Saturday, December 21, 2024
12/21/2024
Project Summary/ Abstract Racial and ethnic health inequities persist despite decades of evidence showing how societal structures drove their development. Quality improvement (QI Initiatives, seemingly intended to promote equity, have great potential to exacerbate disparities if there is not intentional focus on benefitting the population(s) experiencing inequity. Attempts at equity-focused QI have underperformed by 1) focusing on improvement for all, rather than on erasing disparities, 2) deploying a top-down stakeholder approach, rather than a community-informed approach, 3) lacking a framework for considering quality measures through the contexts of systemic racism, and 4) prioritizing ease of measurement over measures that are a priority to patients and communities. Recent calls have been made for QI interventions that leverage partnerships between communities experiencing inequities, providers serving these populations, and QI researchers to reduce health care disparities using outcome measures that measure quality in ways meaningful to all stakeholders. Data and technology can be harnessed to improve health equity by stratifying electronic health record (EHR) data by race, ethnicity, and language (REaL) to create equity-focused QI dashboards to identify inequitable patterns in clinical processes and health outcomes and inform QI initiatives to reverse them. However, if dashboard metrics and the interventions to address them are not cooperatively designed by patients and providers, this limits their influence and effectiveness. The study proposed within this K-Award is intended to be a first step in a larger program of research that will serve to bridge health inequities research with medical informatics tools at the intersection of Quality Improvement and Implementation Science, by 1) Identifying healthcare quality measures using a community-informed, equity-focused approach, 2) Incorporate community-informed healthcare quality measures into QI dashboards, and 3) using community-engaged intervention mapping to design strategies to decrease health inequity. Equity-focused dashboards will provide concrete, real-time data to both inform strategies and measure improvement, whether they be advanced structural competency training for providers, changes to clinic policy and workflow, or interventions to address unmet social needs. This career development award is designed to provide critical training in the fundamentals of quality improvement, implementation science, community-engaged intervention design, and medical informatics that are necessary for developing community-informed, practical, and measurable approaches to decrease racial health inequities in primary care populations. This K01 will facilitate the development of patient-informed quality indicators and innovative implementation strategies to improve health equity in primary care. The proposed study is responding to the AHRQ Special Emphasis Notice for Health Services Research to Advance Health Equity (NOT-HS-23-013).
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).