Purpose: This DNP project examines the effectiveness of a brief educational presentation to improve cultural competency care for obesity among African Immigrants. This project focused on providers at southwestern urban primary care clinic to become culturally competent in caring for African immigrants with obesity. The findings and recommendations of this project also serve as resource for other providers locally and nation-wide who provide care for African immigrant population. Method: Utilizing a purposeful sampling method, quantitative pre-test and post-test questionnaires were used to evaluate cultural knowledge and intended clinical practices of participants (N =5), feasibility and satisfaction of the educational activity. Aggregate data collected from the pre-and post-test questionnaires were analyzed and discussed through thematic and descriptive analysis. Results: All participants demonstrated significant enhancement in cultural competency in knowledge in regard to nutrition, physical activity and linguistics/communication, body image perception and obesity management in African cultural context. Also, one hundred percent (n=5) of the participants recorded very high level of satisfaction of the intervention content and delivery. Conclusion: The education intervention was successful in enhancing providers’ cultural knowledge and competence in caring for African immigrants with obesity. It also serves as valuable initiative to further develop culturally competent care based on evidence-based practice to enhance the quality of care delivery for African immigrants as well as other vulnerable minority populations. For the over two million African Immigrants in the United States, obesity and its related complications is a constant struggle for this minority population. Health disparities exist for all minority groups suffering from poverty in the US, and the immigrant population is at a higher risk for these disparities due to the slower rate of acculturation. The effort to address obesity among immigrants especially those of African descent is significantly influenced by providers’ cultural knowledge, sensitivity and competency in healthcare delivery. This project outlines the development, implementation and evaluation of a brief PowerPoint presentation aiming to educate healthcare providers on cultural competency and appropriateness in caring for African Immigrants with obesity.

Parents of children with developmental disabilities (DDs) often suffer from psychological distress stemming from their children’s behavioral problems. One cause of distress is their challenge to accept their children’s illnesses mindfully. A culturally tailored and readily accessible mindfulness intervention may increase mindfulness and reduce distress. Also, there were insufficient studies regarding culturally relevant mindfulness trainings that have been conducted in Thailand. Therefore, a Brief Culturally Tailored Thai Mindfulness intervention (BCTTMi) was developed, merging the work of Jon Kabat-Zinn with Buddhist philosophy. The purpose of this study was to examine the effects of the BCTTMi on stress, anxiety, and mindfulness in these parents. An experimental waitlist control crossover design with the 2-weekend BCTTMi was employed in 22 Thai parents and caregivers of children with DDs. They were all Thais and Buddhists; more than half had practiced meditation. They completed three Thai-version questionnaires: (a) the Parenting Stress Index-Short Form-4th edition; (b) the State Anxiety Inventory-Form-Y-1; and (c) the Mindfulness Assessment Scale, at three measurements (baseline, posttest, and two-week follow-up). Repeated measure ANOVA analyses were used to analyze data. The findings showed that anxiety significantly decreased from baseline to posttest, and mindfulness significantly increased with the BCTTMi. Nevertheless, stress did not significantly reduce over time, and change between intervention and control conditions did not differ for anxiety level. Moreover, there were no differences in any outcomes from posttest to two-week follow-up. In spite of Buddhist homogeneity of participants and sustained stress, mindfulness increased, and anxiety decreased following the BCTTMi. These findings indicate the feasibility of tailoring the mindfulness-based training to specific cultures and its usefulness as an efficient option for parents and caregivers of children with DDs. Further studies regarding the BCTTMi are warranted in broader populations and settings. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2018. / FAU Electronic Theses and Dissertations Collection

The United Kingdom (UK) is becoming increasingly diverse (Office for National Statistics, 2013). Educational psychologists in the UK will need to feel competent in providing services to an increasingly multicultural population. This research study used a mixed method, two-phase, sequential, explanatory study design to explore the self-perceived intercultural competence of UK educational psychologists and trainee educational psychologists (EP/Ts). The study also explored EP/Ts experiences of working with culturally diverse populations. The first phase of this research study used an online adapted version of the MCCTS-R (Holcomb-McCoy & Myers, 1999; Munoz, 2009), and the second phase built upon the first phase with follow-up semi-structured interviews, analysed using Braun & Clarke's (2006) thematic analysis. The results of this research study present a breadth and depth of information. EP/Ts generally perceived themselves to be competent to work cross-culturally with particular areas of competence including knowledge of assessment bias, poverty effects, and positive attitudes towards diverse cultures. EP/Ts also reported areas of lower competence including theories of racial/ethnic identity development, limited experiences of community work and limited knowledge of community resources. However, EP/Ts perceptions about development needs depended upon their awareness. The process of participating in the study raised awareness of gaps in knowledge and limitations in practice. The study concludes with a discussion of implications for the practice of EP/Ts.

Jamaicans, the largest group of English-speaking Caribbean people living in the United States (US), have a history of using bush medicine/complementary therapies (CT) in diabetes management. However, no research described the emic views of Jamaican adults regarding how they select the bush medicine they use or how they know these are suitable to manage diabetes. The purpose of this focused ethnography was to explore and describe how Jamaican adults with diabetes mellitus who live in South Florida select and use complementary therapies for managing their diabetes. The objectives were to: (1) Explore the emic views of Jamaican adults about using CT to manage diabetes mellitus; (2) Describe the rationale given by Jamaicans adults for using CT to manage diabetes mellitus; (3) Analyze and synthesize the data gathered about use of CT for diabetes by Jamaican adults to see if their actions have cultural components that can serve as a basis for providing culturally competent care. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2019. / FAU Electronic Theses and Dissertations Collection

This study explored the social inclusiveness of classrooms with culturally competent teachers who were identified both by their participation in in-service diversity training and by principal nomination. The design of this study was primarily quantitative using a one-way ANOVA to analyze whether fourth and fifth grade students (N = 125) in classrooms with teachers identified as culturally competent are more inclusive in their mutual friendships than students (N = 117) in classrooms with not trained teachers at the same schools. Sociometric questionnaires were used to collect data on mutual friendships. Observations of students in lunchroom settings were also conducted. Findings from the sociometric questionnaire suggest that students with culturally competent teachers, also referred to as culturally responsive teachers in the literature, have broader and more diverse social networks than students in classrooms with not trained teachers. However, in the lunchroom settings where a given student must choose a limited number of students to sit next to at the lunch table, no notable differences between the classrooms emerged. Other than training in diversity issues, teachers in the two groups were very similar.

The topic of this thesis stems from my interest in finding out whether a partial early childhood Certificate qualification could procure employment in early childhood centres for Chinese student teachers, which could then eventuate in Permanent Residency status. Employment in early childhood centres is currently being driven by the need to comply with Ministry of Education requirements which state that centres need to have fifty per cent of their teachers fully qualified and registered by 2007. The literature surrounding the employment experiences of Asian immigrants to New Zealand reveals negative outcomes, and discrimination is cited as one of the causes of this. However, early childhood education in New Zealand espouses a strong philosophy of cultural diversity and inclusive practice.The employment experiences of seven Chinese early childhood student teachers are documented in this thesis using a qualitative mixed-method approach involving Case Study as the overarching methodology/method, supplemented with Narrative Inquiry and Documentary Analyses to collect and analyse the data.The main findings of my research were: there are obstacles that this ethnic group faced in gaining employment relevant to their qualification - this was a negative, but not unexpected outcome. The second major finding was that, despite the over-arching philosophy of early childhood education in Aotearoa/New Zealand, I found that there were several areas where the participants of this study were vulnerable to 'discrimination'. This was predominantly in the form of unfair practices and included: interview experiences; relief teaching; employment contracts; and payment issues. The participants of this study were also vulnerable in other ways. In order to enrol in further study to become fully qualified, they need to achieve a high IELTS (International English Language Testing System) level.A third and much more positive outcome was that participants who found employment did so through practicum placements, networks of friends, and with those centres that were accepting of 'cultural difference'. All of these findings were to some extent largely congruent with the literature on immigration experiences of 'migrants'.Further research needs to be undertaken on this topic by myself, and others in this field, in particular, how International Students are 'protected' in Aotearoa/New Zealand. I found that there was a 'loophole' in the Immigration Points Table and that International Students are possibly being encouraged to enrol in Early Childhood Certificate programmes in the belief that they will find employment and eventually Permanent Residency status. This research shows that this is not always the case.In addition to this, further research needs to focus on the views of centre owners and staff, with regard to employing Chinese early childhood educators; the views of Chinese parents with regard to their perspective of Chinese teachers and lastly, in the area of relief teaching. In the conclusion several recommendations for changes to policy and practice at the tertiary level are raised.

The topic of this thesis stems from my interest in finding out whether a partial early childhood Certificate qualification could procure employment in early childhood centres for Chinese student teachers, which could then eventuate in Permanent Residency status. Employment in early childhood centres is currently being driven by the need to comply with Ministry of Education requirements which state that centres need to have fifty per cent of their teachers fully qualified and registered by 2007. The literature surrounding the employment experiences of Asian immigrants to New Zealand reveals negative outcomes, and discrimination is cited as one of the causes of this. However, early childhood education in New Zealand espouses a strong philosophy of cultural diversity and inclusive practice.The employment experiences of seven Chinese early childhood student teachers are documented in this thesis using a qualitative mixed-method approach involving Case Study as the overarching methodology/method, supplemented with Narrative Inquiry and Documentary Analyses to collect and analyse the data.The main findings of my research were: there are obstacles that this ethnic group faced in gaining employment relevant to their qualification - this was a negative, but not unexpected outcome. The second major finding was that, despite the over-arching philosophy of early childhood education in Aotearoa/New Zealand, I found that there were several areas where the participants of this study were vulnerable to 'discrimination'. This was predominantly in the form of unfair practices and included: interview experiences; relief teaching; employment contracts; and payment issues. The participants of this study were also vulnerable in other ways. In order to enrol in further study to become fully qualified, they need to achieve a high IELTS (International English Language Testing System) level.A third and much more positive outcome was that participants who found employment did so through practicum placements, networks of friends, and with those centres that were accepting of 'cultural difference'. All of these findings were to some extent largely congruent with the literature on immigration experiences of 'migrants'.Further research needs to be undertaken on this topic by myself, and others in this field, in particular, how International Students are 'protected' in Aotearoa/New Zealand. I found that there was a 'loophole' in the Immigration Points Table and that International Students are possibly being encouraged to enrol in Early Childhood Certificate programmes in the belief that they will find employment and eventually Permanent Residency status. This research shows that this is not always the case.In addition to this, further research needs to focus on the views of centre owners and staff, with regard to employing Chinese early childhood educators; the views of Chinese parents with regard to their perspective of Chinese teachers and lastly, in the area of relief teaching. In the conclusion several recommendations for changes to policy and practice at the tertiary level are raised.

INTRODUCTION: According to current census projections, by the year 2050 racial and ethnic minority groups will make up over half of the United States population. With the rise of a more multicultural and diverse population, there has been growing concern with regards to the health disparities and how healthcare professionals can increase positive healthcare outcomes. In an effort to contend with the growing population, the subsequent disparities that will be faced by a more diverse population, and the difficulties many healthcare practitioner’s will encounter while communicating and working with this population group, many healthcare educators have turned their attention to training and educating the next generation of healthcare providers on the practice of cultural competence. For many institutions, however, there is still uncertainty over the most effective means for teaching cultural competence throughout the healthcare curriculum. Data collected from a 2017-2020 study conducted at Boston University in the M.S. in Oral Health Sciences Program, a credential enhancing program for predental students with the aim of providing students with admission into an accredited dental institution, evaluates an effective mechanism for training healthcare professionals in cultural competence skills. This study hypothesizes that one effective and powerful tool for teaching the next generation of health professionals to be culturally competent providers is through role-playing, case-based, simulated exercises which emphasize the importance of the provider patient relationship, holistic approaches to healthcare, and compassion when working with patients. METHODS: A course session was created in an Evidence Based Dentistry Course within the M.S. in Oral Health Sciences Program. From 2017-2019 the course session was composed of three parts: a role-playing enactment of two patient case-based encounters, a real-time class group discussion following both patient encounters, and a PowerPoint presentation emphasizing the key take-away points from the role-playing exercise. At the conclusion of the session, students were asked to participate in a post-session survey regarding the student’s feelings about the session. In 2020, due to the COVID-19 pandemic, a switch in course session modality in the Evidence Based Dentistry course to an online format, prompted a change in the session format. In 2020, students were asked to read both patient encounters on their own, reflect, discuss, and comment on the learning platform Blackboard Learn discussion board on their takeaways from the case, and participate in PowerPoint presentation presented by facilitators. At the conclusion of the 2020 session, students were asked to complete a post-session survey on the effectiveness of the session. In addition to qualitative data obtained from the post-session surveys, in 2020, student discussion board posts were coded and analyzed qualitatively using the coding software NVivo 12 to determine whether students understood the important takeaways from the discussion board portion of the session. RESULTS: According to results from the course session implemented from 2017-2019, overall, the role-playing exercise significantly improved participants understanding of key components of cultural competence. From 2017-2019 students were strongly able to identify the importance of communication in patient encounters, were able to understand the strategies such as communication and compassion in patient encounters, were better able to identify the importance of building a trusting patient -physician relationship, and most importantly, students were able to recognize their own cultural biases when treating patients. Results from 2020, revealed that even with a change in course modality and format to a discussion board format, students were still able to understand the key take-aways of cultural competence from the session. DISCUSSION: This study reveals that students were able to understand cultural competence after completion of both iterations of the course session from 2017-2019 & 2020 and that this session can be an effective method for training the next generation of healthcare professionals the practice of cultural competence. While this study provides insight into the future of cultural competence training, it is important to recognize that more studies must be conducted to provide additional answers to several questions about the most effective mechanism for teaching cultural competence, what to teach in cultural competence education, and when to begin training students the practice of cultural competence.

No / Previous attempts to involve African and African-Caribbean communities in a city in north England in identifying and assessing their health needs have been largely unsuccessful. A comprehensive literature review highlighted that research on Africans and African-Caribbeans is limited and uneven, and dominated by studies focusing on cardiovascular disease, diabetes, mental health and blood disorders. Health information on these communities is largely based on immigrant mortality statistics derived from national datasets. This paper highlights how participatory approaches to community participation and engagement were used in the assessment of the health needs of culturally diverse minority communities as a means of reducing health disparities. The study sought to overcome the shortcomings of traditional techniques for health needs assessment by testing a novel method of rapid participatory appraisal using a triangulation approach to ensure that all perspectives were addressed. The research adopted a mixed-methods strategy comprising distinct phases: a comprehensive review of the literature, a qualitative needs assessment involving representatives of the African and African-Caribbean communities using meta-planning, and a review of health service provision. The approach used in the study was efficient, rapid and feasible for the African and African-Caribbean people to use in obtaining data from their peers. The findings showed a convergence between areas of need identified by health providers and community members in this appraisal, and between these results and other published literature. However, there was a divergence on the extent of change necessary, with institutional responses stressing alterations within existing systems, and community members recommending the establishment of targeted services for African and African-Caribbean communities run by ethnically matched staff.

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