Global health research to promote social justice: a critical perspective

Researchers who use a critical perspective analyze the historical, political, economic, social, cultural, and gender factors that impact on the people being studied. Research is regarded as a way to promote social justice. The purpose of this article is to describe why and how a critical perspective was used in designing and implementing research with Aymara women healers in the high plains of Peru. The study is used to demonstrate the usefulness of a critical perspective in global health nursing research to promote social justice.     

Transformation for health: a framework for health disparities research

The task of generating knowledge addressing disparities in health among vulnerable populations in American society is explored. The community-based participatory approach as an alternate paradigm to traditional research is mentioned as a process for understanding the realities of the populations of interest. Identification and testing of mediating and moderating variables is suggested to guide the process of increasing knowledge regarding health disparities. Transformation for Health is proposed as a conceptual framework to study how these third variables influence the relationship between the primary variables of interest. A theoretical example is offered describing the application of the framework to study the mediators and moderators in an investigation of childhood obesity. Analytical challenges in the exploration of "third variables" are described, and the authors recommend that salient methodological issues should be addressed when conducting these types of investigations.     

Participatory action research to understand and reduce health disparities

Participatory action research (PAR) is an excellent way to systematically learn about the conditions under which people experience health disparities, what it is like from the perspective of those experiencing such disparities and, even more importantly, how to ameliorate this major public health problem and create a more equitable and effective health care system. This article describes the method of PAR, supports the appropriateness of PAR to learn about and reduce health disparities, and then presents some specific examples of research projects that have employed or are planning to employ PAR. These examples are from the work of several authors of this article, who are members of an interdisciplinary working group that serves as a forum for discussion of issues related to qualitative research methods and facilitates the development of qualitative studies. All of the authors of this article are part of a task force of this working group that is focusing specifically on community outreach with the goal of reducing health disparities within specific communities.     

Advancement of health disparities research: a conceptual approach

Although nurse researchers have contributed in significant ways to the body of literature on health disparities, a broad framework and approach to health disparities is needed if we are to understand the complex interplay of variables that contribute to health disparities. This article reports on the work of the Center for the Advancement of Health Disparities Research and its development of a conceptual framework and method for approaching health disparities research and on a sample of nursing research consistent with this framework.     

Clinical trials: bringing research to the bedside

Over the years, clinical trials with their structured treatment plans and multicenter involvement have been instrumental in developing new treatments and establishing standard of care therapy. While clinical trials strive to advance medical knowledge, they provide scientifically sound, state of the art care and their use should be increased. The Brain Tumor Cooperative Group, one such NCI-sponsored cooperative group, has been the primary group for the treatment of malignant gliomas. As the field of neuro-oncology expands, the neuroscience nurse needs to develop an understanding of clinical trials and their operation. The nurse is in an optimal position to support medical research and the research participant.     

Feminist research: its relevance to nursing

It is the author's intention to explore feminist research and discover its relevance to nursing practice In order to achieve this, definitions of feminism and feminist research will be made From these it will be possible to place the feminist research process within a historical context to further understand its focus Then an analysis of feminist research will be made, examining feminist epistemology, feminist methodology and the methods used by feminist researchers At this point an examination of who should or can do feminist research will be made, followed by a discussion about the validity of feminist research     

Practice-based research networks: nursing centers and communities working collaboratively to reduce health disparities

Practice-based research networks (PBRNs) can provide a range of opportunities for nurses working in primary care settings. This article reports on the early experiences of the Midwest Nursing Centers Consortium Research Network (MNCCRN), one of only two nursing PBRNs in the nation. Findings from the MNCCRN's first research study, Wellness for a Lifetime, indicate success with implementing research across geographically distant sites, and positive client outcomes related to improving nutrition and physical activity. Lessons learned in establishing a PBRN and implementing research studies in the real world are described as well as challenges for the future.     

A concept analysis of social justice in global health

BackgroundFundamental nursing responsibilities include health promotion, disease prevention, and alleviation of suffering both locally and internationally.PurposeTo examine the state of knowledge and provide clarity on the concept of social justice in global health.MethodUsing a modified Walker and Avant approach, literature was synthesized based upon discipline, including: nursing, public health, social work, philosophy, international law, international development studies, and religious studies. A theoretical definition, antecedents, defining attributes, and consequences were identified along with gaps in current knowledge and understanding. A model case was followed by direction for further concept development.FindingsSocial justice in global health nursing is a fundamental human right to be protected and a moral obligation demonstrated by action. It results in change that improves the health of individuals and populations both locally and globally by recognizing and confronting injustice, oppression, and inequity while promoting participation, opportunity, justice, equity, and helping relationships.DiscussionNursing must bring its unique perspective to policies and practices pertinent to issues of inequity. As the largest group of health care providers globally, nursing has the responsibility and political potential to mediate change and address factors integral to ensuring social justice in global health.     

The Black-White perception gap and health disparities research

Reducing and eliminating racial and ethnic health disparities has become a national research priority. This research agenda requires new research frameworks that encompass the social determinants of health and the translation pathways of these social contexts into physiological morbidity. Within these sociobiological research frameworks, identity and emotions are seen as crucial links in the causal pathways from stressors to biological responses. In this country, the lived social reality of African American individuals is experienced through the color of their skin. Their identity is bound with the racial inequities of our society. It has been suggested that the emotions of anger and frustration resulting from this institutionalized racial discrimination are an emotional causative pathway to the pathophysiology contributing to the health disparities experienced by African Americans. However, as much as we espouse the concept of cultural competency in health care, until recently, there has been very little honest dialogue about how race and racism influences health. This article will explore the Black-White cultural perception gap and attempt to provide insight on the relationship to African American health and implications for health disparities research.     

Change in process: bringing about change in health care through action research

• ? A 2-year action-research project aiming to facilitate the management of change was carried out in a district general hospital.
• ? Hospital managers and senior ward nurses had very different views concerning the source of challenges and problems within the hospital organization.
• ? A case-study of nurses' experience of change at ward level was produced as part of the diagnostic phase of the action research.
• ? The results of the case-study indicated that general managers and professionals had different agendas for change hut that there is common ground between them.

     

Models of inter-institutional collaboration to build research capacity for reducing health disparities

Health disparities are inequities in the health of different groups of people that may lead to needless pain, suffering, and premature death. The Yale-Howard Partnership Center on Reducing Health Disparities by Self and Family Management is part of a federally-funded initiative to foster the development of partnerships among researchers, faculty, and students at minority-serving institutions and research-intensive institutions. The goal of the initiative is to maximize the resources available to each of the partnering institutions. The purpose of this article is to describe the models of research collaboration that have emerged from the Yale-Howard Partnership Center on Reducing Health Disparities by Self and Family Management.