Characteristics of interventions that address racism in the United States and opportunities to integrate equity principles: a scoping review.

IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Systematic Reviews Pub Date : 2024-10-23 DOI:10.1186/s13643-024-02679-x
Brooke DiPetrillo, Paris B Adkins-Jackson, Ruqaiijah Yearby, Crystal Dixon, Terri D Pigott, Ryan J Petteway, Ana LaBoy, Aliza Petiwala, Margaret Leonard
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Abstract

Background: As a driver of racial and health inequities, racism is deeply ingrained in the interconnected systems that affect health and well-being. Currently, no common frame is employed across researchers, interventionists, and funders to design, implement, and evaluate comprehensive interventions to address racism. Consequently, there is a need to examine the characteristics of interventions implemented in the United States that address racism across social and structural determinants of health and socio-ecological levels. Additionally, we utilized a Health Equity Action Research (HEART) framework to assess how interventions integrate equity principles.

Methods: This scoping review examined the characteristics of multi-level interventions that addressed racism and appraised the interventions using a Health Equity Action Research frame. A comprehensive search strategy was conducted across nine electronic databases between 24 October 2022 through 15 November 2022. Records were included if they were available in English, discussed or evaluated a multi-level intervention or program conducted in the United States, and discussed or evaluated the intervention or program regarding the health and well-being of racialized and ethnically minoritized groups.

Results: A total of 13,391 records were identified, of which 91 met the eligibility criteria and were included in the analysis. Most records reported the racialized group impacted by an intervention, of which the majority were racialized as African American or Black (n = 42) and Hispanic or Latino/a/x (n = 18). Eighty-one (89%) of interventions reported health outcomes and concentrated on the individual level. Most funders reported across the records, and 86 (51%) were a federal agency or department. A further 43 (25%) were private foundations, 12 (7%) were nonprofit organizations, 10 (6%) were private universities, and 4 (2%) were public universities. Regarding alignment with the HEART framework, 14% of interventions reported a mixed-methods approach, 45% reported community engagement, and less than 1% reported researcher self-reflection.

Conclusions: Most interventions prioritized people who are racialized as Black and report health outcomes. Since intervention designs, objectives, and methodological approaches vary, no standard frame defines racism and health equity. Applying the HEART framework offers a standard approach for interventionists and researchers to examine power, integrate community voice, and self-reflect to advance health equity.

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美国解决种族主义问题的干预措施的特点以及纳入公平原则的机会:范围审查。
背景:作为种族和健康不平等的驱动因素,种族主义在影响健康和福祉的相互关联的系统中根深蒂固。目前,研究人员、干预者和资助者在设计、实施和评估应对种族主义的综合干预措施时没有采用共同的框架。因此,我们有必要研究在美国实施的干预措施的特点,这些干预措施涉及健康的社会和结构性决定因素以及社会生态层面,旨在解决种族主义问题。此外,我们还利用健康公平行动研究(HEART)框架来评估干预措施如何整合公平原则:本范围界定综述研究了针对种族主义的多层次干预措施的特点,并利用健康公平行动研究框架对干预措施进行了评估。在 2022 年 10 月 24 日至 2022 年 11 月 15 日期间,对九个电子数据库进行了全面检索。只要记录是英文的,讨论或评估了在美国进行的多层次干预或计划,并讨论或评估了有关种族化和少数族裔群体的健康和福祉的干预或计划,就会被收录:共找到 13,391 条记录,其中 91 条符合资格标准并纳入分析。大多数记录报告了受干预措施影响的种族化群体,其中大多数种族化群体为非洲裔美国人或黑人(n = 42)和西班牙裔或拉丁裔/a/x(n = 18)。81项(89%)干预措施报告了健康结果,并集中在个人层面。大多数资助者的报告都是跨记录的,其中 86 个(51%)是联邦机构或部门。另有 43 个(25%)是私人基金会,12 个(7%)是非营利组织,10 个(6%)是私立大学,4 个(2%)是公立大学。关于与 HEART 框架的一致性,14% 的干预措施报告了混合方法,45% 报告了社区参与,不到 1%报告了研究人员的自我反思:结论:大多数干预措施都优先考虑被种族化为黑人并报告健康结果的人。由于干预措施的设计、目标和方法各不相同,因此没有一个标准框架来定义种族主义和健康公平。应用 HEART 框架为干预者和研究人员提供了一种标准方法,以检查权力、整合社区声音并进行自我反思,从而促进健康公平。
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来源期刊
Systematic Reviews
Systematic Reviews Medicine-Medicine (miscellaneous)
CiteScore
8.30
自引率
0.00%
发文量
241
审稿时长
11 weeks
期刊介绍: Systematic Reviews encompasses all aspects of the design, conduct and reporting of systematic reviews. The journal publishes high quality systematic review products including systematic review protocols, systematic reviews related to a very broad definition of health, rapid reviews, updates of already completed systematic reviews, and methods research related to the science of systematic reviews, such as decision modelling. At this time Systematic Reviews does not accept reviews of in vitro studies. The journal also aims to ensure that the results of all well-conducted systematic reviews are published, regardless of their outcome.
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