Institutional procedural discrimination, institutional racism, and other institutional discrimination: A nursing research example

Abstract

Institutional discrimination matters. The purpose of this longitudinal communitybased participatory research study was to examine institutional procedural discrimination, institutional racism, and other institutional discrimination, and their relationships with participants' health during a maternal and child health program in a municipal initiative. Twenty participants from nine multilingual, multicultural community-based organizations were included. Overall reported incidences of institutional procedural discrimination decreased from April 2019 (18.6%) to November 2019 (11.8%) although changes were not statistically significant and participants reporting incidences remained high (n = 15 in April and n = 14 in November). Participants reported experiencing significantly less "[when]different cultural ways of doing things were shared, the project did not support my way" from April 2019 (23.5%, n = 4) to November 2019 (0%, n = 0), Wilcoxon signed-rank test Z = −2.00, p < 0.05. Some participants reported experiencing institutional racism (29.4%, n = 5) and other institutional discrimination (5.9%, n = 1). Participants experiencing institutional racism, compared to those who did not, reported a higher impact of the Initiative's program on their quality of life (t = 3.62, p < 0.01). Participatory survey designs enable nurse researchers to identify hidden pathways of institutional procedural discrimination, describe the impacts experienced, and examine types of institutional discrimination in health systems.

Organizational contexts, implementation processes, and capacity outcomes of multicultural, multilingual Home‐Based Programs in public initiatives: A Mixed‐Methods study

“…Study participants were required to use the NIRN model to develop their home‐based programmes and they reported that the use of the mainstream Western implementation model and scientific process for capacity building did not fit their thinking processes (Parker et al, In review; Lim et al, 2022). This resulted in more participants reporting that the meetings and materials presented were based on Western culture, so more people had difficulty understanding the work in November (65%, n = 11) than in April (47%, n = 8) (Lim et al, 2022). These findings are consistent with a previous study that the NIRN model provided a programme implementation framework, however, it was very complex, resource intensive and the language developed for the educational system did not fit well in healthcare (Brémault‐Phillips et al, 2018).…”

“…Participants' regular and contract work continuously accumulated. Not giving enough time to develop a useable home‐based programme can be viewed as institutional procedural discrimination (Lim et al, 2022). So, it is not surprising that there were no statistical changes in implementation processes outcomes.…”

“…Participants' multicultural, multilingual backgrounds and work with families enabled them to get funding. However, after receiving funding, those backgrounds became points of discrimination (Lim et al, 2022). Note.…”

“…Researchers used this information to develop the institutional procedural discrimination instrument. Detailed information about institutional procedural discrimination is reported in another article (Lim et al, 2022). Most instruments asked about participants' perspectives about their CBOs, except the institutional procedural discrimination and ease of information instruments, which asked about individual experiences.…”

“…This 12-item, binary (yes/no) instrument asks about participants' experiences of institutional procedural discrimination during the Initiative's HBP intervention (Lim et al, 2022). The first four survey items measured experiences such as changing procedures without permission, having meetings and materials based on Western culture, words on documents being changed without explanation and cultural ways not being respected when they were known.…”