An Introduction to Structural Competency for Haitian-Identified Patients: History, Culture, and Access to Care.

INTRODUCTION: The Haitian population within the US represents the largest diaspora outside of Haiti, with most Haitians residing in major urban communities. Despite clear differences in health outcomes specific to Haitians, the community has traditionally been aggregated into the general Black population. To address specific health disparities, this workshop was designed to distinguish and elaborate on the health care problems affecting Haitians. METHODS: We created an interactive 60-minute workshop including a PowerPoint presentation, two case presentations, and a 5-minute informational video to bring awareness of the historical perspectives impacting Haitian/Haitian American health, access to care, and health care disparities to providers. Knowledge was assessed by pre- and postworkshop evaluation forms. The module was aimed at health care professional learners. RESULTS: Seventy-four people with diverse ethnoracial identities, including medical students, residents, academic faculty, physicians, nonmedical graduate students, and health care staff and administrators, attended three workshops. All learning objectives were met, with pre- and postworkshop data indicating a statistically significant increase in participants' reported confidence. Workshop attendees commented positively on the group discussion component, the workshop's interactive nature, the opportunity to apply taught knowledge to case presentations, and the historical context provided. DISCUSSION: As the number of Haitian immigrants continues to rise throughout US urban communities, providers must increase their culture competency in training and delivery to improve care for a major population. This module can help better prepare health care providers and trainees to offer competent care to Haitian/Haitian American patients.

Language of sexual violence in Haiti: perceptions of victims, community-level workers, and health care providers.

Non-partner sexual violence (NPSV), an important risk factor for HIV, is of global public health significance and understudied. The 2010 earthquake interacted syndemically with structural factors to increase sexual violence and HIV risk for women in Cité Soleil, Haiti. We used an exploratory sequential qualitative design and Grounded Theory to investigate language/terminology for NPSV, victims and perpetrators, and health effects of NPSV on victims, in four focus groups: Health care providers (HCPs) (n=3; n=8), community advocates (n=8), and victims (n=8). Crucial differences exist among stakeholders: HCPs prefer French and possess different explanatory models of illness from victims, who provided more extensive and explicit descriptions (e.g., "strangled like a chicken," "tuyo"/"faucet"/"flooding" for gang rapes). Victims also reported purposeful injury to their external and internal genitalia, signaling STI/HIV risk. Reconciling within-culture differences between victims and HCPs can inform screening, diagnosis, treatment, follow-up and delivery of relevant interventions.

Fibered confocal spectroscopy and multicolor imaging system for in vivo fluorescence analysis.

We report the design and implementation of spectroscopic and multicolor imaging capabilities into a fibered confocal fluorescence microscope (FCFM) already capable of in vivo imaging. The real time imaging device and the high resolution fiber probe make this system the first reported capable of performing multi color detection in the field of FCFM. The advantages of the system will allow in vivo morphological and functional imaging. Preliminary experiments were carried out in tissue samples to demonstrate the potential of the technique. The quality of the axial sectioning achieved in the confocal fluorescence spectroscopy mode is demonstrated experimentally, and applications to multicolor imaging are shown.