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Concept: Linguistic rights

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In the Netherlands, ethnic minority populations visit their general practitioner (GP) more often than the indigenous population. An explanation for this association is lacking. Recently, health literacy is suggested as a possible explaining mechanism. Internationally, associations between health literacy and health care use, and between ethnicity and health literacy have been studied separately, but, so far, have not been linked to each other. In the Netherlands, some expectations have been expressed with regard to supposed low health literacy of ethnic minority groups, however, no empirical study has been done so far. The objectives of this study are therefore to acquire insight into the level of health literacy of ethnic minorities in the Netherlands and to examine whether the relationship between ethnicity and health care use can be (partly) explained by health literacy.

Concepts: Women's rights, Minorities, Minority, Linguistic rights, Minority language, United States, United Kingdom, Minority group

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Most literature on racial prejudice deals with the racial attitudes of the ethnic majority and ethnic minorities separately. This paper breaks this tradition. We examine the social distance attitudes of white and non-white British residents to test if these attitudes follow the same trends over time, whether they are driven by the same social processes and whether they are inter-related. We have three main findings. Firstly, social distance from other ethnic groups has declined over time for both white and ethnic minority Britons. For the white majority there are both period and cohort elements to this decline. Secondly, we see some evidence that social distance between the majority and minority groups is reciprocal. Specifically, minorities who experience rejection by the white British feel a greater sense of distance from them. Thirdly, we find that all groups share the perception of the same ethnic hierarchy. We see evidence of particularly widespread hostility towards Muslim Britons from all ethnic groups suggesting that Muslims are singled out for negative attention from many British residents of all other backgrounds, including a large number who do not express hostility to other groups.

Concepts: Minority group, Minority language, Minorities, Linguistic rights, Minority, Minority religion, United States, United Kingdom

2

Accountable care organizations (ACOs) are intended, in part, to improve health care quality. However, little is known about how ACOs may affect disparities or how providers serving disadvantaged patients perform under Medicare ACO contracts. We analyzed racial and ethnic disparities in health care outcomes among ACOs to investigate the association between the share of an ACO’s patients who are members of racial or ethnic minority groups and the ACO’s performance on quality measures. Using data from Medicare and a national survey of ACOs, we found that having a higher proportion of minority patients was associated with worse scores on twenty-five of thirty-three Medicare quality performance measures, two disease composite measures, and an overall quality composite measure. However, ACOs serving a high share of minority patients were similar to other ACOs in most observable characteristics and capabilities, including provider composition, services, and clinical capabilities. Our findings suggest that ACOs with a high share of minority patients may struggle with quality performance under ACO contracts, especially during their early years of participation-maintaining or potentially exacerbating current inequities. Policy makers must consider how to refine ACO programs to encourage the participation of providers that serve minority patients and to reward performance appropriately.

Concepts: Minority language, Minority religion, Linguistic rights, United Kingdom, Minorities, Minority, United States, Minority group

2

This meta-analysis focuses on parent training programs for ethnic minority families and reports on (i) the adaptation of program content and (ii) the process that informs these adaptations. Relevant studies are reviewed to determine the adaptations made and the impact of the adaptations on parenting and child outcomes. Studies were eligible for inclusion if they enrolled predominantly ethnic minority parents with children aged 0-12 years, used a randomized controlled trial design with post-intervention assessments, focused on group-based parent training programs and on prevention of parenting problems, and reported parenting behavior outcomes. A total of 18 studies were included in the analysis. The results show that parent training programs targeting ethnic minority parents have a small but significant effect on improving parenting behavior (k = 18, Cohen’s d = 0.30), child outcomes (k = 16, Cohen’s d = 0.13), and parental perspectives (k = 8, Cohen’s d = 0.19). Most of the programs made adaptations related to surface and deep structure sensitivity. Programs with cultural adaptations, especially deep structure sensitivity (k = 7, Cohen’s d = 0.54), are more effective in improving parenting behavior. Because only a third of the included studies provided details on the processes that guided the adaptations made, additional studies are needed to provide information on the process of adaptation; this will enable others to learn from the procedures that can be undertaken to culturally adapt interventions.

Concepts: Linguistic rights, Minority language, United Kingdom, Sociology, Minorities, Minority, Parent, Minority group

2

Variation in provision of palliative care in kidney services and practitioner concerns to provide equitable access led to the development of this study which focussed on the perspectives of South Asian patients and their care providers. As people with a South Asian background experience a higher risk of Type 2 Diabetes (T2DM) and end stage kidney failure (ESKF) compared to the majority population but wait longer for a transplant, there is a need for end of life care to be accessible for this group of patients. Furthermore because non English speakers and people at end of life are often excluded from research there is a dearth of research evidence with which to inform service improvement. This paper aims to explore issues relating to the process of recruitment of patients for a research project which contribute to our understanding of access to end of life care for ethnic minority patients in the kidney setting.

Concepts: Linguistic rights, Minority religion, Minorities, Minority language, United Kingdom, Minority group, United States, Minority

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Ethnic/racial minorities encounter disparities in healthcare, which may carry into end-of-life (EOL) care. Advanced cancer, highly prevalent and morbid, presents with worsening symptoms, heightening the need for supportive and EOL care.

Concepts: Minorities, Linguistic rights, Minority language, Minority, United Kingdom, Minority group

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Medical students from ethnic minorities underperform in knowledge and skills assessments both in pre-clinical and clinical education compared to the ethnic majority group. Motivation, which influences learning and academic performance of medical students, might play an important role in explaining these differences, but is under-investigated. This study aimed to compare two types of motivation (autonomous and controlled) of ethnic minority (Western and non-Western) and majority (Dutch) students, and their association with academic performance.

Concepts: Linguistic rights, Minority language, Sociology, Minority religion, Minority, United Kingdom, United States, Minority group

1

Like the European general population, ethnic minorities are aging. In this group, important social determinants of health (social participation, social isolation and loneliness) that lead to negative health outcomes frequently occur. Interventions targeting these determinants may decrease negative health outcomes. The goal of this article was to identify effective interventions that improve social participation, and minimise social isolation and loneliness in community dwelling elderly ethnic minorities.

Concepts: Minority language, Minorities, Linguistic rights, Minority, United Kingdom, Sociology, United States, Minority group

1

Many recent mentoring initiatives have sought to help improve the proportion of underrepresented racial and ethnic minorities (URMs) in academic positions across the biomedical sciences. However, the intractable nature of the problem of underrepresentation suggests that many young scientists may require supplemental career development beyond what many mentors are able to offer. As an adjunct to traditional scientific mentoring, we created a novel academic career “coaching” intervention for PhD students in the biomedical sciences.

Concepts: Linguistic rights, Educational psychology, Minority language, Minority, Coaching, Minority group, United States, United Kingdom

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The ethnic minority population in developed countries is increasing over time. These groups are at higher risk of mental illness and demonstrate lower participation in research. Published evidence suggests that multiple factors like stigma, lack of trust, differences in explanatory models, logistical issues and lack of culturally aware researchers act as barriers to ethnic minority recruitment into mental health research. To reduce inequalities in participation, there is a need to devise innovative and culturally sensitive recruitment strategies. It is important that researchers share their experience of employing these strategies so that ethnic minority participation can be facilitated.

Concepts: Minorities, Linguistic rights, Minority language, Minority, Minority group, United States, Sociology, United Kingdom