Study Points

Conducting Culturally Sensitive Psychosocial Research

Course #96593 - $25 • 5 Hours/Credits

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  • Participation Instructions
    • Review the course material online or in print.
    • Complete the course evaluation.
    • Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.
  1. Why should healthcare practitioners become familiar with research concepts?

    INTRODUCTION

    Practitioners should also be familiar with psychosocial research concepts and skills. Practitioners use an array of interventions when working with individuals and/or families, and many funding agencies and organizations are requesting scientific evaluations of interventions and programs to determine how effective they are. Often, anecdotal data are not sufficient, as these funding agencies desire empirical data demonstrating effectiveness.

    Finally, even if practitioners do not conduct psychosocial research, they are consumers of research. Practitioners should be equipped with the skills to critique research literature and to understand the methodologic limitations of studies in order to understand if the findings were interpreted accurately, as this impacts how practitioners shape their practices and deliver services.

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  2. Which of the following assumptions create a basis for basic research?

    REVIEW OF RESEARCH CONCEPTS AND RESEARCH PHILOSOPHIES

    Basic research has been defined as social research that is used for the primary purpose of advancing knowledge without the consideration of the economic or social benefits, practical ramifications to practice, or transferring the information to key individuals in sectors who can apply the findings [1,91]. It is a bottom-up strategy of collecting information to advance knowledge [156].

    Traditionally, a significant amount of financial and time investments have been made in basic research, resting on three assumptions [5]:

    • Basic research will lead to solutions for existing social problems.

    • Findings from basic research will trickle down to various segments of society.

    • The market will employ the most promising solutions.

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  3. The problem identification phase of research is comparable to which phase of clinical practice?

    REVIEW OF RESEARCH CONCEPTS AND RESEARCH PHILOSOPHIES

    In research, a specific topic to be studied is identified. This topic is very specific, observable, and measurable. From this topic, specific research questions are generated, for which answers will be sought. Similarly, in clinical practice, an assessment of each client is conducted to identify the specific problem to be worked on. The identified problem should be concrete and behaviorally oriented in order to best help the client identify the problem. After the problem is identified, assessments in the research and practice arenas are similar. In research, prior literature and the body of knowledge are assessed to understand what methodologies have been used and what has previously been learned in order to build on the existing knowledge foundation [3]. Similarly, in practice, the practitioner assesses the client's strengths, resources, and barriers in order to understand how he or she might respond to the current situation. The researcher should engage the practitioner and those working in the community to identify shared concerns or problems [124].

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  4. Epistemology is defined as the study of

    REVIEW OF RESEARCH CONCEPTS AND RESEARCH PHILOSOPHIES

    Understanding the nature and sources of knowledge is known as epistemology [7]. It has been proposed that there are four sources of knowledge [8,9,10,11,12,13,93,125]:

    • Ethical knowledge: Practitioners often make decisions when an ethical or moral situation is confronted. These decisions are guided by an ethical awareness of what is right or wrong as dictated in a code of ethics outlined in one's professional discipline.

    • Aesthetic knowledge: This type of knowledge is linked with the art of clinical practice. It entails the practitioner's perceptions, understanding, empathy, values, and daily experiences. A response stemming from aesthetic knowledge is influenced in part by whom the practitioner is and the practitioner's clinical interaction with the client.

    • Personal (experiential) knowledge: This type of knowledge is based on practitioners' experiences, both from their own participation with a situation and from their interpersonal relationships with others. It is believed to be highly pragmatic by practitioners, because the individual has had direct interaction with the problem or situation. Personal knowledge also stems from practitioners' intuition or gut instincts. Intuition is traditionally dismissed in the sciences because it involves a rapid understanding of something without conscious use of reasoning. However, this type of knowledge plays an important role in the reflective process.

    • Empirical knowledge: This type of knowledge is derived from empirical research, which involves a systematic investigation and observation of a phenomenon. One goal of empirical research is to develop a scientific body of knowledge from which a professional discipline may draw. Another goal is to begin to identify causal relationships and to link interventions to outcomes in a systematic manner. This course focuses on empirical knowledge, particularly culturally sensitive research methods used to acquire empirical knowledge on psychosocial topics.

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  5. Information or guidelines gained from the code of ethics outlined in one's professional organization is an example of

    REVIEW OF RESEARCH CONCEPTS AND RESEARCH PHILOSOPHIES

    Understanding the nature and sources of knowledge is known as epistemology [7]. It has been proposed that there are four sources of knowledge [8,9,10,11,12,13,93,125]:

    • Ethical knowledge: Practitioners often make decisions when an ethical or moral situation is confronted. These decisions are guided by an ethical awareness of what is right or wrong as dictated in a code of ethics outlined in one's professional discipline.

    • Aesthetic knowledge: This type of knowledge is linked with the art of clinical practice. It entails the practitioner's perceptions, understanding, empathy, values, and daily experiences. A response stemming from aesthetic knowledge is influenced in part by whom the practitioner is and the practitioner's clinical interaction with the client.

    • Personal (experiential) knowledge: This type of knowledge is based on practitioners' experiences, both from their own participation with a situation and from their interpersonal relationships with others. It is believed to be highly pragmatic by practitioners, because the individual has had direct interaction with the problem or situation. Personal knowledge also stems from practitioners' intuition or gut instincts. Intuition is traditionally dismissed in the sciences because it involves a rapid understanding of something without conscious use of reasoning. However, this type of knowledge plays an important role in the reflective process.

    • Empirical knowledge: This type of knowledge is derived from empirical research, which involves a systematic investigation and observation of a phenomenon. One goal of empirical research is to develop a scientific body of knowledge from which a professional discipline may draw. Another goal is to begin to identify causal relationships and to link interventions to outcomes in a systematic manner. This course focuses on empirical knowledge, particularly culturally sensitive research methods used to acquire empirical knowledge on psychosocial topics.

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  6. Which of the following is NOT a characteristic of empirical knowledge?

    REVIEW OF RESEARCH CONCEPTS AND RESEARCH PHILOSOPHIES

    Because this course focuses on conducting psychosocial research with ethnic minorities, it is important to review the characteristics of empirical research. Characteristics that are unique to empirical knowledge that set it apart from the other types of knowledge have been identified [15]:

    • Empirical knowledge is empirical, which means it is derived from scientific methods based on direct observation of the world.

    • Empirical knowledge aims for objectivity. Although it is not possible to be completely objective, researchers implement mechanisms to reduce the impact of their biases, worldviews, assumptions, and subjectivities in the research process.

    • Empirical knowledge is provisional; in other words, the research findings are never conclusive. They are accepted tentatively, leaving open the possibility for future studies to either confirm or refute the findings.

    • Empirical knowledge is public, as the information is made available for review and critique.

    • Empirical knowledge is characterized by systematization and replication. Research follows a set of rules and procedures to ensure that other researchers can conduct studies in the same manner.

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  7. A main attribute of critical theory is the assumption that

    REVIEW OF RESEARCH CONCEPTS AND RESEARCH PHILOSOPHIES

    Critical theory emerged after World War I in reaction to logical positivism [22]. It was argued that there are three different types of knowledge: empirical/analytical knowledge, historical/hermeneutical knowledge, and emancipatory knowledge [22,23]. Empirical/analytical knowledge relies on knowledge derived from technical rules by which concepts can be measured and the environment controlled. Historical/hermeneutical knowledge focuses on understanding individuals' subjective experiences. Emancipatory knowledge focuses on illuminating oppressions experienced by individuals that emanate from societal institutions; once individuals realize that they are oppressed and marginalized, they will be called into social action to liberate themselves [2; 22; 158]. Individuals can only realize their oppression when they can rationally evaluate the constraints of their marginalization by participation in the scientific process [98]. Therefore, scientific knowledge can liberate and create social change [127]. Emancipatory knowledge is at the heart of critical theory.

    Critical theory argues that there are multiple social realities and that it is not easy to observe and measure social phenomenon. Critical theorists take this one step further and maintain that individuals' social realities are influenced by oppression, subjugation, marginalization, and other factors that maintain the societal status quo [2]. These factors include gender, socioeconomic status, sexual orientation, religion, and disability status [17]. Critical theorists assert that these dimensions contribute to hierarchal power relations and that all individuals construct their experiences based upon power relations within a social and historical context [17]. Researchers who are influenced by this perspective will consider how historical, social, and cultural context influence the topic by identifying who has the power and how this power has affected the topic being studied and the researcher's biases [127].

    Critical theorists assert that science and research are political, because the formulation of what to study is politically, economically, and socially charged. Topics that relate to marginalization and oppression are taken for granted, and for the most part, researchers avoid investigating such issues. These theorists believe that if researchers take on a stance involving critical theory people will be liberated from the oppressive and hierarchical structures [98].

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  8. One concern regarding ethnic minority-focused research is

    REASONS FOR CONDUCTING CULTURALLY SENSITIVE AND RELEVANT PSYCHOSOCIAL RESEARCH

    Historically, research theories and the empirical literature have focused on homogeneity [132]. As such, collecting research data that allows for comparisons of racial and ethnic groups is a controversial issue [30]. Concern exists regarding the possibility of reinforcing stereotypes and prejudices by using benchmarks that are based on white, European standards and triggering social division when focusing on racial and ethnic differences [30,133]. Yet, by ignoring these important variables, the understanding of how these social categories influence social inequities is masked, and this can have adverse health, mental health, and social outcomes.

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  9. Which of the following components is part of culturally sensitive research?

    CULTURALLY SENSITIVE RESEARCH PROCESSES

    The following dimensions have been suggested as part of the framework of what constitutes culturally sensitive research [32; 137; 138; 139; 165]:

    • Culturally congruent research methods: The use of qualitative research methods to "investigate and capture holistic contextualized pictures of the social, political, economic, educational factors" is advocated. However, this does not necessarily mean that it is not possible to draw on quantitative research methods to study cultural groups and their experiences, and quantitative methods are not dismissed altogether. Another research method that may be suitable is Participatory Action Research (PAR), also known as community-based participatory research. This method has its epistemologic base in critical theory and actively involves the people affected by the social problem.

    • Culturally specific knowledge: Knowledge pertaining to the group's unique historical and cultural experiences is used. The researcher also acknowledges his/her insider and outsider perspectives related to the research process. For example, researchers will be outsiders to a certain extent even if they are from the same ethnic minority or cultural group. As researchers, they will hold the power to define the "problem." Researchers may be given the opportunity to obtain insider perspective by studying and becoming more familiar with the cultural group's norms, beliefs, and values. The outsider/insider perspective should be continually balanced. One way to enter into a group is to interview community leaders and providers in order to enhance understanding of the sociopolitical context and the issues that the community faces. Therefore, context is of paramount importance.

    • Cultural resistance to theoretical dominance: The research process acknowledges the vital role of a group's experiences with discrimination, prejudice, marginalization, and oppression and attempts to further uncover, understand, and respond to these processes.

    • Culturally sensitive data interpretations: The analysis, interpretation, presentation, and dissemination of data reflect the cultural group's social realities. The group's knowledge base should be considered as legitimate as the dominant culture's.

    • Culturally informed theory and practice: Theories advanced from the research reflect the group's experiences and can direct the formulation of interventions, policies, and service delivery that are also culturally relevant. Researchers have an obligation to work with the nonacademic community in a collaborative manner to promote change that is beneficial for the cultural group and the community.

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  10. One concern with using quantitative research design when studying ethnic minority populations is the

    CULTURALLY SENSITIVE RESEARCH PROCESSES

    Quantitative research designs, guided by logical positivistic paradigms, assume there is one defined, objective reality that can be measured. Therefore, it is debatable whether these traditional research designs are optimum for conducting research with ethnic minority groups. If there is one universal reality, then should one assume that the monocultural and Eurocentric conceptualizations of a phenomenon apply to ethnic minority groups? Instead of accepting this theory, some assert that qualitative research designs guided by interpretivism may be more amenable when working with ethnic minority groups [36]. In this scenario, starting with the lived experience of research participants, researchers would not force a schema on the conceptualization of a problem. Furthermore, some assert that qualitative research fosters relationships between researchers and participants. This is particularly crucial in research with cultural groups and racial/ethnic minorities that are more relationship-centered [104]. Qualitative designs may also be more amenable to high context cultures, given that they tend to rely on oral traditions [105]. Finally, reflexivity, an inherent part of qualitative research, can identify the insidious ways in which Eurocentricism can enter into the research process [106].

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  11. When defining a study population, ethnicity of the participants may be best determined by

    CULTURALLY SENSITIVE SAMPLING DESIGNS

    Researchers often define ethnicity based on research participants' self-classification. The rationale for using self-identification classifications warrants merit. It can be argued that individuals kn11ow best what their cultural values and preferences are and how these influence the construction of their identity. Yet, how other groups ascribe meaning and identity also plays a role in the construction of ethnic identity [44]. Researchers describe a focus group study where the eligibility criterion was "self-identify as Chinese" [41]. One focus group participant maintained that she was Taiwanese, although she was ethnically Chinese. However, she did not want to be affiliated with the political ideologies of mainland China. Hence, her perceived ethnic and cultural identity was Taiwanese.

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  12. Convenience sampling involves

    CULTURALLY SENSITIVE SAMPLING DESIGNS

    There are many different sampling strategies that may be used to recruit ethnic minorities for participation in psychosocial research. As discussed, probability sampling designs pose challenges. Consequently, nonprobability sampling designs are used more frequently. Unlike probability or random sampling, nonprobability sampling designs are not concerned with obtaining a sample that represents the larger population of interest [2]. Convenience or purposive sampling, a type of nonprobability sampling design, is used to recruit participants who fit a predefined criterion, using multiple recruitment methods, such as disseminating information about the research study through flyers, advertisements, and word of mouth. Potential participants would then be screened to determine if they meet the eligibility criteria. Studies using convenience sampling include [45,46,47,48,141,169]:

    • Researchers use bilingual interviewers who visit ethnic grocery stores, churches, English classes, and other places where Asian Americans congregated

    • Researchers recruit students from psychology classes

    • Researcher speaks on two radio shows for women

    • Researcher recruits Chinese elders from tai chi classes and cultural events

    • Researchers visit ethnic fairs

    • Researchers recruit African American men from barbershops

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  13. Which of the following is NOT a limitation to using ethnic surnames to identify research participants?

    CULTURALLY SENSITIVE SAMPLING DESIGNS

    Another type of nonprobability sampling method is selection by ethnic surnames. The underlying assumption in using ethnic surnames as an identifier is that the ethnic group under study has surnames that are unique from other groups and are representative [52]. Himmelfarb, Loar, and Mott, for example, identified 35 Jewish surnames and used a random sampling of persons with these distinct Jewish surnames [53]. They found there were no major differences between samples obtained based on these surnames and sampling from lists obtained from Jewish organizations. Similarly, Shin and Yu compared the proportion of persons with the surname Kim in eight groups from different regional, occupational, and socioeconomic backgrounds [54]. They approximated that the surname Kim reflected more than one-fifth (22%) of the Korean population. Consequently, using Kim as the identifier was a viable method for selecting potential Korean American participants. In another example, Chinese elderly were identified using Chinese surnames from 1990 Medicare enrollment files and then compared to their demographic profiles from 1990 U.S. Census data [52]. The demographic profiles from these two datasets were comparable, supporting the use of ethnic surnames as a viable sampling technique. However, several caveats should be acknowledged when ethnic surnames are used for sampling purposes. A particular ethnic surname is not always exclusively representative of that ethnic group, and not all ethnic minority households may have a unique surname [55]. Finally, this technique does not identify those ethnic minority women who marry outside their ethnic group [52].

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  14. Which of the following response styles is characterized by research respondents agreeing with the question(s) regardless of content?

    CULTURALLY SENSITIVE INSTRUMENTS AND MEASUREMENT

    Acquiescence bias is another form of response style, whereby research respondents agree with the question(s) regardless of the content [62]. Some researchers speculate that cultural values emphasizing harmony influence this response pattern, and they posit that a cultural script in Hispanic culture known as simpatia, which emphasizes harmonious, cooperative, and positive social relations, has a role in acquiescence bias in this population [40]. Some studies, for example, have found that certain racial/ethnic groups are more likely to choose the option "yes" in yes/no questions [166].

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  15. When evaluating an instrument used in a study involving an ethnic minority population, assessing the mode of administration is an aspect of determining

    CULTURALLY SENSITIVE INSTRUMENTS AND MEASUREMENT

    Operational equivalence refers to whether the procedures, ways of administering the instrument, instructions, and formatting of the instrument are logical for other cultures [144]. Many instruments, for example, have a time reference for the participant to consider (i.e., in the last week). However, not all cultural groups will share the same concept of chronology as the group for which the instrument was originally developed and targeted [58]. Researchers should also consider whether the mode of administration is culturally consistent with the norms of the cultural group. For example, some cultures may find it culturally offensive to have a young interviewer ask elder research participants personal questions [41,58].

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  16. What is the main advantage of using a direct translation method?

    CULTURALLY SENSITIVE INSTRUMENTS AND MEASUREMENT

    This method involves a one-way translation of the instrument by a bilingual translator and emphasizes a literal translation. As a result, the instrument may look unnatural or stilted in the new language. Or when literally translated, it is simply confusing. For example, the term "and/or" is frequently used in English, but it does not translate well and is frequently confusing for Spanish speakers [145]. Cultural idioms are likewise difficult and require knowledge of both cultures. Additionally, the translated instrument is solely dependent upon the translator's skill and knowledge. This translation method is commonly used when there is only one accessible translator, and it is one of the most time-efficient and cost-effective methods available [66,145]. When direct translating procedures are used, it is highly recommended that the translated version be tested on a sample of respondents from the target language. The main dilemma of this translation method is that any differences or similarities found in the subject matter under examination may be due to the cultural group rather than errors in translation [67]. This type of translation is most suitable for instruments with strong established validity and reliability in their original source language; however, it does not take into account minimizing cultural biases or examining for construct equivalence [103].

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  17. Using the reputation and recognition of an institution or organization that sponsors a research study to gain legitimacy is referred to as

    CULTURALLY SENSITIVE DATA COLLECTION AND RECRUITMENT PROCEDURES

    Ascribed credibility refers to a perceived attribute connoting position and authority. These attributes or characteristics might include age, gender, credentials, or race [41]. For example, in Asian culture there is an emphasis on hierarchal relationships. The age and gender of an interviewer might affect perceived credibility. In other situations, research participants may ask interviewers personal questions about their age, marital status, and education in order to assess the interviewer's ascribed credibility. Researchers should carefully train interviewers how to respond to personal questions and limit the amount of information they disclose [41].

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  18. The Tuskegee Study

    BARRIERS TO ETHNIC MINORITY RESEARCH PARTICIPATION

    African Americans' wariness of research can also be linked back to the Tuskegee Study, conducted from 1932 to 1972 by the U.S. Public Health Service. The Tuskegee Study examined the course of syphilis in approximately 400 African American men with the disease [78]. By 1945, penicillin had become the accepted course of treatment for syphilis; however, in order to continue to follow the course of the disease, the researchers did not inform the research participants of this advancement [79]. These men went untreated for another 40 years, resulting in more than 100 deaths [79].

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  19. Which of the following factors contributes to the reluctance of ethnic minority groups to participate in research?

    BARRIERS TO ETHNIC MINORITY RESEARCH PARTICIPATION

    The Tuskegee Study continues to perpetuate fear that ethnic minorities who are recruited for research, particularly clinical trials, are merely experiment subjects [80]. Distrust of researchers continues to be the top barrier to research participation among African Americans [168]. In a focus group study with African Americans examining perceptions towards medical research, researchers found that participants saw the value of clinical research; however, they did not want to participate in research because they feared their race was being used as inhuman subjects. They were also concerned about the risks associated with medical research, fearing that researchers would not always be completely truthful when conveying the risks and benefits [81]. Interestingly, when asked about the Tuskegee Study, all participants were familiar with the study; however, many conveyed inaccurate information. When the moderator attempted to provide correct historical information regarding the study, this information was challenged as inaccurate and deceptive [81]. This speaks to how indelibly embedded the Tuskegee Study has become in African American consciousness. It will likely taint research for many years to come. Even today, African Americans report lower levels of trust of healthcare providers in general compared to their white counterparts. These varying levels of trust may result in disparities in health care and preventive services [150].

    Similarly, other cross-cultural studies indicate that people in general do not trust physicians and the healthcare system. This general apprehension appears to extend to medical research. A group of researchers conducted focus groups with Japanese lay persons and interviews with physicians about medical research [82]. Their findings showed that Japanese lay individuals were concerned with use of experimental elements such as placebos and randomization. The findings also highlighted the role of Japanese cultural norms emphasizing harmony in affecting the notion of voluntary participation in the informed consent process, leading Japanese patients to feel uncomfortable refusing their physicians and research. Ultimately, this may adversely color their views regarding medical research. Physicians express concern about how the media has negatively shaped public attitudes toward research, and they stress the need for more awareness and education to be disseminated. A greater collaborative effort between research communities and the public is needed to combat these perceptions.

    Fear of government officials can also impede research participation. Some ethnic minority immigrants have relatives who are either undocumented residents or perhaps are themselves undocumented residents. Many view the consent form as a way of extrapolating additional private information [174]. Therefore, they may be fearful that researchers could report the data back to the government, leading to deportation [41,113]. Immigrants originating from countries where political persecution is common may be fearful of any inquiries and potential ramifications, particularly research perceived to be sponsored by the government [83].

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  20. Which of the following is NOT true regarding the dissemination of research findings among ethnic minority groups?

    CULTURALLY SENSITIVE DISSEMINATION OF RESEARCH FINDINGS

    One of the major factors eliciting distrust among ethnic minority communities toward researchers is their experience of feeling as though their communities are being used as laboratories [85,86]. The term "tourist-researchers" or "helicopter researchers" has been used to describe researchers who obtain data without taking the cultural context into account and without giving back to the community [152,166].

    This is augmented by the power dynamics inherent in the researcher/researched relationship [87,88]. Researchers often define the "problem," and after the data are collected, they tend to leave the communities and analyze the data without any consultation with community experts, leaders, or residents. As a result, researchers are perceived as "outsiders," representing mainstream power structures [87,88]. It is suggested that the researcher/researched relationship is also embedded with overtones of one party "looking over" or "looking after" another party, where the researcher is seen as having an authoritative role [76]. Historically, as outsiders, researchers have interpreted the data in a manner that pathologizes the community. They often analyze and interpret the data without taking into account the community's historical and sociocultural contexts. This is a form of marginalization, whereby a group is viewed and labeled as distinct from the norm [153]. Therefore, culturally sensitive researchers should ensure that findings are relayed back to the community in such a way that it leads to a dialogue about how the data can be employed to shape and support needed social programs and policies. This is a way of giving back to the community, and it serves to build a foundation of credibility and trust for researchers to conduct future studies in the communities [41]. Often, results of research are published in academic journals and may be difficult for communities to access and/or understand. Researchers should therefore identify nonacademic outlets for distribution of research results (e.g., radio, ethnic newspapers, social media, blogs) [166].

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  • Back to Course Home
  • Participation Instructions
    • Review the course material online or in print.
    • Complete the course evaluation.
    • Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.