Background: The conduct of systematic reviews and other evidence syntheses often involves narrowly focused questions addressing proximal and individual behavioral causes for health outcomes, without considering that distal social determinants of health deeply influence health behaviors and health outcomes. Addressing pervasive racial health inequities, often driven by social determinants and structural racism, requires disrupting research norms by centering marginalized groups. Evidence synthesis guidance does not routinely require incorporating racial health equity across review processes, and a national consensus on how to center racial health equity in evidence syntheses is currently lacking. A key aspect of rethinking methods in the context of racial health equity is revisiting the purpose, nature, and outcomes of engaging stakeholders—including patients, clinicians, community organizations, purchasers, payers, health systems, policy makers, and training institutions—in reviews.
Objectives: (1) To systematically review and characterize current practices in engaging stakeholders in evidence syntheses of interventions to improve racial health equity and (2) to compile and synthesize extant guidance for engaging diverse stakeholders in evidence syntheses.
Methods: We searched MEDLINE and the Cochrane and Campbell Collaboration databases, relevant synthesis and stakeholder organization web sites, and reference lists of salient papers. We included evidence syntheses addressing effects of interventions that aimed to improve racial health equity or methods/guidance documents that addressed approaches for engaging diverse stakeholders in syntheses. Two reviewers independently screened citations. One reviewer will conduct data extraction and quality assessment, with verification by a second reviewer. We will conduct descriptive analysis of key characteristics related to engagement.
Results: Our database and additional searches identified more than 7,500 citations. Screening and extraction are ongoing, but preliminary signals suggest that few reviews of racial health equity interventions explicitly report involving stakeholders. Guidance relevant to stakeholder engagement typically does not directly address engaging racially or ethnically diverse stakeholders but does speak to general equity and ethics considerations.
Conclusions: This review of stakeholder engagement specific to racial health equity, part of a larger Robert Wood Johnson Foundation-funded project, will help advance our understanding of current and needed guidance for involving racially/ethnically diverse stakeholders. Patient, public, and/or healthcare consumer involvement: Protocol review by technical experts.