Díaz-Santos Mirella, González David Andrés, Henry Samantha K, Vuong Kevin Dat, Strutt Adriana Macias
Mary S. Easton Center for Alzheimer's Disease Research, UCLA Department of Neurology, Los Angeles, CA 90095, USA.
Center for Cognitive Neuroscience, UCLA Department of Psychiatry & Biobehavioral Sciences, Los Angeles, CA 90095, USA.
Arch Clin Neuropsychol. 2023 Apr 26;38(3):347-364. doi: 10.1093/arclin/acad011.
A brain health equity neuropsychology research framework (NRF) is crucial to the anti-racist movement in cognitive assessments. Universalist interpretation of neuropsychological tools contributes to systemic disparities, and there is a need for a clear conceptual framework for disentangling the direct and indirect impact of social determinants of health (SDH) on brain-behavior relationships and neuropsychological performance. The aim of this paper is to present a NRF anchored in the principles of brain health and health equity that is inclusive, and can be implemented across racially and ethnically diverse communities.
The Re-engaging Individuals and societies for Structural Evolution (RISE) NRF aims to address this via a two-pronged approach: 1. Focusing on community engagement and recruitment and retention of individuals and societies typically not equitably represented in brain health studies, and 2. Integrating the conceptual structure of individual, community, and SDH, while considering the broader historical and current structures that differentially shape these.
The proposed RISE NRF is dynamic and multidirectional. It identifies barriers and proposes strategies to engage communities and diversify recruitment. It identifies evidence-based guidance on non-cognitive determinants of health to include, consider or explore in brain health research.
The RISE NRF can guide the development of culturally and linguistically responsive methodologies and assist with clearly conceptualized and contextualized interpretation of neuropsychological tools to foment a transformative science that benefits the brain health of marginalized communities.
脑健康公平神经心理学研究框架（NRF）对于认知评估中的反种族主义运动至关重要。对神经心理学工具的普遍主义解释导致了系统性差异，因此需要一个清晰的概念框架来厘清健康的社会决定因素（SDH）对脑-行为关系和神经心理学表现的直接和间接影响。本文的目的是提出一个基于脑健康和健康公平原则的包容性NRF，该框架可在不同种族和族裔的社区中实施。
“重新参与个体和社会以实现结构演变”（RISE）NRF旨在通过双管齐下的方法来解决这一问题：1. 专注于社区参与以及招募和留住那些在脑健康研究中通常未得到公平代表的个体和社会群体；2. 整合个体、社区和SDH的概念结构，同时考虑到对这些结构产生不同影响的更广泛的历史和当前结构。
拟议的RISE NRF是动态且多方向的。它识别出障碍，并提出吸引社区参与和使招募多样化的策略。它确定了在脑健康研究中纳入、考虑或探索健康的非认知决定因素的循证指南。
RISE NRF可以指导文化和语言适应性方法的开发，并有助于对神经心理学工具进行清晰的概念化和情境化解释，以推动一门造福边缘化社区脑健康的变革性科学。
