Dimensionality and R4P: A Health Equity Framework for Research Planning and Evaluation in African American Populations

• Published in: Maternal and child health journal Vol. 22; no. 2; pp. 147 - 153
• Main Authors: Hogan, Vijaya, Rowley, Diane L., White, Stephanie Baker, Faustin, Yanica
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-02-2018; Springer; Springer Nature B.V
• Subjects: African Americans; Commentary; Dimensional analysis; Gynecology; Health aspects; Health disparities; Health Equity; Health Plan Implementation; Health Policy; Health promotion; Health Status Disparities; Healthcare Disparities - organization & administration; Humans; Maternal and Child Health; Medicine; Medicine & Public Health; Minority & ethnic groups; Pediatrics; Population Economics; Public Health; Sociology; Evaluation; Health equity; Health disparities; African American
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-017-2411-z

Introduction
 Existing health disparities frameworks do not adequately incorporate unique interacting contributing factors leading to health inequities among African Americans, resulting in public health stakeholders’ inability to translate these frameworks into practice.
Methods
 We developed dimensionality and R4P to integrate multiple theoretical perspectives into a framework of action to eliminate health inequities experienced by African Americans.
Results
 The dimensional framework incorporates Critical Race Theory and intersectionality, and includes dimensions of time—past, present and future. Dimensionality captures the complex linear and non-linear array of influences that cause health inequities, but these pathways do not lend themselves to approaches to developing empirically derived programs, policies and interventions to promote health equity. R4P provides a framework for addressing the scope of actions needed. The five components of R4P are (1) Remove, (2) Repair, (3) Remediate, (4) Restructure and (5) Provide.
Conclusion
 R4P is designed to translate complex causality into a public health equity planning, assessment, evaluation and research tool.