For pediatric practices to advance health equity and mitigate the impacts of systemic racism on health disparities and health care outcomes, the entire care team needs to be engaged, informed, and trained on equitable approaches to care. Principal activities clinicians and care teams can take to begin to advance health equity in pediatric practices include:
Recognizing implicit biases and their impact on patient care
Understanding how practitioners’ cultural competency and humility influences patient experience of care and trust in providers
Learning the differences between health equity, health disparities, and social determinants of health
Identifying health disparities within the primary care practice and community
Adopting evidence-based interventions that may reduce health disparities
Training practice staff on skills like screening, referral, and follow-up for connecting patients with social support
Training Resources
The following resources on training and workforce development in health equity are a starting point for pediatricians and practice leaders. They aim to help clinical leaders expand their perspectives and facilitate personal and professional development—for themselves and practice staff—toward more equitable delivery of care.
Implicit Bias in Pediatrics: An Emerging Focus in Health Equity Research, by Jean L. Raphael and Suzette O. Oyeku, is a discussion of an AAP journal article on pediatric pain management that demonstrates how implicit bias influences provision of care.
It’s Time to Address the Role of Implicit Bias within Health Care Delivery, Health Affairs Blog, by Shantanu Agrawal and Adaeze Enekwechi, suggests ways to address health equity through changes to the health care workforce, as well as to the use of data in performance measurement and payment policy.
How Does Implicit Bias Affect Health Care is an instructional video from the Institute for Health Care Improvement.
The Diversity-Informed Tenets for Work with Infants, Children and Families are guiding principles for infant, child, and family professionals to help embed diversity, equity, and inclusion practices in daily work. The Tenets, an initiative of the Irving Harris Foundation, are widely endorsed by child health care organizations and advocates.
Fostering Social and Emotional Health through Pediatric Primary Care: Common Threads to Transform Everyday Practice and Systems, from the Center for the Study of Social Policy, includes guidelines and suggestions for equity-informed and culturally appropriate care (e.g., strengths-based observation with parents).
Empathetic Listening, a training module on how to listen to identify a patient’s underlying needs, feelings, and values to inform provision of appropriate care. The module is offered by the American Medical Association CME program Steps Forward.
How and Why to Listen Until Someone Feels Heard, an article from the Stanford Social Innovation Review with lessons on empathic listening and relationship-centered care to help clinicians connect with patients.
Unconscious (Implicit) Bias and Health Disparities: Where Do We Go from Here?by Irene V. Blair, John F. Steiner, and Edward P. Havranek, is a research road map for the exploration of the role of implicit bias in perpetuating heath disparities; the paper discusses specific ways clinicians, researchers, policymakers, and community members can work to address implicit bias.
The Cultural Competence Self-Assessments from the National Center for Cultural Competence at Georgetown University are a suite of resources for health care providers, administrators, health care educators, and advocates.
Providing Culturally Effective Pediatric Care, a practice transformation resource from the American Academy of Pediatrics.
Health Equity and Children’s Rights policy statement by the American Academy of Pediatrics.
What are health disparities and health equity? We need to be clear by Paula Braveman.
Child Health Disparities: What Can a Clinician Do? by Tina L. Cheng, Mickey A. Emmanuel, Daniel J. Levy and Renee R. Jenkins.
Fostering Social and Emotional Health through Pediatric Primary Care: Common Threads to Transform Everyday Practice and Systems by the Center for the Study of Pediatric Practice.
Health, Equity, and Young Children: Pediatric Roles by Charles Bruner, BUILD Initiative and Child and Family Policy Center.
Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating Developmental Science Into Lifelong Health, by the American Academy of Pediatrics’ Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care, and Section on Developmental and Behavioral Pediatrics.
Racial and Ethnic Disparities in Health, a comprehensive list of professional resources and training materials curated by the Maternal and Child Health Library, a project of the National Center for Maternal Child Health at Georgetown University.
IHI Health Equity, a roundup of readings, training, and resources from the Institute for Healthcare Improvement.
The health equity webinar series from the National Institute for Children’s Health Quality covers topics like combating racism in health systems, successful health equity program implementation, and getting started on addressing health equity.
The Ramirez June Developmental Disabilities Navigator Initiative helps connects immigrants with developmental disabilities and their families to resources, information, and services. It is a collaboration between the NYS Developmental Disabilities Planning Council (DDPC) and the NYS Office for New Americans (ONA). The ONA Developmental Disabilities Navigator is available to conduct targeted outreach and trainings for new Americans and service providers. Contact NewAmericans@dos.ny.gov to connect with this initiative or schedule a presentation.
This flyer has information on connecting new Americans with developmental disabilities and their families to resources and services in New York State: [English][Spanish][Chinese][Korean][Russian][Bengali][Haitian Creole].
Kids Wellbeing Indicators Clearinghouse (KWIC) from the New York State Council on Children and Families maintains data on children’s health and well-being and participates in the Annie E. Casey Foundation’s Kids Count network of data providers.
Health Data NY is New York State Department of Health’s official data inventory and houses over 40 data sets related to children’s health. Topics covered among data sets include performance on key child and adolescent health measures across managed care plans; enrollment in Medicaid and Child Health Plus; availability of Women, Infant, and Children (WIC) services; and health care utilization.
County Health Rankings lists social, economic, and health indicators that affect communities.
Population Health techniques for practice management from the American Academy of Pediatrics.
Screening Time, an American Academy of Pediatrics clearinghouse of screening tools.
Community Resource Referral Platforms Guide from the Social Interventions Research and Evaluation Network (SIREN) at UCSF helps care teams understand the range of options from online tools like NowPow, Healthify, and UniteUs.
Empathic Inquiry: A Patient-Centered Approach to Social Determinants of Health Interviewing (video) from the Oregon Primary Care Association.
Training Primary Care Residents on Social Determinants of Health is a suite of conceptual frameworks, screening tools, and examples of referral feedback loops from Greater New York Hospital Association.
AHRQ’s Primary Care Practice Facilitation Curriculum is a series of training modules designed for Patient-Centered Medical Home practice facilitators. Focused on supporting practices adopting new models of care and continuous quality improvement strategies for practice transformation, the curriculum provides multiple skill-building modules and addresses various topics, including data assessment, optimization of electronic medical records, performance management and redesigning workflows.
Assessing and Addressing the Social Determinants of Health During COVID-19 (Webinar Series).
This webinar series from the National Association of Community Health Centers provides information on emergent strategies for assessing and screening for social determinants of health and health related social needs during the COVID-19 pandemic.
Telehealth Support Compendium
The American Academy of Pediatrics' online resource with general information and technical support for incorporating telehealth services into the practice; includes Getting Started in Telehealth, a startup guide.
Burke, Bryan L., and R. W. Hall. "Telemedicine: pediatric applications." Pediatrics 136, no. 1 (2015): e293-e308.
Burke, et al's 2015 Pediatrics article discusses challenges and opportunities for implementation and application of telehealth approaches to care provision in the pediatric practice.
American Academy of Family Physicians (AAFP) Telehealth Toolkit
This comprehensive toolkit from AAFP helps pratices develop and implement a telehealth strategy. It adds on to an earlier AAFP resource, Using Telehealth to Care for Patients During the COVID-19 Pandemic.
Guidance on the Necessary Use of Telehealth During the COVID-19 Pandemic
This clinical guidance statement from the American Academy of Pediatrics sets out interim guidance on the use of telehealth as a method health care access and service delivery during the COVID-19 pandemic.
Telemedicine for Health Equity Toolkit
This toolkit from the Center for Care Innovations provides information on the provision of telehealth/telemedicine, including remote clinical services like phone and video visits, remote patient monitoring, use of patient portals, and mobile health tools.