With racism driving perinatal health disparities, antiracist tools and trainings are necessary for WIC nutrition professionals who serve as frontline providers for Black and Indigenous families of color. Black families, in particular, are the most likely to experience harms from discrimination in health care and health services, even from well-intentioned providers in caring professions. This thesis investigates the role of racism, both interpersonal and structural, and how it may influence WIC enrollment, participation and culture of care. After providing a basic overview about WIC including recent participation and demographic statistics and trends, I share my own ethnographic observations and reflections on my positionality in the WIC clinic setting. I review research on the most commonly identified barriers to and benefits from WIC participation, including how those benefits intersect with contributing factors in the crisis in Black perinatal health in the United States, and make the case for including experiences of bias and racism as an overlooked barrier. With a focus on improving the client experience, I use an urban bioethics lens to inform strategies (including antiracism training for WIC staff) to increase and sustain WIC participation and the concomitant benefits participation can incur, particularly for Black mothers and birthing people and their families. I review the literature that informed our training, describe key components of the training, and summarize the findings from the evaluation and assessment of the WIC nutrition professionals who attended. Lastly, I posit how the convergence of COVID-19 and the racial justice uprisings of 2020, both accelerated the acceptance of the need for innovations in how WIC is implemented, and created the conditions to facilitate rapid changes towards more equitable policies and procedures at both the local and federal level. Many of these changes were previously thought to be desirable but unattainable, and I reflect on the need to seize this opportunity to intentionally build upon that progress by applying a racial equity framework to envision a post-pandemic WIC. / Urban Bioethics

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The nursing profession perpetuates an outdated model that fails to address the health concerns of racialized gender-diverse people. Evidence supports that this population experiences poorer health outcomes, care-avoiding habits, and incompetent healthcare providers. A literature review illuminated gaps in the nursing lens when considering gender-diverse identities outside of Whiteness. An intersectionality framework and cultural humility were used to explore the contexts in which nurses provide care. To fill this knowledge gap, the proposed research question was: How prepared are nurses to provide care to racialized gender-diverse people? A questionnaire was developed by modifying three pre-existing instruments. The online questionnaire served as a pilot feasibility study to collect preliminary baseline descriptive cross-sectional data about Ontario nurses' training, education, knowledge, attitudes, and beliefs about racialized gender-diverse people. Findings indicated potential gaps in training and education that may affect racialized gender-diverse peoples' healthcare. Recommendations are provided for future research and interventions.

Culturally diverse clients often face barriers to accessing and using health and education services, which may affect the clients’ performance outcomes and impact the quality of services. These barriers include practitioners’ insufficient cultural competence and humility and an ineffective health care system. The Cultural Humility program aims to train and educate occupational therapy practitioners to gain confidence and improve their cultural humility and practical communication skills to maintain, establish, and manage therapeutic relationships. The program duration will be twelve 2-hour biweekly sessions over 6 months, in person at clinical settings or on a virtual platform. The program includes learning modules, such as lectures, simulation or video modeling, and discussion sessions with brain-based learning for occupational therapy practitioners. The program will provide meaningful opportunities for practitioners to reflect on their practice attitudes, gain confidence, change their mindsets, and learn practical communication skills for use with clients from various cultural backgrounds. The aim of the Cultural Humility program is to apply these practical techniques related to cultural humility, bringing synergy and authenticity to practitioners’ daily practice, and improving their clients’ performance and outcomes.

Public school closures and the provision of occupational therapy services during the COVID-19 pandemic revealed inequities and barriers that affect Latinx families’ and children’s access to resources. In Massachusetts, many students receiving occupational therapy services may have missed mandated and necessary occupational therapy services due to systemic barriers and the lack of skills to advocate for their needs. Occupational therapy practitioners (OTPs) may have lacked the self-efficacy and ability to facilitate the families’ advocacy. Culturally appropriate evidence-based interventions are needed to serve Latinx families and their children and prevent them from being underserved. A literature review identified that OTPs might not have the necessary skills to work effectively with culturally diverse groups. This skills gap reduces the OTPs’ ability to provide culturally appropriate interventions and holistic care to Latinx children and their families. A proposed solution to this problem is the 6-month, theory- and evidence-based I AM. Intercultural Advocacy and Mentoring Program: Increasing Occupational Therapy Practitioners’ Advocacy Skills in Collaboration With Latinx Families With Young Children for OTPs who work with Latinx families and children. The program aims to promote OTPs’ self-efficacy, cultural humility, and rapport- and trust-building skills. The I AM Program will ensure professionals working with Latinx families and children practice cultural humility, thus enhancing services for the client and building strong, trusting relationships and thriving communities.

Indiana University-Purdue University Indianapolis (IUPUI) / Social work has deep roots in and a commitment to social justice and eliminating and addressing the oppression of people of diverse backgrounds. This commitment is based on the National Association of Social Work 2021 Code of Ethics. In order for social workers to learn how to ethically challenge social injustice with cultural humility, they need to develop a high level of self-awareness, or critical consciousness (Freire, 2003) and commitment to marginalized groups. This makes the role of a social work educator a critical one. Social work educators have their own biases and experiences of oppression and privilege. In order to support and prepare social work students with the skills of self-awareness and cultural humility, the educator must analyze their pedagogy, such as the inclusion of Black, Indigenous, and People of color (BIPOC) authors, the use of open dialogue, and engagement in creating and supporting brave spaces, while accurately describing social work history. Specifically, social work educators need to be aware of their social positioning in which oppression and/or privilege shape their realities, since this impacts their sense of self and teaching practices. This proposal seeks to apply qualitative research methods to investigate whether social work educators' social positioning and the associated privilege or oppressive experiences are important to understand their pedagogical and instructional practices/strategies relative to antiracism.

Workplace arrogance has emerged as a research focus area for many industrial-organizational psychologists. Employees who demonstrate arrogance tend to demonstrate poor job performance, executive failure and poor overall organizational success. The present study investigates arrogance measured by the Workplace Arrogance Scale (WARS: Johnson et al., 2010) in relation to the Honesty Humility facet of the HEXACO Personality Index-Revised (HEXACO PI-R: LEE & Ashton, 2004). A total of 273 participants completed the WARS and HEXACO PI-R Honesty-Humility Facet of the HEXACO. Results show significant, strong negative correlations between the Honesty-Humility subfacets and the overall Honesty Humility facet score with the WARS scores. These findings indicate that workers high in arrogance lack important honesty-humility characteristics. Once we fully understand the complex mixture of personality traits that make up workplace arrogance, we can begin to screen for it in the hiring process and develop ways to better address it in the workplace.

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Millions of people around the world have fled their home countries in search of refuge, and there is a great likelihood they experience traumatizing events in their journeys to safety. Refugees are screened for mental health issues in the resettlement process in the United States, and there is a large body of established research regarding refugee mental health needs and strengths. However, far less is known about counseling refugees, and even less so about counselors working with the population. This dissertation study sought counselors' reflections on their experiences, both personal and professional, they feel help prepare them to see refugee clients. Four post-masters counselors participated in the video interviews. Participants were diverse (3 women, 4 ethnicities, counseling refugees from all areas of the world). Minimum criteria was having three adult refugee clients for a minimum of three sessions each. Four main themes emerged as result of analysis: 1) Trauma-informed, 2) Cultural competence and humility, 3) Counselor determination, and 4) Integration of Self. Participants specifically identified trauma-informed practices, cultural competence, and cultural humility as integral parts of necessary training for counselors to see this population. Counselors in this study found they were ill-prepared when they began seeing refugees and had to overcome obstacles to provide needed therapy. Results show a gap between what is known about refugees in academic literature and counselors' knowledge of the population which highlights the need for accessible curriculum and training on refugee issues as well as best practices for serving refugee clients. Implications for counselors, counselor educators, and future research are shared. / Doctor of Philosophy / People who have refugee status often struggle to meet basic needs upon resettlement. They have experienced potentially traumatizing events in their journeys, and their mental health needs are not often met. While a great body of research on refugee mental health exists, far less is known about counseling refugees, and even less so about counselors working with the population. This dissertation study sought counselors' reflections on their experiences, both personal and professional, they feel helped prepare them to see refugee clients. Four counselors participated in the video interviews. Minimum criteria was having three adult refugee clients for a minimum of three sessions each. Four main themes emerged as result of analysis: 1) Trauma-informed, 2) Cultural competence and humility, 3) Counselor determination, and 4) Integration of Self. Counselors in this study found they were ill-prepared when they began seeing refugees and had to overcome obstacles to provide needed therapy. Results show a gap between what is known about refugees in academic literature and counselors' knowledge of the population which highlights the need for accessible curriculum and training on refugee issues as well as best practices for serving refugee clients. Implications for counselors, counselor educators, and future research are shared.