Department of Medicine, Division of Geriatrics, Duke University Medical Center, Durham, NC, USA.
Department of Medicine, Division of Cardiovascular Medicine, Duke University Medical Center, Duke Clinical Research Institute, Durham, NC, USA.
J Natl Med Assoc. 2018 Aug;110(4):305-313. doi: 10.1016/j.jnma.2017.06.005. Epub 2017 Aug 2.
Disparities in health and healthcare are widely documented for underrepresented racial and ethnic populations across a spectrum of diseases and care settings. An evidence base for addressing racial and ethnic disparities in health and healthcare requires investigators trained to conduct health disparities research.
To increase knowledge, stimulate interest, teach skills to evaluate and conduct, and foster collaborations in health disparities research.
We designed, implemented and evaluated a Health Disparities Research Curriculum (HDRC). Participants were early-stage investigators.
HDRC included twelve monthly sessions during 2015-2016. Instructors were mostly HDR investigators. Sessions combined didactic presentations, discussions, small group activities, and participant presentations.
Pre- and post-surveys to assess participants' perceptions of knowledge and skills.
Of 21 enrollees, 13 were from under-represented groups and 14 were women. Four reported some prior training in HDR, and 12 reported currently conducting HDR. Among the 12 participants who completed both the pre and post HDRC survey, initially the most commonly cited barriers to pursuing HDR were lack of knowledge (N = 6) and funding (N = 7). In the post-survey, the number citing lack of knowledge decreased (N = 2) and the number listing lack of funding increased (N = 9). There were increases in the number of participants reporting increased knowledge of HDR methods (pre-post: 4 vs. 8) and competence to design (3 vs. 7) and implement (2 vs. 9) HDR research.
The Duke HDRC augments efforts to reduce health disparities by providing training in HDR for young investigators. Our data indicate that the course was feasible, well-received, and increased perceived knowledge and competence. HDRC and similar courses may increase the quantity, quality and scope of HDR and thus move us closer to health equity.
在各种疾病和医疗环境中,代表性不足的种族和族裔人群的健康和医疗保健存在广泛的差异,这一点已得到广泛记录。解决健康和医疗保健方面的种族和族裔差异需要有专门从事健康差异研究的调查人员来提供证据。
增加知识,激发兴趣,教授评估和开展健康差异研究的技能,并促进健康差异研究方面的合作。
我们设计、实施和评估了健康差异研究课程(HDRC)。参与者是早期阶段的调查人员。
HDRC 包括 2015-2016 年期间的 12 个每月课程。讲师大多是 HDR 调查人员。课程结合了讲座、讨论、小组活动和参与者演讲。
在课前和课后进行调查,以评估参与者对知识和技能的看法。
在 21 名注册者中,有 13 人来自代表性不足的群体,有 14 人是女性。有 4 人报告之前接受过 HDR 方面的一些培训,有 12 人报告目前正在进行 HDR。在 12 名完成 HDRC 课前和课后调查的参与者中,最初最常提到的从事 HDR 的障碍是缺乏知识(N=6)和资金(N=7)。在课后调查中,提到缺乏知识的人数减少(N=2),提到缺乏资金的人数增加(N=9)。报告对 HDR 方法的知识增加(课前-课后:4 对 8)和设计(3 对 7)和实施(2 对 9)HDR 研究的能力增加的参与者人数有所增加。
杜克 HDRC 通过为年轻调查人员提供 HDR 培训,为减少健康差异做出了贡献。我们的数据表明,该课程是可行的,受到了欢迎,并增加了对知识和能力的认识。HDRC 和类似课程可能会增加 HDR 的数量、质量和范围,从而使我们更接近健康公平。