Online Program

Healthcare Equity Education Training: Informing diversity and inclusion policy at cancer centers

Wednesday, November 4, 2015

Eugenia Eng, MPH, DrPH, Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina at 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
Barbara Akins, BSN, MS, Behavioral Health, Cone Health System, 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
Carol Cothern, BS, Greensboro Health Disparities Collaborative, The Partnership Project, Greensboro, 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
Steven Evans, MD, Pittsburgh Surgical Specialists, Inc, University of Pittsburgh
Karen Foley, RN, University of Pittsburgh Medical Center, Pittsburgh, PA
Deena Hayes-Greene, Racial Equity Institute, Greensboro, NC
Dwight Heron, MD, FACRO, FACR, University of Pittsburgh/ UPMC CancerCenter
Skip Hislop, Cone Health, NC
Nora Jones, MEd, 501(C)3 agency which sponsors anti-racism workshops, The Partnership Project, Greensboro, NC
Kalsoom Khan, MD, Cancer Center, Cone Health System, Greensboro, NC
Alexandra Lightfoot, EdD, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, Chapel Hill, NC
Lilli Mann, MPH, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
Matthew Manning, MD, Cancer Center, Cone Health System, Greensboro, NC
Lyn B. Robertson, DrPH, RN, MSN, School of Medicine, University of Pittsburgh, Pittsburgh, PA
Jennifer Schaal, MD, The Partnership Project, Greensboro, NC
Beth Smith, RN, MSN, NE-BC, Cone Health Systems Regional Cancer Center

Background: Institutions with diversity and inclusion policies that focus solely on individuals’ personal bias risk becoming myopic. Persistent inequity in cancer treatment outcomes demands that institutions establish policies to prevent implicit biases from seeping into decision-making. Healthcare Equity Education Training (HEET) for providers and staff at two cancer centers is 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.

Methods: HEET is a 3-year process informed by an anti-racism framework that is a 2-hour workshop, followed by quarterly sessions. Tailored by each center’s HEET planning committee, facilitators engaged providers and staff in: (a) adopting a common vocabulary and insights on implicit bias as preconditions for structural change; (b) reviewing EHR data regarding treatment outcomes by race; and (c) recognizing levels of structural racism, both in their organization and communities, which can undermine quality and completion of cancer care.

Results: Process evaluation findings revealed that engaging each medical center’s Diversity Officer, council or committee: (a) increased participation from non-cancer specialties, (b) changed participants’ mindset about how implicit bias is associated with their role and responsibilities, and (c) generated new protocols to enhance accountability for racial equity in cancer care coordination.

Conclusion: The role of a medical center’s Diversity and Inclusion structure is essential for a CBPR partnership to look beyond implicit bias and address where in an institution’s operations accountability for equity can come into play. 

Learning Areas:

Chronic disease management and prevention
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 traditional Cultural Competence Training and Healthcare Equity Education Training, in relation to implicit bias. Identify at least 2 barriers within a cancer center that may interfere with offering and completing Healthcare Equity Education Training. Articulate the process in which an anti-racism framework can inform changes to an institution’s policies for diversity and inclusion.

Keyword(s): Health Systems Transformation, Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am Co-Principle Investigator for the ACCURE study.
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.