Background: The CDC’s COVID-19 Disparities grant (OT21-2103), a two-year $2.25 Billion initiative, provided public health agencies an opportunity to address critical capacity issues to advance health inequity. As a non-profit, public health institute tasked with providing technical assistance to 2103 recipients, Health Resources in Action (HRiA) had an insider’s view to the challenges health administrators face in implementing their equity focused goals and objectives. The challenges include formal policy constraints both within and outside agency control and engrained cultural norms and practices. Addressing both, from a full systems-change approach, is needed to build better approaches to health equity work that center community, build trust, and create more effective programs.

Methods: HRiA developed three tools that were piloted with and implemented by health administrators and health department staff representing all regions of the country: Health Equity Readiness Tool; Foundations of Community Engagement Toolkit; Legal Barriers to Equity Workbook. These tools seek to 1. Provide systems-level analysis of existing agency practices related to equity, 2. Build capacity of staff to identify internal policies and cultural norms and formal external laws and regulations that restrict health equity practice, and 3. Identify actions that increase the ability of public health agencies to build more effective relationships with community to implement public health programs that address inequitable health outcomes.

Results: Public health administrators and HRiA collaboratively used these tools in live and asynchronous trainings and 1:1 coaching sessions to diagnose specific needs. Presenters will share examples of how these tools were used and how identified capacity building opportunities are being embedded in workplans and strategies of recipients of the CDCs Public Health Infrastructure Grant.

Conclusion: Systems change approaches that recognize the role of both internal and external factors are necessary to advance the ability of health administrators to effectively implement health equity initiatives.