"Black Nurses in the Home is Working": Advocacy, Naming, and Processing Racism to Improve Black Maternal and Infant Health
"Black Nurses in the Home is Working": Advocacy, Naming, and Processing Racism to Improve Black Maternal and Infant Health
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DOI：
10.1007/s10995-021-03283-4
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发表时间：
2021-11-24
影响因子：
2.3
通讯作者：
Paul, Sherly
中科院分区：
文献类型：
--
作者：
Hunte, Roberta;Klawetter, Susanne;Paul, Sherly
目标
1) 探究与种族主义相关的压力如何影响黑人女性的健康、怀孕和育儿。
2) 探究具有文化针对性的项目如何影响与种族主义相关的压力和黑人女性的健康、怀孕以及育儿之间的关系。
方法
这项定性研究采用黑人女性主义方法，以黑人女性的生活经历和观点为核心。对一个为黑人家庭提供围产期护理的具有文化针对性的项目的客户和工作人员进行了焦点小组访谈。以生殖正义框架为指导进行了主题分析。
结果
参与者包括23名该项目的客户和工作人员，她们都自认为是黑人女性。分析得出了四个主题：1) 结构性种族主义的普遍影响；2) 共同的身份促进信任和治愈；3) 种族主义直接影响心理健康；4) 在宏观和微观层面的倡导是一项至关重要的服务。
实践结论
结果显示了结构性种族主义对黑人女性身心健康的长期性和毒害性。明显和隐蔽的种族主义形式存在于多个系统中，需要在宏观和微观层面进行干预。优先考虑提供者与客户/患者之间种族一致性的具有文化针对性的围产期护理项目是受欢迎且有效的护理模式。黑人围产期护理应包括具有文化针对性的方法、代表黑人并与黑人一起进行倡导、关注与种族主义相关压力的心理健康支持以及对隐性偏见的审视。以生殖正义原则为指导的多管齐下的干预措施提供了一个解决人际和系统性种族压迫的整体框架。
Objectives 1) To explore how racism-related stress impacts Black women's health, pregnancy, and parenting. 2) To explore how a culturally-specific program affects the relationship between racism-related stress and Black women's health, pregnancy, and parenting. Methods This qualitative study uses a Black Feminist approach to center the lived experiences and perspectives of Black women. Focus groups were conducted with clients and staff of a culturally-specific program that provides perinatal care for Black families. A thematic analysis was conducted using a Reproductive Justice framework as a guide. Results Participants consisted of 23 program clients and staff who all identified as Black women. Four themes emerged from the analysis: 1) The pervasive reach of structural racism, 2) Shared identities facilitate trust and healing, 3) Racism directly impacts mental health, and 4) Advocacy on macro and micro levels is a vital service. Conclusions for Practice Results show the chronicity and toxicity of structural racism on Black women's physical and mental health. The presence of overt and subtle forms of racism occur in multiple systems and require interventions on macro- and micro-levels. Culturally-specific perinatal care programs that prioritize racial concordance between providers and clients/patients are well-received and effective models of care. Black perinatal care should include culturally-specific approaches, advocacy on behalf of and alongside Black people, mental health support with attention to racism-related stress, and interrogation of implicit bias. Multipronged interventions guided by Reproductive Justice principles provide a holistic framework to address interpersonal and systemic racial oppression.