Minority Health Professions Foundation 100 Edgewood Avenue, Suite 1020 Atlanta, GA 30303 (678) 904-4217 www.minorityhealth.org
One of the things we’re preparing for is the Annual Symposium on Career Opportunities in Biomedical Sciences. We bring together approximately 1,000 high school and university students to highlight the kinds of health professions and biomedical careers they could pursue. Our aim is to encourage and motivate participation of underrepresented minorities in the sciences and health professions and thereby increase their presence in the physician and scientific workforce.
The changing ethnic/racial climate in the United States demands an increase in the number and diversification of biomedical scientists and health professionals. However, African Americans and other underrepresented minorities (URMs) continue to be significantly underrepresented among the Nation’s scientists and health professionals.
According to the 2000 U.S. Census Report, the U.S. population consisted of approximately 12.3% blacks, 0.9% American Indian/Alaska Natives, 3.6% Asians, 12.5% Hispanic/Latino and 75.1% whites. URMs remain well below the national average with regard to education, employment and health status. While today these minorities make up more than 25% of the U.S. population, historically they continue to be underrepresented in the medical and research professions. Among the nation’s scientists, blacks represent 2.3%, Hispanics 2.8% and American Indian/ Alaskan Natives 0.3%. There have been modest increases of underrepresented minority physicians over the past 20 years. In 2000, the U.S. physician workforce was comprised of 5.1% Hispanics, 4.4% African Americans and 0.2% American Indians.
The symposium features people in health and science fields who can talk to students about what they do and serve as live role models. We’re expecting over 1,000 students from across the country who will attend 16 workshops led by caring professionals from similar backgrounds who role model the lifestyle, behavior and determination that it takes to become a scientist or health professional.
How does Minority Health Professions Foundation connect with students on a national level?
We work with Historically Black Colleges and Universities from all over the country to recruit students. We recruit American Indian and Hispanic students from national organizations similar to the MHPF that focus on the specific interests of these groups, i.e., the American Indian Higher Education Consortium and the Hispanic Serving Health Professions Schools. These students include high school students in the 11th and 12th grades and college students.
We get a lot of requests for not only for steering students to majority schools but also to recruit minority faculty. For example, we’ll contact the HBCUs to post jobs at majority schools when we hear of them.
Do you also work with community colleges to connect with students who are studying in one of the allied health fields?
One of the things we will probably do more of this year is have direct contact with community colleges for the symposium. More students are going to community colleges as an introduction to four-year colleges.
We are cooperating with the U.S. Agency for International Development to support faculty to attend training for tuberculosis prevention and elimination. Through this program, we provide support for MHPF faculty to receive training and to serve on international assessments teams with organizations like the World Health Organization (WHO). This training is held in Tanzania and Vietnam.
Does the foundation help provide any other training programs for students or professionals?
Yes. One way the MHPF is currently supporting professional development of students is through an internship program at Florida A&M University where the emphasis is on the development of research skills related to assessing and analyzing disease and health problems that primarily affect disadvantaged populations. This includes the human affects associated with environmental pollution, environmental and occupational health concerns, and health promotion and disease prevention through community involvement and education. Through the internship process, students learn about public health data sources, such as medical data, environmental data and survey data.
Part of the foundation’s mission is to support research. What is MHPF doing now in terms of research?
The Foundation is participating in a Cooperative Agreement with the CDC/Agency for Toxic Substances and Disease Registry where research projects in the MHPF member institutions are being undertaken to understand the link between exposure to several hazardous substances and their human health effects. Results will reduce the uncertainties of public health assessments and will provide the most effective measures to prevent or mitigate the adverse human health effects of these toxic substances. Lead exposure, for example, remains a significant health threat to the nation’s population, especially children. Yet it is not clear at what level of exposure this damaging effect occurs. The relationship between lead exposure and elevated blood pressure needs also to be clarified. Human studies at Charles Drew University of Medicine and Science and Morehouse School of Medicine as well as animal and cellular studies at the Colleges of Pharmacy of Texas Southern and Florida A&M Universities are being conducted to answer these uncertainties about lead toxicity.
An environmental multimedia study of lead, cadmium, zinc and manganese is being conducted at Xavier University College of Pharmacy. The aim of this study is to develop a comprehensive understanding of routes of exposure of toxic substances from an urban environment and from environmental media of soils, water, sediments and aquatic organisms to people. Analysis of these different environmental media in various areas of New Orleans revealed that these hazardous substances co-exist and are higher in the inner city regions. These findings have been shared with the scientific community through many peer-reviewed publications.
Health care has been changing a great deal in the last few years. How has this affected the evolution of the MHPF’s work?
We are about to develop a five-year strategic plan based on what we see in health care today and what the role of an organization like the MHPF should be. The health profession’s workforce is aging. We’ve got to ensure that a younger generation of minorities becomes a part of the workforce of the future.
We need to encourage, motivate and train young people to be a part of the health professions. People now who are in those professions are retiring, so we’ve got to get a new group of people in those fields.
Part of our challenge is getting the word out to young people. A lot of the kids just don’t know about the opportunities. We have a charge to make known what you can do. Students often say to us, “Oh, we never knew that these fields existed.”
At the symposium, we conduct over 16 workshops on different professions. In addition, one of the things we’re going to do with the Web site is highlight health professions. All of the kids who have ever attended a symposium can go to the Web site and access this information.
What do you see as Minority Health Professions Foundation’s primary task for the future?
I see our focus being how we can impact the health profession’s workforce. Even now we’re seeing that minorities are not appropriately represented. I think its been shown that people of the same ethnic group can better serve and identify with that group’s needs. It’s important that we increase the numbers of minorities who provide health care services so that minority populations are better served
National Alliance for Hispanic Health 1501 Sixteenth Street, NW Washington, D.C. 20036 (202) 387-5000 Email: [email protected] www.hispanichealth.org
The National Alliance for Hispanic Health was founded in 1973 by a group of mental health professionals to improve the treatment of Hispanics by the mental health system. Within a few short years, the group had expanded its mission to addressing the health care needs of Hispanic families. Thirty-one years later its mission is multifaceted and includes helping consumers and providers, as well as promoting the appropriate use of technology, improving the science base for accurate decision making, and promoting philanthropy.
Since the Alliance was founded, the percentage of Hispanics in the United States has grown, and the needs of the community have changed. But the Alliance has maintained the same principles since the beginning: seeking out community-based solutions, representing all Hispanic groups, and refusing funding from alcohol and tobacco companies.
The U.S. Census Bureau predicts that by the year 2020, Hispanics will account for 18% of our total population (according to the Alliance, by 2050, that number is expected to reach 25%.) Although Hispanics have longer life expectancies than Americans of other ethnic and racial backgrounds, they are more likely to suffer from chronic illnesses. The exact causes for these discrepancies are unknown, but the Alliance hopes to keep such issues a major area of concern and research for the medical and scientific communities.
What does this mean for allied health care providers? According to Jane L. Delgado, president and CEO of the Alliance, those who provide health care to Hispanic people must understand and appreciate the culture. She adds that merely understanding the language or being tolerant of non-English speakers is not enough. In an interview with DAHC, Delgado talks about the AllianceÕs missions and challenges and what health care workers can do to help.
One of the Alliance’s missions is to raise ‘cultural proficiency’ among providers. What does the term mean and why is it significant in the medical treatment of Hispanics?
In the 1990s, cultural competency was the term used to encompass the ability to value another language or culture. The lessons learned were that the least competent providers believed themselves to be competent and that competency was inadequate for the often-intimate interaction that underlies the therapeutic encounter. What was needed was at the more advanced level of cultural proficiency in which a different language and culture is held in high esteem. This concept is an essential part of the clinical interaction. The interaction between provider and patient requires that the provider recognize and incorporate the values of the patient into their clinical work.
What can providers do to improve their treatment of Hispanic patients? What are common problems that could be avoided?
To improve treatment of Hispanics, providers must rely on what Pete Duarte, former CEO of Thomason Hospital in El Paso, Texas, defined as the ‘R&D’of good clinical care, (i.e., Respect and Dignity.) As a first step, providers should understand that the mentality of compliance is not helpful. Instead, all clinical encounters need to occur in a positive environment where the major theme is ‘working together.’ While this is true for all patients, it is more so the case with Hispanic patients because of the decades of disconnect with the health provider community.
At a fundamental level, the issue of language spoken must be addressed. While it is unlikely that every provider can communicate in the same language as every patient, there is a need to have mechanisms in place to make possible communication when the language of the patient is not English. At a minimal level, well meaning providers need to understand that interpreting is a skill that must be learned; merely being able to speak a language does not make a person skilled. There are some simple cautions to keep in mind, e.g., use of pantomime is open to misinterpretation and that speaking slowly and loudly will not make English understood by a non-English speaker.
Hispanics live longer than other ethnic groups in the United States, yet suffer a higher incidence rate of diabetes, depression and arthritis. What is the Alliance doing to improve the quality of life for Hispanic people with chronic illnesses?
We work through our four centers to improve the quality of life for Hispanics: 1. Center for Consumers operates national information help lines (for general information (866) SUFAMILIA and for prenatal care (800) 504-7081); develops materials on a variety of health topics; works with youth to involve them in health; reaches out to consumers to make sure they have the latest information to make healthier decisions about their lives; and, through the action forum on our Web site, directs communication by individuals with their elected officials.
2. Center for Providers improves the cultural proficiency of providers through training and technical assistance, works with community-based organizations, and forms local and national coalitions to address health issues.
3. Center for Technology works to ensure that Hispanics benefit from the appropriate use of technology. As founding board members of the Patient Safety Institute, we strive to make sure that the most accurate data are available at the point of care.
4. Center for Science and Policy works with the National Institutes of Health and the greater research community to understand how basic science, risk factors, treatment and outcome apply to Hispanics; to increase the number of Hispanics in the sciences; and to fill the gap between the bench and the bedside. All of our knowledge from consumers, providers, technology and science drive what we do in the policy area.
What is the most significant project the Alliance is involved in now?
All of our projects are significant to the 25 dedicated national staff who have made their life work improving the health of Hispanics. We understand that each project helps us to fulfill our mission regardless of whether it is releasing our report on genes and Hispanics, answering the concerns of a consumer who does not know where there is a clinic close to their home, or launching a national campaign to make sure that older Hispanics obtain the new prescription drug discount card.
What type of research is the Alliance advocating to be conducted in the upcoming years?
We want good research that is inclusive of Hispanics in a way that insures a healthy lifespan for all. We need research that creates models of health, risk factors, diagnosis, treatment, and follow-up that include and explain the Hispanic experience.
How can allied health professionals and students help the organization’s missions?
You can do several things:
Keep us informed of emerging issues and opportunities to improve health.
Become a member of the Alliance.
Be an active member of your respective professional organization.
Make your voice heard by communicating with elected officials. Our Web page (hispanichealth.org) has a new feature ÒAction ForumÓ that makes it easy for you to track legislation of interest to you and send an email to your elected representatives.
In less than 50 years Hispanics are expected to make up one fourth of the population in this country. How far has the medical community come in treating this growing patient population at the same level as the population at large, and how far does it have to go to meet the resulting challenges?
All of our projects are significant to the 25 dedicated national staff who have made their life work improving the health of Hispanics. We understand that each project helps us to fulfill our mission regardless of whether it is releasing our report on genes and Hispanics, answering the concerns of a consumer who does not know where there is a clinic close to their home, or launching a national campaign to make sure that older Hispanics obtain the new prescription drug discount card.
The answers are simple: 1. Not far enough, 2. How far we have to go varies by where we are. The important point is that by working together we will all get there and enjoy healthier lives.
The year is 1988. Seeking fellowship and peer support, Filipino nursing students at San José State University in California begin to meet regularly to share their feelings about the issues and challenges they face as they work toward their BSN degrees. For many of the students, especially those who have recently immigrated to the U.S., cultural issues–such as overcoming language barriers, homesickness and adjusting to an unfamiliar cultural environment—are an especially important concern.
Through these peer discussions, the students quickly realize that their learning reaches beyond the classroom and clinical areas, challenging who they are and whom they need to become in order to be successful in their studies and their future nursing careers. The group is a safe place to “vent,” to receive support and to learn appropriate techniques for overcoming obstacles.
Flash forward to 1997. After nearly a decade of these informal group meetings, the Filipino Nursing Students Association (FNSA) at San José State University School of Nursing was officially formed—and it has become so successful that it has developed into a national model to help Filipino students at other nursing schools across the country unite and assist one another.
Each year, on the first Saturday in February, the FNSA holds a conference at San José State. The most important development to emerge from the 1999 conference was the decision to create a national organization for Philippine nursing students, with San José’s FNSA as the flagship chapter. As a result, the Philippine Student Nurses Association of America (PSNAA) was born, holding its own first annual conference in 2000.
Katherine Abriam-Yago, RN, EdD, associate professor and student retention coordinator at San José State University School of Nursing, is the faculty advisor involved in the creation of both the FNSA and the PSNAA. As a Filipino American herself, Abriam-Yago attended nursing school at the University of San Francisco with only a handful of other minority students. She always knew that she would use the wisdom she gained through her experiences to mentor other students from culturally diverse backgrounds through the difficult years of nursing school.
“My father used to tell me, ‘You will always be judged by the color of your skin, but your education will open doors for you. When you are involved in an important role, you must help others,’” she remembers.
Cultural Coping Strategies
Abriam-Yago is particularly proud of the FNSA’s success in creating an environment where Filipino students—who make up approximately 20-25% of the San José State nursing school’s student population—can come together to share their feelings, problems and advice. The students bond with each other as they work together to master the cultural and professional components that will help them become successful nurses. The group provides guidance and emotional support to help its members realize that they don’t have to travel this academic journey alone. In fact, they find that other students are facing the same issues, and together they discuss ways to resolve them.
Abriam-Yago first saw the need for a group like the FNSA 14 years ago when she developed and launched the San José State nursing school’s orientation program for new students. At that time, only 25% of the students were persons of color—a figure that has since risen to 75%.
Today, orientation sessions for incoming Filipino students are also a key part of FNSA’s support network. A panel of nursing undergraduates welcomes the new students to the nursing program, answers any questions they may have about what they can expect during their course of study and discusses strategies for becoming successful students. At this session, the new students are introduced to the FNSA, as well as other groups and associations that can provide peer mentoring and support.
As the students begin to settle into their nursing studies, they help each other master academic skills–such as time management, critical thinking and prioritizing—and overcome cultural obstacles that can interfere with the learning process. According to Abriam-Yago, some of the most common cultural challenges Filipino students face include adjusting to American communication patterns, learning to be assertive with authority figures and trying to balance the demands of their studies with the pressures of their traditional family responsibilities.
Because strong communication skills are such an essential component of a successful nursing career, language barriers can be a significant impediment for Filipino students who speak English as a second language. Not only must they learn the basics of American English, including idiomatic and slang expressions, they need to master nursing and medical terminology as well.
“Being able to articulate their needs is an important issue with Filipino nursing students,” says Abriam-Yago. “For example, they will respectfully say they understand [what they hear or read in class] when they really do not.” Sharing strategies to help each other identify their needs, become better communicators and integrate their new knowledge with their cultural background is the essence of the FNSA.
When students are just beginning to learn their future profession, they often have difficulty feeling confident enough to be assertive—and for Filipino students, cultural barriers can compound the problem. Because questioning what others say, especially those in authority, is not generally taught in Filipino culture, they must learn to balance respect with appropriate ways of speaking up on behalf of their patients’ interests, such as questioning doctor’s orders that they feel are incorrect.
FNSA members collectively address these issues by participating in group assertiveness training and leadership development activities. Additionally, Abriam-Yago and other professional nurses who are members of the national Philippine Nurses Association of America (PNAA) and the regional Philippine Nurses Association of Northern California (PNANC) act as role models to inspire the students and help them further boost their self-confidence.
“I have found that there is a stereotype that Filipino nurses are not competent enough or they cannot communicate as well [as other nurses],” says Kathleen M. Morales, current president of the FNSA. “I don’t think about that; I demonstrate that I am competent, that I can do what any nurse can do and that I am proud to be who I am.” In addition to her leadership role in the FNSA, Morales has been accepted into the Golden Key National Honor Society, has received several scholarships and recently completed an internship at the University of California at San Francisco (UCSF). She has decided to attend graduate school at UCSF to become a geriatric nurse practitioner.
Filipino culture’s strong emphasis on family values is still another factor that can complicate matters for students already struggling to handle the stress of a rigorous BSN program. Some students may be responsible for supporting members of their extended family back in the Philippines—for example, sending a relative to school or helping in the care of younger children and elderly family members.
Furthermore, if students fall behind in their studies or do not do as well as they had hoped, the disappointment can be painful and families can be harsh. “Filipino parents are very strict about education,” notes Morales. “I have heard of parents putting their children to shame because they received a B rather than an A. Or if the student fails a class, the parents get really upset and regard their child as a failure. You wouldn’t believe how many students are scared to tell their parents they failed.”
From the Classroom to the Community
Membership in the FNSA is open to all students, regardless of ethnicity. For example, a Caucasian or Hispanic nursing student who is interested in working with the local Filipino community may find it helpful to join the group, not only to find fellowship with other students but also to participate in the association’s community health and outreach programs. This gives them first-hand opportunities to learn more about Filipino health issues and the cultural nuances that can help them provide more culturally sensitive care.
These community health projects are an important part of the FNSA’s broader mission to improve the health of Filipinos living in the San José area (see “Students with a Mission”). “Our intention is not only to help one another [as students] but also to give back to our community by providing volunteer services to different community centers and associations around the Bay Area,” explains Morales. “Our mission is to better ourselves so that we may in turn benefit others.
“When the Filipino community sees Filipino nursing students, they are proud of their culture and feel a sense of security and comfort with us,” Morales continues, adding that some Filipino immigrants are fearful of seeking health care, either because of language barriers or a lack of trust in Caucasian health providers. Being able to work with student nurses who share their cultural heritage can do much to help these patients overcome their fears, she says. “And they can also speak their own language [with us], so they do not need to speak English.”
FNSA members have collaborated with the PNANC on projects such as blood pressure screenings, blood drives and health fairs. They also recently participated in a multiple sclerosis walk, a breast cancer walk and an Asian bone marrow drive. Of the latter project, Abriam-Yago says proudly, “I received a letter of thanks for our participation. We were able to recruit over 50 individuals to donate their bone marrow.”
Priming the Pipeline
Will the fledgling Philippine Student Nurses Association of America eventually become affiliated with the PNAA? It’s too early to tell, says Abriam-Yago, noting that the PNAA is still in the process of officially defining its relationship with the student group. In San José, however, its local chapter, the Philippine Nurses Association of Northern California, works closely with the FNSA to provide the students with mentoring and support, and to encourage them to join the PNANC when they graduate.
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According to PNANC President Araceli D. Antonio, RN, MS, “Our mission is to promote fellowship and unity among Filipino nurses, to foster a positive image and to provide activities that assist in the professional development of the Filipino nurse.” As part of that commitment, the association provides scholarships to deserving Filipino undergraduate and graduate nursing students.
In addition, the PNANC invites FNSA members to attend its board meetings, workshops, seminars and other educational events. It also offers assistance, such as registration discounts and help with travel expenses, to nursing students who want to attend the PNANC’s annual conferences and the national PNAA annual convention.
Participating in these professional networking events beyond the nursing school campus gives the students an invaluable chance to learn about future career opportunities and make connections with other Filipino nurses who can serve as mentors and role models. As Abriam-Yago, who brought a delegation of FNSA members, including Morales, to the 2001 PNAA convention in Chicago, puts it, “We’re preparing the next generation of Filipino nurses.”
Going National
In the three years since the FNSA first set its sights on expanding into a national organization for Filipino nursing students, it has been working to create sister Philippine Student Nurses Association of America chapters at other schools around the country. Currently, FNSA members are mentoring a group of students at the Rutgers University College of Nursing in New Jersey to help them start a chapter based on the successful San José model.
Abriam-Yago adds that the February PSNAA annual conferences at San José State provide an ideal forum for students nationwide to network with FNSA members and discuss issues and challenges involved in forming a chapter. The recently completed 2002 conference brought together some 65 students, most of them from other parts of California.
Are you a Filipino nursing student or faculty member who would like more information about the Philippine Student Nurses Association of America? The FNSA invites you to contact Kathleen M. Morales at [email protected] or Katherine Abriam-Yago at (408) 924-3159, [email protected]. Students who are interested in starting a PNSAA chapter at their school will need a faculty advisor to help them with the process.
Students with a Mission
The Filipino Nursing Students Association at San José State University has come a long way since its early days as an informal peer discussion group. Today, its mission statement includes the following ambitious goals:
Purpose:
To support and mentor Filipino nursing students and to promote the health of the Filipino community.
Functions:
1. To provide culturally sensitive information and resources to Filipino nursing students in the School of Nursing.
2. To promote mentorship and fellowship of Filipino nursing students.
3. To support and participate with other Filipino community and nursing organizations locally and nationally.
4. To participate in the planning, development and evaluation of health care delivery and policy making for Filipinos in the San José area.
5. To promote quality nursing care for the Filipino communities in the San José area.
6. To compile and maintain a Directory of the Filipino nursing students at San José State University.
7. To promote and undertake research that promotes the health of the Filipino population in the San José area.
8. To establish resources to support scholarships for Filipino nursing students.
According to Webster’s New Collegiate Dictionary, the word “unite” has the following meanings:
• To bring together so as to form a whole. • To bring together by a common interest, attitude or action • To join and act together in a common purpose or endeavor.
Now consider that racial and ethnic minority nurses–including African American, Hispanic, Asian/Pacific Islander, American Indian/Alaska Native and Filipino nurses–collectively account for 13.4% of the nation’s total RN population, according to the most recent National Sample Survey of Registered Nurses. Imagine what could be accomplished if all of these minority RNs, regardless of their different ethnicities, joined forces and came together to form a whole–a single entity united by common concerns and committed to acting together for the common purpose of increasing diversity in the nursing profession and improving the health of minority Americans.
The project directors for NCEMNA’s Nurse Stimulation Program. (L-R) Dr. Antonia Villarruel (NAHN), Dr. Bette Keltner (NANAINA), Dr. Betty Smith Williams (NCEMNA president), Dr. Lorna Harris (NBNA) and Dr. Luz Porter (AAPINA and PNAA).
For seven years now, the National Coalition of Ethnic Minority Nurse Associations (NCEMNA), based in Culver City, Calif., has been doing exactly that. Formed to unite the concerns and strengths of all nurses of color, today the coalition continues to expand its strategic efforts to act together on behalf of minority nurses and patients–and the emphasis is on action.
The idea of forming a unified coalition of ethnic nursing associations actually began more than seven years ago–back in May 1997, when the U.S. Department of Health and Human Services (HHS), Bureau of Health Professions, Division of Nursing, held a conference in Denver on minority health issues. Leaders from several prominent minority nursing associations were invited to give presentations at the conference and share their expertise. For these distinguished nursing leaders of color, being together at the same event was an ideal opportunity to network and get to know each other better.
“Some of us already knew each other; others of us were meeting for the first time,” says NCEMNA President Betty Smith Williams, DrPH, RN, FAAN, a founder and past president of the National Black Nurses Association (NBNA). “We began to talk together about our respective associations’ issues and goals. We found that we had mutual concerns, and we began to realize that joining our forces into a coalition would enable us to leverage our combined expertise to achieve mutual goals and accomplish more together than each association could accomplish alone.”
PhD Candidate Heyoung Lee, RN, presents her poster on ” The Family Attitude Scale (FAS): Translation Validity and Language Equivalence.
A little more than a year later, that vision had become reality. In December 1998, NCEMNA was officially incorporated as a 501(c)(3) non-profit professional organization. The four founding member associations were the NBNA, the National Association of Hispanic Nurses (NAHN), the National Alaska Native American Indian Nurses Association (NANAINA) and the Asian American/Pacific Islander Nurses Association (AAPINA). A fifth member, the Philippine Nurses Association of America (PNAA), joined the coalition soon after. The current president of each association, plus either a past president or the president-elect, serves on the NCEMNA board of directors.
From its inception, the coalition has been a collaborative national force and powerful advocate for both the concerns of minority nurses and for the health care needs of ethnic minority populations, who continue to suffer disproportionately high rates of disease and mortality compared to the Caucasian majority. NCEMNA’s goals include:
• Support for the development of a cadre of ethnic nurses reflecting the nation’s diversity. • Advocacy for culturally competent, accessible and affordable health care. • Promotion of the professional and educational advancement of ethnic nurses. • Education of consumers, health care professionals and policy makers on health issues of ethnic minority populations. • Development of ethnic minority nurse leaders in areas of health policy, practice, education and research. • Endorsement of best practice models of nursing practice, education and research for minority populations.
“Power in Numbers”
In many ways, NCEMNA is a truly unique nursing organization. Individual nurses cannot join the coalition; rather, it could be thought of as an “association of associations.” But if you are a member of one of the five minority nurse associations that make up the coalition, NCEMNA does indeed speak for you. In fact, it serves as a single, uniform voice for the approximately 350,000 nurses of color nationwide who belong to the participating associations. And it’s a voice that has gained volume and attention over the past seven years.
“There is power in numbers–and visibility,” comments Roxanne Struthers, PhD, RN, president-elect of NANAINA and assistant professor at the University of Minnesota School of Nursing in Minneapolis. “NANAINA is a smaller association, so it’s nice to be part of a larger organization in order to address the health disparities we face.”
“One of the benefits to being part of NCEMNA is to have the opportunity to participate on national projects,” adds Rudy Valenzuela, MSN, RN, FNP-C, president of NAHN and director of clinical services and health promotion for the Regional Center for Border Health in San Luis, Arizona.
As a single voice speaking for some of the fastest-growing population segments in the country, the coalition has succeeded in getting influential players to listen–from majority nursing associations and scholarly journals to federal health policy makers and the health care corporate sector. Says Williams, “My thinking, especially among some of the majority powers, is that it’s easier for them to deal with one organization instead of five separate associations. Therefore, I think NCEMNA is viewed as a positive.”
Dr. Claire Hastings explains her poster “Linking Clinical Research and Practice to Redeuce Health Disparities: A Conceptual Model” to an attentive audience.
Increasingly, health care decision makers have come to see the coalition as not just “a positive” but an invaluable source of knowledge and expertise about the minority nurse population and the crisis of racial and ethnic health disparities in America. For example, in both 2000 and 2002, NCEMNA representatives participated in national collaborative workshops on minority health issues and research needs with high-ranking officials of the National Institute of Nursing Research (NINR).
For the 2000 workshop, each of the coalition’s five member associations prepared a state-of-the-art white paper on the health status and needs of their particular ethnic community as well as recommendations for nursing research to improve the health of these populations. The five white papers were subsequently published in the journal Nursing Outlook in 2001 and 2002. And in 2002, a panel of four NCEMNA representatives presented an education session entitled “Tapping Ethnic Minority Nurses to End the Nursing Shortage” at the national biennial convention of the American Nurses Association (ANA), the nation’s largest nursing professional association.
“We have been sought out in many arenas,” Williams agrees. “When there is a call for nursing leaders, we’re at the table. We’ve assumed a position in nursing where our input and the quality of who we are have gained substantial recognition. That’s an accomplishment in terms of recognition of the value of minority nurses.”
“One of NCEMNA’s main achievements is advancing the recognition that minorities are present in the nursing workforce and that we are an important aspect of health care because we are the providers who are educated on the cultural [aspects] of treatment,” adds Valenzuela.
One health care industry corporate player that has also recognized the value of NCEMNA’s efforts is Aetna, the Fortune 500 insurance giant. “We presented a grant proposal to Aetna and they were responsive because they share our interests and goals,” says Williams. “We shared our vision with company officers and their support enabled us to work on writing a grant.”
Dr. Betty Smith Williams
In the initial stage of NCEMNA’s partnership with Aetna, the firm’s Aetna Foundation provided funding to help the coalition develop the infrastructure it needed to move forward as an organization, such as hiring a small administrative staff. Today the main focus of the NCEMNA/Aetna collaboration is an innovative program that offers financial and mentoring assistance to outstanding nursing students of color who are interested in research careers. The annual Aetna/NCEMNA Scholars Program, initiated in 2003 and supported by a grant from the Aetna Foundation, provides financial support to 10 minority nursing students–two from each NCEMNA member association. The scholars, who are nominated for the program by their associations, also receive mentoring in such areas as personal/professional development, leadership development and cultural competency.
Researching Solutions
The Aetna/NCEMNA Scholars Program is just one example of what has become a primary focus for NCEMNA in the 21st century: creating programs to increase the number of ethnic minority nurse scientists and researchers who can investigate the causes of minority health disparities and find solutions for eliminating them. As in many other nursing specialties, nurses of color are severely underrepresented in the research field, Williams notes. “I certainly believe the massive nature of the shortage of ethnic minority nurse scientists [compared to] the number of ethnic people in the country presents a huge imbalance,” she states.
Furthermore, much like the current nursing faculty shortage, aging researchers are beginning to retire, creating a critical need for a new generation of nurse scientists who can fill the vacancies and continue the work.
For many years, minority nursing leaders have recognized the urgent need to develop a network of researchers of color who can discover new knowledge about diseases that disproportionately affect minority Americans. This knowledge, in turn, can lead to new treatment strategies and preventive interventions that will help close the gap of unequal health outcomes.
“The more minority nurses there are in research, the more that information will get translated into practice, which is really what we need–innovations, investigations and translation,” asserts Struthers, a member of the Ojibwe tribe.
The need for training and professional development programs that will help stimulate the growth of a cadre of minority nurse researchers was a major focus of NCEMNA’s collaborative workshops with NINR, one of the National Institutes of Health (NIH). The consensus of the discussions was that a multi-pronged method of identifying, mentoring and promoting minority nursing students with the potential to become researchers would be the most effective approach.
To obtain federal funding for the development of such a program, NCEMNA turned to the National Institute of General Medical Sciences (NIGMS), another NIH institute. “NIGMS is the NIH division that has been working since the 1980s to increase the number of ethnic minority scientists in the health professions,” Williams explains. “Over the years NIGMS has provided grant funding to organizations such as the Society for Advancement of Chicanos and Native Americans in Science (SACNAS).”
Because many of NCEMNA’s board members are seasoned grant writers, it didn’t take long to pull the grant proposal together. “We [had a board meeting] in November, then wrote and submitted the grant in February,” Williams recalls.
The result: In 2004, NIGMS awarded the coalition a $2.4 million grant to fund a five-year initiative called “NCEMNA: Nurse Stimulation Program.” The grant leadership team is comprised of distinguished nurse educators and researchers from each of the five NCEMNA member associations.
“That was quite an accomplishment, because most of the NIGMS funds go to universities,” says Williams, who is the grant’s principal investigator. “Our position, however, was that as a nonprofit minority nursing professional organization, all of our member associations have direct contact with a large pool of ethnic minority nurses who could be encouraged and developed to pursue careers in research.”
Building a Network
What exactly is the NCEMNA: Nurse Stimulation Program? It’s a unique, landmark project designed to engage and cultivate the next generation of nurse scientists from racial and ethnic minority populations. Its mission is threefold:
• To create a network of ethnic minority nurse researchers. • To develop mechanisms to support ethnic minority researchers at all career levels. • To engage ethnic minority students to consider nursing research as a career trajectory. NCEMNA will use several strategies to accomplish these goals. They include: • Creating a database of minority nurse researchers and students that will be used to promote communication, the exchange of ideas and support for programs of research between current and potential nurse scientists. • Providing opportunities for aspiring minority nurse researchers to take part in mentoring development sessions, attend scientific symposia and interact with leading nurse scientists from across the United States.
Earlier this year, NCEMNA marked another milestone–and it’s no coincidence that this latest accomplishment is directly related to the launch of the Nurse Stimulation Program. On March 10-13, the coalition held its first-ever National Conference in Washington, D.C. With a theme of “Creating Research Careers: The Beginning,” the inaugural conference was an ideal first step for setting the program’s mentoring, networking and professional development vehicles in motion.
To identify potential candidates for the Nurse Stimulation Program who would be invited to the conference to gain an introduction to the research field, the coalition initially gathered data from the five members associations. NCEMNA then issued a call for candidates who would be interested in participating in a mentoring program that would direct individuals into research careers.
After receiving at least 100 applications, the coalition selected a total of 50 mentees–10 from each of the five member organizations. Additionally, NCEMNA selected five doctorally prepared nurse educators–again, one from each minority nursing association–to serve as mentors.
“We felt it was important to have the mentee pool include nurses and students from all educational levels,” Williams emphasizes. “We have mentees who are students in BSN, MSN and PhD programs, as well as new nursing faculty members who have not had a lot of research experience. It’s especially critical to start cultivating future minority nurse scientists early, while they are still in baccalaureate programs.”
While the concept of minority nurse mentoring programs is not new, it’s important to remember that many of the current generation of minority nursing faculty and scientists had to achieve their professional accomplishments without the guidance of like-minded minority mentors–because there were none available. These nursing pioneers were the trailblazers and barrier-breakers, and their successes came from their tenacity and vision. “When [our generation] came along, there was no one to take us by the hand and help develop us in academia. You achieved independently in those environments or you didn’t survive,” explains Williams.
That’s one reason why so many of today’s minority nursing leaders believes it’s crucial to reach out to the next generation of minority nurses through mentoring. “Providing financial assistance to students is important, but equally important is creating mentors,” says Valenzuela. “NCEMNA is already starting to do that. We’re creating an infrastructure to allow the numbers of minority nurses going into research and academic fields to increase.”
Adds Struthers, “Having role models is so important, because you can look at how others do things and how they have accomplished things that you’d like to achieve.”
Staying Connected
For the 50 Nurse Stimulation Program mentees, attending the1st Annual NCEMNA National Conference was an exciting opportunity to immerse themselves in the world of research. The event’s first day, which was open to the public, was devoted to scientific sessions and poster presentations by leading minority nurse researchers from around the country. The rest of the conference was a closed session set aside exclusively for mentoring. Two different mentoring tracks were offered, based on the mentees’ educational and career levels: one for undergraduate and graduate students, the other for mentees with more advanced educational preparation, such as new PhDs and faculty.
The mentoring sessions were inspirational and empowering for all who were there, says Struthers. “The standout moment was hearing the mentees, one after the next, talk about their plans for research careers. I enjoyed that so much because it was so powerful and is so needed,” she explains.
Over the year following the conference, the mentees and their mentors will continue to communicate regularly with each other, through informal emails and phone calls as well more formal communications, such as one-on-one meetings. “They will also stay connected through the use of Internet vehicles, such as Web networks and chat groups or forums,” adds Williams.
As this year’s mentees begin to take their first steps toward research careers under the guidance of their mentors, NCEMNA is carefully monitoring and evaluating the program “so that we know what is working and what isn’t,” Williams says. “We’re quite pleased with the early evaluations of the conference. It’s a growing process and we expect to be increasingly effective.” She also anticipates an equally strong response when NCEMNA issues the call for its next group of mentees, who will attend the coalition’s 2006 annual conference next March in Chicago.
Sharing the Wealth
While some notable coalitions, such as the European Union, are still experiencing growing pains, the National Coalition of Ethnic Minority Nurse Associations has shown a remarkable steadiness in pursuing its mission and increasing the power of its collective voice over the past seven years. Williams attributes this success to hard work, careful strategic planning and, above all, the high level of leadership, education and accomplishment that unites its member associations.
“Some of these ethnic nursing associations have been in existence for more than 30 years,” she notes. “Between us, we have an immense wealth of pioneering leaders in academia, research and clinical practice.” Through initiatives such as NCEMNA: Nurse Stimulation Program and the Aetna/NCEMNA Scholars Program, the coalition is not only ensuring that this legacy will continue but also advancing an agenda that will make a significant impact on increasing the diversity of the nation’s nursing profession. “With education and knowledge generated by an increase in research, there is power to recruit minority nurses because we will have something to offer them,” says Williams.
For more information about NCEMNA and its five member associations, visit www.ncemna.org.
Editor’s Note: Minority Nurse Senior Editor Pam Chwedyk also contributed to this article.
A blue-ribbon occasion: Omana Simon, MSN, FNP, RN (right), president of the National Association of Indian Nurses of America (NAINA), and Lydia Albuquerque, RN (left), president of the NAINA-affiliated American Association of Indian Nurses of New Jersey, Chapter 2 (AAIN-NJ2), present an award to Nancy Holecek, RN, senior vice president of Saint Barnabas Health Care System, in recognition of the New Jersey-based company’s recruitment and support of immigrant nurses from India. The presentation was part of AAIN-NJ2’s inaugural seminar, “Integrating Diversity, Creating Change,” held June 13 in Union, N.J. For more information about the National Association of Indian Nurses of America, visit www.nainausa.com/gpage.html. (Editor’s Note: Freelance writer Lorraine Steefel, DNP, RN, CTN, contributed to this news item.)
