Healthcare Advocacy

Evidenced by leading journals in academic medicine, health professions education has taken up the call to advance equitable healthcare. One pressing area where gaps and inequities are apparent is transgender (trans) people's access to gender-affirming medicine such as hormones and surgeries. Reasons for the dire state of care include education gaps. While specific content knowledge has been identified as lacking in medical school curricula, less research has focused on the complex social practices required of clinicians and educators working in gender-affirming medicine, and how these skills are learned through practice. In order to inform health professions education in this key area of need, we conducted a study to better understand the social practices, and the learning that occurs therein, of genderaffirming medicine. We identified the work processes of 22 clinicians, clinician-educators, trans patients, and clinical care administrators with attention to how policies and protocols influenced practice, learning, and teaching. The results of our study elucidate: (1) that practicing of gender-affirming medicine is strictly dictated by standardized assessment protocols, which serve as a form of curriculum; and (2) how health professionals learn and teach health advocacy as a form of resistance to protocols identified as creating inequities. These findings suggest an opportunity to view protocols-and their inherent limitations-more deliberately as teaching and learning tools, specifically for learning advocacy.

Displacement and child labor are intricately linked, affecting millions of children and young adults under the age of 25 years. The number of youth and young adults experiencing homelessness is estimated to be around 1.5 per 1,000 individuals per the U.S. Department of Housing and Urban Development (HUD) Office of Community Planning and Development's "Point-In-Time Count" (PIT) statistics, with a 15% increase between 2022 and 2023. A national household survey -"Voices of Youth Count," revealed that one in 30 youth from 13-17 years experienced homelessness over 12-months. Teens separated from their homes due to natural disasters, poverty, addiction, abuse, or due to conflict often find themselves at a heightened risk of being forced into child labor. This relationship is underpinned by a vicious cycle of continued poverty, economic instability, and decreased access to health-focused resources.

Background: Alcohol is one of the most widely used recreational drugs in the world however, over the last decade its consumption has become an increasing concern along public health policy makers and international development agencies. The Caribbean populace particularly has in recent times had challenges from alcohol abuse which has posed significant morbidity and mortality of all age groups. This research has its focus on alcohol consumption among young adults using Dominica as case study. To determine the prevalence of alcohol consumption in young adults in Dominica. Also, to determine the common reasons and influencing factors to start alcohol consumption in younger age groups in Dominica. A total of 73 respondents from the city of Roseau and its neighbouring villages who attended a health fair organised in All Saints University School of Medicine, Roseau, Dominica. The research was a cross sectional study that involved use of a questionnaire for the collection of data. The findings showed that 66.67% consumed alcohol with majority of them being males (73.91%). Onset for consumption was higher in the age group 16-20 years with reasons being: peer pressure, social activities, curiosity and adult influence. Again, the age group 16-20 years had the highest onset for alcohol consumption giving major reason of social activity (71.43%). The study showed that most common age to start consuming alcohol was between 16-20 years and common reasons to start included 'social activities' and 'peer pressure' for majority and for a few 'curiosity' and 'adult influence'. It becomes incumbent on the government, healthcare practitioners and other stakeholders to promote responsible drinking and discourage premature drinking. In conclusion, applying regression analysis, age is a predictor of alcohol consumption and for each unit increase in age, there is an average increase of 13% in alcohol consumption considering a constant gender among Dominicans.

The social roles of health professionals, such as advocate, collaborator and communicator, matter to patient care. Without effective enactment of these roles, patients can feel unheard, and experience practitioner conflict or excess burden in navigating systems or advocating for quality and compassionate care. 1-3 Hence, health professions education (HPE) needs research into what these roles look like in practice, how clinicians come to learn them, and how we might go about teaching or fostering their development.

Evidenced by leading journals in academic medicine, health professions education has taken up the call to advance equitable healthcare. One pressing area where gaps and inequities are apparent is transgender (trans) people's access to gender-affirming medicine such as hormones and surgeries. Reasons for the dire state of care include education gaps. While specific content knowledge has been identified as lacking in medical school curricula, less research has focused on the complex social practices required of clinicians and educators working in gender-affirming medicine, and how these skills are learned through practice. In order to inform health professions education in this key area of need, we conducted a study to better understand the social practices, and the learning that occurs therein, of genderaffirming medicine. We identified the work processes of 22 clinicians, clinician-educators, trans patients, and clinical care administrators with attention to how policies and protocols influenced practice, learning, and teaching. The results of our study elucidate: (1) that practicing of gender-affirming medicine is strictly dictated by standardized assessment protocols, which serve as a form of curriculum; and (2) how health professionals learn and teach health advocacy as a form of resistance to protocols identified as creating inequities. These findings suggest an opportunity to view protocols-and their inherent limitations-more deliberately as teaching and learning tools, specifically for learning advocacy.

Introduction: The Breast Health Education & Screening of Asian Women (BHESAW) is an innovative community-based outreach program funded by Komen for the Cure that is designed to increase awareness of breast cancer through breast health education and screenings. Factors that may contribute to low level of participation in mammograms of Asian women are explored. Despite the convincing scientific evidence on the efficacy of breast cancer screenings, Asian women have one of the lowest rates of mammography. Project goal: The goal of the project is to increase the screening rate of breast screening mammograms for Asian women by promoting awareness, improving access, and reducing cultural and linguistic barriers. It is based on the indigenous model of utilizing trained community "lay" health care advocates who act as interpreters. Method: The project employs the participation of Community Health Advocates (CHAs) informing their respective communities about the screenings by way of group or one-on-one recruitment. The CHAs use the provider-established eligibility criteria when recruiting participants and assist with completing recruitment participation forms. The CHAs coordinate with the project director to select a screening venue that is convenient and accessible to the participants. Implementation: The entire screening process is explained to breast screening participants using their own language and being respectful of their cultural beliefs and practices. After the screenings, all women receive Breast Health Awareness education as well as translated literature on cancer prevention and the importance of early detection. The Community Health Advocates also continue to assist the participants in navigating relevant services related to follow-ups and referrals when indicated. Relevance to practice: Utilization of CHAs may serve as an important resource for healthcare providers in promoting not only health awareness but also cultural sensitivity in the community. This makes this project unique from other CHA programs that have been implemented and studied.

Background: Alcohol is one of the most widely used recreational drugs in the world however, over the last decade its consumption has become an increasing concern along public health policy makers and international development agencies. The Caribbean populace particularly has in recent times had challenges from alcohol abuse which has posed significant morbidity and mortality of all age groups. This research has its focus on alcohol consumption among young adults using Dominica as case study. Aim of the study: To determine the prevalence of alcohol consumption in young adults in Dominica. Also, to determine the common reasons and influencing factors to start alcohol consumption in younger age groups in Dominica. Methods and Findings: A total of 73 respondents from the city of Roseau and its neighbouring villages who attended a health fair organised in All Saints University School of Medicine, Roseau, Dominica. The research was a cross sectional study that involved use of a questionnaire for the collection of data. The findings showed that 66.67% consumed alcohol with majority of them being males (73.91%). Onset for consumption was higher in the age group 16-20 years with reasons being: peer pressure, social activities, curiosity and adult influence. Again, the age group 16-20 years had the highest onset for alcohol consumption giving major reason of social activity (71.43%). Conclusion: The study showed that most common age to start consuming alcohol was between 16-20 years and common reasons to start included 'social activities' and 'peer pressure' for majority and for a few 'curiosity' and 'adult influence'. It becomes incumbent on the government, healthcare practitioners and other stakeholders to promote responsible drinking and discourage premature drinking. In conclusion, applying regression analysis, age is a predictor of alcohol consumption and for each unit increase in age, there is an average increase of 13% in alcohol consumption considering a constant gender among Dominicans.

Background: Alcohol is one of the most widely used recreational drugs in the world however, over the last decade its consumption has become an increasing concern along public health policy makers and international development agencies. The Caribbean populace particularly has in recent times had challenges from alcohol abuse which has posed significant morbidity and mortality of all age groups. This research has its focus on alcohol consumption among young adults using Dominica as case study. Aim of the study: To determine the prevalence of alcohol consumption in young adults in Dominica. Also, to determine the common reasons and influencing factors to start alcohol consumption in younger age groups in Dominica. Methods and Findings: A total of 73 respondents from the city of Roseau and its neighbouring villages who attended a health fair organised in All Saints University School of Medicine, Roseau, Dominica. The research was a cross sectional study that involved use of a questionnaire for the collection of data. The findings showed that 66.67% consumed alcohol with majority of them being males (73.91%). Onset for consumption was higher in the age group 16-20 years with reasons being: peer pressure, social activities, curiosity and adult influence. Again, the age group 16-20 years had the highest onset for alcohol consumption giving major reason of social activity (71.43%). Conclusion: The study showed that most common age to start consuming alcohol was between 16-20 years and common reasons to start included 'social activities' and 'peer pressure' for majority and for a few 'curiosity' and 'adult influence'. It becomes incumbent on the government, healthcare practitioners and other stakeholders to promote responsible drinking and discourage premature drinking. In conclusion, applying regression analysis, age is a predictor of alcohol consumption and for each unit increase in age, there is an average increase of 13% in alcohol consumption considering a constant gender among Dominicans.

Background: Alcohol is one of the most widely used recreational drugs in the world however, over the last decade its consumption has become an increasing concern along public health policy makers and international development agencies. The Caribbean populace particularly has in recent times had challenges from alcohol abuse which has posed significant morbidity and mortality of all age groups. This research has its focus on alcohol consumption among young adults using Dominica as case study. To determine the prevalence of alcohol consumption in young adults in Dominica. Also, to determine the common reasons and influencing factors to start alcohol consumption in younger age groups in Dominica. A total of 73 respondents from the city of Roseau and its neighbouring villages who attended a health fair organised in All Saints University School of Medicine, Roseau, Dominica. The research was a cross sectional study that involved use of a questionnaire for the collection of data. The findings showed that 66.67% consumed alcohol with majority of them being males (73.91%). Onset for consumption was higher in the age group 16-20 years with reasons being: peer pressure, social activities, curiosity and adult influence. Again, the age group 16-20 years had the highest onset for alcohol consumption giving major reason of social activity (71.43%). The study showed that most common age to start consuming alcohol was between 16-20 years and common reasons to start included 'social activities' and 'peer pressure' for majority and for a few 'curiosity' and 'adult influence'. It becomes incumbent on the government, healthcare practitioners and other stakeholders to promote responsible drinking and discourage premature drinking. In conclusion, applying regression analysis, age is a predictor of alcohol consumption and for each unit increase in age, there is an average increase of 13% in alcohol consumption considering a constant gender among Dominicans.

Background: Alcohol is one of the most widely used recreational drugs in the world however, over the last decade its consumption has become an increasing concern along public health policy makers and international development agencies. The Caribbean populace particularly has in recent times had challenges from alcohol abuse which has posed significant morbidity and mortality of all age groups. This research has its focus on alcohol consumption among young adults using Dominica as case study. Aim of the study: To determine the prevalence of alcohol consumption in young adults in Dominica. Also, to determine the common reasons and influencing factors to start alcohol consumption in younger age groups in Dominica. Methods and Findings: A total of 73 respondents from the city of Roseau and its neighbouring villages who attended a health fair organised in All Saints University School of Medicine, Roseau, Dominica. The research was a cross sectional study that involved use of a questionnaire for the collection of data. The findings showed that 66.67% consumed alcohol with majority of them being males (73.91%). Onset for consumption was higher in the age group 16-20 years with reasons being: peer pressure, social activities, curiosity and adult influence. Again, the age group 16-20 years had the highest onset for alcohol consumption giving major reason of social activity (71.43%). Conclusion: The study showed that most common age to start consuming alcohol was between 16-20 years and common reasons to start included 'social activities' and 'peer pressure' for majority and for a few 'curiosity' and 'adult influence'. It becomes incumbent on the government, healthcare practitioners and other stakeholders to promote responsible drinking and discourage premature drinking. In conclusion, applying regression analysis, age is a predictor of alcohol consumption and for each unit increase in age, there is an average increase of 13% in alcohol consumption considering a constant gender among Dominicans.

Evidenced by leading journals in academic medicine, health professions education has taken up the call to advance equitable healthcare. One pressing area where gaps and inequities are apparent is transgender (trans) people’s access to gender-affirming medicine such as hormones and surgeries. Reasons for the dire state of care include education gaps. While specific content knowledge has been identified as lacking in medical school curricula, less research has focused on the complex social practices required of clinicians and educators working in gender-affirming medicine, and how these skills are learned through practice. In order to inform health professions education in this key area of need, we conducted a study to better understand the social practices, and the learning that occurs therein, of gender-affirming medicine. We identified the work processes of 22 clinicians, clinician-educators, trans patients, and clinical care administrators with attention to how policies and protocols influenced practice, learning, and teaching. The results of our study elucidate: (1) practicing of gender-affirming medicine is strictly dictated by standardized assessment protocols, which serve as a form of curriculum; and (2) how health professionals learn and teach health advocacy as a form of resistance to protocols identified as creating inequities. These findings suggest an opportunity to view protocols – and their inherent limitations – more deliberately as teaching and learning tools, specifically for learning advocacy.

Background: Alcohol is one of the most widely used recreational drugs in the world however, over the last decade its consumption has become an increasing concern along public health policy makers and international development agencies. The Caribbean populace particularly has in recent times had challenges from alcohol abuse which has posed significant morbidity and mortality of all age groups. This research has its focus on alcohol consumption among young adults using Dominica as case study.