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Background: Amid persistent disparities in Covid-19 vaccination and burgeoning research on vaccine hesitancy (VH), we conducted a scoping review to identify multilevel determinants of Covid-19 VH and under-vaccination among marginalized populations in the U.S. and Canada. Methods: Using the scoping review methodology developed by the Joanna Briggs Institute, we designed a search string and explored 7 databases to identify peer-reviewed articles published from January 1, 2020–October 25, 2022. We combine frequency analysis and narrative synthesis to describe factors influencing Covid-19 VH and under-vaccination among marginalized populations. Results: The search captured 11,374 non-duplicated records, scoped to 103 peer-reviewed articles. Among 14 marginalized populations identified, African American/Black, Latinx, LGBTQ+, American Indian/Indigenous, people with disabilities, and justice-involved people were the predominant focus. Thirty-two factors emerged as influencing Covid-19 VH, with structural racism/stigma and institutional mistrust (structural)(n = 71) most prevalent, followed by vaccine safety (vaccine-specific)(n = 62), side effects (vaccine-specific)(n = 50), trust in individual healthcare provider (social/community)(n = 38), and perceived risk of infection (individual)(n = 33). Structural factors predominated across populations, including structural racism/stigma and institutional mistrust, barriers to Covid-19 vaccine access due to limited supply/availability, distance/lack of transportation, no/low paid sick days, low internet/digital technology access, and lack of culturally- and linguistically-appropriate information. Discussion: We identified multilevel and complex drivers of Covid-19 under-vaccination among marginalized populations. Distinguishing vaccine-specific, individual, and social/community factors that may fuel decisional ambivalence, more appropriately defined as VH, from structural racism/structural stigma and systemic/institutional barriers to vaccination access may better support evidence-informed interventions to promote equity in access to vaccines and informed decision-making among marginalized populations.

ABSTRACTThis teaching note presents the adaptation of four innovative pedagogical techniques from Boal’s Theatre of the Oppressed (TO) to effectively teach ethics across the social work curriculum. Each of the four techniques (Forum Theatre, Newspaper Theatre, Image Theatre, and Legislative Theatre) will be described in general and then modeled as an activity to use across four social work curricular areas, respectively: clinical practice, research, field education, and organizational policy. Teaching preparation/tips will be provided to guide educators on how to successfully employ these techniques to enhance student competencies to identify and address ethical issues and to participate in moral dialog. The teaching note will conclude with an analysis of the advantages and limitations of using TO techniques in the classroom.

AbstractIn Canada, the evolution of gay rights and surrogacy legislation present a unique sociopolitical context in which gay men consider parenthood. This study explored the motivations of gay men and gestational surrogates to pursue surrogacy in Canada. Interviews were conducted with (a) gestational surrogates who had been implanted with one or more embryos from a donated egg and gay fathers’ sperm and (b) gay men who completed gestational surrogacy to have a biological child. Data were analyzed through interpretive phenomenological analysis (IPA) strategies. Findings are framed within ecological systems theory (EST) to demonstrate how both proximal and distal contexts have either facilitated or hindered the decision to pursue surrogacy for gay men. A new theoretical interpretation of surrogacy shows that reproductive decision-making is situated across a complex continuum, from acts of resistance that challenge heteronormative parenthood and kinship practices to reenactments of traditional family systems and hegemonic gender norms.

The Assisted Human Reproduction Actregulates the practice of altruistic surrogacy in Canada, criminalizing monetary compensation yet permitting reimbursements for expenditures associated with pregnancy. Limited stipulations regarding permissible expenditures have created ambiguity for service users and providers. Despite these complexities, gestational surrogacy in Canada continues to proliferate. Yet, with limited empirical research in Canada, it is unclear how legislation has supported or hindered the practice of surrogacy. This paper reports on findings from a qualitative study that explored supports and barriers to surrogacy across six domains: (1) accessible surrogacy information, (2) surrogacy consulting services, (3) fertility clinic practices, (4) hospital policies, (5) public attitudes, and (6) federal legislation. Future practice and policy recommendations can encourage interdisciplinary dialogue to guide clinical practice and inform legislative action.

The digital age has revolutionized how individuals interact. The number of computer users has increased exponentially, along with expanding local and global networks and opportunities for learning, entertainment, and support. Most recently, cyber communication is becoming an important part of face-to-face social work practice as an administrative and therapeutic exchange between practitioners and clients, with both benefits and challenges. The purpose of this article is to present results of a study that used grounded theory to explore the application and adaptation of information and communication technology (ICT) in traditional clinical social work practice within organizations and private practice. The overwhelming finding was that it is no longer possible not to engage in the use of ICT. We discuss implications for practice, including clinical, practical, and ethical benefits and issues of ICT.