Transforming Health Equity Research in Integrated Primary Care: Antiracism as a Disruptive Innovation

转变综合初级保健中的健康公平研究：反种族主义作为颠覆性创新

基本信息

批准号：
10753762
负责人：
Norman Bruce Anderson
金额：
$ 12.5万
依托单位：
FLORIDA STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-23 至 2026-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10753762
关键词：
Address Adoption African American population Attention Attitude Awareness Behavior Black American Black race Communication Communities Complex Diagnosis Diffuse Diffusion Diffusion of Innovation Discrimination Ensure Evidence based intervention Foundations Future Health Health system Healthcare Healthcare Systems Imprisonment Individual Inequity Institutional Racism Institutionalization Integrated Health Care Systems Intervention Intervention Studies Jail Light Low income Maps Mathematics Measurement Measures Mental Health Mental Health Services Methods Minority Groups Modeling Monitor Organizational Culture Outcome Pathway interactions Patients Phase Policies Prevalence Primary Care Prisons Process Provider Race Research Science Specific qualifier value Sterile coverings System Testing Training Activity Translating Translational Research Treatment Efficacy United States Violence anti-racism behavioral and social science care systems combat community based participatory research community engagement comorbidity computerized coronavirus disease design evidence base experience health care delivery health care service health disparity health equity health inequalities improved innovation insight marginalized population model building patient centered medical home physical conditioning primary care setting racial health disparity racism response screening simulation social health determinants theories therapy development tool

项目摘要

Increased media attention regarding COVID-related health disparities combined with horrific institutionalized violence against Black Americans have revitalized the call to action to address systemic racism in health care. Among the consequences of systemic racism in health care are significant health disparities in prevalence, diagnosis, and treatment of comorbid physical and mental health conditions. Despite decades of studies acknowledging health disparities based on race and an increased awareness of the social determinants of health, we seem to be lightyears away from significant change. There are shockingly few evidence-based interventions to change racism attitudes, behaviors, and practices at the provider and organizational-systems level. New paradigms are needed to intervene on, and not just document, racism in health care systems. We propose to develop and test a transformative paradigm for translating basic behavioral and social science into new anti-racism interventions for primary care settings. The paradigm is the first of its kind to integrate community-based participatory research, systems science, diffusion of innovation theory, and item response theory, leveraging an established framework of early phase translational behavioral and social science to rigorously define new anti-racism interventions within complex health systems and rigorously develop measures to assess impact. Anti-racism is a disruptive innovation in integrated primary care systems in the United States, one that can be rigorously mapped using community-engaged systems science methods. This map identifies “inflection points” likely to result in the most impactful intervention targets, and then established pathways can be used to translate fundamental behavioral and social science discoveries into new interventions at these points. Systems science modeling can then simulate potential interventions and produce mathematical standards for intervention efficacy in future trials. This transformative paradigm will also detail innovative methods to develop efficient and effective measurement tools to rigorously monitor outcomes. This transformative paradigm of antiracism as a disruptive innovation will not only revolutionize health equity interventions in integrated primary care systems but will provide a foundation for improving health care racism in other systems.

媒体对与共同相关的健康差异的关注增加了可怕的针对黑人美国人的制度化暴力已振兴了解决系统性种族主义的呼吁在医疗保健中。在医疗保健中系统性种族主义的后果之一是健康差异合并身体和心理健康状况的患病率，诊断和治疗。尽管数十年研究认可基于种族的健康差异，并提高了对社会的认识健康的决定因素，我们似乎是远离重大变化的光年。令人震惊的很少基于证据的干预措施，以改变提供商的种族主义参与者，行为和做法组织系统级别。需要进行新的范式来进行干预，而不仅仅是记录种族主义卫生保健系统。我们建议开发和测试转化范式以翻译基本行为和社会科学成为初级保健环境的新的反种族主义干预措施。范式是首先是整合基于社区的参与研究，系统科学，创新的扩散理论和项目响应理论，利用早期翻译行为的既定框架和社会科学在复杂的卫生系统中严格定义新的反种族主义干预措施，严格制定评估影响的措施。反种族主义是综合主要的破坏性创新美国的护理系统，可以使用社区参与系统进行严格映射的系统科学方法。该地图确定了可能导致最有影响力的干预目标的“拐点” 然后建立的途径可用于翻译基本的行为和社会科学发现在这些点进行新的干预措施。然后，系统科学建模可以模拟潜在的干预措施和在以后的试验中产生数学标准以进行干预效率。这种变革性范式也将详细的创新方法来开发高效和有效的测量工具，以严格监控结果。这种反狂主义作为一种破坏性创新的变革性范式不仅会彻底改变健康公平干预综合初级保健系统，但将为改善医疗保健种族主义提供基础在其他系统中。