Implications of centering racial health equity in systematic reviews: results of qualitative interviews with stakeholders
ANA BEATRIZ PIZARRO, COCHRANE
Janelle Armstrong-Brown, RTI International
Tiffany Duque, Cochrane
Nila Sathe, RTI International
2RTI International, USA
3Clinical Research Center, Fundación Valle del Lili, Colombia
Background: Evidence synthesis guidance does not routinely require incorporating racial health equity across synthesis processes, and a national consensus on how to center racial health equity in evidence syntheses is currently lacking. Diverse stakeholder voices—from patients, clinicians, community organizations, researchers including systematic reviewers, purchasers, payers, research funders, health systems, policymakers, and training institutions—can inform new guidance on the processes, methods, analyses, and dissemination of systematic reviews that center racial health equity.
Objectives: To obtain diverse stakeholder perspectives on (1) definitions of racial health equity; (2) optimal scope, team composition, methods, interventions, dissemination, and translation approaches that facilitate centering racial health equity in systematic reviews; and (3) measures of success and priority areas for centering racial health equity in systematic reviews.
Methods: We will conduct 25 to 35 one-on-one interviews with stakeholders representing varied perspectives. We will use both deductive and inductive approaches to qualitative analysis linking codes to our research questions and formulating cross-cutting themes across multiple interviews and stakeholder groups.
Results: Preliminary results point to key nuances in how racial health equity is defined. Stakeholders support centering racial health equity in systematic reviews, particularly when wide racial disparities are documented. While reviews should continue to focus on effectiveness of interventions, stakeholders also point to the importance of systematically assessing the context and implications of disparities in etiology, access to care, and uptake of interventions. Stakeholders suggest broadening evidence inclusion to qualitative data to have a mixed synthesis review process that provides additional context to racial health inequities. Stakeholders also suggested expanding systematic review methodology to require analytic frameworks to frame questions in ways that consider racial and ethnic centricity. In terms of stakeholder involvement, stakeholders emphasized including those with lived experience in review teams from the beginning of a review and compensating them for their contributions.
Conclusions: This qualitative exploration of stakeholder perspectives, funded by the Robert Wood Johnson Foundation, will help contextualize our understanding of current practices, gaps in methodological guidance, and future research directions for centering racial health equity.
Patient, public and/or healthcare consumer involvement: Included among interviewed stakeholders.