Kelly Gonzales | Portland State University (original) (raw)

Papers by Kelly Gonzales

Medical education online, 2018

Trends in faculty rank according to racial and ethnic composition have not been reviewed in over ... more Trends in faculty rank according to racial and ethnic composition have not been reviewed in over a decade. To study trends in faculty rank according to racial and ethnicity with a specific focus on Indigenous faculty, which has been understudied. Data from the Association of American Medical Colleges' Faculty Administrative Management Online User System was used to study trends in race/ethnicity faculty composition and rank between 2014 and 2016, which included information on 481,753 faculty members from 141 US allopathic medical schools. The majority of medical school faculty were White, 62.4% (n = 300,642). Asian composition represented 14.7% (n = 70,647). Hispanic, Latino, or of Spanish Origin; Multiple Race-Hispanic; Multiple Race-Non-Hispanic; and Black/African American faculty represented 2.2%, 2.3%, 3.0%, and 3.0%, respectively. Indigenous faculty members, defined as American Indian/Alaska Native (AIAN), Native Hawaiian or Other Pacific Islander (NHPI), represented the s...

ABSTRACT Objective: To build on Evans-Campbell’s [2008. “Historical Trauma in American Indian/Nat... more ABSTRACT
Objective: To build on Evans-Campbell’s [2008. “Historical Trauma
in American Indian/Native Alaska Communities: A Multilevel
Framework for Exploring Impacts on Individuals, Families, and
Communities.” Journal of Interpersonal Violence 23 (3): 316–338.
doi:10.1177/0886260507312290.] multilevel framework of historical
trauma and health by focusing on the cycle of fetal alcohol
spectrum disorders (FASD) in the socio-cultural, historical, and
interpersonal context of trauma shared by American Indian and
Alaska Native (AI/AN) peoples.
Methods: We analyzed qualitative data from focus groups with
seventy four urban AI/ANs who were 15 years of age and older.
Community-based participatory research methods were used for
data collection and analysis. Our study explored knowledge and
attitudes about FASD, perspectives on FASD risk factors, and
culturally relevant approaches to FASD prevention and healthcare.
Results: According to our study’s participants, efforts to address
FASD among urban AI/ANs should align with and emerge from
community values, promote healing, consider the broader context
that influences behaviors, and reflect the community’s
understanding that FASD risk behaviors are inextricably linked
with historical and contemporary trauma.
Conclusion: Effective, multiple-level FASD prevention approaches
for AI/ANs may include prioritizing Indigenous culture, supporting
intergenerational cohesion, focusing on non-stigmatic healing of
traumas, and authentically engaging community knowledge. This
work draws on community and cultural strengths in an effort to
reduce the occurrence of substance-exposed pregnancies, and
encourages transformational changes in systems that serve AI/AN
peoples to promote a healthy and thriving community and future
generations.

The Everyday Discrimination Scale (EDS) has been used widely as a measure of subjective experienc... more The Everyday Discrimination Scale (EDS) has been used widely as a measure of subjective experiences
of discrimination. The usefulness of this measure for assessments of perceived experiences of discrimination
by American Indian and Alaska Native (AI/AN) peoples has not been explored. Data derived
from the Special Diabetes Program for Indians—Healthy Heart Demonstration Project (SDPI-HH), a
large-scale initiative to reduce cardiovascular risk among AI/ANs with Type 2 diabetes. Participants
(N 3,039) completed a self-report survey that included the EDS and measures of convergent and
divergent validity. Missing data were estimated by multiple imputation techniques. Reliability estimates
for the EDS were calculated, yielding a single factor with high internal consistency ( .92). Younger,
more educated respondents reported greater perceived discrimination; retired or widowed respondents
reported less. Convergent validity was evidenced by levels of distress, anger, and hostility, which
increased as the level of perceived discrimination increased (all p .001). Divergent validity was
evidenced by the absence of an association between EDS and resilient coping. Resilient coping and
insulin-specific diabetes knowledge were not significantly associated with perceived discrimination (p
.61 and 0.16, respectively). However, general diabetes-related health knowledge was significantly
associated with perceived discrimination (p .02). The EDS is a promising measure for assessing
perceived experiences of discrimination among those AI/ANs who participated in the SDPI-HH.

Objective The objective of this study was to examine patient–provider relationships among America... more Objective The objective of this study was to examine patient–provider relationships among American Indians and Alaska Native (AI/AN) patients by examining associations between patient activation, perceived provider weight bias and working alliance. Patient activation is generally defined as having the knowledge, skills and confidence to manage one's health. Methods Among a sample of 87 AI/AN adults presenting for general medical care at an urban clinic in the northwest region of the USA, ordinary least squares regression analysis was completed to examine associations. Results Better working alliance scores were associated with increased patient activation, while perceived provider weight bias was associated with reduced patient activation. In addition , those with class II obesity had decreased patient activation. Conclusion These findings point to the importance of a positive patient–provider relationship in AI/ANs. Optimal patient engagement and subsequent health outcomes warrant additional consideration of patients' perceptions of provider weight bias within the context of health promotion and interventions.

Medical education online, 2018