There are differences of intent and impact between short-term and long-term engagement of U.S. academic institutions with communities of need in developing nations. Global health programs that produce long-term transformative change rather than transient relief are more likely to be sustainable and in ethical harmony with expressed needs of a region or community. This article explores characteristics of successful ethical partnerships in global health and the challenges that threaten them, introducing a consensus community engagement model as a framework for building relationships, evolving an understanding of needs, and collaboratively developing solutions and responses to priority health needs in underserved regions of the world. The community engagement model is applied to a case study of an initiative by a U.S. school of nursing to establish long-term relationships with the nursing community in the Caribbean region with the goal of promoting transformative change through collaborative development of programs and services addressing health care needs of the region's growing elderly population and the increasing prevalence of noncommunicable chronic diseases. Progress of this ongoing long-term relationship is analyzed in the context of the organizational, philosophical, ethical, and resource commitments embodied in this approach to initiation of transformative and sustainable improvements in public health.

Health policy makers, providers, clinicians, and social scientists are among those who have identified racial and ethnic diversification of the health care workforce as one strategy for solving the seemingly intractable problem of health disparities in the U.S. population. But evidence supporting the impact of such diversification on narrowing health disparities is lacking, thus making it unclear if the push for workforce diversification is empirically or politically driven. Moreover, data are largely derived from the study of physicians, making it difficult to generalize findings to nursing and other health professions. This article reviews the evidence that supports the impact of a diverse workforce on patient outcomes and delivery services. Assuming a positive social value in the absence of the data, the authors review the approaches that have been successful in diversifying the nursing workforce. The authors conclude with recommendations for research and policies, including best practices, for enhancing recruitment and retention of a diverse nursing workforce.

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The increasing interconnectedness of the world and the factors that affect health lay the foundation for the evolving practice of global health diplomacy. There has been limited discussion in the nursing literature about the concept of global health diplomacy or the role of nurses in such initiatives. A discussion of this concept is presented here by the members of a Task Force on Global Health Diplomacy of the American Academy of Nursing Expert Panel on Global Nursing and Health (AAN EPGNH). The purpose of this article is to present an integrative review of literature on the concept of global health diplomacy and to identify implications of this emerging field for nursing education, practice, and research. The steps proposed by Whittemore and Knafl (2005) were adapted and applied to the integrative review of theoretical and descriptive articles about the concept of global health diplomacy. This review included an analysis of the historical background, definition, and challenges of global health diplomacy and suggestions about the preparation of global health diplomats. The article concludes with a discussion of implications for nursing practice, education, and research. The Task Force endorses the definition of global health diplomacy proposed by Adams, Novotny, and Leslie (2008) but recommends that further dialogue and research is necessary to identify opportunities and educational requirements for nurses to contribute to the emerging field of global health diplomacy.