Using a Multisectoral Approach to Advance Health Equity in Rural Arizona: Community-Engaged Survey Development and Implementation Study

Remiker, Mark; Sabo, Samantha; Jiménez, Dulce; Longorio, Alexandra Samarron; Chief, Carmenlita; Williamson, Heather J.; Teufel-Shone, Nicolette I.

doi:10.2196/25577

Cited by 7 publications

(8 citation statements)

References 11 publications

(11 reference statements)

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“…The national push to address social determinants of health to improve equitable availability of and access to prevention initiatives may bring needed resources to rural multisector collaborations, especially to address rural food insecurity and inadequate access to healthy foods. Remiker and colleagues offer an approach for area multisector planning and prioritizing for equity action ( 40 ). Existing strengths found in the rural underresourced areas in our study can facilitate multisector collaborations for cancer prevention, including commitment to address community needs, long-standing relationships, small community structures, openness to collaboration, and willingness to share limited resources.…”

Section: Implications For Public Healthmentioning

confidence: 99%

Facilitators of Multisector Collaboration for Delivering Cancer Control Interventions in Rural Communities: A Descriptive Qualitative Study

et al. 2022

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Purpose and Objectives Multisector collaboration is a widely promoted strategy to increase equitable availability, access, and use of healthy foods, safe places for physical activity, social supports, and preventive health care services. Yet fewer studies and resources exist for collaboration among governmental and nongovernmental agencies to address public problems in rural areas, despite an excess burden of risk factors for cancer morbidity and mortality. We aimed to learn about cancer prevention activities and collaboration facilitators among rural informal interagency networks. Evaluation Methods In 2020, researchers conducted semistructured interviews with staff from rural public health and social services agencies, community health centers, and extension offices. Agency staff were from 5 service areas across 27 rural counties in Missouri and Illinois with high poverty rates and excess cancer risks and mortality. We conducted a thematic analysis to code interview transcripts and identify key themes. Results Exchanging information, cohosting annual or one-time events, and promoting other agencies’ services and programs were the most commonly described collaborative activities among the 32 participants interviewed. Participants indicated a desire to improve collaborations by writing more grants together to codevelop ongoing prevention programs and further share resources. Participants expressed needs to increase community outreach, improve referral systems, and expand screenings. We identified 5 facilitator themes: commitment to address community needs, mutual willingness to collaborate, long-standing relationships, smaller community structures, and necessity of leveraging limited resources. Challenges included lack of funding and time, long travel distances, competing priorities, difficulty replacing staff in remote communities, and jurisdictional boundaries. Although the COVID-19 pandemic further limited staff availability for collaboration, participants noted benefits of remote collaborative meetings. Implications for Public Health Rural areas need consistent funding and other resources to support health-improving multisector initiatives. Existing strengths found in the rural underresourced areas can facilitate multisector collaborations for cancer prevention, including long-standing relationships, small community structures, and the need to leverage limited resources.

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Section: Implications For Public Healthmentioning

confidence: 99%

Facilitators of Multisector Collaboration for Delivering Cancer Control Interventions in Rural Communities: A Descriptive Qualitative Study

et al. 2022

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“…In 2020, the CCIS steering committee promoted the inclusion of practitioners and policymakers as essential partners for integrating IS and health equity research to produce meaningful and sustained impact [ 30 ]. Such integration is aligned with Health in All Policies initiatives [ 106 , 107 ], multisectoral approaches [ 108 , 109 ], and promotion of community engagement in IS [ 70 ], all of which are crucial in generating relevant, feasible, and sustainable solutions to promoting health equity.…”

Section: Discussionmentioning

confidence: 99%

Grounding implementation science in health equity for cancer prevention and control

Adsul

Chambers

Brandt

et al. 2022

Implement Sci Commun

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Background The past decade of research has seen theoretical and methodological advances in both implementation science and health equity research, opening a window of opportunity for facilitating and accelerating cross-disciplinary exchanges across these fields that have largely operated in siloes. In 2019 and 2020, the National Cancer Institute’s Consortium for Cancer Implementation Science convened an action group focused on ‘health equity and context’ to identify opportunities to advance implementation science. In this paper, we present a narrative review and synthesis of the relevant literature at the intersection of health equity and implementation science, highlight identified opportunities (i.e., public goods) by the action group for advancing implementation science in cancer prevention and control, and integrate the two by providing key recommendations for future directions. Discussion In the review and synthesis of the literature, we highlight recent advances in implementation science, relevant to promoting health equity (e.g., theories/models/frameworks, adaptations, implementation strategies, study designs, implementation determinants, and outcomes). We acknowledge the contributions from the broader field of health equity research and discuss opportunities for integration and synergy with implementation science, which include (1) articulating an explicit focus on health equity for conducting and reviewing implementation science; (2) promoting an explicit focus on health equity in the theories, models, and frameworks guiding implementation science; and (3) identifying methods for understanding and documenting influences on the context of implementation that incorporate a focus on equity. Summary To advance the science of implementation with a focus on health equity, we reflect on the essential groundwork needed to promote bi-directional learning between the fields of implementation science and health equity research and recommend (1) building capacity among researchers and research institutions for health equity-focused and community-engaged implementation science; (2) incorporating health equity considerations across all key implementation focus areas (e.g., adaptations, implementation strategies, study design, determinants, and outcomes); and (3) continuing a focus on transdisciplinary opportunities in health equity research and implementation science. We believe that these recommendations can help advance implementation science by incorporating an explicit focus on health equity in the context of cancer prevention and control and beyond.

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“…Without a common language for health equity, creating and sustaining multisectoral partnerships as well as guiding policy and resource allocation, while remaining respectful of populations of concerns, can be limited (14,15,22). The root causes of health inequity are diverse, complex, dynamic, and interdependent in nature (17), making clarity and intentionality of utmost importance when pursuing equity efforts that strategically involve various stakeholders with their own agendas (5). Without clear consensus on health equity, stakeholders often struggle to agree on concrete goals and conditions of success potentially contributing to co-opted or wasted resources and efforts and initiatives that lose their focus on health equity (5,22).…”

Section: Discussionmentioning

confidence: 99%

“…The survey was administered to leaders in ve counties and 13 sectors in northern Arizona. Survey development and outcomes are described in detail in Remiker (2021) (17). The RHES's development was guided by a regional, multisectoral community advisory council (CAC) that assisted in design and administration.…”

Section: Methodsmentioning

confidence: 99%

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A Multisectoral Approach to Advance Health Equity in Northern Arizona: County-level Leaders’ Perspectives on Health Equity

Jiménez

Sabo

Remiker

et al. 2022

Preprint

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Background: Multisectoral and public-private partnerships are critical in building the necessary infrastructure, policy, and political will to ameliorate health inequity. By focusing on health equity, researchers, practitioners, and decision-makers make explicit the systematic, avoidable, unfair, and unjust differences in health status across population groups sustained over time and generations, beyond the control of individuals. Health equity requires a collective process in shaping the health and wellbeing of the communities in which we live, learn, work, play, move, and grow.Methods: Data are drawn from the Southwest Health Equity Research Collaborative’s Regional Health Equity Survey (RHES). The RHES is a community-informed, cross-sectional online survey comprised of 31 quantitative and 17 qualitative questions. Generated to elicit an interdisciplinary body of knowledge and guide future multisectoral action for improving community health and well-being, the RHES targeted leaders representing five large rural northern Arizona counties and 13 distinct sectors. To explore, multisectoral leaders’ knowledge, attitudes, and actions to address the social, environmental, and economic conditions that produce and sustain health inequity were analyzed using a priori coding scheme and emergent coding with thematic analysis.Results: Although leaders were provided the definition and asked to describe the root causes of inequities, the majority of leaders described social determinants of health (SDoH). When leaders described root causes of health inequity, they articulated systemic factors affecting their communities and described discrimination and unequal allocation of power and resources. Most leaders described the SDoH of their communities by discussing compounding factors of poverty, transportation, and housing among others, that together exacerbate inequity. Leaders also identified specific strategies to address SDoH and advance health equity in their communities, ranging from providing direct services, to activating partnerships across organizations and sectors in advocacy for policy change.Conclusion: Our findings indicate that community leaders in the northern Arizona region acknowledge the importance of multisectoral partnerships and collaborations in improving health equity for the populations that they serve. However, a common understanding of health equity remains to be widely established, which is essential for conducting effective multisectoral work with the goal of advancing health equity.

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Using a Multisectoral Approach to Advance Health Equity in Rural Arizona: Community-Engaged Survey Development and Implementation Study

Cited by 7 publications

References 11 publications

Facilitators of Multisector Collaboration for Delivering Cancer Control Interventions in Rural Communities: A Descriptive Qualitative Study

Facilitators of Multisector Collaboration for Delivering Cancer Control Interventions in Rural Communities: A Descriptive Qualitative Study

Grounding implementation science in health equity for cancer prevention and control

A Multisectoral Approach to Advance Health Equity in Northern Arizona: County-level Leaders’ Perspectives on Health Equity

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