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Background In the USA, access to quality healthcare varies greatly across racial and ethnic groups, resulting in significant health disparities. A new term, “racial health equity” (RHE), is increasingly reported in the medical literature, but there is currently no consensus definition of the term. Additionally, related terms such as “health disparities,” “health inequities,” and “equality” have been inconsistently used when defining RHE. Methods The primary purpose of this scoping review is to investigate the current use and underlying concepts used to define racial health equity. The study will address two key questions: (1) “What terminology and definitions have been used to characterize RHE?” and (2) “What knowledge gaps and challenges are present in the current state of RHE research and theory?” The review will collect and analyze data from three sources: (1) websites from key national and international health organizations, (2) theoretical and narrative published articles, and (3) evidence synthesis studies addressing interventions targeting racial health equity and minority stakeholder engagement. Discussion Defining “racial health equity” and related terminology is the first step to advancing racial health equity within the USA. This review aims to offer an improved understanding of RHE constructs and definitions, bringing greater unity to national racial health equity research efforts across disciplines. Systematic review registration This protocol is registered with the Open Science Framework at https://osf.io/7pvzq .

Joanna Briggs Institute (JBI) is an international research organization and collaborative network hosted in the Faculty of Health and Medical Sciences at the University Of Adelaide, South Australia. Now in its 25th year of activity, JBI is concerned with improving health outcomes in communities globally by promoting and supporting the use of the best available evidence to inform decision making in health policy and practice. The JBI Model of Evidence Based Healthcare, developed in the early 2000s, represents an articulation of the evidence ecosystem and the pragmatic approach required to navigate the complexity of health systems globally to improve health outcomes. The programs of JBI are aligned with the JBI Model and are representative of the supportive structures that facilitate the pragmatic realization of each of the elements of evidence based healthcare. •Overview of JBI.•Overview of JBI Model of Evidence Based Healthcare.•Overview of component parts of the Model.•Situates the JBI Model within the Evidence Ecosystem.

The purpose of this study was to explore the experience of certified registered nurse anesthetists (CRNAs) choosing to quit their primary place of employment. Interpretative phenomenological analysis is the qualitative framework for this study. Ten CRNAs were interviewed about their experience of quitting their job. Interview transcripts were analyzed for common themes. Common themes were the desire for better work-life fit, the impact of stressful work intensity, and exposure to poor leadership. This study suggests that a focus on ensuring job fit for personal goals outside of work may improve CRNA retention. This study also provides practice implications for hospital leadership, as well as direction for future qualitative and quantitative research.

To identify evidence syntheses of health interventions addressing racial health equity reporting the use of equity-focused frameworks and logic models.OBJECTIVESTo identify evidence syntheses of health interventions addressing racial health equity reporting the use of equity-focused frameworks and logic models.The search strategy included three sources; a search of three bibliographic databases to identify systematic reviews assessing interventions to improve racial health equity, semistructured interviews with diverse group and a targeted organization website searches (eg, National Institute of Health, United States Preventive Services Task Force) to identify relevant logic models and frameworks. The searches were conducted between January 1, 2020, and January 25, 2023. We used a qualitative approach to identify and describe key characteristics of equity-focused logic models and frameworks used in evidence syntheses.STUDY DESIGN AND SETTINGThe search strategy included three sources; a search of three bibliographic databases to identify systematic reviews assessing interventions to improve racial health equity, semistructured interviews with diverse group and a targeted organization website searches (eg, National Institute of Health, United States Preventive Services Task Force) to identify relevant logic models and frameworks. The searches were conducted between January 1, 2020, and January 25, 2023. We used a qualitative approach to identify and describe key characteristics of equity-focused logic models and frameworks used in evidence syntheses.Of the 153 racial health equity-focused evidence syntheses identified, two explicitly used logic models to describe the intervention mechanism. We identified seven existing health equity frameworks from semistructured interviews and electronic search of key websites that were categorized by stated purpose as providing guidance for 1) research, 2) health policy, 3) digital health-care solutions, and 4) clinical preventive services. Two out of seven frameworks included guidance on integrating frameworks or logic models in evidence synthesis while the majority provided contextual information on how to define or consider race or racism as a structural determinant of health.RESULTSOf the 153 racial health equity-focused evidence syntheses identified, two explicitly used logic models to describe the intervention mechanism. We identified seven existing health equity frameworks from semistructured interviews and electronic search of key websites that were categorized by stated purpose as providing guidance for 1) research, 2) health policy, 3) digital health-care solutions, and 4) clinical preventive services. Two out of seven frameworks included guidance on integrating frameworks or logic models in evidence synthesis while the majority provided contextual information on how to define or consider race or racism as a structural determinant of health.There is limited use of logic models and frameworks in evidence syntheses addressing racial health equity. There is a need for more applied frameworks providing guidance for framing, conducting and interpreting findings of evidence syntheses addressing racial health equity.CONCLUSIONThere is limited use of logic models and frameworks in evidence syntheses addressing racial health equity. There is a need for more applied frameworks providing guidance for framing, conducting and interpreting findings of evidence syntheses addressing racial health equity.The goal of this study was to find reviews of health programs that focus on improving racial health equity, and to see if they used special frameworks or models designed to address equity. To do this, we searched three major research databases, conducted interviews with a diverse group of people, and looked at relevant organization websites (like the National Institute of Health and the World Health Organization) between January 2020 and January 2023. We used a qualitative approach to study the key features of these equity-focused frameworks and models. We found 153 reviews focused on racial health equity, but only two of them used logic models to explain the intervention. From interviews and website searches, we identified seven existing health equity frameworks. These were grouped into four categories: research, health policy, digital health care, and clinical preventive services. Only two of these frameworks provided advice on how to use them in evidence reviews, while most focused on understanding how race and racism impact health as a social factor. In conclusion, there is limited use of frameworks and models in reviews about racial health equity. More practical frameworks are needed to help guide the research and interpretation of these reviews.PLAIN LANGUAGE SUMMARYThe goal of this study was to find reviews of health programs that focus on improving racial health equity, and to see if they used special frameworks or models designed to address equity. To do this, we searched three major research databases, conducted interviews with a diverse group of people, and looked at relevant organization websites (like the National Institute of Health and the World Health Organization) between January 2020 and January 2023. We used a qualitative approach to study the key features of these equity-focused frameworks and models. We found 153 reviews focused on racial health equity, but only two of them used logic models to explain the intervention. From interviews and website searches, we identified seven existing health equity frameworks. These were grouped into four categories: research, health policy, digital health care, and clinical preventive services. Only two of these frameworks provided advice on how to use them in evidence reviews, while most focused on understanding how race and racism impact health as a social factor. In conclusion, there is limited use of frameworks and models in reviews about racial health equity. More practical frameworks are needed to help guide the research and interpretation of these reviews.

To identify evidence syntheses of health interventions addressing racial health equity reporting the use of equity-focused frameworks and logic models. The search strategy included three sources; a search of three bibliographic databases to identify systematic reviews assessing interventions to improve racial health equity, semistructured interviews with diverse group and a targeted organization website searches (eg, National Institute of Health, United States Preventive Services Task Force) to identify relevant logic models and frameworks. The searches were conducted between January 1, 2020, and January 25, 2023. We used a qualitative approach to identify and describe key characteristics of equity-focused logic models and frameworks used in evidence syntheses. Of the 153 racial health equity-focused evidence syntheses identified, two explicitly used logic models to describe the intervention mechanism. We identified seven existing health equity frameworks from semistructured interviews and electronic search of key websites that were categorized by stated purpose as providing guidance for 1) research, 2) health policy, 3) digital health-care solutions, and 4) clinical preventive services. Two out of seven frameworks included guidance on integrating frameworks or logic models in evidence synthesis while the majority provided contextual information on how to define or consider race or racism as a structural determinant of health. There is limited use of logic models and frameworks in evidence syntheses addressing racial health equity. There is a need for more applied frameworks providing guidance for framing, conducting and interpreting findings of evidence syntheses addressing racial health equity. The goal of this study was to find reviews of health programs that focus on improving racial health equity, and to see if they used special frameworks or models designed to address equity. To do this, we searched three major research databases, conducted interviews with a diverse group of people, and looked at relevant organization websites (like the National Institute of Health and the World Health Organization) between January 2020 and January 2023. We used a qualitative approach to study the key features of these equity-focused frameworks and models. We found 153 reviews focused on racial health equity, but only two of them used logic models to explain the intervention. From interviews and website searches, we identified seven existing health equity frameworks. These were grouped into four categories: research, health policy, digital health care, and clinical preventive services. Only two of these frameworks provided advice on how to use them in evidence reviews, while most focused on understanding how race and racism impact health as a social factor. In conclusion, there is limited use of frameworks and models in reviews about racial health equity. More practical frameworks are needed to help guide the research and interpretation of these reviews.

The current literature lacks an established and adoptable definition of “racial health equity.” This study aimed to catalog and evaluate, via thematic analyses, definitions and terminology related to racial health equity across the specific studies from the Robert Wood Johnson Foundation and Cochrane-US (United States) (RWJF-Cochrane) “Centering Racial Health Equity in Systematic Reviews” project and to propose a working definition based on study findings. We employed an integrative review framework to analyze current definitions of racial health equity terms identified within published studies from the RWJF-Cochrane project. Definitions of racial health equity were identified via dual reviewer screening of all identified studies and interview transcripts, which included recent systematic reviews (published since 2020), theoretical and conceptual health literature, and listening exercises with interest holders involved in systematic reviews addressing health equity. Identified definitions were analyzed via thematic coding using the Braun and Clarke framework. We reviewed 157 systematic reviews, 29 interviews, and 16 articles related to racial health equity for the presence of racial health equity definitions. This review resulted in 32 definitions of racial health equity from theoretical and conceptual health literature (n = 16) and interest holder transcripts (n = 16). No systematic reviews contained definitions of racial health equity. Retrieved definitions emphasize equality in health or health care, including outcomes, processes, or care; themes of discrimination in health-care settings; and acknowledgments of the intersections of social determinants of health with health equity. Definitions varied on the role of improving health-care access in achieving racial health equity. A working definition of racial health equity is proposed using common themes identified across definitions. Our findings highlight that a clear and consistent definition of racial health equity will assist researchers, practitioners, and policymakers with developing metrics and interventions aimed at reducing racial health inequities. Thus, we propose a working definition for racial health equity, which emphasizes 1) fairness and justice in health, 2) equality in health outcomes and access across racialized groups, 3) a recognition that social consequences of one's race and/or ethnicity may influence health or the quality of health care received. We also note areas of variability in understandings that require further discussion. •Zero out of 157 systematic reviews defined racial health equity in our analysis.•We identified 32 definitions from 16 articles and 16 interest holder interviews.•Most interest holder definitions emphasized health equality or outcomes.•Structural racism appeared in 10 of 16 article definitions.•We propose a working definition to guide equity-focused research and policy.

Systematic reviews hold immense promise as tools to highlight evidence-based practices that can reduce or aim to eliminate racial health disparities. Currently, consensus on centering racial health equity in systematic reviews and other evidence synthesis products is lacking. Centering racial health equity implies concentrating or focusing attention on health equity in ways that bring attention to the perspectives or needs of groups that are typically marginalized. This Cochrane US Network team and colleagues, with the guidance of a steering committee, sought to understand the views of varied interest holders through semistructured interviews and conducted evidence syntheses addressing (1) definitions of racial health equity, (2) logic models and frameworks to centering racial health equity, (3) interventions to reduce racial health inequities, and (4) interest holder engagement in evidence syntheses. Our methods and teams include a primarily American and Canadian lens; however, findings and insights derived from this work are applicable to any region in which racial or ethnic discrimination and disparities in care due to structural causes exist. In this series, we explain why centering racial health equity matters and what gaps exist and may need to be prioritized. The interviews and systematic reviews identified numerous gaps to address racial health equity that require changes not merely to evidence synthesis practices but also to the underlying evidence ecosystem. These changes include increasing representation, establishing foundational guidance (on definitions and causal mechanisms and models, building a substantive evidence base on racial health equity, strengthening methods guidance, disseminating and implementing results, and sustaining new practices). Centering racial health equity requires consensus on the part of key interest holders. As part of the next steps in building consensus, the manifold gaps identified by this series of papers need to be prioritized. Given the resource constraints, changes in norms around systematic reviews are most likely to occur when evidence-based standards for success are clearly established and the benefits of centering racial health equity are apparent. Racial categories are not based on biology, but racism has negative biological effects. People from racial or ethnic minority groups have often been left out of research and ignored in systematic reviews. Systematic reviews often help clinicians and policymakers with evidence-based decisions. Centering racial health equity in systematic reviews will help clinicians and policymakers to improve outcomes for people from racial or ethnic minority groups. We conducted interviews and a series of four systematic reviews on definitions, logic models and frameworks, methods, interventions, and interest-holder engagement in syntheses. We found that much work remains to be done in centering racial health equity in systematic reviews. Specifically, systematic reviewers need to change who is represented on their teams, establish foundational guidance (on definitions and causal mechanisms and models, identify what interventions work to address racial health equity, strengthen method guidance, disseminate and implement results, and sustain new practices).