School policing has expanded dramatically in U.S. public schools, yet its mental health consequences among Hispanic adolescents remain understudied. Although a growing body of scholarship examines the educational and social outcomes of school policing for Latine youth, few studies have isolated the association between specific policing exposures and depressive symptoms in this population. This study examined the association between school policing experiences, school discipline, and depressive symptoms among 15-year-old Hispanic youth, testing whether the distinction between police presence and direct police contact differentially predicts depressive symptomology. Using data from the Year 15 wave of the Future of Families and Child Wellbeing Study (FFCWS; N = 813 Hispanic youth, 51.8
Within the pediatric rehabilitation context, there is the lack of data in the peer reviewed literature on the intersection of race and disability. The purpose of this research was to explore the intersection of race and disability and the role it plays when parents are accessing and receiving pediatric rehabilitation services for their children with disabilities in Ontario, Canada. A multiple descriptive qualitative case study design was used. Three semi-structured interview guides were developed, and three interviews were conducted for each case, resulting in a total of nine interviews. An inductive approach was used to generate themes and data were analyzed using both within-case and cross case analyses. Intersectional and DisCrit theories informed data collection, analysis, and interpretation. A total of three cases were studied. Case analysis results identified four themes for barriers to accessing services for racialized parents of children with disabilities. Parents described experiencing ableism from their cultural communities and challenges receiving a formal diagnosis. Findings also highlighted the need for diverse service providers and a desire for cultural support groups to increase comfort and belonging. At the intersection of race and disability racialized parents who have children with disabilities may be experiencing a “double burden” effect navigating compounding effects of oppression in multiple areas of their lives. The experiences of racialized parents of children with disabilities are complex, their broader life experiences affect the way they approach pediatric rehabilitation, and they may be experiencing a “double burden” effect.
This study examined service providers’ perspectives on how race, ethnicity, and immigration status shape help-seeking experiences and institutional responses for Black, Latino, and immigrant male victims of female-perpetrated intimate partner violence (IPV). Semi-structured Zoom interviews were conducted with 10 service providers, primarily from the United States (with one provider each from Canada and Ireland), who work with male victims of female-perpetrated IPV. Participants included 5 attorneys, 2 domestic violence agency professionals, 2 mental health clinicians, and 1 executive director of a men and families center. Data were analyzed using an inductive reflexive thematic analytic approach. Three themes were identified: (1) Barriers to Help-Seeking, Protection, and Support, reflecting intersecting internal, structural, immigration-related, and institutional constraints; (2) Identity-Responsive Practices, describing providers’ strategies for adapting services to diverse male victims; and (3) Gender as the Initial Lens of Institutional Interpretation, reflecting providers’ descriptions of gender as the initial lens through which male victimization was interpreted, with race, ethnicity, and immigration status shaping institutional responses. From the perspective of service providers, improving protection for Black, Latino, and immigrant male victims of female-perpetrated IPV requires more than stigma reduction. Findings suggest that systems should address credibility bias, expand culturally and linguistically responsive services, and integrate immigration-informed pathways to promote more equitable access to safety.
Chronic stress is a well-documented psychosocial driver of cardiovascular disease (CVD) disparities disproportionately affecting African American adults, yet the psychometric adequacy of patient-reported outcome measures (PROMs) in this population remains unexamined. This systematic review evaluated the scientific evidence on the psychometric quality of chronic stress PROMs in a racially specific population at elevated cardiovascular risk. PubMed/MEDLINE, Embase, CINAHL, and PsycINFO were searched (January 2000 to December 2025). Eligible studies reported psychometric properties of chronic stress PROMs in African American adults. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) Risk of Bias checklist. Evidence quality was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Protocol registration: (OSF: https://osf.io/sn73g ). Of 2,581 records identified, 1,781 were screened after duplicate removal; five studies evaluating five instruments met inclusion criteria: the Perceived Stress Scale-10 (PSS-10) and four race-specific PROMs. All instruments demonstrated acceptable internal consistency (total scale α = 0.83 to 0.89; subscale α = 0.70 to 0.94) and partial structural validity. No instrument achieved a COSMIN Category A recommendation, as content validity was not established for any instrument and evidence for responsiveness, measurement error, and measurement invariance was absent or limited. Psychometric gaps constrain the equitable use of chronic stress PROMs in African American adults and undermine the capacity to monitor stress-related CVD disparities. Validation studies prioritizing community-engaged content validity, responsiveness, and measurement invariance are needed to advance measurement equity for prevention.
Māori in Aotearoa New Zealand (Aotearoa NZ), Aboriginal and Torres Strait Islander peoples in Australia, First Nations, Inuit and Métis peoples in Canada, and American Indian and Alaska Native peoples in the United States experience substantial inequities in type 2 diabetes. While numerous diabetes programs for Indigenous populations have been described across these countries, the structural features that characterise Indigenous models of diabetes care remain less clearly articulated. This scoping review aimed to identify and describe the structural components of Indigenous models of diabetes care reported in literature from Aotearoa NZ, Australia, Canada and the United States. A scoping review was conducted following the Arksey and O’Malley framework, with methodological guidance from the Joanna Briggs Institute and Indigenous-informed scoping review approaches. Electronic databases and grey literature sources were searched to identify studies describing Indigenous diabetes initiatives in Aotearoa NZ, Australia, Canada and the United States. Database searches identified 10,683 records. Following the removal of 10 retracted publications and 4,642 duplicate records, 6,031 records underwent title and abstract screening. Full-text articles were assessed against the eligibility criteria, resulting in 38 included studies. Data were charted using a structured extraction template capturing program characteristics, governance structures, workforce roles, delivery settings, and care practices. Extracted data were analysed to identify recurring structural components of Indigenous diabetes initiatives. Component domains were refined through iterative discussions with the research team and a kaumātua (esteemed elder) advisory rōpū (group). Frequency counts were generated to map the presence of components across the included studies. Thirty-eight sources were included in the review. Ten components of Indigenous diabetes care were identified and grouped into three domains: governance and service design, workforce and delivery structures, and cultural foundations of care. The most frequently reported components included cultural–clinical integration, Indigenous workforce roles, culturally safe care structures and accountability, and Indigenous governance and leadership. Programs were commonly delivered in community settings and often used hybrid workforce models that combined clinical professionals with Indigenous health workers, navigators, or peer educators. Many initiatives also embedded cultural practices and Indigenous knowledge systems within program delivery. Indigenous diabetes initiatives across Aotearoa NZ, Australia, Canada and the United States are characterised by integrated models of care that combine governance structures, culturally grounded workforce roles, community-based delivery environments, and cultural foundations of care. By synthesising these structural components, this review provides a framework for understanding how Indigenous diabetes initiatives are organised and delivered. The findings may inform future research, service design, and policy development to improve diabetes care for Indigenous communities. A formal protocol was developed prior to commencing screening and extraction; however, it was not prospectively registered.
In Australia, progress towards the UNAIDS 95-95-95 targets is lower among people living with HIV born overseas compared to those born in Australia. Stigma is a major barrier to achieving these targets. This project aimed to identify differences in experiences of HIV-related stigma and healthcare outcomes between people born in Asia, Latin America, and Australia. Between April-August 2023, 153 Sydney Sexual Health Centre clients who were living with HIV completed an anonymous online survey. 71 participants were born in Australia, 45 in Latin America, 24 in Thailand, and 13 in China. Half of all participants (50.3
Racial discrimination is associated with negative mental health outcomes among students, yet it remains understudied at German universities. In a period of two months in 2022 a cross-sectional study was conducted at a German university using an anonymous bilingual online questionnaire for data collection. Among 179 students who had experienced racial discrimination in their lives, 106 (59.2
Renal medullary carcinoma (RMC) is a rare, aggressive kidney cancer affecting young Black patients. A previous analysis of the Surveillance, Epidemiology and End Results (SEER) database reported an approximately five-fold higher mortality among Black patients. We reassessed whether this disparity is reproducible and examined the roles of race–ethnicity misclassification and access to surgery. We identified RMC cases (histology code 8510/3) in the SEER database (2000–2022). Overall survival was modelled with multivariable Cox regression and cancer-specific survival with Fine–Gray competing-risks regression. The SEER race code was reclassified into the National Institutes of Health five-class race–ethnicity scheme, and access to surgery was examined with inverse-probability-of-treatment weighting. Robustness was assessed across six analytic approaches and a leave-one-cell-out diagnostic. Of 148 patients, 147 were analysed (median age 27 years; 79
The shift toward non-operative management of acute appendicitis raises concerns for delayed diagnosis of appendiceal neoplasms. Our aim was to determine the prevalence and predictors of appendiceal neoplasms among patients presenting with acute appendicitis. This retrospective cohort study at the University Hospital of the West Indies (UHWI) identified consecutive patients who underwent appendicectomy from January 2016 to December 2020. Clinical records were reviewed to confirm a preoperative diagnosis of acute appendicitis; cases operated for other indications were excluded. Bivariate analyses and Firth’s logistic regression models compared patients with and without neoplasms to identify independent demographic, clinical, laboratory, and radiological predictors. Of 441 patients with acute appendicitis, 12 (2.72
Retinal imaging, including fundus photography (FP) and fluorescein angiography (FA), are more sensitive for monitoring non-proliferative diabetic retinopathy (NPDR) compared to dilated fundus examination. However, the impact of socioeconomic factors on receipt of this retinal imaging is unknown. We evaluate associations between socioeconomic factors and receipt of FP or FA among patients diagnosed with moderate to severe NPDR by linking data across multisite electronic medical records. We linked 16 academic electronic record systems and further linked diverse socioeconomic variables. Cox proportional hazards modeling was used to assess factors associated with the main outcome measure of the receipt of FP or FA in 2,082 patients with moderate to severe NPDR. Males (23.3
Hereditary colorectal cancer (CRC) is recognized as an escalating global public health concern, yet it remains neglected among ethnic minority, indigenous, and/or understudied populations. This study aimed to evaluate the current genetic and molecular research on hereditary and early-onset CRC in these neglected groups. A comprehensive review of literature published from 2018 to 2024 was conducted to characterize the profiles of CRC screening, diagnosis, and management in diverse underserved populations worldwide. The findings indicated that although the molecular features associated with Lynch syndrome were largely consistent across different groups, significant discrepancies were observed in early-onset CRC presentations when compared with well-studied populations. These observations suggested that neglected populations harbored unique genetic profiles that could advance the understanding of CRC pathogenesis and inform broader genetic research on other hereditary disorders. Furthermore, the feasibility of implementing the strategies developed for indigenous South African populations on a global scale was critically assessed. It was concluded that unified, region-specific approaches were essential to enhance early diagnosis, improve interventions, and ultimately contribute to a more equitable global health landscape in the management of hereditary CRC.
Despite bearing a disproportionate burden from poor health outcomes, members of racial and ethnic groups who experience health disparities are consistently underrepresented in health research. While many have sought to understand this problem by focusing on community mistrust of science, there is increasing recognition that research teams' attitudes and practices contribute to the lack of diversity in research participation in multiple ways. In this study, we explored the experiences of research team members as they attempted to implement practice changes to increase the recruitment of underrepresented participants from racial and ethnic minoritized groups. Investigators and research team members (n = 33) who attended a one-day workshop on inclusive strategies in research recruitment were interviewed three months after the training. The interviews were virtual, audio-recorded, and fully transcribed. Thematic analysis followed the guidelines set out by Braun and Clarke. Analysis revealed themes including the importance of team culture, the presence or absence of shared values, and resources (time, funds, relationships), as well as leadership "buy-in” for participants’ ability to implement inclusive recruitment strategies. Findings point to the structure, culture, and history of conducting science as obstacles to researchers' ability to implement strategies to address the lack of diversity in research participation.
Recruitment for clinical trials among Black populations in the U.S. Deep South is challenging due to general distrust of medical research. The COVID-19 pandemic exacerbated this phenomenon at a time when distrust of the medical community was high. This study evaluated the likelihood of participation in a COVID-19 clinical trial among Black residents in urban and rural counties in the State of Alabama. From 3 counties, 296 participants were queried regarding their awareness of COVID-19 clinical trials, likelihood of participating, medical mistrust, experience with racism, and trust in sources of COVID-19 information. Bivariate analyses compared data by county. A multivariate regression model estimated likelihood of participation in a COVID-19 clinical trial. Participants were majority female (76.9
Evidence for inclusion strategies in the workplace is limited. In our previous research we identified challenges for newly qualified racially minoritized physiotherapy staff within a large UK urban NHS Trust. In this study we evaluated the impact of strategies co-created to facilitate their inclusion. A process and outcomes evaluation approach was used with our previous work to co-create and implement inclusion strategies. Mixed methods of data collection included a staff survey, workplace guidelines, proforma usage, and interviews with key protagonists which were informed by a theory of change. Six months after the project was implemented, we found that newly qualified staff responded more positively to statements about feeling included. There was little improvement in socializing or connecting on a personal level with colleagues, despite a greater variety and frequency of social events. Even though participants were unchanged in their perception of space for inclusive conversations, more agreed they were able to converse about race albeit with ambivalence about whether action would be taken. We noted a small increase in proportions of newly qualified staff feeling vulnerable and unable to bring their authentic self to work. This study implemented a proactive co-design approach for inclusion in physiotherapy with partial success. The findings at 6-months show some change in raising awareness, fostering dialogue and improving perceptions. However, a limitation of the process employed is that it may have surfaced deeper racial and intersectional tensions that require sustained and complex local and organizational action, which is an ongoing and iterative endeavor.
This paper examines forms of racialized stress experienced by Black mothers throughout the life course. The literature suggests that racialized pre- and post-natal stress experienced within health care settings tend to create pathways for negative physical and mental health outcomes. These outcomes highlight the need for critical resources to improve the quality of maternal mental health among Black birthing populations. We incorporate perspectives from social work – Grand Challenge to Eliminate Racism and sociology to re-envision the exhaustive efforts made by Black mothers to protect their children in the face of racism. Our analysis suggests that Black mothers often exercise agency to resist mental health effects that may impair their ability to parent in a healthy manner. Resilience may emerge in the form of cognitive flexibility and the healing power of spirituality. Strategies to eliminate racism include adoption of an anti-racist perspective inclusive of an intersectionality paradigm as well as qualitative methodologies to address interlocking systems of sexism and racism experienced by Black mothers throughout their parenting journey.
When dealing with a cancer diagnosis, patients and informal caregivers often face situations that challenge their communication skills and may prompt them to seek counseling or other supportive resources. However, studies and interventions addressing effective communication needs within the Spanish-speaking community are scarce. This study aims to document the communication needs and preferences of cancer patients and caregivers about the format and delivery of a culturally tailored community-based intervention. Using a community-engaged research framework, we conducted a cross-sectional survey of 92 cancer patients and caregivers in Puerto Rico. Participants selected communication needs for which they desired additional support, and patient and caregiver responses were compared using Fisher’s exact tests with correction for multiple comparisons. Ninety-two participants (52 patients and 40 caregivers) completed the survey. The highest rated communication topics included ‘Develop problem-solving skills’ (76.9
Unintentional home injuries are a major public health burden in Canada, with racialized and newcomer communities experiencing disproportionate risk. However, limited research has examined the lived experiences and structural determinants of home-injury risks within these populations. Authors in this study examined how recent Afghan immigrants and refugees in Vancouver, British Columbia, experience and navigate home-injury risks within resettlement contexts. Using a community-based participatory research approach, we partnered with a Community Advisory Board, who were Afghan newcomers to Vancouver, to guide the research process. We conducted nine semi-structured interviews and one focus group (n=eight) with Afghan newcomers (arrived in Canada since 2019). We collected data in the Dari language and translated them into English. We analyzed the data using Braun and Clarke’s reflexive thematic analysis, guided by an intersectional theory. Four themes illustrated home injury experiences as a socially negotiated process shaped by vulnerability and resilience: (1) structural vulnerability, wherein housing precarity, linguistic exclusion, and institutional mistrust compounded home injury risks; (2) gendered and intergenerational home safety burden, with women and daughters disproportionately responsible for prevention, interpretation, and caregiving; (3) cultural adaptation and embodied learning, as participants learned unfamiliar safety technologies through lived experience; and (4) community networks and resilience as protective infrastructure, functioning as trusted, language-congruent channels for home safety knowledge and support. Preventing home injuries among Afghan newcomers to Vancouver requires moving beyond individual-level behaviour change toward structural, equity-driven interventions that integrate culturally safe, community-partnered education with intersectoral action across housing, settlement, health, and social services.
Everyday discrimination is a pervasive social stressor that has been linked to adverse health outcomes and contributes to persistent health inequities in the United States. Understanding contemporary patterns of discrimination across racial and ethnic groups remains an important public health priority. Our study examined racial and ethnic differences in multiple forms of everyday discrimination among U.S. adults. Data were drawn from the 2023 National Health Interview Survey, a national U.S. sample of non-institutionalized adults aged ≥ 18 years. The analytic sample included 28,797 adults who identified as White, Black, Hispanic, or Asian. Everyday discrimination was measured using the Everyday Discrimination Scale. Separate multiple logistic regression models were estimated to assess associations between race and ethnicity and five discrimination measures, adjusted for covariates. Both Black and Asian adults had higher odds of reporting multiple forms of everyday discrimination compared to White adults. Black adults exhibited elevated odds across all five measures, particularly being perceived as threatening (OR = 2.25, 95
Using legal epidemiological and social determinants of health frameworks, this study examines how racial and spatial inequalities shape cardiometabolic health outcomes in Greenville County, South Carolina. We used Census tract–level data from the CDC PLACES project, and the U.S. Census Bureau to assess associations between racial/ethnic composition and cardiometabolic indicators, including coronary heart disease, hypertension, and obesity. Our regression-based mediation analysis examined whether socioeconomic factors (household income and education attainment) explained these associations. Tracts with greater Black and Hispanic/Latino populations had much higher cardiometabolic disease and risk factor rates. These inequities were partly mediated by lower educational attainment and income, emphasizing the role socioeconomic inequality plays in emergence of racial and spatial disparities of health outcomes in these communities. The results demonstrate the way structural inequities ingrained in land-use policy, education opportunities, and neighborhood characteristics contribute to racial inequities for the health of our communities. Policies that expand access to education and economic opportunities, ensure fair land use, and promote equitable urban and regional planning are critical for reducing health inequity in rapidly growing medium sized regions in the U.S.
The rate of diabetes and blood pressure (BP) control are low, particularly in patients with diabetes receiving care from federally qualified health centers (FQHCs). The Office-Gap IMPACT study (Office-Guidelines Applied to Practice Improving Diabetic Patients’ Adherence to Treatment and Prevention of Cardiovascular Disease) is a patient activation intervention to improve care and health outcomes for patient with diabetes and cardiovascular disease in FQHCs and community health centers. This baseline analysis of the Office-GAP IMPACT study (1) aimed to describe the individual-level demographic and clinical characteristics of patients with diabetes enrolled in the Office-GAP study, (2) assess the associations between these characteristics and baseline BP and glycemic control, and (3) assess the differences in BP and glycemic control in three different counties in Michigan. We enrolled 392 patients with diabetes in 17 clinical teams in 12 FQHCs located in three counties in Michigan. Teams were randomized into intervention, Office-Gap + Texting (group 1) vs. enhanced control, Texting only (group 2). Baseline demographic and clinical data were analyzed. Among 392 patients, 68
