School of Health Sciences, Cleveland State University, Cleveland, Ohio (Dr Walsh); Department of Anthropology, University of Connecticut, Storrs, Connecticut (Dr Willen); and Trinity College, Hartford, Connecticut (Dr Williamson).
J Public Health Manag Pract. 2022;28(Suppl 1):S82-S90. doi: 10.1097/PHH.0000000000001171.
Achieving a meaningful reduction in health inequities will require not only policy and programmatic changes but also an increased understanding of structural racism and its deleterious impact on health and well-being. One way to enhance understanding is to actively promote "perspective transformation" (PT) around race among health equity stakeholders. Experiences of PT are defined as moments or events that bring about a deepened understanding of racism and that may result in new ways of thinking and acting.
To identify catalysts and effects of PT among health equity stakeholders.
Semistructured, in-person interviews were conducted with stakeholders (n = 50) as part of a 2-phase, mixed-methods study (n = 170). Interviews were audio-recorded, transcribed, and coded using a mixed-methods software platform.
Health Improvement Partnership-Cuyahoga (HIP-Cuyahoga), a regional health and equity initiative in Greater Cleveland, Ohio.
A purposive sample of participants in HIP-Cuyahoga spanning 5 groups: metro-wide decision makers, public health professionals, clinicians, community leaders, and community members.
More than two-thirds of interviewees reported at least one discrete experience that catalyzed PT, as defined earlier. Three catalysts were especially common: witnessing, learning, and personally experiencing racism. A fourth, less common catalyst involved getting uncomfortable during discussions of race and racism. Experiences of PT resulted in common effects including acquiring new terms, concepts, and frameworks; carrying the conversation forward; finding fellow travelers; and feeling energized and motivated to confront structural racism and its consequences. People of color tended to experience PT, and its catalysts and effects, differently than White interviewees.
Many health equity stakeholders have experienced PT around racism and its impact. Experiencing PT is associated with new skills, capacities, and motivations to confront racism and its impact on health and well-being. Understanding how different groups experience PT can help advance efforts to promote health equity.
要想大幅减少健康不公平现象，不仅需要改变政策和项目，还需要深入理解结构性种族主义及其对健康和福祉的有害影响。增强理解的一种方法是在健康公平利益攸关方中积极推动对种族问题的“视角转换”（PT）。PT 体验是指加深对种族主义的理解，并可能导致新的思维和行动方式的时刻或事件。
确定健康公平利益攸关方中 PT 的催化剂和效果。
作为两阶段混合方法研究（n=170）的一部分，对利益攸关方（n=50）进行了半结构化的现场访谈。访谈使用混合方法软件平台进行录音、转录和编码。
俄亥俄州克利夫兰大都市区的区域健康和公平倡议——健康改进伙伴关系-凯霍加（HIP-Cuyahoga）。
HIP-Cuyahoga 参与者的目的抽样，涵盖 5 个群体：全市范围的决策者、公共卫生专业人员、临床医生、社区领袖和社区成员。
超过三分之二的受访者报告了至少一次以前定义的推动 PT 的离散体验。三个催化剂特别常见：目睹、学习和亲身经历种族主义。第四个不太常见的催化剂涉及在讨论种族和种族主义时感到不舒服。PT 体验导致了常见的效果，包括获得新的术语、概念和框架；推动对话；寻找志同道合的人；并感到有活力和动力去对抗结构性种族主义及其后果。与白人受访者相比，有色人种更倾向于体验 PT 及其催化剂和效果。
许多健康公平利益攸关方已经体验过种族主义及其影响方面的 PT。体验 PT 与对抗种族主义及其对健康和福祉的影响的新技能、能力和动力相关。了解不同群体如何体验 PT 可以帮助推进促进健康公平的工作。
