Journal of Nursing Education

Major Article 

Perceptions of Campus Climate on Program Satisfaction for Accelerated Nursing Students

Jessica Alicea-Planas, PhD, RN, CHES; Meredith Wallace Kazer, PhD, APRN, FAAN

Abstract

Background:

Nationwide, schools of nursing have recognized the significance of increasing their diversity but continue to be challenged with recruitment and retention of historically underrepresented students. In 2008, the New Careers in Nursing program was implemented to alleviate the shortage and increase nursing diversity.

Method:

Secondary analysis of a subsample of participants was used to investigate how campus climate affected program satisfaction of accelerated nursing students of color. Specific objectives included exploring social supports such as interpersonal interactions and experiences with faculty and peers.

Results:

Those who self-identified with an under-represented group were more likely to feel uncomfortable with those whose race/ethnicity was different from their own, more likely to report hearing racists or stereotypical remarks in school, and less likely to have a supportive group of friends on campus.

Conclusion:

The results of this study revealed significant relationships between campus climate variables that included peer and faculty interactions. These results are relevant to all nursing programs seeking to create a more welcoming environment within their campus community. [J Nurs Educ. 2019;58(7):409–416.]

Abstract

Background:

Nationwide, schools of nursing have recognized the significance of increasing their diversity but continue to be challenged with recruitment and retention of historically underrepresented students. In 2008, the New Careers in Nursing program was implemented to alleviate the shortage and increase nursing diversity.

Method:

Secondary analysis of a subsample of participants was used to investigate how campus climate affected program satisfaction of accelerated nursing students of color. Specific objectives included exploring social supports such as interpersonal interactions and experiences with faculty and peers.

Results:

Those who self-identified with an under-represented group were more likely to feel uncomfortable with those whose race/ethnicity was different from their own, more likely to report hearing racists or stereotypical remarks in school, and less likely to have a supportive group of friends on campus.

Conclusion:

The results of this study revealed significant relationships between campus climate variables that included peer and faculty interactions. These results are relevant to all nursing programs seeking to create a more welcoming environment within their campus community. [J Nurs Educ. 2019;58(7):409–416.]

Although the RN population has grown to nearly 3.2 million (Kaiser Family Foundation, 2016), the diversity of the profession has not progressed as rapidly to meet the demands of the country. White female RNs are overrepresented relative to the general population (76.9% versus 69.4%, respectively), and Hispanic, Black, Native American, and Pacific Islander individuals comprise smaller percentages of the RN population than they do in the United States (McMenamin, 2015). The nursing profession has been characterized as “almost exclusively a profession of White women with minimal diversity of race, ethnicity or gender,” (Gillespie, Pritchard, Bankston, Burno, & Glazer, 2017, p. 104).

This lack of multiculturalism has been cited as a contributor to health inequities and disparities in health outcomes among racial/ethnic groups (Smedley, Stith, & Nelson, 2003). A seminal report on diversity in the health care workforce noted many health professions (including nurses) bear “little resemblance to the diverse population they serve, leaving many Americans feeling excluded by a system that seems distant and uncaring” (Sullivan Commission, 2004, p. 8). Although patients may report preferences for providers who share their own race and cultural diversity, there is mixed evidence of patient–provider concordance in improvements to health disparities (Jerant, Bertakis, Fenton, Tancredi, & Franks, 2011; Sweeney, Zinner, Rust, & Fryer, 2016; Traylor, Schmittdiel, Uratsu, Mangione, & Subramanian, 2010). Detz et al. (2014) found that language concordance contributes to improved participation in diabetes self-care for rural Latino patients.

Nationwide, schools of nursing have recognized the significance of a less-than-diverse workforce (American Association of Colleges of Nursing [AACN], 2019) and are aware of the U.S. Department of Labor projections of needing more than one million new RNs by 2020. Yet, nursing programs continue to be challenged with both recruitment and retention of historically underrepresented student populations. One approach used as a way for nursing schools to increase capacity are accelerated programs offered at the baccalaureate and master's level. These programs make use of previous nonnursing educational experiences and allow students a shorter route to licensure. In addition to the academic and financial supports that are already being provided by various pipeline programs, introspection of institutional practice and campus climate have been suggested as an additional element of change to support the success of underrepresented students.

In 2008, to help alleviate the national nurse shortage and increase the diversity among nursing professionals, the New Careers in Nursing (NCIN) program was implemented. Funded by The Robert Wood Johnson Foundation and the AACN, an investment of over $35 million was made to schools of nursing across the United States. For 8 years (2008–2015), this national program supported more than 3,500 students from diverse or nontraditional backgrounds with partial scholarships to pursue degrees in accelerated baccalaureate and master's programs. The purpose of this study was to investigate how campus climate affected program satisfaction of accelerated nursing students of color enrolled in the NCIN program through a process of secondary analyses.

Background

Conversations on the institutional environment's role in shaping student retention in higher education began decades before its significance was fully understood (Tinto, 1975). Although many focused on academics, Tinto's student integrative model noted that personal and social supports were central to college persistence (Tinto, 2006). Other scholars have noted that ethnic minorities view the context of campus climates differently than their peers (Doan, 2011; Fischer, 2007; Martin, Spenner, & Mustillo, 2017). More importantly, a student's ability to connect with the campus community in order to feel socially unified is considered crucial (Demetriou & Schmitz-Sciborski, 2011). When underrepresented students perceive a less-than-hospitable campus climate, they will have more difficulty adjusting academically, socially, and emotionally (Martin et al., 2017; Veal, Bull, & Miller, 2012). For culturally diverse students, interpersonal interaction and feelings of acceptance are a significant piece of creating a positive learning experience (Ackerman-Barger & Hummel, 2015; Veal et al., 2012) and are influenced by exchanges between students, faculty, and other staff.

Prior to the NCIN study, little was known about the experience of second-degree nursing students, as this is not a well-studied population. Second-degree nursing programs have been in existence for over 40 years and are thought to bring greater diversity to the profession (Elfman, 2013). DeWitty, Huerta, and Downing (2016) reported that students who participated in the NCIN scholars' program were significantly more diverse than the general national nurse population. Many students in accelerated programs enter with years of work experience in other professions, have families, and/or continue to be employed while pursuing their nursing degrees. Not surprisingly, they struggle with a distinct set of challenges and typically begin programs with a different set of skills. Factors for attrition in accelerated programs include the rigor of the academics, intensity of programs, family obligations, and burden of work (Rouse & Rooda, 2010).

No previous studies were found that discussed the impact of nursing student's perception of campus climate on their overall program satisfaction or completion. Further study is essential to determine effective strategies to promote and retain a diverse population of nursing students. Enhanced understanding of the student's experience will help to improve admission and retention among diverse nursing students. Specific objectives of this study included exploring social supports that included interpersonal interactions and experiences with faculty and peers. These results are relevant to all nursing programs seeking to create a more welcoming environment within their campus community and strengthen connectedness with a more diverse student body.

The NCIN program was initiated in 2008 to address four major goals. One of these goals was to affect the nursing shortage and increase diversity of the workforce. The funding supported more than 3,500 students, from diverse or economically disadvantaged backgrounds, with $10,000 scholarships to pursue degrees in accelerated baccalaureate and master's programs. All recipients of the funding were invited to complete three surveys related to their experiences at various time points (entry, midpoint, and exit) during their educational journey.

Method

Institutional review board approval was obtained prior to any data analysis. The final deidentified data set included 3,503 participants from 130 nursing programs, across 40 states (plus Washington, D.C.) and 414 different variables. Univariate and bivariate analysis were completed using SPSS® (version 21). Tests for normality, linearity, and heteroscedasticity were conducted on the independent and dependent variables of interest and revealed non-normally distributed data. Standard transformations were not successful (in part due to the limited variance in many of the responses). Original variable items that were collected on a 5- or 6-point Likert scale were dichotomized (yes/no) or separated into three categories (yes/sometimes/no) based on the distribution of responses.

Reliability analysis for the following variables (quality of interaction with faculty, quality of interaction with faculty advisor, satisfaction with faculty-to-student relations, satisfaction with faculty attitude toward student, satisfaction with faculty availability to meet with student, and satisfaction with faculty instructional methods) demonstrated a high level of internal consistency (reliability coefficient of .901, six items). These items were combined to create a faculty interaction variable. Reliability analysis for the following variables (quality of interaction with fellow nursing students, quality of interaction with other NCIN recipients, satisfaction with peer support in academic setting, satisfaction with socializing with nursing students outside of class, satisfaction with quality of class discussions) demonstrated a moderate level of internal consistency (reliability coefficient of .753, five items). These items were combined to create a peer interaction variable. Race/ethnicity was dichotomized into two categories: self-identifying with an underrepresented racial/ethnic group within the RN population (Hispanic, American Indian/Alaska Native, African American, Native Hawaiian, multiple races), and self-identifying with a sufficiently represented racial/ethnic group within the RN population (Asian, Caucasian, other) (AACN, 2019).

From the original data set, there were 432 cases identified as having no missing variables of interest. All bivariate analyses were run on this subset of 432 cases. A series of chi-square analyses were conducted to examine whether overall program satisfaction and belonging to an underrepresented group differed by demographic characteristics and campus climate variables. Next examined was whether the predictor variables independently predicted overall program satisfaction by entering each variable into a single predictor logistic regression. Variables significantly related to the outcome variable at a p-value no greater than .05 were entered into a multiple logistic regression analysis to examine which variables were associated with overall program satisfaction.

Results

Nearly 42% of the subsample was male (n = 181), 58% was female (n = 251), and 26.6% was married. The average age was 28.2 years (SD 5.9) and ranged from 17 to 59 years. Race/ethnicity varied, with the largest number of students of color self-identifying as Black or African American (n = 106, 24.5%). Hispanics/Latinos represented 16.4% of the participants and 0.9% of American Indian and Alaskan Natives (Table 1 provides complete demographic characteristics). More than half of those in this sample were categorized by their schools as economically disadvantaged (n = 244, 56.5%). Schools in the eastern and southern regions of the United States were equally represented by students (n = 145, 33.6%, and n = 140, 32.4%, respectively), and the smallest number of participants were from west coast schools (n = 52, 12%). Fourteen percent of the students had received their prior degree within 1 year of starting the accelerated nursing program, 54% received it between 1 to 5 years prior, and the remaining 33% received it 6 or more years prior.

Demographic Characteristics of New Careers in Nursing Subsample Used in Data Analysis

Table 1:

Demographic Characteristics of New Careers in Nursing Subsample Used in Data Analysis

A chi-square analysis revealed there was no relationship found between overall experience with program and gender [χ2 (1, n = 432) = 1.75, p = .19], race/ethnicity [χ2 (1, n = 432) = .001, p = .97], economic background [χ2 (2, n = 432) = .460, p = .79], or feeling comfortable with students/faculty/staff whose race and ethnicity is different from your own in the school of nursing environment [χ2 (1, n = 432) = 2.21, p = .14]. There was a significant association between overall experience with accelerated nursing program and the following variables: peer interactions [χ2 (2, n = 432) = 50.95, p < .001], faculty interactions [χ2 (2, n = 432) = 189.81, p < .001], having a supporting group of friends at college [χ2 (2, n = 432) = 7.54, p = .02], hearing racist or stereotypical remarks in school [χ2 (1, n = 432) = 6.98, p = .008], feeling supported by the school of nursing faculty [χ2 (2, n = 432) = 26.53, p = .000], feeling supported by school of nursing staff [χ2 (2, n = 432) = 26.22, p = .000], and feeling supported by school of nursing students [χ2 (2, n = 432) = 12.26, p = .002]. Correlations between the dependent variable and faculty interactions were the strongest. The single predictor logistic regression analyses revealed these same variables were significantly related (at the p < .05 level) to overall program satisfaction (Table 2).

Bivariate Relationship Between Campus Climate Variable and Overall Experience With Accelerated Program (N = 432)

Table 2:

Bivariate Relationship Between Campus Climate Variable and Overall Experience With Accelerated Program (N = 432)

To test the hypothesized model, all significant variables from the single logistic regressions were entered into a multiple logistic regression model to predict overall experience with program (satisfaction). The results of the model are summarized in Table 3. Results of the logistic regression indicated that the model provided a statistical significance over the constant only model, [χ2 (13, 432) = 204.64, p < .001]. The Nagelkereke R square indicated that the model accounted for 55% of the total variance. Of the predictors entered into the model only one variable was significant (Table 3): faculty interactions (negative, p < .01; average, p < .01). In relation to students who had positive faculty interactions, those with average or negative faculty interactions were 24 and 77 times (respectively) less likely to report a positive experience with the accelerated nursing program. There was limited variance in the subsample and NCLEX® pass rates, and for this reason it was not used in the analysis. Of the subsample, 94.3% passed and 98.9% succeeded after two tries.

Results of Multiple Regression Analysis of Overall Experience With Accelerated Program in a Sample of 432 New Careers in Nursing Participants

Table 3:

Results of Multiple Regression Analysis of Overall Experience With Accelerated Program in a Sample of 432 New Careers in Nursing Participants

A chi-square test was performed to examine the relationship between race/ethnicity and the campus climate variables of interest. The relationship between these variables was significant: having a supporting group of friends at college [χ2 (1, n = 432) = 6.31 p = .012], hearing racist or stereotypical remarks in school [χ2 (1, n = 432) = 12.54, p < .001], and feeling comfortable with students, faculty, and staff whose race and ethnicity is different from one's own in the school of nursing environment [χ2 (1, n = 432) = 5.78, p = .016]. All other campus climate variables of interest were not significant. These results indicated that those who self-identified with an underrepresented group were more likely to feel uncomfortable with students, faculty, and staff whose race/ethnicity was different from their own, more likely to report hearing racist or stereotypical remarks in school and less likely to have a supportive group of friends on campus.

Limitations

The results of this study were generated from a secondary analysis of the NCIN data collected between 2008 and 2015. As with any secondary analyses, several limitations are usually encountered. Over the course of the program, there were various iterations of the surveys used, ultimately affecting the number of cases with complete data across all desired variables. Although this study aimed to measure the influence of race/ethnicity and perceptions of campus climate on program satisfaction, only responses to limited questions, not specifically designed for this purpose, could be entered into the data analyses. Moreover, the measures were chosen almost a decade ago and more sensitive measurement tools to assess campus climates are available (Hurtado, Griffin, Arellano, & Cuellar, 2008). The data set was also limited in variance and included data only from second-degree students, limiting the overall generalizability. As no previous studies were found that discussed the influence of nursing students' perception of campus climate on their overall program satisfaction, this study lends credible evidence to nurse educators interested in promoting more supportive educational environments.

Conclusion

Over the past decade, colleges and universities that educate nursing students have struggled to enroll and maintain a more diverse student population. Second-degree and accelerated programs have been used as a way to increase the diversity of the nursing profession. Many educational institutions have also moved toward holistic admission processes that seek to evaluate students using nontraditional quantitative benchmarks of achievement such as leadership, communication, and life skills (Glazer & Bankston, 2014), and this is a direction that must continue. However, while admitting adequate numbers of students of color to nursing programs is a substantial step in improving the diversity of nursing programs, it is only one element of the equation. Retaining these students throughout the entire nursing program and facilitating graduation and successful passage of the NCLEX is necessary to affect the diversity of the nursing workforce and promote improved patient outcomes. A key factor in program retention and successful completion is student satisfaction, and a person's experience (positive or negative) within a program may influence future applicants.

The results of this study revealed significant relationships between campus climate variables that included peer and faculty interactions; having a supportive group of friends; the frequency of hearing racist or stereotypical remarks in school; feeling supported by faculty, staff, and students within the school of nursing; and comfort within the nursing school environment. When added to a multiple regression equation, the combination of these factors explained 55% of the total variance in having a positive experience with the nursing program.

Education for current faculty and staff is necessary, considering the significant influence of these interactions on the student experience. Schools can be creative in how they provide faculty with this increased awareness. In a qualitative study of 197 undergraduate nursing students, graduate nursing students, faculty, and staff who participated in diversity book club meetings, movie showings, and speaker presentations, eight themes were identified: Knowledge Continuum, Humanness Is Universal, Personal Connection, the Problem, Awareness of Disparity, Acceptance, Make a Difference, and No Change (Gillespie et al., 2017). The authors concluded that although unconscious bias existed throughout the sample, the entertainment programs resulted in positive changes to diversity knowledge, attitudes, and behaviors.

Although the NCIN database didn't include students who left the program, it can be assumed that students who are dissatisfied with their nursing educational program may be at higher risk for attrition. The results of this analyses revealed that lower rates of negative faculty and peer interactions resulted in the highest level of satisfaction among second-degree students in accelerated nursing programs. These are two areas that are ripe for administration intervention for improvement. In this subsample, the data revealed that self-identifying with under-represented groups was significantly associated with feeling uncomfortable within the school of nursing environment and being more likely to not have a supportive group of friends on campus. Creating an environment of inclusion, so that all nursing students feel welcomed and part of the nursing community, is critical to fostering sustainable change, in not just nursing educational environments but for equity within the nursing workforce. As supported by the student integrative model, improving personal and social supports among nursing students is critical to long-term change.

Despite evolving research, the National Advisory Council on Nurse Education and Practice (2008) stated that the patterns of underrepresented minorities in the workforce are fostered through an underrepresentation of nurses in faculty and education. According to an AACN survey (2019), only 12.3% of full-time nursing faculty self-identify with a minority background. The Sullivan Commission on Diversity in the Healthcare Workforce (2004) stated, “Lack of leadership and sparse representation among faculties sends a chilling message to current and potential minority students” (p. 13). What is communicated to all students is that diversity is not valued by the nursing profession. A more balanced faculty will facilitate supporting a more diverse student body. DeWitty et al. (2016) reported that students whose racial/ethnic background matched their mentors were statistically significantly more satisfied with their mentor's assistance. Faculty diversification will increase the diversity among applications, contributing to creating a more welcoming and inclusive campus environment and ultimately a more diverse nursing profession.

Nursing leaders must advocate for equitable resources to promote the satisfaction and success of all nursing students. Each student has different needs, and a one-size-fits-all system of support is not sustainable among an increasingly diverse student population. Monetary challenges related to financing a second-degree amidst limited financial aid and home and family responsibilities presents one of the greatest challenges for these students. In a study of second-degree students (Rouse & Rooda, 2010), it was reported that budget counseling and stress-relieving activities to facilitate a balance of work, family, and school responsibilities were desired. Additional resources for counseling was also identified as a tool to empower students to overcome challenges. It is worth noting that these challenges may be even greater among racial and ethnically diverse student populations. The availability of school-based discretionary funds for books and supplies, relief from work for extra studying time, and small deficits in tuition payments may be critical in preventing attrition.

Seldomridge and DiBartolo (2007) commented that as the demographics of accelerated students change, support services may also need to be modified to meet the needs of a more diverse student population. Specifically, they recommended workshops on managing workload, study skills, critical reading and writing, and stress management. Cantwell, Napierkowski, Gundersen, and Naqvi (2015) measured the effectiveness of a second-degree accelerated nursing education pilot program implemented to decrease attrition among minority students. A pre-immersion program (9 days of activities and content provided 6 weeks before classes started) focused on enhancing study skills and included social activities to help students develop relationships with faculty and peers. The program was successful in reducing the attrition rates of students who scored lower on the Test of Essential Academic Skills (TEAS).

To produce sustainable change in the diversity of nursing students and the workforce, nursing educational leadership must demonstrate a zero tolerance policy for racist or stereotypical remarks and work to create inclusive environments. Recently released by the AACN (2017), the Diversity, Inclusion, and Equity in Academic Nursing position statement provides support and guidance for all nursing programs so that “students, staff, faculty, and administrators recognize the value of and need for diversity to achieve excellence in teaching, learning, research, scholarship, service, and practice” (p. 2). This attitude must be embraced by nursing deans and directors, who must then ambitiously assess and address institutional bias directly and work to create culturally conscious and inclusive educational environments.

In a healthy campus climate, everyone feels welcomed, respected, nurtured, and valued. In an unhealthy environment, individuals feel marginalized and isolated. For a diverse student body to thrive (and not just survive), campus climate should be a component explicitly addressed in all comprehensive diversity plans. Part of that strategic plan must include increasing the racial/ethnic representation among nursing faculty, which seems to be key to creating an environment that feels more welcoming for underrepresented students. This study added compelling data to support the need for more inclusive campus climates that admit and retain a diverse nursing student population. Through the essential action of educators, nursing can effectively improve the diversity of the workforce and positively influence the health of our increasingly diverse patient population.

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Demographic Characteristics of New Careers in Nursing Subsample Used in Data Analysis

VariableValue
Gender, n
  Male181 (41.9%)
  Female251 (58.1%)
Mean age ± SD (range)28.2 ± 5.9 (17 to 59)
Marital status, n
  Married115 (26.6%)
  Divorced or widowed32 (7.4%)
  Never married285 (66%)
Race/ethnicity, n
  American Indian or Alaska Native4 (0.9%)
  Asian54 (12.5%)
  Black or African American106 (24.5%)
  Hispanic or Latino71 (16.4%)
  Native Hawaiian or Pacific Islander2 (0.5%)
  White144 (33.3%)
  Multiple races59 (11.3%)
  Other2 (0.5%)
Region, n
  East145 (33.6%)
  Midwest95 (22%)
  South140 (32.4%)
  West52 (12%)
Economically disadvantaged, n
  Yes244 (56.5%)
  No156 (36.1%)
  Unknown32 (7.4%)
Years since last degree, n
  < 160 (14%)
  1 to 297 (22.6%)
  3 to 5135 (31.4%)
  6 to 1088 (20.5%)
  > 1050 (11.6%)

Bivariate Relationship Between Campus Climate Variable and Overall Experience With Accelerated Program (N = 432)

VariableNegative Overall ExperiencePositive Overall ExperienceB (SE)Wald (χ2)Exp (B)95% CIp


n%n%
Gender
  Male4323.813876.2−0.294 (0.223)1.740.7450.482–1.15.19
  Female7429.517770.5
Economically disadvantaged
  No4528.811171.2
  Yes6325.818174.20.152 (0.229)0.4421.170.743–1.83.51
  Unknown928.12371.90.035 (0.431)0.0071.040.445–2.41.94
Underrepresented
  No542714673−0.008 (0.217)0.0010.9920.648–1.51.97
  Yes6327.216972.8
Supportive friends
  Yes9225.327274.7
  Sometimes1731.53768.5−0.306 (0.317)0.9350.7360.396–1.37.33
  No857.1642.9−1.37 (0.553)6.150.2540.086–0.750.01
Comfort with others
  No1736.23063.80.479 (0.325)2.171.610.854–3.05.14
  Yes1002628574
Hearing racists or stereotype remarks
  No2618.811281.2−0.658 (0.252)6.840.5180.316–0.848.01
  Yes913120369
Faculty support for minorities
  Yes6520.625179.4
  Sometimes4242.95657.1−1.06 (0.247)18.50.3450.213–0.560.00
  No1055.6844.4−1.57 (0.494)10.10.2070.079–0.546.00
Staff support for minorities
  Yes6720.825579.2
  Sometimes4646.95253.1−1.21 (0.245)24.60.2970.184–0.480.00
  No433.3866.7−0.643 (0.628)1.050.5250.154–1.80.31
Student support for minorities
  Yes6422.222477.8
  Sometimes4134.57865.5−0.601 (0.239)6.50.5440.340–0.869.01
  No12481352−1.17 (0.425)7.60.3100.135–0.712.01
Faculty interactions
  Positive17626494
  Average6659.54540.5−3.13 (0.316)97.70.0440.024–0.082.00
  Negative3485615−4.48 (0.509)77.50.0110.004–0.031.00
Peer interactions
  Positive5618.225181.8
  Average4743.96056.1−1.26 (0.245)26.40.2850.176–0.460.00
  Negative1477.8422.2−2.75 (0.596)22.10.0640.020–0.201.00

Results of Multiple Regression Analysis of Overall Experience With Accelerated Program in a Sample of 432 New Careers in Nursing Participants

Campus Climate CharacteristicB (SE)WaldExp (B)Converted Odds Ratioa95% CIp
Peer interactions
  Positive (reference group)
    Average0.068 (0.345)0.0391.110.900.545–2.10.84
    Negative−1.59 (0.846)3.540.2034.920.039–1.07.06
Faculty interactions
  Positive (reference group)
    Average−3.19 (0.354)81.120.04124.40.021–0.083.00
    Negative−4.38 (0.580)57.090.01376.90.004–0.039.00
Supportive friends
  Yes (reference group)
  Sometimes−0.407 (0.467)0.7570.6661.500.267–1.66.38
  No−0.561 (0.939)0.3570.5711.750.091–3.60.55
Hearing racist or stereotypical remarks
  Yes−0.588 (0.353)2.90.5551.800.278–1.11.10
  No
Faculty support for minorities
  Yes (reference group)
  No−0.615 (1.24)0.2460.541.850.047–6.16.62
  Sometimes0.266 (0.977)0.0741.300.770.192–8.85.79
Staff support for minorities
  Yes (reference group)
  No0.356 (1.24)0.0821.421.400.125–16.27.78
  Sometimes−0.518 (0.958)0.2930.5961.680.091–3.89.59
Student support of minorities
  Yes (reference group)
  No0.671 (0.909)0.5451.960.5110.330–11.61.46
  Sometimes0.622 (0.477)1.701.860.540.732–4.74.19
Authors

Dr. Alicea-Planas is Associate Professor, and Dr. Kazer is Dean and Professor, Egan School of Nursing and Health Studies, Fairfield University, Fairfield, Connecticut.

This study was funded by a grant from the Robert Wood Johnson Foundation.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Jessica Alicea-Planas, PhD, RN, CHES, Associate Professor, Egan School of Nursing and Health Studies, Fairfield University, 1073 North Benson Road, Fairfield, CT 06824; e-mail: jplanas@fairfield.edu.

Received: December 18, 2018
Accepted: April 09, 2019

10.3928/01484834-20190614-05

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