Promoting Safe and Supportive Health Care Spaces for Youth Experiencing Racism

IF 3 3区 医学 Q1 PEDIATRICS Academic Pediatrics Pub Date : 2024-08-01 DOI:10.1016/j.acap.2024.01.009
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Abstract

Objective

This qualitative study applies a community-based participatory research approach to elicit formative data on pediatric patient experiences of racism in the health care setting and to explore clinic-based opportunities for supporting pediatric patients experiencing racism.

Methods

The study is situated within the outpatient practice of a large tertiary academic medical center in a midsize Midwestern city. Community partners were involved in all aspects of the research, including research protocol design, recruitment, data analysis, community dissemination, and manuscript preparation. Participants were youth between 11 and 18 years, in middle or high school, self-identifying as a person of color, Latinx or Indigenous who answered yes to the question “have you ever experienced race-related prejudice and discrimination?” Parent/guardians of youth meeting inclusion criteria participated in separate focus groups. Data were analyzed using an interpretative phenomenological analysis approach.

Results

Major findings were divided into 2 categories: 1) racism-related experiences in the health care setting; and 2) patient and parent/guardian recommendations to support pediatric patients experiencing racism. Among health care setting experiences, primary emerging themes included racism experienced in the health care setting, patient-clinician communication around racism, patient-clinician concordance, and high-quality clinical care. Recommendations were presented within the 4 domains of racism: intrapersonal, interpersonal, structural, and institutional.

Conclusions

Racism experiences worsen child biological, psychological, and behavioral functioning, yet research is lacking on how health care professionals may best support pediatric patients experiencing racism. Study findings suggest opportunities for providing safer and more supportive health care spaces for youth experiencing racism.

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促进为遭受种族主义的青少年提供安全和有利的医疗保健空间
目标本定性研究采用基于社区的参与式研究方法,收集儿科患者在医疗环境中遭遇种族主义的形成性数据,并探索以诊所为基础为遭遇种族主义的儿科患者提供支持的机会。方法本研究位于中西部一个中等城市的大型三级学术医疗中心的门诊实践中。社区合作伙伴参与了研究的方方面面,包括研究方案设计、招募、数据分析、社区传播和手稿准备。参与者为 11 至 18 岁的初中或高中青少年,自我认同为有色人种、拉丁裔或土著人,并对 "你是否经历过与种族有关的偏见和歧视 "这一问题的回答为 "是"。符合纳入标准的青少年的家长/监护人参加了单独的焦点小组。数据采用解释现象学分析方法进行分析:1) 在医疗环境中与种族主义相关的经历;2) 患者及样本;家长/监护人对支持经历种族主义的儿科患者的建议。在医疗保健环境中的经历中,新出现的主要主题包括医疗保健环境中的种族主义经历、患者与医生之间围绕种族主义的沟通、患者与医生之间的一致性以及高质量的临床护理。在种族主义的四个领域中提出了建议:人内、人际、结构和机构。结论和相关性种族主义经历会恶化儿童的生理、心理和行为功能,但目前还缺乏关于医疗保健专业人员如何为经历种族主义的儿科患者提供最佳支持的研究。在这项基于社区的参与式定性研究中,参与者对医疗环境中的种族主义经历、围绕种族主义的沟通以及患者与医生种族一致性的重要性进行了反思。参与者的建议为经历种族主义的青少年提供了更安全、更具支持性的医疗场所。
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来源期刊
Academic Pediatrics
Academic Pediatrics PEDIATRICS-
CiteScore
4.60
自引率
12.90%
发文量
300
审稿时长
60 days
期刊介绍: Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.
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