Racial and ethnic disparities are widespread in the US health care system. A 2007 report from the Veterans Affairs (VA) Health Services Research & Development Service (HSR&D) Evidence-based Synthesis Program (ESP) found disparities were prevalent in a variety of clinical arenas within the Veterans Affairs health care system. The report identified several promising avenues for future interventions designed to reduce racial and ethnic disparities.

The objectives of this review are to describe the state of disparities intervention research within the VA, glean lessons from systematic reviews of intervention research not limited to VA settings, and develop an organizing framework to describe studies in this field of research. This report is also intended to inform future disparities intervention research in the VA, as well as VA policies and programs to reduce disparities.

Contents

• PREFACE
• EXECUTIVE SUMMARY
  • BACKGROUND
  • METHODS
  • RESULTS
  • SUMMARY OF FINDINGS
  • DISCUSSION
• INTRODUCTION
  • BACKGROUND
• METHODS
  • TOPIC DEVELOPMENT
  • SEARCH STRATEGY
  • STUDY SELECTION, QUALITY ASSESSMENT, AND DATA ABSTRACTION
  • DATA SYNTHESIS
  • PEER REVIEW
• RESULTS
  • LITERATURE SEARCH
  • KEY QUESTION #1 What is the state of research on interventions to reduce race/ethnic disparities or to improve health and health care in minority populations within VA health care settings?
  • KEY QUESTION #2 What are the results of interventions (within and outside the VA) to reduce racial/ethnic disparities or to improve health and health care in minority populations?
  • SUMMARY OF RESULTS ACROSS INTERVENTIONS
• DISCUSSION
  • STATE OF INTERVENTION RESEARCH
  • CONCEPTUAL FRAMEWORK
  • FUTURE RESEARCH AND IMPLICATIONS FOR VA HEALTH CARE SETTINGS
• REFERENCES
• APPENDIX A SEARCH STRATEGY
• APPENDIX B INCLUSION/EXCLUSION CRITERIA FOR PRIMARY STUDIES AND REVIEWS
• APPENDIX C QUALITY RATING CRITERIA FOR REVIEWS
• APPENDIX D EVIDENCE TABLE
• APPENDIX E REVIEWER COMMENTS AND RESPONSES

Prepared for: Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service, Washington, DC 20420. Prepared by: Evidence-based Synthesis Program (ESP) Center, Portland VA Medical Center, Portland, OR, Devan Kansagara, MD, MCR, Director

Suggested citation:

Quiñones AR, O'Neil M, Saha S, Freeman M, Henry S, Kansagara D. Interventions to Reduce Racial and Ethnic Disparities. VA-ESP Project #05-225; 2011

This report is based on research conducted by the Evidence-based Synthesis Program (ESP) Center located at the Portland VA Medical Center, Portland OR funded by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development. The findings and conclusions in this document are those of the author(s) who are responsible for its contents; the findings and conclusions do not necessarily represent the views of the Department of Veterans Affairs or the United States government. Therefore, no statement in this article should be construed as an official position of the Department of Veterans Affairs. No investigators have any affiliations or financial involvement (e.g., employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in the report.