Browsing by Author "Nicholas, Celeste"

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    Advancing the Implementation of CLAS Standards to Support Health of South Asian Americans
    (2023) Barnabas, Beatrice Benjamin; Stone, Cynthia; Nicholas, Celeste; Reed, Steven
    Asian Americans are the fastest-growing racial and ethnic group in the United States, projected to reach nearly 34 million by 2050. A subset of Asian Americans, South Asians, face tremendous cultural, socioeconomic, linguistic, and structural obstacles to achieving good health. In 2018, the Office of Minority Health established the National Culturally and Linguistically Appropriate Services Standards (CLAS) framework for improving healthcare quality and advancing health equity for increasingly diverse communities, including South Asians. The purpose of this qualitative study is to understand how providers in California, a state with a large South Asian population, are implementing the CLAS Standard. California is one of ten states that enacted legislation requiring mandatory cultural competency training in accordance with the CLAS standards. Semi-structured interviewers were conducted with a range of providers (n=12) in California to identify facilitators and barriers to successful implementation and inform strategies to advance the CLAS standard to support the health of South Asians. Responses were categorized within the three elements of Solberg’s (2007) framework for quality improvement: Compliance and Enforcement of the CLAS Standard (priority), Cultural Competence Training and Adherence to the CLAS Standard (change process capability); and Support for the Health of South Asian Americans (care process content). Within each element, responses were identified as facilitators or barriers, including examples from multiple participants. Findings show that while there is enforcement of cultural competency training in the workplace, lack of clear understanding and/or delineation between CLAS and other training promoting health equity is evident amongst providers. Further, providers value supporting South Asian Americans by advocating for proper inclusion and health data that is representative and disaggregated for this population. A plan for change to advance the implementation of the CLAS Standard is presented guided by Kotter’s Change Management Model.
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    Design and Implementation of the Diabetes Impact Project: A Multisector Partnership to Reduce Diabetes Burden in Indianapolis Communities
    (Wolters Kluwer, 2023) Staten, Lisa K.; Weathers, Tess D.; Nicholas, Celeste; Grain, Tedd; Haut, Dawn P.; Duckett-Brown, Patrice; Halverson, Paul K.; Caine, Virginia; Community and Global Health, School of Public Health
    Context: Community-level health disparities have not arisen suddenly but are the result of long-term systemic inequities. This article describes the design and implementation of a community-engaged multisector partnership to address health disparities by reducing the diabetes burden in 3 Indianapolis communities through the implementation of evidence-based strategies across the prevention continuum. Program: The project has 5 foundational design principles: engage partners from multiple sectors to address community health, focus on geographic communities most affected by the health disparity, practice authentic community engagement, commit for the long term, and utilize a holistic approach spanning the prevention continuum. Implementation: The design principles are incorporated into the following project components in each community: (1) health system community health workers (hCHWs), (2) neighborhood CHWs (nCHWs), (3) community health promotion initiatives, and (4) resident steering committees, as well as a backbone organization responsible for overall coordination, project communication, evaluation, and partnership coordination. Evaluation: This complex multilevel intervention is being evaluated using data sources and methodologies suited to each project component and its purpose overall. Each component is being evaluated independently and included holistically to measure the impact of the project on the health and culture of health in the communities. Key Performance Indicators were established upon project initiation as our common metrics for the partnership. Because complex interventions aiming at population-level change take time, we evaluate Diabetes Impact Project-Indianapolis Neighborhoods (DIP-IN), assuming its impact will take many years to achieve. Discussion: Health disparities such as the diabetes prevalence in project communities have not arisen suddenly but are the result of long-term systemic inequities. This complex issue requires a complex holistic solution with long-term commitment, trusted partnerships, and investment from diverse sectors as seen in this project. Implications for policy and practice include the need to identify stable funding mechanisms to support these types of holistic approaches.
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    Enhancing PBL authenticity by engaging STEM professional volunteers
    (Purdue University, 2021) Nicholas, Celeste; Scribner, J. Adam; Community and Global Health, Richard M. Fairbanks School of Public Health
    The article profiles a project addressing a central issue in reform-driven STEM education – the need to align educational experiences with real-world STEM. We profile an interdisciplinary project which aimed for authenticity by: 1) purposefully designing an authentic PBL project and 2) incorporating STEM professional volunteers as facilitators. Volunteers enhanced authentic elements of the project task (e.g., open-ended task, accountability) and context (e.g., autonomy, collaboration). Volunteers alleviated pedagogical barriers to PBL – their expertise allowed both volunteers and teachers to take up the facilitator roles foundational to PBL. Professional volunteers can play vital roles in STEM capacity-building initiatives, including those seeking to broaden participation. Further research is needed to understand how to best prepare and utilize volunteers in a variety of classroom roles, including as PBL facilitators.