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. 2021 Dec 14:9:664709.
doi: 10.3389/fpubh.2021.664709. eCollection 2021.

Expanding the Reach of an Evidence-Based, System-Level, Racial Equity Intervention: Translating ACCURE to the Maternal Healthcare and Education Systems

Stephanie L Baker  1   2 , Kristin Z Black  1   3 , Crystal E Dixon  1   4 , Christina M Yongue  1   4 , Hailey Nicole Mason  5 , Patrick McCarter  1   6 , Matthew Manning  1   6 , Joanne Hessmiller  1   7 , Ida Griesemer  1   5 , Aditi Garikipati  1   8 , Eugenia Eng  1   5 , Daniel Kelvin Bullock  9 , Claire Bosire  1   5 , Kimberly M Alexander  1   10 , Alexandra F Lightfoot  1   5   11
Affiliations

Expanding the Reach of an Evidence-Based, System-Level, Racial Equity Intervention: Translating ACCURE to the Maternal Healthcare and Education Systems

Stephanie L Baker et al. Front Public Health. .

Abstract

The abundance of literature documenting the impact of racism on health disparities requires additional theoretical, statistical, and conceptual contributions to illustrate how anti-racist interventions can be an important strategy to reduce racial inequities and improve population health. Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) was an NIH-funded intervention that utilized an antiracism lens and community-based participatory research (CBPR) approaches to address Black-White disparities in cancer treatment completion. ACCURE emphasized change at the institutional level of healthcare systems through two primary principles of antiracism organizing: transparency and accountability. ACCURE was successful in eliminating the treatment completion disparity and improved completion rates for breast and lung cancer for all participants in the study. The structural nature of the ACCURE intervention creates an opportunity for applications in other health outcomes, as well as within educational institutions that represent social determinants of health. We are focusing on the maternal healthcare and K-12 education systems in particular because of the dire racial inequities faced by pregnant people and school-aged children. In this article, we hypothesize cross-systems translation of a system-level intervention exploring how key characteristics of ACCURE can be implemented in different institutions. Using core elements of ACCURE (i.e., community partners, milestone tracker, navigator, champion, and racial equity training), we present a framework that extends ACCURE's approach to the maternal healthcare and K-12 school systems. This framework provides practical, evidence-based antiracism strategies that can be applied and evaluated in other systems to address widespread structural inequities.

Keywords: community-based participatory research (CBPR); evidence base; health disparities; intervention translation; racial equity; racism and antiracism; systems change in health care.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
ACCURE component: from real-world data to enhanced transparency and accountability.
Figure 2
Figure 2
Core components of ACCURE and representative examples in the maternal healthcare and education systems.
See this image and copyright information in PMC

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