Advancing racial equity in social care research and implementation: Lessons learned from research and community leaders

Advancing racial equity in social care research and implementation: Lessons learned from research and community leaders [PDF]

Speakers: Félice Lê-Scherban, Richard Dollery, Christina Brown, Kelley Traister, Hyden Terrell, Rita Nelson. All speakers are affiliated with Drexel University Dornsife School of Public Health and Drexel Urban Health Collaborative.

Description:

This session was comprised of three complementary presentations followed by a facilitated small-group discussion. The first presentation shared results of a quantitative analysis of associations between maternal lifetime experiences of racial discrimination (EOD) and current household material hardships (difficulties affording food, housing, utilities, and health care) among families with young children. Analyses use survey data collected by Children’s HealthWatch (ChCHW), a network of pediatricians and public health researchers that has been conducting research since 1998 to inform policy decisions to alleviate hardships and improve equity for families with young children. ChCHW surveys caregivers of young children aged younger than 4 presenting at emergency departments or primary care clinics in safety-net hospital settings in 4 US cities (Boston, Little Rock, Minneapolis, Philadelphia). The data uses validated scales and published screening questions for EOD and household hardships (housing instability, energy insecurity, and healthcare hardships) as well as a combined measure of being hardship-free, defined as reporting none of the household hardships. Covariate-adjusted logistic regression evaluated associations of maternal EOD frequency and each individual hardship as well as hardship-free status. Frequency of maternal lifetime EOD was associated with lower odds of being hardship-free in a dose-response manner. Healthcare provider education on trauma is important in order to be cognizant of and sensitive about the interplay of lived experience and basic needs access for providing trauma-informed patient care and social needs interventions. The other two presentations featured members of the Data & Research Core of the West Philly Promise Neighborhood (WPPN), a US Department of Education-funded place-based initiative to support 'cradle-to-career' opportunities for children living or going to school in a defined 2-square-mile area of West Philadelphia. Drexel University serves as the lead agency with over twenty community, governmental, and service-provision partner organizations. WPPN aims to improve education, health and economic successes for children, their families, and communities. The WPPN Data & Research Core leads research and evaluation activities to support the delivery and measure the impacts of WPPN. The first presentation described WPPN’s community-engaged research activities, including a longitudinal population-based survey of caregivers administered by research-trained community resident surveyors. The presentation also described integration of this research with development of a place-based community health worker model to connect families to multiple systems of support. Originally funded 2017-2021, WPPN is currently in a no-cost-extension period during which Data & Research Core activities focus on data communication, dissemination, and capacity-building. Much of this work is led by WPPN Data Leads, who are former WPPN community surveyors who have transitioned into new positions spearheading community data communication, dissemination, and capacity-building activities. In the second WPPN presentation, Data Leads shared their experiences in community-engaged data collection and research in a community that has experienced substantial racial trauma and economic disinvestment. Participants were then divided into small groups in break-out rooms, each facilitated by a Data Lead, to discuss approaches to addressing racism and advancing racial equity in a hypothetical case study of a social care research project to be conducted in a health care setting. The full group re-convened for a brief sharing-out session. These data and examples provided attendees with deeper understanding of the ways racism and discrimination must be deliberately addressed in social care research and programs, and approaches to foster equal research partnerships with community members.

Learning Objectives

1. Describe relationships between interpersonal and structural racism and family access to basic needs and implications for clinical care and social care programs
2. Define key elements of community-engaged research partnerships and how they advance racial health equity
3. Apply concepts from presented research and community partnerships to designing social care research and programs in health care settings