Duke launches center to promote health equity, reduce racial and ethnic disparities

Aiming to make the health care industry more equitable, Duke has launched the Center for REsearch to AdvanCe Healthcare Equity, also known as REACH Equity.

The center is funded by one of 12 grants awarded by the National Institute on Minority Health and Health Disparities—a subunit of the National Institutes of Health. It will focus on multidisciplinary approaches to improve health care for members of minority groups and eliminate disparities in the delivery of care.

“I’m most excited about the opportunity to conduct research which will have a real world impact on our ability to reduce and eliminate racial and ethnic disparities and have an evidence base that promotes health equity,” said Mary Klotman, dean of the School of Medicine. 

REACH Equity’s primary goals center around developing and testing methods to reduce ethnic disparities in health by improving the quality of patient-centered care in the clinic. 

Leigh Ann Simmons, associate professor in the School of Nursing, will serve as a member of the Research Education and Training Subcore of the center. This division will analyze patient visits to ensure that every component of a patient’s life is being addressed in providing effective care. 

“One of the primary goals of the Research Education and Training Subcore is to educate and train students, from undergraduate students all the way to post-graduate doctors, to be health disparities researchers and to integrate health disparities research with emphasis on promoting equity in clinical care,” Simmons said. 

She added that the subcore will also seek to improve communication with patients and ensure that health care providers at every step and level are engaging in shared decision-making.

To meet all of its aims, REACH Equity will open up an annual research colloquium, opportunities for mentored research for medical and nursing students and post-docs and a pilot funding program for early stage investigators, among other programs. 

Kimberly Johnson, associate professor of medicine and leader of REACH Equity, also emphasized the center’s role in providing research opportunities for undergraduates through early stage faculty.

“We want to create a pipeline of people working in this area to grow an evidence base and create impact,” she said. "Key in that will be facilitating the acquisition of skills necessary to conduct research in health disparities." 

REACH Equity already has three pre-planned projects that it will execute once officially established. The first will focus on developing and testing an implicit bias training program for health care providers, and the second will test a communication coaching intervention aimed at teaching providers better communication with patients different from themselves. The last will test a mobile app allowing families in the intensive care unit to report their needs and will enable clinicians to visualize needs and receive decision support from various resources to address them. 

“[The other investigators and I] saw this center as an opportunity to move from identifying differences’ existence and to find ways to reduce and eliminate them,” Johnson said. “We are moved by the opportunity to do something that might make a difference.”

The center has received strong support and enthusiasm from Duke’s health care community. 

“[Duke's] core missions are research, clinical care and education. This project impacts all the core missions, and it does it by engaging learners from the beginning,” Klotman said. “This [project] is not just in the School of Medicine or the health system. It’s across campus—it’s one of those projects that has a really broad reach.”

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