Building Outreach and Diversity in the Field of Addictions
Building Outreach and Diversity in the Field of Addictions
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DOI：
10.1111/ajad.13097
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发表时间：
2020-09-01
影响因子：
3.7
通讯作者：
Jegede, Oluwole
中科院分区：
文献类型：
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作者：
Jordan, Ayana;Jegede, Oluwole
在成瘾研究人员和提供者中促进种族和族裔多样性的刻意行动日益被认为是努力缓解该领域日益恶化的健康差距的必要步骤。面对日益加深的阿片类药物危机，人们很容易意识到专注于多样化劳动力的紧迫性，在这种危机中，不断变化的种族人口人口倾向于代表不足的少数族裔(URM)，需要直接需要来自种族和族裔URM背景的具有文化知识的研究人员和提供者。本白皮书的目的是强调在成瘾领域对多样性、公平和包容性(DEI)的迫切需要，并定义这些术语，以便对这些概念的含义有一个共同的理解。在这篇文章中，我们描述了在研究和现有的医疗队伍中缺乏种族和民族多样性，并提出了Dei基础设施对于改善患者结果是必要的。我们提供了在成瘾领域内致力于增加种族和民族URM研究人员、临床提供者和教职员工数量的方案努力的例子。本报告概述了深思熟虑的招聘战略，以强调定向外联的重要性。最后，我们讨论了如何衡量DEI努力以准确跟踪进展。Dei可以采取几种形式，但为了本文的目的，我们特别强调在成瘾领域增加来自种族和民族URM背景的人的好处。对相关文献的回顾强调了Dei镜片对成瘾有用和适用的三个主要领域。(A)Dei镜片允许研究人员和提供者的发展，他们更密切地代表了所服务的不同患者群体，并可以帮助创建、传播和评估根据文化定制的预防和治疗干预措施。1(B)Dei提高了来自不同人群的患者的入院率和保留率，这些患者更有可能向URM提供者寻求治疗。2(C)通过改善对治疗建议的遵守，以及患者报告对种族或民族匹配的提供者的更大满意度，Dei可以改善健康结果。1、2为了建立一种共同的语言和对DEI所涉及的细微差别的理解，我们对每个概念都提供了明确的定义。多样性描述了机构和组织在多大程度上代表了劳动力中个人特征的构成异质性。3最理想的情况是，参与决策、领导和知情成瘾护理所需的任何其他领域的人应该反映成瘾患者的人口统计数据，包括性别、性取向以及不同的种族和民族背景。公平意味着每个人都可以获得成功所必需的东西。对于每个人来说，“必要的”内容可能看起来是一样的，也可能不是相同的，并且URM组通常需要不同的资源、技能或支持。公平不同于平等，平等允许每个人拥有相同的资源，但平等并不总是等同于成功。采用股权框架改变了制度和条件，使那些被排斥或受压迫的人能够受益，并成为被投资的变革推动者。当障碍被消除，当人们被看重和欣赏为自己，然后愿意并能够充分参与决策时，包容就存在了。在包容的环境中，人们感到被赋权、被欣赏和被倾听，无论他们的种族或民族背景如何。
Deliberate actions to promote racial and ethnic diversity among addiction researchers and providers is increasingly being recognized as a necessary step in the effort to mitigate worsening health disparities in the field. The urgency in focusing on a diverse workforce can readily be appreciated in the face of a deepening opioid crisis, where a changing ethnodemographic population is weighted toward underrepresented minorities (URM) and requires a direct need for culturally informed researchers and providers from racial and ethnic URM backgrounds. The purpose of this paper is to reinforce the immediate need for diversity, equity, and inclusion (DEI) in the field of addictions, and to define these terms for a shared understanding of what these concepts entail. In this article, we describe the lack of racial and ethnic diversity in research and the existing medical workforce and make the case that DEI infrastructure is necessary to improve patient outcomes. We provide examples of programmatic efforts within the field of addiction that are dedicated to increasing the number of racial and ethnic URM researchers, clinical providers, and faculty. An overview of deliberate recruitment strategies is provided to highlight the importance of directed outreach. We conclude with a discussion of how DEI efforts can be measured to accurately track progress. DEI can take several forms, but for purposes of this article we specifically highlight the benefits of increasing people from racial and ethnic URM backgrounds in the field of addiction. A review of the pertinent literature highlights three main areas where a DEI lens is useful and applicable to addiction.(a) DEI allows for the development of researchers and providers who more closely represent the heterogeneous population of patients served and can help to create, disseminate, and evaluate culturally tailored prevention and treatment interventions. 1 (b) DEI improves initiation and retention rates of patients from diverse populations who are more likely to seek treatment from URM providers. 2 (c) DEI can lead to improved health outcomes with improved adherence to treatment recommendations, and in which patients report greater satisfaction with racial or ethnically matched providers. 1, 2To establish a shared language and understanding of the nuances involved in DEI, we provide clear definitions of each concept. Diversity describes the degree to which institutions and organizations represent the compositional heterogeneity of individual characteristics within the workforce. 3 People who are participating in decision‐making, leadership, and any other areas necessary for informed addiction care most ideally should reflect the demographics of those affected by addiction, including gender, sexual orientation, and varied racial and ethnic backgrounds. Equity means that everyone has access to what is necessary in order to be successful. What is “necessary” may or may not look the same for everyone, and oftentimes URM groups require a different set of resources, skills, or support. Equity is different from equality, which allows for everyone to have the same resources, but which does not always equate to success. Employing an equity framework shifts systems and conditions to allow for those who have been excluded or oppressed to benefit and become invested change agents. 3 Inclusion exists when barriers are eliminated and when people are valued and appreciated as themselves, and then become willing and able to fully be involved in decision‐making. People in an inclusive environment feel empowered, appreciated, and heard, regardless of their racial or ethnic background.