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社区合作开发关于定居者殖民主义与健康的社会决定因素的课程。

Community Collaboration to Develop a Curriculum on Settler Colonialism and the Social Determinants of Health.

作者信息

Chell Margaret A, Smith Caroline, Leader Charge Damon P, Sun Stephanie W, Sundberg Michael A, Gampa Vikas

机构信息

Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA.

University of Colorado School of Medicine, Aurora, Colorado, USA.

出版信息

Teach Learn Med. 2024 Sep 17:1-8. doi: 10.1080/10401334.2024.2403991.

Abstract

American Indian/Alaska Native (AI/AN) communities continue to experience health disparities and poor health outcomes, which are influenced by social determinants of health. The theory of settler colonialism provides a framework for understanding the structures that affect social determinants of health and the resulting health disparities. Western biomedicine and medical education have been implicated in perpetuating settler colonialism, and as a result Indigenous medical educators and leaders have called for increased education and understanding of the structural and social determinants of health affecting Indigenous populations. One important method is through community-based approaches to curriculum design. In collaboration with community leaders and experts, we identified the need for a curriculum on health in the context of settler colonialism, with a focus on resilience and community-directed efforts to improve wellness and care. Alongside Indigenous leaders and educators, we developed a unique curriculum focused on settler colonialism, the social determinants of health, and the assets inherent to the Native Nation where we work. Developed for non-Native learners and clinicians, the curriculum is designed to help provide context for the historical and political etiologies of health inequities experienced by the local community. Local educators helped shape a video lecture series associated with readings and experiential learning activities in 10 domains, providing an overview of settler colonialism and how it affects the social determinants of health. Our model of education draws upon the strengths and assets of communities and can improve health outcomes as well as learners' understandings of AI/AN-specific needs. We expect that our collaborative approach results in improved relationships among the Non-Native learners and providers and community members.

摘要

美国印第安人/阿拉斯加原住民(AI/AN)社区持续面临健康差距和不良健康后果,这些受到健康的社会决定因素的影响。定居者殖民主义理论为理解影响健康社会决定因素的结构以及由此产生的健康差距提供了一个框架。西方生物医学和医学教育被认为在延续定居者殖民主义,因此,本土医学教育工作者和领导者呼吁加强对影响原住民人口的健康结构和社会决定因素的教育和理解。一种重要方法是通过基于社区的课程设计方法。我们与社区领袖和专家合作,确定了在定居者殖民主义背景下开设一门健康课程的必要性,重点是恢复力以及社区主导的改善健康和护理的努力。我们与本土领袖和教育工作者一起,开发了一门独特的课程,重点关注定居者殖民主义、健康的社会决定因素以及我们工作所在原住民国家固有的资产。该课程是为非本土学习者和临床医生开发的,旨在帮助为当地社区所经历的健康不平等的历史和政治病因提供背景。当地教育工作者帮助打造了一个视频讲座系列,该系列与10个领域的阅读材料和体验式学习活动相关,概述了定居者殖民主义及其如何影响健康的社会决定因素。我们的教育模式利用了社区的优势和资产,可以改善健康结果以及学习者对AI/AN特定需求的理解。我们期望我们的合作方法能改善非本土学习者和提供者与社区成员之间的关系。

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