Massachusetts Department of Public Health, Boston, Massachusetts (Drs Manning, Selk, Stone, Yazdy, and Bharel and Mss Blinn, Silva, and Stetler), and Maternal and Child Health Epidemiology Team, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Manning).
J Public Health Manag Pract. 2022;28(Suppl 1):S58-S65. doi: 10.1097/PHH.0000000000001428.
In 2015, the Massachusetts Department of Public Health (MDPH) adopted a Title V maternal and child health priority to "promote health and racial equity by addressing racial justice and reducing disparities." A survey assessing staff capacity to support this priority identified data collection and use as opportunities for improvement. In response, MDPH initiated a quality improvement project to improve use of data for action to promote racial equity.
MDPH conducted value stream mapping to understand existing processes for using data to inform racial equity work. Key informant interviews and a survey of program directors identified challenges to using data to promote racial equity. MDPH used a cause-and-effect diagram to identify and organize challenges to using data to inform racial equity work and better understand opportunities for improvement and potential solutions.
Key informants highlighted the need to consider structural factors and historical and community contexts when interpreting data. Program directors noted limited staff time, lack of performance metrics, competing priorities, low data quality, and unclear expectations as challenges. To address the identified challenges, the team identified potential solutions and prioritized development and piloting of the MDPH Racial Equity Data Road Map (Road Map).
The Road Map framework provides strategies for data collection and use that support the direction of actionable data-driven resources to racial inequities. The Road Map is a resource to support programs to authentically engage communities; frame data in the broader contexts that impact health; and design solutions that address root causes. With this starting point, public health systems can work toward creating data-driven programs and policies to improve racial equity.
2015 年，马萨诸塞州公共卫生部（MDPH）通过了一项标题 V 母婴健康优先事项，即“通过解决种族正义问题和减少差距，促进健康和种族公平”。一项评估工作人员支持这一优先事项能力的调查发现，数据收集和使用是改进的机会。作为回应，MDPH 启动了一个质量改进项目，以改善数据的使用，以促进种族公平。
MDPH 进行了价值流映射，以了解用于告知种族公平工作的数据使用现有流程。关键知情人访谈和对项目主管的调查确定了使用数据促进种族公平所面临的挑战。MDPH 使用因果关系图来识别和组织使用数据为告知种族公平工作提供信息以及更好地了解改进机会和潜在解决方案的挑战。
关键知情人强调，在解释数据时，需要考虑结构因素以及历史和社区背景。项目主管指出，工作人员时间有限、缺乏绩效指标、优先事项相互竞争、数据质量低以及期望不明确是挑战。为了解决确定的挑战，团队确定了潜在的解决方案，并优先制定和试行 MDPH 种族平等数据路线图（路线图）。
路线图框架提供了数据收集和使用的策略，这些策略支持以行动为导向的数据驱动资源来解决种族不平等问题。路线图是支持计划的资源，以真实地吸引社区；在影响健康的更广泛背景下构建数据；并设计解决根本原因的解决方案。有了这个起点，公共卫生系统可以努力创建数据驱动的计划和政策，以改善种族公平。
