Abstract
The optimal global health (GH) workforce should be racially and ethnically diverse, yet few persons from historically underrepresented minority (URM) groups in the United States participate in GH training programs. We conducted a study to explore barriers and facilitators for URM individuals to participate in the NIH Fogarty International Center's GH Program for Fellows and Scholars (FGHFS), which offers yearlong international research training opportunities. We used an exploratory sequential mixed methods study design that used qualitative in-depth interviews (n = 18) to inform a subsequent quantitative online survey (n = 82). We assessed URM interest and engagement in GH training at three stages of FGHFS (applicants, alumni, and eligible persons who had not applied). Most participants in both phases were female, Black or African American, aged between 31 and 39 years, and had completed graduate or postgraduate training; a third or less were Hispanic. We identified four principal barriers to participation in GH training programs including lack of exposure to GH, lack of mentorship or support, challenges of global travel and work, and finances. The barriers compounded across training stages. Principal facilitators of training engagement included encouraging mentors and supportive families. Recommendations for increasing the participation of URM individuals in GH research training programs included increased financial support and exposure to GH in academic studies, as well as exposure to role models and mentors who can provide career advising in GH. Our findings suggest that early exposure, mentorship, and sufficient financial support will facilitate URMs' entry into GH.
