ASTARISQ: Addressing systemic and STructurAl Racism to Improve Safety, Quality, and trustworthiness in health delivery systems

PROJECT SUMMARY Our proposal requests support for a series of conference roundtables over a three-year project period to Address systemic and STructurAl Racism to Improve Safety, Quality (ASTARISQ) in Health Delivery Systems (HDS) to support Research Training, Infrastructure and Career Development in response to PA-22-238. ASTARISQ will be convened each year in an innovative, collaborative, and structured approach to achieve three aims: (1) Identify, prioritize, and co-design with impacted community members trainings on anti-racist strategies, policies, and practices to address structural racism in HDS to improve patient safety, quality of care, and trustworthiness in HDS; (2) Convene an interactive series of roundtables to train and prepare diverse stakeholder groups to address structural racism in HDS and health services research (HSR); and (3) Produce and disseminate guidance documents to equip participants and broader audiences with resources and skills in evidence-based, anti-racism-informed strategies to strengthen anti-racist policies and practices. We co-developed and delivered the 2023 Summer Roundtable Series with health systems administrators and stakeholders on five key topics, including race and racism in digital health and information technology, achieving equity, diversity, and inclusion through decentralized clinical trials, overcoming systemic racism and bias in providing quality care, addressing equity in health care access and affordability, and health literacy as liberation and suppression. This proposal uses three innovative methodologies to support the Cycle of Change theoretical framework: (1) addressing racism through individual and organizational change in parallel and in real time to improve safety, quality, and trustworthiness in HDS; (2) engaging and including persons from priority populations in the roundtable planning, presenting, disseminating, and evaluation; and (3) mutual learning to shift current research and clinical practice paradigms. We plan to amplify the impact of each roundtable and to distribute conference evidence and materials broadly, with an emphasis on reaching out to stakeholders identified in AHRQ’s Priority Populations. The roundtable series will present opportunities for all stakeholders to disseminate evidence, implement anti-racist strategies and resources, and establish relationships and improve awareness and implementation of anti-racist approaches to address structural racism and provide examples of best practices, which have the potential to change concepts, methods, and technologies among health delivery systems and stakeholders.