INTRODUCTION
METHODS
Program Description
Competencies
Curriculum
Evaluation Conceptual Framework
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Level 2: Learning—participants’ gains in knowledge, self-efficacy, skills, and attitudes of EDI-focused competencies
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Level 3: Behavior—translation of gained knowledge and skills into tangible EDI-relevant actions
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Level 4: Results—EDI-relevant impacts on participants’ individual leadership, organizations, and communities
Data Collection and Analysis
Level 2: Competency Assessment
Level 3: Behavioral Examples
Level 4: Most Significant Change
Describe in one or two paragraphs the most significant change that has resulted from your involvement with the Change Leadership Initiative. Please describe the situation, task, actions, results, or other details you can relate to the change.
Level 4: Tracking of Reported Leadership Activities
RESULTS
Sample
Demographic Characteristic | Count(%) |
---|---|
Gender*,† | |
n | 29 |
Male | 12 (41%) |
Female | 17 (59%) |
Race* | |
n | 28‡ |
White/Caucasian | 14 (48%) |
Black/African American | 7 (24%) |
Asian | 4 (14%) |
American Indian/Alaska Native | 1 (3%) |
Native Hawaiian or Pacific Islander | 0 |
Bi-racial or multi-racial | 0 |
Other | 2 (7%) |
Ethnicity* | |
n | 29 |
Hispanic or Latinx | 3 (10%) |
Neither Hispanic nor Latinx | 26 (90%) |
Level 2: Learning
Competency Assessment
Competency | N | Baseline mean (0 mo) | Mid-point mean (18 mo) | Endpoint mean (36 mo) | Difference in baseline and endline means (*,†,‡) | Standard deviation |
---|---|---|---|---|---|---|
Personal domain | ||||||
Commitment to intercultural development | 26 | 5.24 | 6.06 | 6.19 | 0.87† | 1.36 |
Social Justice | 26 | 4.86 | 5.86 | 5.97 | 1.13† | 1.55 |
Interpersonal domain | ||||||
Practice of multi-culturalism | 26 | 5.05 | 6.01 | 6.05 | 0.93† | 1.23 |
Organizational doman | ||||||
Organizational capacity for advancing health equity | 24 | 4.18 | 5.51 | 5.69 | 1.41† | 1.46 |
Diversity and inclusion | 25 | 4.98 | 5.97 | 6.08 | 1.04† | 1.43 |
Community and systems domain | ||||||
Health equity | 26 | 5.24 | 6.07 | 6.15 | 0.86† | 1.19 |
Meaningful community engagement | 26 | 4.63 | 5.80 | 6.00 | 1.24† | 1.56 |
Social determinants of health | 26 | 4.93 | 6.08 | 6.16 | 1.17† | 1.82 |
Level 3: Behavior
Behavioral Examples—Online Wisdom Logs (OWLs)
Theme (competency) | Frequency of theme | Example |
---|---|---|
Personal domain | ||
Commitment to diversity and social justice (n = 24) | ||
Advocating | 8 | Participant advocated for the inclusion of a representative from a marginalized group in an institutional research advisory committee. |
Developing new organizational systems or policies | 6 | Participant led the effort to develop an institutional policy to hire more staff and clinicians that reflect the racial and ethnic makeup of the client population. |
Social justice (n = 17) | ||
Advocating | 7 | Participant facilitated the inclusion of parents of children with special healthcare needs to play a key teaching role in all training provided through their WPIP to healthcare professionals who provide medical and dental services to children with special healthcare needs, in order to advocate for the specific concerns of parents and children. |
Using influence to promote social justice | 4 | Participant used their influence and connections to encourage and empower a client who is trans to advocate for themselves to be able to access the school locker room of their identified gender. |
Interpersonal domain | ||
Practice multiculturalism (n = 14) | ||
Developing or updating program to be more culturally sensitive to clients | 6 | Participant ensured that client had access to traditional healer to support the client’s stated spiritual needs. |
Taking personal steps to better understand cultures different than their own | 4 | Participant committed to learning about a client’s cultural background in order to provide the best medical care for that individual. |
Organizational domain | ||
Build organizational capacity to advance health equity (n = 17) | ||
Facilitating expanded organizational and institutional capacity for EDI | 6 | Participant helped steer EDI Committee at their institution to move beyond data collection on EDI issues to actual implementation of programs and policies to expand diversity and inclusion. |
Increasing access and/or services for marginalized communities | 6 | Participant initiated new program to increase insurance enrollment for an underserved population by ensuring materials are presented in clients’ language, providing translation, and developing culturally appropriate materials. These changes resulted in the clinic producing some of the highest insurance enrollment numbers of any clinics in their state. |
Foster diversity and inclusion (n = 18) | ||
Advocating for increased diversity and inclusion in their organization/institution | 6 | Participant was invited to join their hospital system’s Diversity Committee. They advocated for policies that are more sensitive to the cultural and contextual needs of clients living in poverty. |
Developing organizational policies | 4 | Participant played key role in updating their profession’s oath of practice for new clinicians to include “disability” as a factor that will not affect their judgement or ability to care for patients. |
Community and systems domain | ||
Health equity (n = 16) | ||
Increasing access and/or services for marginalized communities | 5 | Participant helped facilitate a partnership between the university dental school and a local not-for-profit organization to provide dental services to children who are ineligible for state insurance due to immigration status and lack of citizenship. |
Impacting organizational infrastructure | 4 | A participant led the creation of an Office of Community Initiatives at their hospital in order to support expanded screenings and services to address health inequalities in the community. |
Meaningful community engagement (n = 17) | ||
Promoting community voices | 10 | Participant convened and led a focus group of transgender community members to inform the development of the website for a transgender health center. |
Training others | 2 | Participant played a role in developing a workshop series where clients who are in addiction recovery to lead trainings for local community members on the causes, effects, and treatments for opiate dependency. |
Social determinants of health (n = 16) | ||
Program improvements | 4 | In response to regular meetings with residents of a local community, a participant collaborated with the local hospital to develop a food pantry to address high levels of food insecurity present in the neighborhood. |
Training others | 4 | Participant developed a class at their academic institution to focus on introducing students to the concepts of social determinants of health and how it will impact their work as future health providers. |
Level 4: Results
Most Significant Change (MSC)
Theme | Frequency | Example |
---|---|---|
Advocating for marginalized groups | 7 | “We have worked extensively with the press to promote our center and vision to bring transgender healthcare from the margins to the mainstream.” “I have authored a chapter in a book on primary care for the transgender patient, and am presently writing an article on transgender medicine for the upcoming [publisher] encyclopedia of transgender studies.” “We are leveraging our [work from the program] for funding, growth planning, and a greater impact on transforming the culture of care for communities struggling with addiction, in [our state] and beyond.” |
Creating programs that value EDI principles | 6 | “Eventually, a pilot program was developed that improved health equity for an impoverished community by providing clinical trauma screenings and behavior health services for [an urban] community in [state].” “Because of our...support from [the program], I am hopeful that the Gender Wellness Center will continue to thrive and be celebrated within our organization and our community.” |
Exploring personal biases | 4 | “I have also appreciated the challenge and education around looking at bias. It is not always easy to do. … I have had the luxury of spending time talking about [bias] and how it affects different people. … That kind of time is a gift.” |
Self-awareness/Personal learning around EDI principles | 6 | “I am now able to bring the best out of each person on my team in a way that I was never able to accomplish in the past.” “[In CS] I was exposed to societal analyses of gaps in health and social equity. I learned how to frame ideas and approaches to problems. I received guidance through the modules and books on how to navigate change and find my way to impact.” “I must advocate for health equity most notably for [people] who are at the highest risk. As an occupational therapist, I serve people who are living in poverty. I recognized that I do not fully understand their circumstances.” |
Networking/Inten-tional relationship building | 4 | “Through relationships with stakeholders, most importantly the foster youth, and by recognizing the prevalence and ramifications of adverse childhood experiences in this special population, we have developed and implemented a wellness curriculum that helps youth manage the physiological changes their bodies have endured.” “[My new role as CEO] is a very exciting opportunity where I will be able to incorporate elements of our community mental health literacy program and create a new model of behavioral health wellness in this community.” “I used my social capital as a senior attending physician and president of my hospital’s medical staff to further advance [support of our LGBTQ+ initiative]. I met monthly with a Vice President, developing him as our champion within the organization. I also formed and am leading an Advisory Board to assure ongoing support and guidance from key leaders...within our organization and community.” |
Tracking of Reported Leadership Activities
Leadership Activity Type and Description | |
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Advocacy (n=4) | |
Participant interviewed on an episode of a podcast series about historical racism and its current impacts. | |
Participant led the expansion of primary care, health screenings, and COVID-19 testing to medically underserved populations in their city. | |
Participant invited to speak at a [national popular publication]-sponsored event about disparities and inequities in oral healthcare. | |
Participant played a large role in convincing the leadership of a large medical professional society to sign on to a letter sponsored by the Asian Pacific Islander Health Forum and [academic medical center] Center for Asian American health to advocate for including Asian Americans, Native Hawaiians, and Pacific Islanders in the COVID-19 vaccine allocation plan by the National Academies of Science, Engineering and Medicine. | |
Award (n=3) | |
Participant named as one of [an influential social magazine’s] “100 women we love” for the work she does ensuring underserved populations have access to healthcare. | |
Participant honored with an award from their professional organization for making outstanding contributions to their community. | |
Participant received an award from [a national medical society] that honors practicing physicians who have made an outstanding contribution to the community for citizenship and public service. | |
Career advancement (n=3) | |
Participant announced to be part of the Health Subcommittee on their state Governor’s Council for Racial Justice. The group is tasked with counseling and monitoring the state administration in an effort to end systematic racism and promote equal treatment and opportunity. | |
Participant invited to join a state university’s School of Social Work Community Advisory Council | |
Participant appointed President of the Board for the [national advocacy organization]. | |
Change in policy (n=2) | |
Participant contributed to the passing of a state bill, which prohibits discrimination against immigrants in local health benefits. | |
Participant helped adopt and include race in reporting for Healthcare Effectiveness Data and Information Set measures for maternal mental health. | |
News recognition (n=3) | |
Participant featured in a [national medical society] article encouraging pediatricians for community engagement on various societal issues. | |
Participant featured and interviewed in an article on the future of healthcare systems and the need for a more open impact within communities. | |
Participant featured in a local news article about their work with community professionals to help push for better access to healthcare. | |
Program expansion (n=3) | |
Participant coordinated a food drive in their local community. | |
Participants launched a new mobile dental unit to provide care at [early childhood] programs and in multiple low-wealth communities. | |
CS project expanded an after-school program for a marginalized community group across their state. | |
Training (n=10) | |
Participant co-presented in a webinar series on the experiences of resistance and abolitionism in response to the colonization and policing of People of Color and Indigenous communities; Queer and Trans; and peoplewith disabilities in the Medical Industrial Complex. | |
Participant delivered the keynote address at a global medical provider conference, describing approaches to heal the wounds created by the history of systemic racism in the field of medicine. | |
Participant presented at an integrative medicine annual conference about lessons they learned about building power with communities and undoing harm through their community-based non-profit health clinic. | |
Participant partnered with CS participants in other cohorts to deliver an interprofessional lecture on health inequities in the elderly to a graduate level public health class at a leading state university. | |
Participant gave a talk on racism and health to the entire first year medical school class of a large state university. | |
Participant led a digital panel discussion about healing historical injustices. | |
Participant presented at a local event to facilitate community dialogue about public health and education. | |
Participant was part of a panel at a local workshop about enhancing community-based harm reduction and treatment services in local communities | |
Participant presented a webinar mini-series about the equitable distribution of the COVID-19 vaccine. | |
Participant coordinated a free [early childhood parenting] program to be offered to a marginalized community. | |
Writing (n=3) | |
Participants co-published research on evaluation of development of a rural center of excellence in transgender health. | |
Participant co-authored a study in a peer-reviewed journal about self-injury in transgender and gender-expansive youth. | |
Participant co-authored an article in a peer-reviewed journal about preventative healthcare utilization by youths who have run away, experienced homelessness, or are stably housed. |