142nd APHA Annual Meeting and Exposition

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Healthcare Equity Training: An anti-racism tool for enhancing accountability for cancer care equity

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 11:10 AM - 11:30 AM

Eugenia Eng, MPH, DrPH , Department of Health Behavior, University of North Carolina, Chapel Hill, NC
Deena Hayes-Green , Racial Equity Institute, Greensboro, NC
Kristin Z. Black, MPH , Gillings School of Global Public Health / Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
Brian Cass , University of North Carolina, Cecil G. Sheps Center, Chapel Hill, NC
Samuel Cykert, MD , Division of General Medicine and Clinical Epidemiology and NC Area Health Education Centers Program, University of North Carolina Chapel Hill, Chapel Hill, NC
Karen Foley, RN , University of Pittsburgh Medical Center, Pittsburgh, PA
Ziya Gizlice, PhD , Center for Health Promotion and Disease Prevention, University of North Carolina Chapel Hill, Chapel Hill, NC
Christina Hardy, MPH , Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
Skip Hislop , Cone Health Regional Cancer Center, Greensboro, NC
Janet Yewon
Nora Jones, MEd , 501(C)3 agency which sponsors anti-racism workshops, The Partnership Project, Greensboro, NC
Alexandra Lightfoot, EdD , Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, Chapel Hill, NC
Jeannette McCall , Sisters Network, Greensboro, NC
Sheri Mouw, MD , Gillings School of Global Public Health, Department of Health Behavior, Chapel Hill, NC
Linda Barry Robertson, DrPH, RN, MSN , Dept of Medicine/Hem Onc, University of Pittsburgh, Pittsburgh, PA
Jennifer Schaal, MD , The Partnership Project, Greensboro, NC
Amondre Smith, BA , Department of Public Health Education, North Carolina Central University, Duham, NC
Youland Williams, RN, MSN, NEA-BC , Cone Health Cancer Center, Greensboro, NC
Background: Despite federal guidelines for training providers in Cultural Competent Care, African American cancer patients continue to experience worse outcomes.  Persistent inequity after cancer diagnosis demands a diligent and bold response to address implicit bias embedded within healthcare systems. We will describe and discuss the HealthCare Equity Training (HET), being tested by a CBPR partnership, as part of an NCI-funded systems change intervention trial to increase racial equity in quality and completion of treatment for early stage breast and lung cancer patients at two cancer centers. 

Methods: HET is a 2-year process informed by an anti-racism framework and methods, beginning with a 2-hour workshop, followed by quarterly booster sessions. Facilitators engage care providers and staff in: (a) adopting a common vocabulary and understanding of racial equity, both in their organization and communities; (b) recognizing multiple levels of structural racism; (c) analyzing “pressure point encounters” during treatment that undermine quality and completion of cancer care; and (d) reviewing race-specific EHR data regarding standards of care.

Results: Process evaluation findings are showing participants changing their thinking about their clinical/professional care, the power associated with their role and responsibilities, and how specific procedures and protocol systems can enhance their interactions with patients and colleagues.

Conclusion: The partnership of 2 cancer centers, an anti-racism training organization, a cancer survivor support group, and 2 universities has been essential for conceptualizing and launching HET.  Wanting to understand and address racial equity, as a team and proactively, is an important incentive for recruiting, scheduling, and sustaining participation.

Learning Areas:

Clinical medicine applied in public health
Diversity and culture
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the differences and similarities between Cultural Competence Training and Healthcare Equity Training, in relation to racial equity issues. Articulate the process in which an anti-racism framework can inform changes to the cancer care system. Identify at least 2 barriers that may interfere with offering and completing Healthcare Equity Training.

Keyword(s): Accountability, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the contact principal investigator for the ACCURE project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4115.0: Mapping the landscape of equity and system change in cancer care: The ACCURE project