Master of Genetic Counseling Program, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Genetic Counseling Services, University of Wisconsin Hospital and Clinics, Madison, WI, USA.
J Genet Couns. 2021 Oct;30(5):1388-1398. doi: 10.1002/jgc4.1405. Epub 2021 Mar 18.
As a medical specialty, genetic counseling (GC) espouses cultural sensitivity, a patient-centered approach, and an eye for the individual, familial, and community-wide implications of genetics and genomics in medicine. Within the past decades, the field of GC has recognized and attempted to address a need for the greater diversity of providers and practice settings that will help to address health inequities across underrepresented communities (Channaoui et al., 2020). Accreditation for GC training programs mandates equipping students with multicultural sensitivity and knowledge on health disparities. Currently however, there are limited published data about how GC programs are accomplishing these aims for Native American individuals and communities. Furthermore, there are limited published data on the unique needs and perspectives of Native Americans who may seek GC services. This disconnect may pose barriers for genetic counselors who aim to provide respectful and relevant care to Native American patients. Education of GC students is one important way to set the tone for a lifetime of practice and to inspire awareness and action toward alleviating disparities. Thus, we surveyed GC training programs in North America to investigate how they are working to (a) address disparities in Native American professional representation and student enrollment, (b) deliver culturally relevant curricula and clinical opportunities that serve the needs of Native Americans, and (c) positively engage Native American communities in North America. We found that reported recruitment efforts, curricula content, clinical opportunities, and community engagement efforts to address the needs of Native American are limited across GC training programs surveyed. By bringing awareness to current methods, success factors, and barriers in this space, we hope to open the door for meaningful partnerships between leaders of Native American communities and GC training programs in the pursuit of greater equity.
作为一个医学专业，遗传咨询（GC）倡导文化敏感性、以患者为中心的方法，以及关注遗传学和基因组学在医学中对个体、家庭和社区的影响。在过去的几十年中，GC 领域已经认识到并试图解决需要更多不同类型的提供者和实践环境的问题，以帮助解决代表性不足的社区中的健康不平等问题（Channaoui 等人，2020 年）。GC 培训计划的认证要求学生具备多元文化敏感性和健康差异方面的知识。然而，目前关于 GC 计划如何为美洲原住民个人和社区实现这些目标的公开数据有限。此外，关于可能寻求 GC 服务的美洲原住民的独特需求和观点的公开数据也有限。这种脱节可能会为希望为美洲原住民患者提供尊重和相关护理的遗传咨询师设置障碍。对 GC 学生的教育是为他们的一生实践奠定基调的重要方式，也是激发意识和采取行动减轻差异的重要方式。因此，我们调查了北美的 GC 培训计划，以调查他们如何努力：(a) 解决美洲原住民专业人员代表性和学生入学率方面的差异，(b) 提供满足美洲原住民需求的文化相关课程和临床机会，以及 (c) 积极让北美的美洲原住民社区参与进来。我们发现，在所调查的 GC 培训计划中，针对美洲原住民的招聘工作、课程内容、临床机会和社区参与工作的报告都很有限。通过关注这一领域当前的方法、成功因素和障碍，我们希望为美洲原住民社区的领导者和 GC 培训计划之间建立有意义的伙伴关系打开大门，以追求更大的公平。
