Priscilla Limbo Sagar

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: Firearm or gun violence has become a significant and ongoing public health crisis in the United States. There is little evidence of the current practices of nurses in assessing, screening, and counseling patients and families on firearm ownership and safety. Objectives: The purpose of this exploratory qualitative study was to explore the attitudes, perceptions, and current practices in assessing, screening, and counseling gun ownership and safety among registered nurses, with a secondary aim of identifying the facilitators and barriers to implementing the practice. Method: An exploratory qualitative research study design was used. We recruited focus group participants via e-mail, social media blasts, referrals, and personal contact requests. Participants were interviewed using structured focus group questions via Zoom. Five focus groups included 32 registered and advanced practice nurses. The audio-recorded and transcribed data were analyzed using Braun and Clarke’s approach to thematic analysis. Results: We identified four key themes. First, there was a significant need to educate and train nurses in the assessment, screening, and counseling about firearm safety. Second, there was a need to extend this education to patients, families, and the community. Third, there was a need to advocate for the creation and implementation of policies. Fourth, there was a need to implement mental health assessment as a standard practice before owning a gun, which emerged as a potential solution. Additionally, we found a need to address barriers to assessment and counseling on gun use. The creation of state laws and organizational policies, along with the provision of current data, emerged as other facilitators for assessment, screening, and counseling among nurses about firearms use and safety. Discussion: Ours is one of the first studies to explore attitudes and perceptions about gun ownership and current practices in gun safety assessment, screening, and counseling among registered nurses. The findings lay some foundation for a focused, multifaceted approach and interventions to address gun violence and safety concerns.

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.