Dena Hassouneh

The Influence of Gender Role Stereotyping on Women's Experiences of Female Same-Sex Intimate Partner Violence:

Female same-sex intimate partner violence (FSSIPV) is a serious problem that affects the health and safety of lesbian and bisexual women. To begin to address the paucity of research, a mixed methods study was conducted to identify shared and unique risk and protective factors for FSSIPV. This article reports on qualitative findings related to the influence of gender role stereotyping on womens experiences of FSSIPV. Findings indicate that gender role stereotyping shapes womens experiences of FSSIPV by influencing individual, familial, community, and societal perceptions and responses to this phenomenon.

Mental health, discrimination, and trauma in Arab Muslim women living in the US: A pilot study

In recognition of the need to identify groups of women who may be at high risk for mental disorders and contribute to the knowledge base about ethnic and cultural minority mental health, this paper provides an overview of findings obtained from a small pilot study of mental health in Muslim women living in the US. Findings indicate that Muslim women face numerous stressors that threaten their mental health including discrimination, acculturative stress, and trauma.

Practical strategies for promoting full inclusion of individuals with disabilities in community-based participatory intervention research

Community-based participatory research (CBPR) with disability communities is directed toward facilitating full inclusion of individuals with disabilities and disability community organizations in all aspects of the research process. Within the CBPR framework, academic-disability community partners may value and wish to use experimental designs to test interventions. Being aware of and proactively addressing barriers and challenges to inclusion in the areas of human resources, training, productivity, accommodation, and inadequate funding for disability community organizations are critical for success. Some of the strategies discussed in this article for addressing these challenges include creating redundant systems, providing benefits counseling and individualized payment options for employment, designing trainings to be disability friendly, and carefully considering selection of partners in light of available community resources.

The experiences of underrepresented minority faculty in schools of medicine

Introduction Faculty of color in schools of medicine play an essential role in addressing health disparities, increasing diversity in healthcare, and improving health professions education. Yet inadequate progress has been made in increasing the numbers of faculty of color in medical schools. The reasons for this gap, and ways to address it, are poorly understood. Methods We conducted a grounded theory study of 25 of faculty from groups historically underrepresented in academic medicine at 17 schools in the United States. Faculty were interviewed in person (n=4, 16%) and by telephone (n=21, 84%). Results We identified two processes that contribute to a greater understanding of the experiences of faculty of color: patterns of exclusion and control, and surviving and thriving. We also identified one outcome – faculty of color having influence. Conclusions Strong support from leaders, mentors, and peers to nurture and protect faculty of color in schools of medicine is needed to counteract the negative effects of racism and to promote the positive effects this group has on diversity and excellence in medical education. Specific strategies for survival and success are described.Introduction Faculty of color in schools of medicine play an essential role in addressing health disparities, increasing diversity in healthcare, and improving health professions education. Yet inadequate progress has been made in increasing the numbers of faculty of color in medical schools. The reasons for this gap, and ways to address it, are poorly understood. Methods We conducted a grounded theory study of 25 of faculty from groups historically underrepresented in academic medicine at 17 schools in the United States. Faculty were interviewed in person (n=4, 16%) and by telephone (n=21, 84%). Results We identified two processes that contribute to a greater understanding of the experiences of faculty of color: patterns of exclusion and control, and surviving and thriving. We also identified one outcome - faculty of color having influence. Conclusions Strong support from leaders, mentors, and peers to nurture and protect faculty of color in schools of medicine is needed to counteract the negative effects of racism and to promote the positive effects this group has on diversity and excellence in medical education. Specific strategies for survival and success are described.

Having influence: Faculty of color having influence in schools of nursing

Faculty of color (FOC) play an important role in mentoring students and other FOC in schools of nursing. However, the unique nature of mentoring that FOC provide, which includes transmission of expert knowledge of the operations of racism in nursing academe, is not well understood. Furthermore, the influence FOC have on school cultures has not been well documented. To address this gap in knowledge we conducted a critical grounded theory study with 23 FOC in predominately Euro-American schools of nursing. Findings indicate that FOC Having Influence is a key process that explicates the influence FOC wield, exposing their work, which is often taken for granted, hidden, and, unacknowledged. FOC Having Influence occurred in two areas: 1) the survival and success of students and FOC and 2) shaping practices in schools of nursing and impacting health in communities. Implications for educational practice and future research are presented, based on study findings.

Unconscious Racist Bias: Barrier to a Diverse Nursing Faculty

Faculty of color in the health professions are more likely than majority faculty to work in underserved regions, and they play important roles as mentors for minority students and faculty peers. In addition, faculty of color promote excellence in schools of nursing, leading to improved student outcomes in the areas of cultural competence, humanism, and professionalism (American Association of Medical Colleges, 2009; Hassouneh & Lutz, 2012; Lutz, Hassouneh, Akeroyd, & Beckett, in press). Despite their importance, faculty of color continue to be underrepresented in nursing, comprising only 7% of nursing faculty compared with nearly 16% among U.S. faculty overall (Kaufman, 2007). There are several reasons why faculty of color continue to be underrepresented, including an inadequate pipeline; inequities in appointment, promotion, and tenure; and an inhospitable academic environment (American Association of Medical Colleges, 2009; Davis & Davis, 1998; Fang, Moy, Colburn, & Hurley, 2000; Hassouneh, Akeroyd, Lutz, & Beckett, 2012). From our interviews with nursing faculty throughout the country, we have found that racism plays a key role in perpetuating these inequities (Hassouneh et al., 2012; Hassouneh & Lutz, 2012; Lutz et al., in press). By racism, I am referring to a stratifi cation process by which the population of European descent, through a set of attitudes, behaviors, social structures, and ideologies, has been able to sustain a system of privilege “to the general disadvantage of the population designated as non-White (on a global scale)” (Page, 1999, ¶ 5). In contemporary society, racism results, in part, from unconscious bias. Unconscious bias has been widely hailed as a new diversity paradigm—one that recognizes the role that bias plays in the day-to-day functioning of all human beings (Ross, 2008; Savini, 2010; White & Chanoff, 2011). All people make assumptions and determinations about what is real at any given moment, sort out millions of pieces of information, and, as self-interpreting beings, believe that what is seen is real. Only occasionally do people realize how subjective their perceptions are and how much their perceptions are shaped, not by what is in front of them but by how they interpret what is in front of them through their own personal lenses (Ross, 2008). In the United States, personal lenses have been shaped by a several hundred–year hegemonic legacy of racist conditioning that continues to saturate our lifeworlds (White & Chanoff, 2011). This conditioning occurs at a deep and often unconscious level. The most comprehensive research conducted to date on unconscious bias has been done through Project Implicit (2012), a collaborative research partnership between Harvard University, the University of Virginia, and the University of Washington (https://implicit.harvard. edu/implicit/). According to Project Implicit (2012) Web site’s Four-Category Race Implicit Association Test (IAT) demonstration, “It is well known that people don’t always ‘speak their minds’, and it is suspected that people don’t always ‘know their minds’” (¶ 1). Thus, nursing faculty members who have been conditioned to hold unconscious racist views may act on these views even when they consciously disagree with them. A faculty member may “endorse equality and believe he or she is well intentioned but act in a discriminatory way and justify those actions, quite sincerely, with reference to matters having nothing to do with race” (Savini, 2010, p. 4). A study conducted by researchers at Massachusetts Institute of Technology and the University of Chicago demonstrates this point about unconscious racism. Resumés (of average and highly skilled workers) were sent to employers, including equal opportunity and federal employers. Some of the resumes had typically European-American names and others had typically African-American names. Resumés with typically EuropeanAmerican names received 50% more callbacks than those with typically AfricanAmerican names, and average skilled, typically European-American named candidates received more callbacks than highly skilled typically African-American named candidates. These fi ndings were consistent across occupational and industry categories, including both health care and education (Bertrand & Mullainathan, 2004). One can imagine conversations that likely went on in those businesses as employees and administrators discussed the reasons why they lacked diversity: • There were no qualifi ed minority applicants in the pool. • The minority applicant didn’t look like he/she would be a good fi t. • The minority applicant probably would not want have wanted to relocate to this area. • Minority applicants are in demand so we probably would not be able to retain one.

Health Care Providers’ Perspectives on Barriers and Facilitators to Cervical Cancer Screening in Vietnamese American Women:

Introduction: Vietnamese American women (VAW) are diagnosed and die at twice the rate than White non-Hispanic American women (16.8/100,000 vs. 8.1/100,000 and 4.4/100,000 vs. 2.4/100,000, respectively). Despite efforts to increase cervical cancer (CC) screening among VAW, the participation rates are persistently low (69% to 81%). The purpose of this study was to explore health care providers’ (HCPs) perspectives on barriers and facilitators to CC screening in VAW. Method: This qualitative descriptive pilot study, used open-ended semistructured interviews with 10 HCPs. Results: The HCPs had two to 23 years treating VAW. Major barriers and facilitators identified by the HCPs were as follows: VAW’s decision making about CC screening; sexual health divide; language discordance, relying on interpreters; breaking suspicion; VAW’s exposure to health sources of CC screening; sustainable trust; and motivated health care practices. Discussion: HCPs perceived the reasons for VAW not being screened or delaying CC screening were due to their lack of knowledge, cultural barriers, language, and issues related to trust.

HEALING PATHWAYS: A PROGRAM FOR WOMEN WITH PHYSICAL DISABILITIES AND DEPRESSION

Objective. The objective of this study was to test the efficacy of the Healing Pathways (HP) program in reducing clinically significantly depressive symptoms in women with physical disabilities (WPD). Healing Pathways is a peer-implemented group mental health treatment program targeting WPD who have clinically significant cooccurring depressive symptoms. Participants. Eighty women were randomized in this trial. Design. This study used a community-based participatory intervention research design. Using community-based recruiting methods, participants were recruited from Centers for Independent Living, local disability service organizations, via Craigs list as well as other community locations such as grocery stores and bus stops. Women participated in the HP program for 14 weeks. Results. The primary outcome variable for this study was reduction in depressive symptoms as measured by the Center for Epidemiologic Depression Scale (CES-D). We found that there was a significant interaction effect of treatment by time on depression scores, F(3,210) = 9.51, P < 0.0001, partial η 2 = 0.101. Investigation of the predicted mean profile over time in the intervention group demonstrated that depression scores decreased greatly from baseline to the first posttest and remained stable in the two followups, whereas there was a little change in the mean profile over time in the control group. Conclusion. The HP program has demonstrated initial efficacy in reducing depressive symptoms in women with physical disabilities.

A Conceptual Model to Promote the Retention of Women with Physical Disabilities in Research

Inadequate participant recruitment and retention practices can affect sample representativeness and thus the generalizability of research findings. Retention of research participants has been examined within the literature to some extent; however, there is no consensus on best practice in achieving acceptable results. Furthermore, there is a gap in understanding how to engage and retain women with physical disabilities (WPDs) in research. To address these oversights, we review (1) the significance of retention as a methodological concern, (2) factors that influence the involvement and retention of participants in research, including individual, population, and health-illness considerations, and (3) particular circumstances impacting the inclusion and retention of WPDs in research. On the basis of a review of the literature and our experience with the Healing Pathways randomized controlled trial (RCT), we present a conceptual model to guide culturally sensitive health research implementation with WPDs, and promote the engagement and retention of this group in RCTs and other forms of interventional health research.