Dula F. Pacquiao

Aims: To translate the Clients' Perceptions of Providers' Cultural Competency into Chinese, validate it with Chinese immigrant clients in the United States and explore their healthcare experiences. Background: Culturally competent care is crucial to promote access, utilization and health outcomes among racial and ethnic minorities. Chinese immigrants represent the largest Asian‐American population in the US healthcare providers can enhance patient‐centred care with instruments that assess and improve their cultural competency. The Clients' Perceptions of Providers' Cultural Competency instrument can assess healthcare providers' cultural competency, offer feedback and improve patient‐centred care. Design: An online, cross‐sectional design was utilized for this psychometric study. Method: Data from 121 Chinese immigrants in the United States were analysed using Cronbach's alpha and exploratory factor analysis to assess reliability and construct validity. Criterion validity was examined by testing the association between self‐reported health and cultural competency using a generalized linear model. Results: Cronbach's alpha of the instrument was 0.91. The construct validity of the instrument revealed the four‐dimensional structure. Self‐reported health was significantly associated with cultural competency ( p = 0.003). Conclusion: Findings support the Chinese Clients' Perceptions of Providers' Cultural Competency instrument as a reliable and valid instrument to measure Chinese immigrants' perceptions of healthcare providers' cultural competency.

Introduction: Despite significant initiatives to address adverse social determinants, excess burden of disease and mortality persist among diverse minorities and socially disadvantaged groups. Recent changes to diversity, equity, inclusion, and belonging programs have affected organizational efforts to increase participation of underrepresented groups. Methods: White Paper synthesizes initiatives designed to achieve health and health care equity and provides evidence from studies of different approaches. Results: Distinct differences in approaches and outcomes were found specific to mitigating health disparities from health care inequities. Individual- and organizational-level approaches tend to mitigate inequities in health care delivery but are insufficient in eradicating adverse social determinants of poor health among socially disadvantaged groups. Discussion: Organizational leaders and health care professionals are called upon to engage in multidisciplinary and multisectoral collaboration to influence public policies at the highest level of government and private stakeholders. Culturally competent approaches are envisioned to target individual-, organizational-, and community/societal-level changes.

Background and Purpose:Cultural competence is significant in addressing the health needs of vulnerable populations. This study conducted psychometric testing of a cultural competency instrument in the Philippines.Methods:Brislin’s translation and a cross-sectional online design were used. Exploratory factor analysis (EFA) with varimax rotation examined construct validity of the 23-item scale among 157 adult LGBTQ+ residents. The scale revealed overall reliability (α = .85) including two subscales (α = .87, α = .81, and α = .61). The EFA yielded three theoretical factorial solutions.Conclusion:The Filipino version of the instrument demonstrated reliability and validity. Measuring clients’ perceptions of provider and organizational cultural competency can improve the utilization of healthcare in Filipino LGBTQ+ communities. Future research will examine the dimensional structures of the instrument among expanded LGBTQ+ communities.

Introduction: As part of its mission to advance Transcultural Nursing worldwide, the Transcultural Nursing Society Scholars upholds the central role of the discipline and cultural competence in advocacy, empowerment, and transformation of the life conditions of disadvantaged populations. This White Paper affirms the Scholars’ core belief in the value of Transcultural Nursing and culturally competent care in addressing social determinants to promote health equity. Methods: The Scholars Education Interest Group proposes recommendations for changes in education, practice, and research undergirding the discipline and expand cultural competence to directly address social structural and historical forces that perpetuate health vulnerability in diverse populations. Results: Collaborative leadership between the TCNS Scholars, Board of Trustess and members should develop initiatives to foster implementation of the recommendations and promote global dissemination of exemplars in education, research and practice. Discussion: Collaborative implementation of recommendations will generate evidence of health equity outcomes through TCN and culturally competent care.

Background: Maternal morbidity and mortality in the United States continue to be a worsening public health crisis, with persistent racial disparities among Black women during the COVID-19 pandemic. Innovations in mobile health (mHealth) technology are being developed as a strategy to connect birthing women to their health care providers during the first 6 weeks of the postpartum period. Objective: This study aimed to inform a process to evaluate the barriers to mHealth implementation in the context of the COVID-19 pandemic by exploring the experiences of mothers and stakeholders who were directly involved in the pilot program. Methods: The qualitative design used GoToMeeting (GoTo) individual interviews of 13 mothers and 7 stakeholders at a suburban teaching hospital in New Jersey. Mothers were aged ≥18 years, able to read and write in English or Spanish, had a vaginal or cesarean birth at >20 weeks of estimated gestational age, and were admitted for delivery at the hospital with at least a 24-hour postpartum stay. Stakeholders were part of the hospital network’s obstetrics collaborative subcommittee comprising administrators, physicians, registered nurses, and informatics. Responses were transcribed verbatim and analyzed for emerging themes. The socioecological framework provided a holistic lens for analyzing the multilevel influences on individual experiences. Results: A total of 3 major themes were identified: mothers experienced barriers from personal situations at home and with services in the hospital and community, which were intensified by the COVID-19 pandemic; the COVID-19 pandemic negatively impacted hospital services, priorities, and individual staff; and mothers and stakeholders had positive experiences and perceptions of the mHealth intervention. Conclusions: The use and reach of the mHealth intervention were negatively influenced by interrelated factors operating at multiple levels. The system-wide and multilevel impact of the pandemic was reflected in participants’ responses, providing evidence for the need to re-evaluate mHealth implementation with more adaptable systems and structures in place using a socioecological framework.

BACKGROUND Maternal morbidity and mortality in the United States continue to be a worsening public health crisis, with persistent racial disparities among Black women during the COVID-19 pandemic. Innovations in mobile health (mHealth) technology are being developed as a strategy to connect birthing women to their health care providers during the first 6 weeks of the postpartum period. OBJECTIVE This study aimed to inform a process to evaluate the barriers to mHealth implementation in the context of the COVID-19 pandemic by exploring the experiences of mothers and stakeholders who were directly involved in the pilot program. METHODS The qualitative design used GoToMeeting (GoTo) individual interviews of 13 mothers and 7 stakeholders at a suburban teaching hospital in New Jersey. Mothers were aged ≥18 years, able to read and write in English or Spanish, had a vaginal or cesarean birth at >20 weeks of estimated gestational age, and were admitted for delivery at the hospital with at least a 24-hour postpartum stay. Stakeholders were part of the hospital network’s obstetrics collaborative subcommittee comprising administrators, physicians, registered nurses, and informatics. Responses were transcribed verbatim and analyzed for emerging themes. The socioecological framework provided a holistic lens for analyzing the multilevel influences on individual experiences. RESULTS A total of 3 major themes were identified: mothers experienced barriers from personal situations at home and with services in the hospital and community, which were intensified by the COVID-19 pandemic; the COVID-19 pandemic negatively impacted hospital services, priorities, and individual staff; and mothers and stakeholders had positive experiences and perceptions of the mHealth intervention. CONCLUSIONS The use and reach of the mHealth intervention were negatively influenced by interrelated factors operating at multiple levels. The system-wide and multilevel impact of the pandemic was reflected in participants’ responses, providing evidence for the need to re-evaluate mHealth implementation with more adaptable systems and structures in place using a socioecological framework.