By Nikki Weinstein, Evaluation Specialist IV
Systemic injustices occur across areas that are necessary for communities to thrive, and manifest through disparities in health, housing, employment, and education. Behavioral and health research has a fraught history when it comes to inclusion and racism, which is why it is important to integrate an equity lens into our research initiatives. Working through an equity lens starts with project design and implementation, and includes how we think about leadership, community engagement, and communication in every step of a project and every aspect of the organization. Four important areas in research practice to consider are:
- Decision-making
- Community engagement
- Design and data collection
- Communication
One pillar of equity work is recognizing who is at the decision-making table and whose voices are being heard. It is important to recognize this from the top down, through the diversity of senior managers and leaders, and from the bottom up by empowering staff at all levels to make meaningful contributions to the work and organization. Organizations can also seek out input from internal and external stakeholders to expand the perspectives providing input into decisions – an especially important step for organizations without diverse leadership.
Whenever possible, strive to engage communities that will be affected. Often this means convening and facilitating advisory boards to provide input on project design and implementation. In our COVID-19 vaccine work, for example, we recruited and trained champions to serve as community ambassadors to encourage more people to get vaccinated. It is important to ensure these ambassadors are representative of their diverse communities to maximize their potential positive impact. Sometimes it is necessary to look beyond traditional civic leaders and subject matter experts to leverage the influence of trusted members within communities of interest. Engaging communities may also mean piloting data collection instruments to ensure they are understood and meaningful to the intended audience and disseminating research findings so communities can use the data to create the desired change.
How research projects are designed and how qualitative and quantitative data are collected and analyzed matters. Method and measurement bias should be considered in research design and reflected in the data collection tools. For example, when designing a diabetes health intervention study, researchers at Karna made sure to look at social determinants of health and demographic information of potential research sites to ensure diverse representation in terms of geography (urban/rural/suburban), socio-economic status, types of health insurance coverage, and immigrant status were all included.
Language used in surveys is an important reflection of respect for the populations being surveyed as well. Cognitive pre-testing of data collection instruments with the populations of interest ensures they will be interpreted as intended.
By disaggregating quantitative data for analysis, it is possible to examine important variables to identify differences between and within racial and ethnic groups and to look at confounding variables that may explain findings. In qualitative research, focus groups can be segmented by factors such as race, ethnicity, and gender to make sure that when analyzing themes, differences between groups can be noticed. These methods allow us to use data to create positive behavioral change.
When developing communication materials using a research-based approach, it is important to consider factors that affect how information is interpreted and understood. We know that factors including race and culture affect how messaging is interpreted. Researchers can use message testing to gather data from diverse groups to determine what motivates behavior change. These results influence the choice of messages, language, and images used in communication campaigns for various audiences. Another consideration is ensuring message comprehension, as not all people have the same literacy level. Using research and plain-language methods to tailor communication information and approaches for the intended audience helps address potential literacy concerns. For example, at Karna, we created an information sheet about protecting children and teens from COVID-19 as part of a suite of materials designed for people who read or listen at or below a third-grade level.
Karna strives to take equity into consideration across our research portfolio, with the goal of helping our clients understand how equity influences research results, and how those results can be put into practice to help level the playing field while promoting positive public and behavioral health outcomes across diverse populations.