ix, 127 p. : col. ill., col. maps / Community mediation programs exist to provide the general public a low cost and efficient way to resolve disputes peacefully. Community mediation is a voluntary process in which skilled mediators facilitate a conversation between the disputants, but do not advocate or impose solutions. I question whether community mediation practices, mediators and mediation programs are responsive to minority cultures. This thesis conceptualizes culturally appropriate dimensions to add to dispute resolution practices for a Latino demographic. Using a comparative analysis of community mediation programs in Oaxaca, Mexico and in Oregon, I highlight areas of departure from more traditional views of mediation. I argue that such programs will be more effective by incorporating practices grounded in the Latino cultural context of each region, including greater attention to group-oriented priorities within families, engaging in more personal contact with disputants, provision of childcare, enhancing efforts to attract Spanish-speaking mediators, and training mediators in intra-generational cultural competency. / Committee in charge: Anita M.Weiss, Chairperson; Tim Hicks, Member; Galen Martin, Member

Low income and under-represented minority students face multiple kinds of barriers that limit their access to higher education. In the interest of increasing access to college, pre-college bridge programs exist throughout the United States to serve students from low socio-economic status families. This study examines teaching by women in the Advancement via Individual Determination (AVID) program. AVID is a middle school and high school intervention program that helps middle-achieving low income and under-represented minority students with college access. Critical Portraiture methodology is used to examine the ways that female AVID teachers teach students more than just academic skills that increase access to higher education: the framing of student success, the negotiation and justification of upholding the myth of meritocracy in the classroom, the internalization of parental roles with students, and the navigation of race. / 10000-01-01

Background: Advance care planning (ACP) is a method used for patients to express in advance their preferences, beliefs and values for life-sustaining treatments at the end-of-life. With growing ethnocultural diversity in Canada, health care providers are managing an increasing number of diverse beliefs/values that are commonly associated with preferences for mechanical ventilation (MV) at the end-of-life. The aim of this project is to explore methods used by health care providers to set care plans for MV with ethnocultural populations. Methods: Qualitative analysis of semi-structured interviews with open-ended questions and two clinical vignette components was conducted with eight (8) health care providers who engage in ACP. Participants were recruited using a snowball-sampling approach from five acute-care hospitals within the Ottawa region. Results: Three major themes emerged from collected dataset: 1) Goals of care across illness trajectories, 2) Respecting beliefs, values, and wishes for care, and 3) Cross-cultural support in ACP. Using a value-based approach in ACP was described as an effective method for managing and interpreting diverse beliefs/values that impact decisions for MV. However, organizational, systemic, and personnel barriers that exist continue to hinder the provision of cross-cultural ACP across health settings. Contexte: La planification préalable des soins (PPS) est une méthode utilisée par les patients et les familles pour exprimer à l'avance leurs préférences liées aux traitements de prolongation de vie. En raison de la diversité ethnoculturelle croissante au Canada, les professionnels de la santé sont confrontés à des croyances et valeurs différentes, souvent associées à une préférence pour l’initiation et le maintien de la ventilation mécanique (VM) en fin de vie. L'objectif de ce projet consiste à explorer les stratégies utilisées par les professionnels de la santé lors des discussions associées à la VM auprès d'une clientèle multiculturelle. Méthodes: Huit (8) participants (médecins et infirmières) impliqués dans la PPS ont accepté de participer à une entrevue semi-structurée avec des questions ouvertes et deux scénarios cliniques. Les participants ont été recrutés à l'aide de la méthode d’échantillonnage par réseau (« boule de neige ») de cinq hôpitaux de la région d'Ottawa. Résultats: Trois grands thèmes ont émergé des entrevues: 1) les objectifs de soins à travers les trajectoires de la maladie, 2) le respect des croyances, valeurs et souhaits pour les soins, et 3) le soutien dans la PPS en contexte interculturel. Lors de la PPS, utiliser une approche basée sur les valeurs a été décrite comme une méthode efficace pour interpréter et prendre en compte les diverses croyances et valeurs qui ont une influence sur les décisions liées à la VM. Cependant, les barrières systémiques, organisationnelles et personnelles continuent d'entraver les services associés à la PPS en contexte interculturel dans les établissements de santé.

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Anthropological research conducted in a local Texas hospital provides data to analyze cultural competency. Increasing health equity is a key aspect of cultural competency literature, hospital, and national goals. Examining the local context allows for the analysis of how one hospital can affect public health in the area by using patient-centered care. Using observational and interview data to create the ideal of the patient journey shows how patient families experience cultural competency. Overall, the patient families felt they experienced culturally competent healthcare, however from the hospital structure perspective there could more goals to attain.

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No description available.

Healthcare agencies and researchers identify several areas in which healthcare disparity affects elder, African-American diabetics including higher rates of diagnosis, higher limb amputation, increased kidney failure, and stroke. While the disparities have been documented, elder, African-American diabetics rarely have been invited into discussions concerning these disparities, research questions, project or program design, and results. They are not asked to be stakeholders in health care or health policy discussions. This study used grounded theory as a participatory action research method to invite elder, African-American, diabetics into the discussion using focus groups. The patient participants then suggested providers they believed to be "successful" in their care who were then interviewed. The analysis suggests that where patient/ provider communication has been peripheral that care and perception of care and patient suffer. Where successful communication was central to the patient/provider relationship, provider preconceptions lessened and patient compliance levels rose. This dissertation offers several downstream, midstream, and upstream recommendations using a patient-focused lens. / Ph. D.

Environmentally-constructed, regional culture as defined by geographic place is not generally included in family therapy research and training concerning race, ethnicity, gender, sexual orientation, and other contextual factors. This grounded theory research project explores how practitioners working with families acknowledge, access, and use region as a cultural context in their service delivery, specifically in the New River Valley region of Southwest Virginia. Ecological theory, social construction theory, family systems theory, and cultural competency perspectives were used to frame the research questions, to develop the interview protocol, and to support the analysis of the properties and dimensions of the concepts and categories that emerged from the data analysis. The resulting grounded theory revealed that clinicians working with regionally distinct clients combine a client-centered approach with multiple-layers of regional knowledge and self-awareness. / Ph. D.

This study addressed three research objectives related to non-Muslim nurses’ experiences providing health care to Muslim patients in Saudi Arabian hospitals. These objectives included: first, understanding what it is like to care for Muslim patients considering both religion and culture; secondly, exploring what it is like being cared for by non-Muslim nurses. In order to address these objectives, the study has employed a qualitative approach, represented in hermeneutic phenomenology. The target groups in this study were Muslim patients and non-Muslim nurses who were interviewed using interviews and focus group discussions. The study found that religious, cultural and linguistic factors have a negative effect on non-Muslim nurses’ experience of care in Saudi Arabia, which included a personal impact, and a practical impact resulting from working practices. However, the results indicated that nurses had some problems with family members who interfered in decisions related to patients, and that they also encountered disrespect from patients’ relatives and friends. The study results indicated that non-Muslim nurses, to some extent, have an understanding of the different aspects and practices of Islam, such as praying, fasting and spirituality. The study results also revealed a significant relationship between spirituality (Islamic faith) and the provision of health care. Nurses believe that religious and spiritual practices have an effect on care. However, they failed to understand the importance of religion and spirituality to Muslims in general and patients in particular. The lack of training and orientation concerning specific issues of religion and culture negatively affected not only the communication between nurses and patients, but also the provision of health care. It was envisaged that this study would have a positive impact on the delivery of nursing training and education, because it highlights the need to tailor this to specific contexts. The study distinguishes itself from other studies conducted in the same field by investigating non-Muslim nurses’ and Muslim patients’ confusion between religion and culture. The study stressed an overlap between religion and culture in Saudi society, which consequently affected nurses’ provision of health care. It was essential in this study to investigate the differences between religion and culture, to see of non-Muslim nurses would understand religion and culture are not the same; while in some cases they complement one another, in other cases they contradict. Furthermore, the study addressed the issue of professionalism when caring for Muslim patients’ and non-Muslim nurses’ point of view. Although nurses claimed to provide healthcare in professional way, they were not fully aware of Saudi local culture or the impact of religion on patient’s daily life It can be concluded, in general, that non-Muslim nurses are facing challenges to providing healthcare to Saudi Muslim patients, due to a lack of understanding of the importance of cultural values and religious practices, and the lack of training and alignment on such issues.