2023 HSR&D/QUERI National Conference

4003 — Practices to Enhance Diversity, Equity, and Inclusion in the Health Services Research Workforce: An Environmental Scan of Academic Institutions

Lead/Presenter: Angela Kyrish,  COIN - Bedford/Boston
All Authors: Kyrish AM (Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System), Egbuogu CB (Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System) Ferris SD (Dana Farber Cancer Institute) Cubanski LQ (Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System) Garvin LA (VA Boston Healthcare System and Boston University School of Public Health) Foster MV (VA Boston Healthcare System & Boston University School of Medicine, Boston, MA) Quach ED (Center for Healthcare Organization and Implementation Research and the New England Geriatric Research, Education and Clinical Center, VA Bedford Healthcare System, Department of Gerontology, University of Massachusetts Boston) Cutrona SL (Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, University of Massachusetts Medical School) McInnes DK (Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System)

Research institutions in academia and government are working to increase diversity among their research faculty, staff, and investigators in an effort to combat the effects of structural racism. Prioritizing a diverse health services research (HSR) workforce is important to adequately address the issues of health equity and disparities. However, data on effective practices to support a diverse HSR workforce is sparse. The objective of our study is to identify, describe, and evaluate practices and initiatives that enhance the hiring, promotion, and retention of employees from underrepresented groups (such as race/ethnicity, gender identity, and disabilities) in the HSR workforce.

We conducted an environmental scan of academic institutions conducting HSR to identify practices that promote a more diverse workforce. We reviewed the websites of the top 10 schools of public health and top 10 research schools of medicine in the U.S. (per U.S. News and World Report, 2021) and documented practices and initiatives implemented to increase the hiring, promotion, and/or retention of employees from underrepresented groups. Information was also documented on outcome measures and indicators of practice effectiveness. We then performed semi-structured interviews with representatives from academic institutions to gather additional information on practices and their effectiveness. A rapid qualitative analysis approach was used to analyze data.

Three central themes emerged from data analysis. First, similar diversity, equity, and inclusion (DEI) practices are being executed across institutions. These included mentoring programs tailored to faculty/staff from underrepresented groups, trainings on the topics of diversity and anti-racism, and revision of guidelines to the hiring and/or promotion process. Second, data from interviews indicated the importance of financial resources and leadership/institutional support in order for practices to be successfully implemented within the institution. Third, outcome measures are in early stages of development and implementation; evaluation results, when available online or through interviews, were largely qualitative or inconclusive. Recently implemented measures include annual documentation of compositional diversity of faculty/staff and surveys to understand the institutional climate as experienced by underrepresented groups. These measures aim to track effectiveness of DEI practices and initiatives and better understand gaps and deficiencies.

Findings indicate that initiatives to improve HSR workforce diversity are universal across top academic institutions, with several specific diversity practices being widely implemented across sites. Financial resources and institutional/leadership support appear to enhance implementation and sustainment of these practices and are important factors to consider when replicating diversity practices at other HSR institutions, including VA HSR centers. However, despite the prevalence of diversity activities at institutions, outcome measures remain at the developmental stage, with few institutions reporting conclusive effectiveness results.

Diversity practices and initiatives have been developed, but guidelines are needed for HSR institutions to report on DEI practices and document effectiveness. This will aid in the replication and spread of practices across the HSR workforce, including other academic institutions as well as VA HSR centers and programs.