A Roadmap and Best Practices for Organizations to Reduce Racial and Ethnic Disparities in Health Care

Robert Wood Johnson Foundation Finding Answers: Disparities Research for Change National Program Office, University of Chicago, Chicago, IL, USA.
Journal of General Internal Medicine (Impact Factor: 3.42). 08/2012; 27(8):992-1000. DOI: 10.1007/s11606-012-2082-9
Source: PubMed


Over the past decade, researchers have shifted their focus from documenting health care disparities to identifying solutions to close the gap in care. Finding Answers: Disparities Research for Change, a national program of the Robert Wood Johnson Foundation, is charged with identifying promising interventions to reduce disparities. Based on our work conducting systematic reviews of the literature, evaluating promising practices, and providing technical assistance to health care organizations, we present a roadmap for reducing racial and ethnic disparities in care. The roadmap outlines a dynamic process in which individual interventions are just one part. It highlights that organizations and providers need to take responsibility for reducing disparities, establish a general infrastructure and culture to improve quality, and integrate targeted disparities interventions into quality improvement efforts. Additionally, we summarize the major lessons learned through the Finding Answers program. We share best practices for implementing disparities interventions and synthesize cross-cutting themes from 12 systematic reviews of the literature. Our research shows that promising interventions frequently are culturally tailored to meet patients' needs, employ multidisciplinary teams of care providers, and target multiple leverage points along a patient's pathway of care. Health education that uses interactive techniques to deliver skills training appears to be more effective than traditional didactic approaches. Furthermore, patient navigation and engaging family and community members in the health care process may improve outcomes for minority patients. We anticipate that the roadmap and best practices will be useful for organizations, policymakers, and researchers striving to provide high-quality equitable care.

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    • "We identified whole-of-population approaches and community engagement approaches, including community health centres and the WHO Health Promoting Hospitals initiative. A review of 12 systematic reviews of best practice to reduce racial and ethnic healthcare inequities found that promising interventions included addressing health system culture and quality of care (Chin et al., 2012). In Australia, Aboriginal Community Controlled Health Organizations are a practical expression of selfdetermination in Indigenous health policy and service delivery and have proven effective (Freeman et al., 2011; Russell, 2013). "
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    • "Healthcare clinics, universities, and community organizations, both non-and for-profit, all have important roles to play in addressing disparities in diabetes. Collaborative, multifactorial approaches may be essential to promoting the health of underserved communities and reducing disparities in diabetes outcomes (Chin et al., 2012). "
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