Purpose Faculty from different racial and ethnic backgrounds developed and piloted an antiracism curriculum initially designed to help medical students work more effectively with patients of color. Learning objectives included developing stronger therapeutic relationships, addressing the effects of structural racism in the lives of patients, and mitigating racism in the medical encounter. Method The antiracism curriculum was delivered and evaluated in 2019 through focus groups and written input before and after each module. The process and outcome evaluation used a grounded theory approach. Results Three emergent themes reflect how medical students experienced the antiracism curriculum and inform recommendations for integrating an antiracism curriculum into future medical education. The themes are: 1) the differential needs and experiences of persons of color and Whites, 2) the need to address issues of racism within medical education as well as in medical care, and 3) the need for structures of accountability in medical education. Conclusions Medical educators must address racism in medical education before seeking to direct students to address it in medical practice.
Residents in the Eastern Region, Ghana with access to improved water sources (e.g., boreholes and covered wells) often choose to collect water from unimproved sources (e.g., rivers and uncovered wells). To assess why, we conducted two field studies to coincide with Ghana’s rainy and dry seasons. During the rainy season, we conducted semi-structured in-depth interviews among a convenience sample of 26 women in four rural communities (including one woman in the dry season). We asked each participant about their attitudes and perceptions of water sources. During the dry season, we observed four women for ≤4 days each to provide context for water collection and water source choice. We used a grounded theory approach considering the multiple household water sources and uses approach to identify three themes informing water source choice: collection of and access to water, water quality perception, and the dynamic interaction of these. Women selected water sources based on multiple factors, including season, accessibility, religious/spiritual messaging, community messaging (e.g., health risks), and ease-of-use (e.g., physical burden). Gender and power dynamics created structural barriers that affected the use of unimproved water sources. A larger role for women in water management and supply decision-making could advance population health goals.
Objective Examine intentions to buy and eat dark green leafy vegetables (DGLV). Design Cross-sectional survey assessing demographics, behavior, intention, and Reasoned Action Approach constructs (attitude, perceived norm, self-efficacy). Setting Marion County, Indiana. Participants African American women responsible for buying and preparing household food. Main Outcome Measure(s) Reasoned Action Approach constructs explaining intentions to buy and eat DGLV. Analysis Summary statistics, Pearson correlations, and multiple regression analyses. Results Among participants (n = 410, mean age = 43 y), 76% and 80%, respectively, reported buying and eating DGLV in the past week. Mean consumption was 1.5 cups in the past 3 days. Intentions to buy (r = 0.20, P < .001) and eat (r = 0.23, P < .001) DGLV were positively associated with consumption. Reasoned Action Approach constructs explained 71.2% of the variance in intention to buy, and 60.9% of the variance in intention to eat DGLV. Attitude (β = .63) and self-efficacy (β = .24) related to buying and attitude (β = .60) and self-efficacy (β = .23) related to eating DGLV explained significant amounts of variance in intentions to buy and eat more DGLV. Perceived norm was unrelated to either intention to buy or eat DGLV. Conclusions and Implications Interventions designed for this population of women should aim to improve DGLV-related attitudes and self-efficacy.
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