Structural competency in pre-health and health professional learning: A scoping review

Caiola, Courtney; Richardson, Taylor N.; Black, Kristin Z.; Calogero, Christie; Guard, Kaitlin; Haberstroh, Amanda; Corral, Irma

doi:10.1080/13561820.2022.2124238

Cited by 4 publications

(2 citation statements)

References 46 publications

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“…The Structural Competency Working Group (2020), an interprofessional group based in the Bay Area of California, organizes to promote structural competency training and also disseminates open-access curricula to enhance this effort. Intentional interprofessional collaborations such as these, along with wide implementation of standardized, open-access curricula and training evaluation, are suggested to move structural competency forward and decrease the disciplinary silos health care professionals experience in addressing these complex issues (Caiola, et al, 2022). In addition, training in addressing the SDH cannot be isolated to professional health care education programs such as nursing and medical school.…”

Section: Training In Social Determinants Of Healthmentioning

confidence: 99%

A Fundamental Shift in Nursing is a Requisite for Achieving Health Equity: The Nurses' Role in Addressing Social Determinants of Health

Wise

Caiola²,

Njie-Carr³

2023

J Assoc Nurses AIDS Care

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Section: Training In Social Determinants Of Healthmentioning

confidence: 99%

A Fundamental Shift in Nursing is a Requisite for Achieving Health Equity: The Nurses' Role in Addressing Social Determinants of Health

Wise

Caiola²,

Njie-Carr³

2023

J Assoc Nurses AIDS Care

Self Cite

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“…This suggests that providers and staff in both HIV and other healthcare settings will need to be aware of how different types of stigma contributes to feelings of marginalization and decreased care utilization. In addition, previous studies have shown that structural competency training for healthcare professionals, including primary care physicians caring for individuals with PLOS ONE opioid use disorder, can help provide guidance on how to recognize and address structural factors that lead to different types of stigma and health inequities [41][42][43]. Thus, a structural competency curriculum for providers and healthcare staff could be used to provide more understanding of the structures that are shaping the experiences of young adults living with HIV and their communities and ultimately provide a more integrated and patient-centered approach to care.…”

Section: Plos Onementioning

confidence: 99%

A qualitative analysis examining intersectional stigma among young adults living with HIV in Atlanta, Georgia

et al. 2023

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HIV-related stigma is a barrier to engagement in care for young adults living with HIV. Other intersecting forms of stigma (e.g., racism, sexism, homophobia), may worsen HIV-related stigma and impact engagement in care. From November 2020 to February 2021, we conducted 20 in-depth qualitative interviews among young adults living with HIV attending a large, comprehensive HIV care center in Atlanta, Georgia. Semi-structured interview guides based on Earnshaw and Chaudoir’s HIV Stigma Framework and the theory of intersectionality facilitated discussion around experiences with various forms of stigma and its possible influence on healthcare engagement. Using the social-ecological model, we used thematic analysis to contextualize how young adults living with HIV experienced intersectional stigma and enacted, anticipated, and internalized HIV stigma in both healthcare and non-healthcare settings. Most participants identified as male, Black/African American, and gay. Participants described stigma at intrapersonal, interpersonal, clinic, and community levels. Intrapersonal stigma was associated with delayed care seeking, isolation, and fear of disclosure. Interpersonal stigma included discrimination from family and friends and avoidance of close relationships to elude disclosure. At the clinic level, stigma included negative experiences with staff in HIV and non-HIV healthcare settings, which contributed to decreased engagement in care. Stigma in the community included differential treatment from employers, community leaders, and religious community and was associated with feelings of helplessness related to current societal inequalities. Coping/motivating mechanisms for stigma included prioritizing health, eliciting support from the medical care team and peers. Our findings show different intersecting stigmas are barriers to healthcare at multiple levels for young adults living with HIV, potentially exacerbating existing health and social disparities. To improve engagement in care among young adults living with HIV, future interventions should address the different mechanisms of stigma at community, clinic, interpersonal and intrapersonal levels by enhancing social support and improving healthcare structural competency.

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