Achieving Behavioral Health Equity for Children, Families, and Communities Proceedings of a Workshop (2019) / Chapter Skim
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6 Accelerating the Rate of Learning Through Population-Based Research Strategies
6 Accelerating the Rate of Learning Through Population-Based Research Strategies
Pages 43-52
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From page 43... ...
Four Research Strategies to Address Health Equity James first summarized four population-based strategies that can be, or are currently being, utilized to address health equity: Community-Based Participatory Research (CBPR) , Multi-Level Interventions, Pragmatic Study Design, and Quality Improvement Framework.
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Multilevel Intervention According to James, the multilevel intervention involves, at a minimum, three levels: patient, provider, and health care system. It is able to target multiple determinants of health simultaneously within complex systems.
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From page 45... ...
Pragmatic Study Design James said the Pragmatic Study Design evaluates the effectiveness of interventions in the health care setting where individuals receive routine medical care. NIMHD does not have a current solicitation in this area, but the National Institute on Diabetes and Digestive and Kidney Diseases does have a current solicitation focused on pragmatic research in health care settings to improve diabetes and obesity prevention care, two areas that significantly impact minority populations.
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From page 46... ...
A benefit is that this framework offers a platform to address modifiable aspects of health care disparities and gives proactive attention to the social determinants of health. However, according to James, some health care organizations do not routinely collect race and ethnicity data, so they would be unable to ddress a racial and ethnic disparities with this framework.
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From page 47... ...
They also recommended enhancing public health surveillance by incorporating geographic variables and social determinants of health for geographically defined populations, and ensuring that active efforts are made to address disparity reduction during both the planning and implementation stages of new big data approaches. Rapid Health Care Learning Systems James referenced a 2006 workshop on the learning health care system (Institute of Medicine, 2007)
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From page 48... ...
Expanding on James' description, the learning health care system aims to achieve improved outcomes through new knowledge and technologies, big data, and the increasingly dynamic and complex health care environment. The learning health care system, Margolis stated, is a single system for producing better health.
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From page 49... ...
Margolis shared that the learning health care system has been replicated in other clinical networks, including the Solutions for Patient Safety Network, The Ohio Perinatal Collaborative, and the National Pediatric Quality Improvement Collaborative. A nonclinical example, the All Children Thrive Network, showed improvement in reading scores in schools that participated in the quality improvement network.3 2 For more information, see http://www.improvecarenow.org.
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Patients can document their symptoms and view data on an online dashboard. Margolis also emphasized that rather than a top-down approach, learning health care system networks use a bottom-up approach through which exponential growth is documented (see Figure 6-2)
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From page 51... ...
ACCELERATING THE RATE OF LEARNING 51 FIGURE 6-2 Change in community characteristics. NOTE: IRB = Institutional Review Board, DUAs = Data Use Agreements.
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