Suchergebnisse

BACKGROUND: Healthcare quality measurements in the United States illustrate disparities by racial/ethnic group, socio-economic class, and geographic location. Redressing healthcare inequities, including measurement of and reimbursement for healthcare quality, requires partnering with communities historically excluded from decision-making. Quality healthcare is measured according to insurers, professional organizations and government agencies, with little input from diverse communities. This community-based participatory research study aimed to amplify the voices of community leaders from seven diverse urban communities in Minneapolis-Saint Paul Minnesota, view quality healthcare and financial reimbursement based on quality metric scores. METHODS: A Community Engagement Team consisting of one community member from each of seven urban communities —Black/African American, Lesbian-Gay-Bisexual-Transgender-Queer-Two Spirit, Hmong, Latino/a/x, Native American, Somali, and White—and two community-based researchers conducted listening sessions with 20 community leaders about quality primary healthcare. Transcripts were inductively analyzed and major themes were identified. RESULTS: Listening sessions produced three major themes, with recommended actions for primary care clinics. #1: Quality Clinics Utilize Structures and Processes that Support Healthcare Equity. #2: Quality Clinics Offer Effective Relationships, Education, and Health Promotion. #3: Funding Based on Current Quality Measures Perpetuates Health Inequities. CONCLUSION: Community leaders identified ideal characteristics of quality primary healthcare, most of which are not currently measured. They expressed concern that linking clinic payment with quality metrics without considering social and structural determinants of health perpetuates social injustice in healthcare.

<p class="Pa6"><strong>Background: </strong>To fight racism and its poten­tial influence on health, health care profes­sionals must recognize, name, understand and talk about racism. These conversations are difficult, particularly when stakes feel high—in the workplace and in interracial groups. We convened a multidisciplinary, multi-racial group of professionals in two phases of this exploratory project to develop and pilot an intervention to promote effec­tive dialogues on racism for first year medi­cal students at the University of Minnesota Medical School.</p><p class="Default"><strong>Methods: </strong>Informed by a Public Health Crit­ical Race Praxis (PHCRP) methodology in Phase I, initial content was developed by a group of seven women primarily from racial and ethnic minority groups. In a later phase, they joined with five White (primarily male) colleagues to discuss racism and race. Participants met monthly for 12 months from Jan 2016-Dec 2016. All participants were recruited by study PI. An inductive approach was used to analyze meeting notes and post intervention reflections to describe lessons learned from the process of employing a PHCRP methodology to de­velop the aforementioned curriculum with a multidisciplinary and multi-racial group of professionals dedicated to advancing conversations on racial equity.</p><p class="Pa6"><strong>Results: </strong>Participants from Phase I described the early meetings as "powerful," allowing them to "bring their full selves" to a project that convened individuals who are often marginalized in their professional environ­ments. In Phase II, which included White colleagues, the dynamics shifted: "…the voices from Phase I became quieter…"; "I had to put on my armor and fight in those later meetings…"</p><p class="Default"><strong>Conclusions: </strong>The process of employing PHCRP in the development of an interven­tion about racism led to new insights on what it means to discuss racism among those marginalized and those with privilege. Conversations in each phase yielded new insights and strategies to advance a conver­sation about racism in health care. <em></em></p><p class="Default"><em>Ethn Dis. </em>2018;28(Suppl 1):271-278; doi:10.18865/ed.28.S1.271.</p>