Background: Despite growth in racial and ethnic diversity of children in the U.S., the pediatric research workforce has diversified little.
Objectives: To determine trends in racial and ethnic representation, identify barriers and facilitators to diversity, and assess strategies to advance diversity in the pediatric research workforce in the U.S.
Methods: We conducted a scoping review of PubMed to identify eligible papers published from January 1, 2010, to December 31, 2021. We supplemented electronic searches with searches of authors’ personal libraries. To be eligible, papers had to provide original research, be published in English, be from the U.S., and report on outcomes relevant to the workforce. Full texts of all abstracts were reviewed for eligibility by two authors and disagreement was resolved through consensus. Information from eligible papers on racial/ethnic representation, barriers and facilitators, and diversity strategies was abstracted onto standardized abstraction forms.
Results: Of 266 potentially eligible papers identified by the search, 46 eligible papers were included and abstracted (Figure). Ten papers reported that the diversity of U.S. pediatric faculty increased modestly over the past decade (Table 1), but 3 papers reported that this reflected a worsening representation compared to the overall U.S. population trends (Table 2). Five papers reported on loss of diverse trainees which has been referred to as the “leaky pipeline”. Ten papers reported a variety of intrapersonal, interpersonal, and institutional barriers for minority faculty success (Table 3). Fifteen papers reported effective strategies to plug the “leaky pipeline” including investment in pipeline programs, implementation of holistic review and implicit bias training, development of mentoring and faculty programs targeted to diverse faculty and trainees, alleviation of burdensome administrative tasks, and creation of inclusive institutional environments (Table 4).
Conclusions: Modest improvements in the racial/ethnic diversity of the pediatric research workforce in the U.S. reflects worsening overall representation given changing population demographics. This has important implications for research prioritization and generating evidence to reduce health inequities. Effective strategies identified in this review should be considered for widespread implementation, but efforts need to be sustained given modest results shown with some strategies.
Patient, public and/or healthcare consumer involvement: Pediatric Trainee

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