Addressing systemic injustices and racism in training and clinical service provision are key next steps in clinical science. While the APA Multicultural Guidelines and accreditation standards have long emphasized this need, most graduate programs offer a single course on diversity, equity, and inclusion topics, which is inadequate to train and sustain culturally humble providers and redress systemic injustices and racism within psychology. Few \"real-world\" examples exist to guide the development of training models. We provide background on the development and components of a specialty clinic, the University of New Mexico\'s Cultural Counseling Center, whose mission is providing culturally informed clinical services to diverse clientele, and to infuse multicultural training throughout the graduate program. Informed by the racial-spatial framework for psychology and critical race theory, we describe our approach intended to: 1) offer applications for the operationalization and delivery of multicultural and antiracist training; 2) enhance supervisory models; and 3) increase awareness of structural competence. Our clinic, developed collaboratively among students and faculty, serves as a safe forum for dialogue around structural injustices and seeks to improve treatment for diverse clients and those underserved in mental health care. We discuss issues of student and faculty engagement and offer the perspectives of faculty and students of color, case examples illustrating our services, and current efforts to expand and formalize community collaborations. We offer a model that integrates coursework, informal activities, and multicultural supervision for comprehensive student training and that promotes a departmental culture of dialogue and support around equity, diversity, and justice.

UNASSIGNED: While many patients desire spiritual care, it is infrequently provided by physicians. When a model of cultural humility and courage is employed, resident physicians can be introduced to the spiritual care of patients.
UNASSIGNED: We developed this 90-minute, onetime session to speak directly to resident physicians about the relationships between medicine and spirituality and the nature of spiritual care. In the session, we facilitated residents in reflecting on their current posture toward spiritual care while addressing its evidence, obstacles, and timing. We also discussed the need for cultural humility and courage as we followed spiritual care to its root: guiding a person in finding meaning in their current circumstances.
UNASSIGNED: We presented this interactive session to 35 internal medicine residents from all four training years. All residents responded to an embedded pre- and postsurvey question modeled after four attitudes towards spiritual care: rejecting, guarded, pragmatic, and embracing. Out of 22 residents who did not report embracing spiritual care in the presession survey, 10 (45%) reported a more positive attitude toward spiritual care on their postcourse surveys. Twenty-seven residents in attendance (77%) also provided feedback about presentation quality, with a mean rating of 4.7 out of 5 indicating overall satisfaction.
UNASSIGNED: A single well-received session on spiritual care for medical residents models the integration of relevant spiritual care curricula into residency training. The resulting module can be modified for physicians of any specialty or seniority and complemented by other skill-based spiritual care curricula.

UNASSIGNED: Cultural humility is a lifelong commitment to self-evaluation, redressing power imbalances in patient-physician relationships and developing mutually trusting beneficial partnerships.
UNASSIGNED: The objective of this study was to determine the feasibility and efficacy of cultural humility training.
UNASSIGNED: From July 2020-March 2021, 90-minute educational workshops attended by 133 medical students, resident physicians and medical education faculty included 1) pre- and post- intervention surveys; 2) interactive presentation on equity and cultural humility principles; 3) participants explored sociocultural identities and power; and 4) reflective group discussions.
UNASSIGNED: There were significant increases from pre to post intervention assessments for perception scores (3.89 [SEM= 0.04] versus 4.22 [0.08], p<0.001) and knowledge scores (0.52 [0.02] versus 0.67 [0.02], p<0.001). Commonest identities participants recognized as changing over time were personality = 40%, appearance = 36%, and age =35%. Commonest identities experienced as oppressed/subjugated were race/ethnicity = 54%, gender = 40% and religion = 28%; whilst commonest identities experienced as privileged were gender= 49%, race/ethnicity = 42% and appearance= 25%. Male participants assigned mean power score of 73% to gender identity compared to mean power score of -8% by female participants (P<0.001). Non-Hispanic Whites had mean power score for race identity of 62% compared to 13% for non-white participants (p<0.001). English as a second language was only acknowledged as an oppressed/subjugated identity by those born outside the United States (p<0.001).
UNASSIGNED: An interactive educational workshop can increase participants\' knowledge and perceptions regarding cultural humility. Participants can self-reflect to recognize sociocultural identities that are oppressed/subjugated or privileged.

UNASSIGNED: Differences in the utilization of carpal tunnel release (CTR) by Blacks and women are well documented, but less is known regarding the impact of patient-provider concordance on treatment recommendations. To investigate this, we surveyed hand surgeons using hypothetical scenarios to evaluate variations in treatment recommendations for carpal tunnel syndrome based on patient-related factors and patient-provider concordance.
UNASSIGNED: Three pairs (six total) of hypothetical scenarios with clinical symptoms of carpal tunnel syndrome were created varying sex, race, and occupation. We used names as a proxy for sex and race. Occupation included manual laborers, secretaries, athletes, and retirees. American Society for Surgery of the Hand members were emailed an anonymous web-based link to participate. We used descriptive statistics to analyze the scenario-based treatment recommendations.
UNASSIGNED: We identified 3,067 eligible members for participation; 770 surgeons responded (25%) and provided recommendations for 3,742 scenarios. For scenarios involving symptomatic patients without electrodiagnostic studies (EDS), with normal EDS, and with abnormal EDS, no difference was noted in surgeon treatment recommendations based on patients\' race, sex, and occupation. Surgeons recommended EDS for 31% and 32.8% of the scenarios with Black female and White male patients, respectively, who did not have EDS at presentation and CTR for 32.3% and 33% of White females and Black males with normal EDS, respectively. Among retired Black female and White male patients older than 80 years of age with abnormal EDS, surgeons recommended CTR in 89.9% and 89.3% of them, respectively. For patient-provider racially concordant pairs, White surgeons recommended CTR to a similar proportion of Black and White hypothetical patients; however, Black surgeons recommended CTR to a greater proportion of patients with Black-sounding names.
UNASSIGNED: We found that surgeon treatment recommendation was not associated with patient race, sex, or occupation; however, differences did emerge based on patient-provider racial concordance, suggesting that alignment of patient and provider identities may influence treatment recommendations.
UNASSIGNED: Prognostic III.

UNASSIGNED: People with disabilities and those with non-English language preferences have worse health outcomes than their counterparts due to barriers to communication and poor continuity of care. As members of both groups, people who are Deaf users of American Sign Language have compounded health disparities. Provider discomfort with these specific demographics is a contributing factor, often stemming from insufficient training in medical programs. To help address these health disparities, we created a session on disability, language, and communication for undergraduate medical students.
UNASSIGNED: This 2-hour session was developed as a part of a 2020 curriculum shift for a total of 404 second-year medical student participants. We utilized a retrospective postsession survey to analyze learning objective achievement through a comparison of medians using the Wilcoxon signed rank test (α = .05) for the first 2 years of course implementation.
UNASSIGNED: When assessing 158 students\' self-perceived abilities to perform each of the learning objectives, students reported significantly higher confidence after the session compared to their retrospective presession confidence for all four learning objectives (ps < .001, respectively). Responses signifying learning objective achievement (scores of 4, probably yes, or 5, definitely yes), when averaged across the first 2 years of implementation, increased from 73% before the session to 98% after the session.
UNASSIGNED: Our evaluation suggests medical students could benefit from increased educational initiatives on disability culture and health disparities caused by barriers to communication, to strengthen cultural humility, the delivery of health care, and, ultimately, health equity.

The need to bring behavior analysis to scale is no more obvious or urgent than now. Collaboration between behavior analysts and healthcare workers, educators, policymakers, mental health clinicians, social workers, and so many other professionals is critical to reaching under-resourced and traditionally marginalized populations. First, however, interprofessional collaboration must be adopted widely and reinforced within the behavior analytic community. Disciplinary centrism and hubris pose barriers to effective interprofessional collaboration, leading one to assume the position that practitioners of the same discipline are better trained and smarter than those of a different field. However, cultural humility (Wright, Behavior Analysis in Practice, 12(4), 805-809, 2019) is an alternative to disciplinary centrism that allows professionals to retain identities born of cultural histories and training (Pecukonis, Journal of Teaching in Social Work, 40(3), 211-220, 2020). Furthermore, cultural reciprocity is a process of self-observation and collaborative inquiry that involves questioning one\'s own assumptions and forces individuals (and professions) to confront the contradictions between their values and their practices (Kalyanpur & Harry, 1999). In this paper, we revisit the call for Humble Behaviorism first made by Alan Neuringer in 1991 and the recommendations of fellow behavior analysts since. Specifically, we introduce a framework of cultural reciprocity to guide humble behaviorists as they acquire behaviors necessary to establish and maintain productive interprofessional relationships. We encourage them to act on their ethical and moral duties to address social problems of global concern and bring behavior analysis to scale.

Various disciplines have undergone a shift towards increasing diversity, multiculturalism, and cultural humility in the past few years. In 2019, a Behavior Analysis in Practice special issue raised a collective call to action for increased diversity and representation within the field at both organizational and individual levels. Since that time, articles, discussions, and reports have been published providing heightened attention to cultural humility toward clients, stakeholders, and practitioners. However, little attention has been directed toward the diversity of individuals supervised by behavior analysts. In particular, effective and compassionate supervision of people with disabilities has not been addressed in the field. Practitioners and supervisors need to have the necessary knowledge and skills to be able to inclusively and effectively train and shape the behavior of supervisees with disabilities. The present article reviews the literature, research, and practices from the field of psychology and makes recommendations of tools to create a disability-affirming environment for supervision in the field of applied behavior analysis.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s40617-023-00846-5.

Cancer is the leading cause of death among Asian Americans, who often face barriers to cancer care. Cancer supportive care needs among Asian Americans remain understudied.
We examined cancer supportive care needs and participant factors correlated with these needs, identified profiles of supportive care needs, and examined whether needs profiles are associated with quality of life among Asian American adults.
We recruited 47 Asian American adults with colorectal, liver, or lung cancer who spoke Chinese, English, or Vietnamese, and were starting or undergoing cancer treatment. We assessed cancer supportive care needs in four domains: cancer information, daily living, behavioral health, and language assistance. Hierarchical cluster analysis was used to identify clusters of participants based on their supportive need profiles to further examine the association between need profiles and quality of life (QoL) assessed by the Functional Assessment of Cancer Therapy. Participants (mean age = 57.6) included 72% males and 62% spoke English less than very well. Older participants (age ≥ 65) and those with annual income <$50K reported higher daily living needs. Men and younger participants (age < 50) reported higher behavioral health needs. We found three clusters displaying distinct cancer supportive need profiles: Cluster 1 (28% of the sample) displayed high needs across all domains; Cluster 2 (51%) had low needs across all domains; and Cluster 3 (21%) had high needs for cancer information and daily living. Cluster 1 participants reported the lowest QoL.
Cancer supportive care needs among Asian American patients with colorectal, liver, and lung cancer were associated with patient characteristics and QoL. Understanding cancer supportive care needs will inform future interventions to improve care and QoL for Asian American patients with cancer.
gov Identifier: NCT03867916.

UNASSIGNED: In the rapidly changing environment of healthcare, striving toward health equity and providing patient-centered care is imperative to the patient\'s experience. To achieve these goals, a comprehensive understanding of the diverse patient populations seeking these services, their needs, and the multitude of religious, cultural, and structural elements that impact their well-being is required. Muslim patients represent a considerable demographic, both in number and complexity of religious and cultural beliefs and practices. This scoping review examines the intersection of religion and cultural values with healthcare delivery in the context of the Muslim patient experience.
UNASSIGNED: The objective of this review is to identify key concepts and challenges that impact the Muslim patient experience.
UNASSIGNED: The research databases Cochrane Library, OVID Medline, and PubMED were used to conduct a comprehensive systemic review of original, empirical peer-reviewed publications with the following search terms: \"Muslim healthcare,\" \"Muslim patient,\" and \"Muslim experience.\"
UNASSIGNED: Inclusion and exclusion criteria were used to narrow down articles to those that addressed Muslim patient needs and their healthcare experience.
UNASSIGNED: A total of 21 articles met the criteria of this scoping review. Five central topics were identified during thematic analysis: Ramadan and Fasting, Barriers in the Patient-Physician Relationship, Trauma and Perceived Discrimination, Mental Health Awareness and Stigma, and Awareness of Advanced Care Planning.
UNASSIGNED: This scoping review demonstrates that in order to provide patient-centered care addressing the unique needs of Muslim patients, religious and cultural values need to be explored under the frameworks of cultural humility and structural competency.

To reduce prejudice and to promote intergroup harmony and equality, the imagined intergroup contact technique, based on the mental simulation of an encounter with an outgroup member, has been proposed. Though a substantial body of research has provided support for the efficacy of imagined intergroup contact in prejudice reduction, an alternative strand of research has raised questions about its effectiveness. In this experiment, we combined imagined intergroup contact with cultural humility, that is, an other-oriented, humble approach toward people with different cultural backgrounds, recognizing status and power imbalances and privileges. Specifically, we tested whether instructions aimed at eliciting cultural humility during imagined contact boosted its effectiveness in reducing prejudice and promoting future contact intentions, compared to a standard imagined contact condition and to a control imagination task. Intergroup anxiety was tested as a mediator of the effects of culturally humble imagined contact on reduced prejudice and on future contact intentions. We found that culturally humble imagined contact, compared to the two other conditions, reduced intergroup anxiety and yielded indirect effects on reduced prejudice and increased future contact intentions. The findings will be discussed by focusing on the integration of cultural humility in prejudice reduction techniques based on intergroup contact.