African American End-Stage Renal Disease And Medication Adherence: What Are The Effects Of Everyday Racism?

This dissertation explored the racial medication adherence disparity in end-stage renal disease (ESRD) patients. Prior research suggests that there are poor rates of medication adherence in the African American ESRD population. However, the reasons for this racial inequity are not understood. This dissertation explored the impact of everyday racism in the healthcare system in general and dialysis centers in particular on medication adherence. To gain an understanding of the possible contribution of everyday racism to medication nonadherence, Critical Race Theory (CRT) was used as the theoretical foundation of the study. A total of 46 African American ESRD patients participated in the study. Twenty seven patients participated in semi-structured, in-depth interviews. Some participants did explicate that they experienced everyday racism in the healthcare system and such experiences impacted their medication adherence. Additionally, all 46 participants completed a survey regarding self-reported medication adherence and everyday racism in the healthcare setting. There was a statistically significant negative relationship between the two constructs. The results of the Pearson’s correlation showed a significant negative relationship (r = -.477, p \u3c .01) between medication adherence and everyday racism in the healthcare system. This study has several limitations. A convenience sample was used for both the qualitative and quantitative portions. Additionally, the quantitative study used a nonexperimental cross-sectional design with a small sample. However, this is the first study to ever examine the impact of everyday racism on medication adherence within the African American ESRD population. Furthermore, these results both qualitatively and quantitatively suggest that everyday racism did impact the medication adherence of the participants. Thus further study is needed to explore this phenomenon since medication nonadherence in the ESRD population results in increased hospitalizations, morbidity, and mortality. Further study could result in new information that could be used to generate novel interventions to address everyday racism in the healthcare system. Social workers are uniquely qualified given their educational training which focuses on cultural competency and their ethical obligation to address social injustice. Additionally, every dialysis patient has a social worker to help them achieve positive health outcomes. Thus, social workers are equipped to work with African American ESRD patients, healthcare providers, and dialysis clinicians to design and implement possible future interventions to achieve medication adherence racial parity within the ESRD population

African American End Stage Renal Disease & Medication Adherence: What Are the Effects of Everyday Racism?

End-stage renal disease (ESRD) is the ninth leading cause of death in the US. African Americans are nearly four times more likely to develop ESRD compared to Whites. ESRD requires a complex medication regimen, and poor medication adherence leads to increased hospitalizations, morbidity, and mortality in end-stage renal disease (ESRD) patients. Studies demonstrate that African American ESRD patients have poorer rates of medication adherence when compared to Whites. However, the reasons for this racial inequity are not understood. This is the first study to explore how everyday racism within the healthcare system, contributes to this disparity. A mixed methods study was conducted to investigate the relationship between everyday racism and medication adherence within the African American ESRD community using Critical Race Theory (CRT) as the theoretical foundation. Data were collected from 46 African American ESRD patients in the South. All participants completed a cross-sectional survey comprised of a medication adherence survey and an everyday racism in the healthcare setting survey. Additionally, 27 of the total sample (N=46) participated in in-depth interviews. A statistically significant negative relationship was found between medication adherence and everyday racism in the healthcare setting (r = -.477, p < .01). Interviews revealed that everyday racism perpetuated within the healthcare setting negatively affected participants’ medication adherence. Three themes were identified: 1) Concern that medical providers did not explain or properly manage medication regimen they prescribed 2) Concern that the medications are not safe 3) Information about medication and labs were withheld or not fully explained

Partnerships to Address School Safety through a Student Support Lens

School safety is a primary concern of school leaders, employees, parents, and a variety of community stakeholders. Attempts to mitigate and prevent school safety concerns often focus on strategies around school climate assessment, emergency communication, school safety plan development, and school resource officer employment (U.S. DHS et al., 2018). Involvement of key stakeholders, such as school social workers, school counselors, and school-based mental health professionals is emphasized in creating and assessing school safety in a wholistic manner. This article provides an overview of a Trainings to Increase School Safety grant program that was implemented with public school stakeholders through partnerships between a university and five public school districts in the Southeastern North Carolina region

Addressing School Safety through a Student Support Lens

This presentation is designed to provide an overview of the The UNCP School Safety Training Program. The UNCP School Safety Training Program, developed by UNCP Social Work and Counseling faculty and funded through the NC DPI School Safety Grant, provides a variety of trainings related to addressing school safety from a student support standpoint. Data from training participants' workshop evaluations will also be highlighted