among minorities. This may help to reduce inequalities in access and health outcomes in palliative care.

Military Culture and Cultural Competence in Public Health: U.S. Veterans and SARS-CoV-2 Vaccine Uptake

As part of the U.S. effort to encourage vaccination for SARS-CoV-2, scholars have emphasized the importance of culture and identity in vaccine uptake decisions. The culture and identity of military service are poorly understood in the context of understanding Veterans' acceptance of COVID-19 vaccines. In analyzing data from semi-structured interviews with Veterans in homeless transitional housing, this article examines their willingness to get vaccinated for COVID-19. Themes invoking military culture included (a) mandatory vaccinations in the military;(b) cynicism and mistrust toward the government;and (c) trust of and reliance on Veteran peers with shared military culture in decision-making. To further understand how military culture influences vaccine uptake and explore avenues for building culturally competent, trust-based health care interventions with Veterans, a previously published case study of Veterans volunteering in Team Rubicon (TR) disaster relief is examined. Veteran participants in TR described the experience of being in a Veteran-centric organization as an empathetic context wherein they were able to: (a) address their reintegration struggles;(b) gain a new appreciation of their Veteran status;and (c) connect with trusted peers. Given TR's credibility, Veteran-serving health care organizations could collaborate with Veteran-led organizations to expand shared efforts to address Veterans' distrust of government-promoted vaccines.

Community Health Workers in Time of Crisis: A COVID-19 Case Study

This article focuses on the lived experiences of those implementing community health worker (CHW) programs during the COVID-19 pandemic. Based in an upper mid-west state, this qualitative case study is bounded by the state-level context and two distinct local case sites—one rural and one urban—and includes the experiences of five CHWs, two program directors, and a state-level administrator. The acute crisis response galvanized the ongoing need for CHWs, not only because they are trusted health messengers, but because they advocate for—and organize with—communities to address inequalities and inform public health institutions. Author-practitioners described personal and community identity as intertwined, a perspective in solidarity with decolonized approaches to humanistic psychology. Highlights discussed include: (a) Personal relationships motivated author-practitioners to join the pandemic response;(b) All pandemic response efforts were interconnected with social determinants of health;(c) The pandemic was as an opportunity to do things differently with more flexibility, personally and organizationally;and (d) Privately funded opportunities enabled local areas to implement quick responses, which influenced eventual state-level responses. All authors described structural racism as a constant context of this work. This article fills gaps in the literature related to the implementation of crisis responses and CHW programs. [ FROM AUTHOR]

Factors Affecting Cultural Competence in a Sample of Nursing Students during the Prolonged COVID-19 Pandemic in Republic of Korea: A Cross-Sectional Study.

Globally, foreign citizens, particularly ethnic and racial minorities, experienced discrimination and received imbalanced medical services and insufficient economic resources during the COVID-19 pandemic. This study aimed to examine the factors that affect the cultural competence of nursing students. This is descriptive cross-sectional study adheres to Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. A convenience sample of 235 nursing students from two nursing colleges in D city completed an online Google Forms questionnaire from 9 August to 12 August 2022. The self-report questionnaire included a sociodemographic data form, a cultural intelligence scale, an ethnocentrism scale, a global competence scale, and a cultural competence scale. The mean score of cultural competence was 95.39 ± 15.64 (out of 135 points); cultural competence was significantly positively correlated with cultural intelligence and global competence (p < 0.001), and significantly negatively correlated with ethnocentrism (p < 0.001). The factors that significantly affected cultural competence were cultural intelligence (ß = 0.31, p < 0.001) and global competence (ß = 0.37, p < 0.001). The explanatory power of these effects was 47.3%. To improve the cultural competence of nursing students, it is necessary to develop, apply, and evaluate the results of curriculum and programs that can enhance the cultural intelligence and global competence of nursing students.