Assumptions about gender and sexuality in the health care system often manifest as structural barriers to accessibility. Stakeholders, such as healthcare program managers, executive directors, practitioners, and other staff members, inform the organization’s structure, which guides providers on the service provision they provide to their LGBTQ+ patients. Thus, understanding health care staff perceptions on how current policies and programs contribute to the health care environment for the LGBTQ+ community will assist efforts for equitable service provision. Semi-structured interviews were conducted on staff from 6 health care organizations. Open-ended questions focused on their perspectives on current practices and policies, organizational areas of growth, as well as barriers, for equitable care. The purpose of the study is to discuss LGBTQ+ health within their organization to elicit staff perceptions on values and perspectives that address LGBTQ+ health disparities. Interviews were transcribed and inductive thematic analysis was done to find common benefits, viewpoints, and areas of improvements. Themes such as lack of knowledge, cultural biases, historical discrimination, and collaborative leadership, emerged. The findings of this study show gaps in delivering coordinated, patient-centered care for LGBTQ+ patients. This suggests greater importance for organizational education and training, particularly related to how historical oppression impacts bias in their setting. The overall implications of the study illustrate the relationship between the themes and organizational impact on service provision, which impacts the accessibility, safety, and quality health care environment for LGBTQ+ patients. This is crucial to giving context and describing the systematic impact on an individuals’ access to and quality of health care for the possible use in future studies.

There is a demand for on-going training resources for American Indian and Alaskan Native (AI/AN) resource parents caring for older youth (12-20 years) in the foster care system. This exploratory, qualitative study evaluated the effectiveness of a resource parent on-going training curriculum, Critical On-Going Resource Family Education (CORE Teen), which was developed in 2016 to increase the stability and longevity of resource parents facing the unique challenges of caring for older youth. CORE Teen was implemented with a tribe located in the south east region of the United States for a pilot study. Two semi-structured focus groups were conducted with a total of 22 parents that participated in the sample: 1) with resource parents that have received CORE Teen, and 2) with those that did not. Interview questions focused on differences in the experiences of resource parents who have received teen-specific, on-going training compared to foster parents without access to resources that specifically target their parenting practices. A thematic content analysis produced these ten themes: (1) desire for information; (2) lack of preparation; (3) normal teen behavior; (4) difficult transitions; (5) trauma; (6) mental health; (7) importance of kinship ties; (8) training outcomes; (9) training recommendations and (10) policy recommendations. Themes indicated that the intervention group articulated a greater comfort level in parenting teens than the parents in the comparison group. Findings highlight the importance of training to increase caregiving capacity of resource parents caring for American Indian youth, who are at the intersection of lacking developmentally appropriate support and historical marginalization.

Latinx individuals feel that mainstream mental health services cannot adequately address their specific needs and that non-Latinx therapists may be insensitive to their psychosocial needs. The Latinx population is a rapidly growing population. In 33 states they account for 58% of the population; in the remaining they account for 7%. As a result of increase in population in the United States, there is an urgent need to understand the Latinx culture and create interventions that are effective for Latinx individuals. Studies reveal barriers around therapists lacking empathy towards Latinx clients, and lack of language metaphors in order to translate mental health diagnosis. To address these gaps, the study aims to discover what are the barriers and needed supports to promote culturally competent care by mental health practitioners serving Latinx communities. This study uses primary data obtained through a quantitative survey from mental health practitioners who are serving or have served Latinx individuals. Chi-square and independent samples t-tests were run to examine bivariate relationships between whether trainings related to cultural competence, humility, and diversity were provided and participant perceptions of cultural competence and understanding of the Latinx culture. A preliminary analysis of 18 participants found no significant differences at the p < .05 level. However, trends suggest practitioners who are provided with training across categories of competence, humility and diversity were likely to report feeling culturally competent. Additionally, no meaningful differences were seen in average ratings of knowledge of the Latinx culture. Preliminary findings suggest trainings are beneficial for practitioners working in mental health within the Latinx community, particularly for facilitating cultural competence but not necessarily for increasing knowledge around the Latinx culture.

Disability research in the Black community is limited nationally and absent for Seattle area residents. This study is an effort to center the narratives of Black Seattle area residents who live with a disability and to identify commonalities among these individuals. This study used qualitative interviews (n=5) as the methodology to identify three key themes across the study participants' lives. The themes identified are: (1) Fear and Shame, (2) Resilience, and (3) Consequences. Based on disability critical race theory, my analysis aimed to understand how participants navigate dominant society with intersecting identities. I found that they often experience adverse outcomes which continue to remain invisible and unacknowledged throughout political, social, and judicial realms of society. This study illuminates the need for state institutions and nonprofits that serve clients with disabilities to expand their reach to include more people of color. Additional research on outcomes experienced by African Americans with disability is needed to combat the institutional invisibility that this population faces.