Abstract

Background: In 2021, the CDC identified racism as a major public health threat, highlighting its impact on social and economic determinants of health, such as education, housing, and employment, which in turn affect health outcomes (CDC, 2021; Waite et al., 2020). The nursing profession is not exempt from these effects; a 2021 survey of nurses revealed prevalent racism within nursing, influencing education, practice, and patient care (National Commission to Address Racism in Nursing, 2021). A comprehensive, multi-level approach within nursing is essential to address this issue.

Purpose: This study employs the socio-ecological model (SEM) to analyze racism in nursing and suggests targeted strategies across individual, interpersonal, community, institutional, and policy levels to foster inclusivity and equity in nursing education.

Methods: Using McLeroy et al.'s (1988) SEM framework, this study conducted a critical literature review to examine racism in nursing education at the intrapersonal, interpersonal, community, institutional, and policy levels (Iheduru-Anderson et al., 2024). Tailored mitigation strategies were developed based on findings.

Results: Key findings and proposed strategies include:

  • Individual level: Internalized racism affects self-perception and confidence among nurses. Solutions include fostering critical self-reflection, decolonizing thought, and raising consciousness.
  • Interpersonal level: Microaggressions and lack of mentorship impact career advancement. Solutions include mentorship programs, support networks, and implicit bias training.
  • Community level: Exclusionary practices have historically persisted in professional organizations. Strategies involve encouraging these organizations to confront racist histories and advocate for racial justice.
  • Institutional level: Limited diversity in faculty and leadership hampers representation. Strategies include holistic admissions, diversifying faculty, and reforming pedagogies.
  • Policy level: Admissions policies and licensure exams often disadvantage minority students. Suggested actions include challenging standardized testing norms, advocating diversity in accreditation standards, and opposing anti-DEI legislation.

Conclusion: The SEM offers an effective framework for addressing racism within nursing education. Multi-level, tailored interventions can support an equitable and inclusive environment in nursing, promoting a workforce that reflects the diversity of the populations it serves.

Notes

References:

CDC. (2021, July 8). Racism and health. Centers for Disease Control and Prevention. https://www.cdc.gov/healthequity/racism-disparities/index.html
Iheduru-Anderson, K., Waite, R., & Murray, T. A. (2024). Examining and mitigating racism in nursing using the socio-ecological model. Nursing Inquiry, 31(3), e12639. https://doi.org/10.1111/nin.12639

McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15(4 ) , 351–377. https://doi.org/10.1177/109019818801500401

National Commission to Address Racism in Nursing (The Commission). (2021, June). Defining racism. American Nurses Association. https://www.nursingworld.org/~49f737/globalassets/practiceandpolicy/workforce/commission-to-address-racism/final-defining-racismjune-2021.pdf

Waite, R., Sawyer, L., & Waite, D. (2020). A call to action for community/ public health nurses: Treat structural racism as the critical social determinant of health it is. Public Health Nursing, 37(3), 470. https://doi.org/10.1111/phn.12736

Description

This study uses the socio-ecological model to examine racism in nursing and propose strategies across individual, interpersonal, community, institutional, and policy levels to foster inclusion and equity in nursing education.

Author Details

Kechi Iheduru-Anderson, EdD, DNP, RN, CNE

Sigma Membership

Alpha Psi

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Faculty Development, Curriculum Development, DEI, BIPOC, Racism in Nursing

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the slide deck.

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Mitigating Racism in Nursing Using the Socio-Ecological Model

Seattle, Washington, USA

Background: In 2021, the CDC identified racism as a major public health threat, highlighting its impact on social and economic determinants of health, such as education, housing, and employment, which in turn affect health outcomes (CDC, 2021; Waite et al., 2020). The nursing profession is not exempt from these effects; a 2021 survey of nurses revealed prevalent racism within nursing, influencing education, practice, and patient care (National Commission to Address Racism in Nursing, 2021). A comprehensive, multi-level approach within nursing is essential to address this issue.

Purpose: This study employs the socio-ecological model (SEM) to analyze racism in nursing and suggests targeted strategies across individual, interpersonal, community, institutional, and policy levels to foster inclusivity and equity in nursing education.

Methods: Using McLeroy et al.'s (1988) SEM framework, this study conducted a critical literature review to examine racism in nursing education at the intrapersonal, interpersonal, community, institutional, and policy levels (Iheduru-Anderson et al., 2024). Tailored mitigation strategies were developed based on findings.

Results: Key findings and proposed strategies include:

  • Individual level: Internalized racism affects self-perception and confidence among nurses. Solutions include fostering critical self-reflection, decolonizing thought, and raising consciousness.
  • Interpersonal level: Microaggressions and lack of mentorship impact career advancement. Solutions include mentorship programs, support networks, and implicit bias training.
  • Community level: Exclusionary practices have historically persisted in professional organizations. Strategies involve encouraging these organizations to confront racist histories and advocate for racial justice.
  • Institutional level: Limited diversity in faculty and leadership hampers representation. Strategies include holistic admissions, diversifying faculty, and reforming pedagogies.
  • Policy level: Admissions policies and licensure exams often disadvantage minority students. Suggested actions include challenging standardized testing norms, advocating diversity in accreditation standards, and opposing anti-DEI legislation.

Conclusion: The SEM offers an effective framework for addressing racism within nursing education. Multi-level, tailored interventions can support an equitable and inclusive environment in nursing, promoting a workforce that reflects the diversity of the populations it serves.