A Portfolio Analysis of Culturally Tailored Trials to Address Health and Healthcare Disparities

Int J Environ Res Public Health. 2018 Aug 28;15(9):1859. doi: 10.3390/ijerph15091859.

Abstract

In 2010, Patient-Centered Outcomes Research Institute (PCORI) was authorized by Congress to improve the quality and relevance of evidence available to help patients, caregivers, employers, insurers, and policy makers make better-informed health decisions. We conducted a qualitative analysis of behavioral health trials in the PCORI Addressing Disparities portfolio to examine cultural tailoring strategies across the following priority populations: racial and ethnic minorities, rural populations, people with low-income or low socioeconomic status, individuals with disabilities, people with low health literacy, and lesbian, gay, bisexual, and transgender (LGBT) communities. The Common Strategies for Enhancing Cultural Appropriateness model was used to examine cultural tailoring strategies within trials. We hypothesized increased intersectionality within a patient population at risk for disparities would correlate with the dosage and type of cultural tailoring strategies applied. Thirty-three behavioral health trials applied cultural tailoring strategies and a majority of trials (n = 30) used three or more strategies. Trends in cultural tailoring were associated with certain racial and ethnic groups; however, increased use of tailoring was not associated with the number of priority populations included in a trial. The PCORI Addressing Disparities portfolio demonstrates how a range of cultural tailoring strategies are used, within comparative clinical effectiveness research trials, to address the needs and intersectionality of patients to reduce health and healthcare disparities.

Keywords: Patient-Centered Outcomes Research Institute; comparative clinical effectiveness research; cultural tailoring; disparities; intersectionality.

MeSH terms

  • Ethnic Groups*
  • Health Services Accessibility
  • Healthcare Disparities*
  • Humans
  • Minority Groups*
  • Rural Population
  • Sexuality
  • United States