Accelerating the Use of Findings from Patient-Centered Outcomes Research in Clinical Practice to Improve Health and Health Care Proceedings of a Workshop Series (2022) / Chapter Skim
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7 Workshop 2, Session 1: Possibilities for AHRQASPEPCORI Collaborations to Improve Health Equity
7 Workshop 2, Session 1: Possibilities for AHRQASPEPCORI Collaborations to Improve Health Equity
Pages 47-58
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From page 47... ...
• Opportunities for AHRQ to leverage PCORTF funding to advance health equity by supporting a research engagement infrastructure, prioritizing and requiring equity impact measurement in comparative effectiveness research, and building a pipeline of an equity-focused workforce through engagement. (Gaglioti)
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From page 48... ...
He noted that AHRQ's proposed strategic framework includes health equity as a high-priority component with desired outcomes that include reducing health disparities for AHRQ's priority populations, engaging underrepresented communities in training and implementation activities, and improving equity and access to needed care. THE ROLE OF DATA IN HEALTH EQUITY Gary Puckrein, founding president and chief executive officer of the National Minority Quality Forum (NMQF)
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From page 49... ...
She said applications for funding should ground their comparative effectiveness research and other implementation work in measuring disparities and evaluating the impact of the interventions on reducing disparities. She said this type of research should determine comparative effectiveness across different populations, and it should prioritize asking about comparative acceptability to different populations or the perceived sustainability or access to interventions for disproportionately impacted populations.
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She said the Jackson Heart Study does that well. When funding or designing a funding opportunity announcement focused on health equity, she suggested funding opportunities focused on health equity should require pipeline infrastructure focused on empowering youth or learners who are members of the disproportionately impacted group of interest.
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Shelton explained that implementation typically occurs at the end of the traditional research process after generating the evidence base. That evidence base is frequently developed in academic set
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Shelton said equity-oriented implementation requires paying explicit attention to culture, context, history, values, assets, and the strengths of the community and ensuring those are integrated into the foundation of how research is conducted. She explained equity-oriented implementation requires prioritizing and building an evidence base that explicitly addresses health inequities, promotes equity, and addresses the root and structural causes of those inequities (Baumann and Cabassa, 2020; Baumann and Long, 2021)
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From page 53... ...
She said when building an evidence base, researchers should consider how they adapt programs to address some of the social determinants of health by adjusting where they are delivered, who delivers them, and how they support or enhance issues of health equity. She suggested funding organizations could also prioritize developing and testing dissemination and implementation strategies that build capacity and reach settings and populations equitably.
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She said doing so will require collaborating, investing, and advancing both meaningful community engagement and implementation science. COMMUNITY PARTNERSHIPS IN RESEARCH George Rust is professor of behavioral sciences and social medicine and director of the Florida State University College of Medicine's Center for Medicine and Public Health and medical executive director for the Lyonne County Health Department.
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Rust described Morehouse School of Medicine's Prevention Research Center as an example of an effective approach to building a community partnership. He noted that Morehouse School of Medicine's Prevention Research Center spent a year working with the community, not to develop its principles of community engagement but for the community to develop its principles of university engagement (Box 7-1)
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. DISCUSSION Community Partnerships and Engagement Rivers asked the group to discuss strategies for better understanding and ensuring community responsiveness in implementation and dissemination work.
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Rust replied that power sharing requires restructuring the grant funding process, including the grant review and peer-review processes at the university level. Rust said accountability is imperative for eliminating outcome disparities, and researchers need to have flexibility to engage in rapid cycle change with an affirmative expectation of moving forward.
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From page 58... ...
That definition can then translate into expectations for grant funding, metrics, and prioritizing evidence-based interventions. Gaglioti encouraged the agencies to use their longitudinal funding to support infrastructure for projectagnostic engagement and partnership infrastructure that prioritizes equity in the measurement of comparative effectiveness research, builds researcher capacity around how to partner and engage, and gives time for those relationships to develop.
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