Search Results (1,274)

Deaf people experience significant barriers to education, healthcare, employment, and information access, resulting in inequities across a myriad of contexts. To better understand these disparities, our all-deaf research team conducted semi-structured interviews with deaf and hearing (parents, caregivers, and educators) adults across Ecuador, exploring how structural, institutional, and social factors influence daily life and well-being. Participants (n = 36) described systemic exclusion from education and employment, limited access to interpreters and assistive technologies, and constrained autonomy due to insufficient family support and institutional resources. These barriers compound health risks by restricting access to care, information, and social participation. Participants’ narratives highlighted how political and economic instability, institutional neglect, and discrimination create structural vulnerabilities that extend beyond individual-level factors. Findings underscore the importance of public health interventions that address structural and communicative inequities, including inclusive education, accessible health services, and community-based support, to improve health equity and quality of life for deaf populations in Ecuador. Full article

This paper proposes a conceptual framework for strengthening school quality assurance through knowledge management to support sustainable education. Drawing on the international priorities of the OECD and UNESCO, the study positions school self-evaluation as a central quality-assurance mechanism that can promote continuous improvement, accountability, equity, and better learning outcomes. Methodologically, the study adopts a quantitative research design to collect data from 978 teachers across 20 schools in Hong Kong. Exploratory factor analysis and structural equation modelling were employed to identify the latent variables and validate the conceptual framework. Results show that effective quality assurance depends on both formal procedures and the school’s capacity to create, share, and use knowledge. Key knowledge management enablers include visionary leadership, professional autonomy, bureaucratic control, information technology infrastructure, and a collaborative culture of knowledge sharing. Within this model, professional autonomy and knowledge sharing link management conditions to evidence-informed reflection, planning, and improvement. The framework is situated in the context of Hong Kong schools while offering broader relevance for education systems seeking sustainable development. The study concludes that sustainable school self-evaluation is driven primarily by teacher professional autonomy (β = 0.738, total effect = 0.795), with knowledge sharing functioning as a critical mediating mechanism that transmits the effects of visionary leadership (indirect β = 0.343) and enabling bureaucratic control (indirect β = 0.103) into evaluation quality. IT infrastructure does not exert a significant direct effect on SSE (β = 0.056, p = 0.098), indicating that technological provision is a necessary but insufficient condition for evaluation effectiveness in the Hong Kong context. Full article

Cariño (care) should be central to equity-centered transformation in science, technology, engineering, and mathematics (STEM) higher education. Yet, relational leadership practices that prioritize culturally grounded care—such as cariño—are often absent in STEM initiatives, leaving unexamined how Women of Color (WOC) enact these practices to advance equity for historically marginalized students. Employing a qualitative methodology grounded in Chicana Feminist Epistemology, in-depth interviews were conducted with five WOC leading a multi-institutional, federally funded STEM initiative. Analysis revealed four interrelated dimensions of what we are calling “Cariño Competence”: (1) relational attunement grounded in moral obligation, (2) protective action when project systems fail students, (3) boundary-setting as care and resistance to extractive labor, and (4) community-sustained resilience through networks of WOC leaders. The findings offer a data-driven theorization of Cariño Competence, capturing how WOC operationalize culturally grounded care as a strategic, protective, and resistive praxis. By centering students as the moral and epistemic anchor of leadership decisions, this study demonstrates how relational, culturally sustaining practices can humanize bureaucratic systems, buffer harm, and advance systemic transformation in STEM higher education. These insights contribute to scholarship on culturally responsive leadership and provide a practical framework for advancing equity, inclusion, and empowerment in higher education contexts. Full article

This article describes the use of dialogue, through the format of critical conversations, as a creative and reflective anti-racist tool to develop understanding of departmental values of anti-racism, equity and social justice with colleagues across academic, technical, and leadership roles. The project focused on the development and facilitation of spaces for dialogue between staff members employed in an education department in a university in a city in the Southwest of England. Making use of concepts from Smith and Lander’s critical pedagogy and critical race theory as well as philosophy for children (P4C), we developed a framework used by adult participants to encourage the development of racial literacy through reflexive practice. More than seventy staff members were invited to attend five sessions over a six-month period. During each session, staff members were given pre-prepared stimuli designed to encourage ‘epistemological shudders’ that stimulate dialogue in relation to professional roles and responsibilities of anti-racism, equity and social justice within our working context. Each session was facilitated by two colleagues, given the agency to make use of the stimuli within the sessions in any way they chose, together with their participants. Feedback from each session was non-mandatory and informal. In this article, we capture our reflections on the processes of developing and adapting P4C within a university education department. We believe that this evolving model acts as a valuable tool for dialogues, particularly when attempting to encourage discussion of topics perceived as providing professional risk due to their sensitive and controversial status within education and more broadly. Full article

Background/Objectives: Strategies to improve the Social Health Authority (SHA)’s equity can be identified by analyzing the Kenya Demographic and Health Survey (KDHS) 2022. This study reports evidence of determinants of health insurance coverage in Kenya. Methods: Household- and individual-level datasets from the Kenya Demographic and Health Survey conducted between February and July 2022 were combined to form the analyzed dataset. Proportions of individuals with and without health insurance were estimated. The associations between potential determinants and health insurance status were calculated using the Rao–Scott chi-square. Logistic regression was used to analyze the determinants of health insurance coverage. Results: Most of the 14,232 participants were literate (75%), relatively poor (56%), in good health (79%), connected to electricity (55%), and radio listeners (61%). About 34% had health insurance, with 93% of the insured covered by the NHIF. Twenty predictors (Adjusted F = 4.2–434.1, p < 0.0001) were included in the complex sample logistic regression model, but only nine were statistically significant predictors of health insurance coverage. The key predictors were education level; wealth index; ownership of a solar panel, television, smartphone, and computer; age; and recent outpatient care (11–80% differences in odds). Conclusions: Health insurance coverage remains low in Kenya due to low education levels, poor economic status, and disparities in access to media. The SHA can emphasize media campaigns in the informal sector to increase premium payments. Accelerating socioeconomic advancement and adopting tax-based funding could speed up Kenya’s progress towards UHC. Full article

Aboriginal people in Western Australia (WA) experience poorer cancer outcomes compared to non-Aboriginal Australians, with significant disparities in cancer screening participation, later-stage diagnosis, and lower survival rates. This narrative review, informed by selected scoping methods, examined 69 peer-reviewed studies contributed by WA researchers from 2000 to 2024 to inform understanding of and address these inequities. Recurring issues requiring attention included promoting cultural safety in healthcare, addressing barriers to and disparities in cancer care, boosting cancer screening and awareness, enhancing education and communication, strengthening support systems and care navigation, improving treatment access and outcomes, and building workforce capacity. Recommendations to address the above challenges and improve cancer care and outcomes for Aboriginal people in WA included addressing barriers and disparities in cancer care; promoting effective education, communication, and culturally appropriate support; enhancing cancer screening participation and awareness initiatives; improving access to cancer treatment and outcomes; strengthening policy and system-level interventions; supporting families and communities throughout their cancer journey; building research capacity and data collection to guide Aboriginal and community-led initiatives. These recommendations highlighted that multi-level interventions are needed, from empowering Aboriginal people and strengthening communities to improving service delivery and driving systematic reforms. Overall, this narrative review informs future research, policy, and practice focused on equity to improve cancer outcomes for Aboriginal people in WA and beyond. Full article

Patient navigation is a promising intervention to address barriers and improve access to cancer clinical trials. Although navigation has been widely studied across the cancer continuum, its role in facilitating clinical trial participation has not been systematically evaluated. This scoping review aims to identify, characterize, and synthesize evidence on patient navigation interventions designed to increase access to cancer clinical trials. Nine databases were searched for English peer-reviewed articles from inception through 5 March 2025. Two independent researchers screened titles, abstracts, and full texts and extracted data using standardized forms. The results were interpreted using descriptive statistics and collated using predetermined conceptual frameworks. Of 10,238 citations identified, 23 studies met inclusion criteria. All were conducted in North America, and five (21.7%) were randomized controlled trials. Thirteen studies (56.5%) evaluated enrollment outcomes, with mixed results. One randomized trial and two observational studies found no significant effect, while three observational studies and seven single-arm reports suggested improved enrollment. Navigation interventions most commonly included education/information provision (100%), care coordination (60.9%), and empowerment (47.8%). Navigators were primarily lay navigators (73.9%), often selected for community or lived experience; training varied widely, and only two programs reported certification. Fifteen studies (65.2%) targeted equity-deserving groups, most frequently racial and ethnic minorities, with reports of increased representation in trial enrollment. Patient navigation shows promise in improving access to cancer clinical trials, particularly for equity-deserving populations, but current evidence is limited, heterogeneous, and largely observational. Standardized definitions, rigorous trial designs, and reporting of navigator training and outcomes are needed to clarify effectiveness. Full article

This study examined how digital equity conditions and bundled professional development policies are associated with sustainable teacher learning, self-efficacy, and student engagement in Greek primary schools. A total of 460 in-service teachers from urban, suburban, and rural areas participated in the study. Data were collected through Likert-scale measures assessing information systems use, TPACK-aligned professional development outcomes, teacher self-efficacy, implementation challenges, and student engagement. The analysis included ANOVA, MANOVA, OLS regression with interaction terms, and theory-informed indirect-pathway models. The findings indicated that infrastructure funding alone was not significantly associated with teacher capacity or student engagement after the introduction of relevant controls. More consistent associations emerged when funding was combined with mandated and time-protected professional development, together with minimum connectivity standards. Teacher self-efficacy was consistent with a partial indirect pathway between information systems use and student engagement, while stronger indirect associations were observed among early-career teachers. In addition, a bundled governance index was associated with narrower urban–rural disparities in teacher capacity. The findings suggest that sustainable digital equity in primary education depends not only on access to resources but also on coherent professional support structures that are associated with teacher confidence, instructional continuity, and long-term engagement. Implications are discussed for the design of sustainable professional development policies in teacher education and primary schooling. Full article

Background: Adults with type 2 diabetes increasingly use patient portals, telemonitoring systems, mobile applications, text messaging programs, and other digital services to support self-management. In practice, however, these approaches often still depend on nursing support to help patients understand, use, and sustain digital care in everyday settings. This scoping review mapped how nurses are involved in supporting adults with type 2 diabetes to use digital tools, information, and services for self-management across care settings. Methods: This scoping review followed Joanna Briggs Institute methodology and was reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The review question was guided by the Population, Concept, and Context framework. A literature search was conducted in January 2026 in PubMed, Scopus, Embase, and EBSCO/CINAHL. A total of 230 records were identified, 71 duplicates were removed, and 159 records underwent title and abstract screening. Fifty-three full-text articles were assessed for eligibility, and 15 studies met the inclusion criteria. Data were extracted using a structured charting table and synthesized descriptively and thematically. Results: The 15 included studies were published between 2021 and 2026 and represented evidence from 10 countries across primary care, community health centers, telehealth programs, and hospital-linked services. Five interrelated themes were identified: nurses as digital self-management educators; nurses as remote monitors and care coordinators; nurses as facilitators of digital engagement, confidence, and supported use; nurses as implementation partners in digital diabetes care; and equity, access, and context as shaping conditions of digital diabetes support. Only one study directly measured digital health literacy, whereas the remaining studies addressed digital engagement more indirectly through onboarding, portal communication, telemonitoring, reminders, tailored feedback, and implementation work. Common barriers included workload, unclear responsibilities, technical difficulties, age- or literacy-related access challenges, language needs, and uneven infrastructure. Conclusions: The included studies suggest that nurses commonly contributed to making digital diabetes care more understandable, usable, and actionable for adults with type 2 diabetes. Their roles were described across education, monitoring, coordination, implementation, and support for digital engagement. Future studies could measure digital health literacy more explicitly, describe nursing tasks in greater detail, and examine how equity-related factors shape digital diabetes care. Full article

Indigenous students continue to experience persistent educational inequities shaped by colonial histories, assimilationist schooling structures, and the marginalization of Indigenous knowledge systems. Although social–emotional learning (SEL) is widely promoted as foundational to student well-being and academic success, dominant SEL frameworks often reflect Eurocentric assumptions that overlook Indigenous understandings of relationality, land, identity, healing, and collective responsibility. In alignment with Sustainable Development Goal 4 (SDG 4), this study examines how SEL and teacher professional development can be reimagined through Indigenous and Local Knowledge (ILK). Using a qualitative collaborative ethnographic design integrated with a structured literature synthesis, the study drew on two years of community-engaged research involving collaborative focus group dialogues, community interactions, and sustained relational engagement with Native teachers, Elders, cultural leaders, and community practitioners (N = 20). Thematic analysis revealed five interrelated themes: culturally grounded SEL frameworks, structural barriers and equity-driven strategies, culture as prevention and healing, schoolwide conditions that sustain belonging and identity, and alignment between Indigenous-centered SEL and SDG 4. Findings highlight the importance of cultural identity, ceremony, storytelling, Elder mentorship, talking circles, land-based learning, relational accountability, and community partnerships in supporting meaningful SEL. The findings also reveal tensions between Indigenous relational approaches to SEL and dominant educational systems shaped by standardization, accountability pressures, and assimilationist schooling structures. The study advances a conceptual model showing how Indigenous-centered SEL, mediated through relational teacher professional development, can support culturally sustaining, healing-centered, equity-oriented, and sovereignty-affirming educational outcomes aligned with SDG 4. In addition to contributing to SEL scholarship, the study offers implications for teacher education, educational policy, and school leadership seeking to advance culturally sustaining and community-responsive educational systems. Full article

Within a global landscape characterised by increasing fragmentation, community empowerment requires interdisciplinary, evidence-based and validated methodology for assuring collaborative and transformative action. This research addresses the need for equity and inclusion in underserved rural areas by investigating the CleanAir@Schools initiative in Romania. The study employed a human-centred, multi-stakeholder methodology, utilising exploratory workshops with educators and pilot implementations to develop a learning framework on Sustainability Education, in which students used passive sensors to measure local air quality. Results indicate that the project successfully mobilised entire school communities, catalysing a pedagogical shift from passive reception to active, inquiry-based environmental education. Furthermore, the strategic use of both digital and analogue technologies ensured accessibility for communities facing digital divides. The research concludes that participatory design acts as a catalyst for long-term community empowerment and social transformation by addressing localised challenges through inclusive, restorative practices. By intentionally centring society’s margins, design research fosters regeneration and care, serving as an essential resource for social innovators and policymakers. Full article

This study advances the model of proactive caring to articulate the strategies and practices employed by higher education professionals to support the retention and graduation of underserved students. Employing an explanatory case study design and drawing upon multiple data sources—including semi-structured interviews, focus groups, and observations—collected from students and higher education professionals, we identified six core elements essential to proactive caring: (1) staff accessibility, (2) trust-building, (3) positive motivation, (4) reinforcement, (5) encouragement, and (6) student accountability. Our findings also reveal that higher educational professionals initiate support prior to students’ arrival on campus by assessing institutional environments to identify potential barriers and leveraging data and experiential knowledge to proactively address these challenges. This research contributes to ongoing efforts to promote access and equity in higher education, particularly in the context of increasing anti-diversity, equity, and inclusion (DEI) legislation. While the current study centers on Students of Color in STEM disciplines, the elements underlying the proactive caring model may be broadly applicable, which offers a framework for empathetic practitioners committed to supporting underserved students throughout their collegiate journey. Full article

This paper examines the intersection between digital learning environments and multilingual education policies, with a focus on the linguistic integration of migrant students in Europe. It explores how technology, particularly mobile-assisted learning, artificial intelligence, and immersive tools, can strengthen language acquisition and promote social inclusion. Drawing on European and Greek policy frameworks, the study shows how digital pedagogies operationalize multilingualism as both an educational objective and a social justice priority. Based on a qualitative review of contemporary research and institutional reports, the findings indicate that digitally enhanced learning environments act as catalysts for equity, intercultural dialogue, and active participation when supported by coherent pedagogical design. The paper concludes by outlining policy recommendations for the development of multilingual digital ecosystems that align technological innovation with democratic, inclusive, and human-centred education. Overall, the analysis highlights that technology-mediated multilingualism can effectively reinforce participation, inclusion, and linguistic integration when embedded within robust policy structures and sound pedagogical practice. Full article

Socio-emotional competencies are increasingly recognized as a relevant dimension of educational sustainability because they are theoretically and empirically linked to student well-being, school coexistence, participation, and the development of more inclusive educational communities. This article examines self-perceived emotional metaknowledge in 181 first-year secondary school students from two Chilean schools located in contrasting territorial contexts: Santiago and Quillón, Ñuble Region. The TMMS-24 was used to assess three dimensions: Emotional Attention, Emotional Clarity, and Emotional Repair. After data cleaning, 181 valid cases were analyzed. Given the repeated-measures structure of the data, a mixed ANOVA was conducted, with emotional dimension as the within-subject factor and locality as the between-subject factor. Reliability analyses, assumption checks, effect sizes, confidence intervals, and Holm-adjusted post hoc comparisons were also included. The results showed no significant main effect of locality, suggesting that the overall level of self-perceived emotional metaknowledge did not differ significantly between Santiago and Quillón. However, a significant main effect of emotional dimension and a significant dimension × locality interaction were found. Emotional Repair obtained the highest scores in the total sample, while Santiago showed significantly higher Emotional Attention than Quillón. These findings suggest that emotional metaknowledge should be interpreted as a multidimensional construct, with specific differences across emotional dimensions rather than broad territorial contrasts. From the perspective of SDG 4, the study suggests the relevance of socio-emotional learning approaches that are context-sensitive, territorially aware, and oriented toward quality, equity, inclusion, and school coexistence. Full article

Although apartheid ended in 1994, its legacy continues to shape South Africa’s higher education system, reinforcing disparities in access, funding, and representation. This study aims to critically examine how apartheid diplomacy has influenced higher education and asks: how do its strategies continue to shape academic practices, institutional relationships, and systemic inequalities in post-apartheid South Africa? It conceptualises apartheid diplomacy as the use of education to entrench racial hierarchies, reproduce class domination, and suppress indigenous knowledge. Grounded in Marxist and Weberian class theories and Crenshaw’s intersectionality framework, the analysis traces how apartheid-era policies institutionalised systemic inequalities and how these legacies persist within institutions. A scoping review was conducted using five databases (EMBASE, APA PsycINFO, Cochrane Library, CINAHL, and Scopus) between January 2007 and April 2025, guided by PRISMA ScR and Arksey and O’Malley’s six-stage framework. Of 75 articles retrieved, 15 met the inclusion criteria. Findings reveal that apartheid diplomacy shaped academic governance, resource distribution, and knowledge production, leaving enduring inequities despite ongoing reforms. Transformation efforts, including financial aid schemes, equity policies, and curriculum debates, have achieved progress but remain constrained by structural, cultural, and intersectional barriers. The study underscores that achieving lasting equity requires continuous policy interventions, inclusive leadership, and curriculum decolonisation, alongside advocacy and interdisciplinary research. It reframes higher education as a diplomatic arena where equity and epistemic justice are negotiated, offering an original lens for understanding and dismantling apartheid’s enduring influence on South African academia. Full article