This blog post contains contributions from an upcoming special issue of Journal of the American Medical Informatics Association

In April 2018, the Computing Community Consortium (CCC) held a visioning workshop on Sociotechnical Interventions for Health Disparity Reduction. The workshop brought together leading researchers from computing, health informatics, behavioral medicine, and health disparities to develop an integrative research agenda that will advance sociotechnical interventions capable of reducing health disparities and improving the health outcomes of socio-economically disadvantaged populations.

Four main themes were addressed during the course of the workshop:

• Theory to Design and Implementation: “How do researchers appropriately identify and map theory to design, implementation, and evaluation?”
• Sociotechnical System Blackboxes: “How can researchers understand when sociotechnical systems elicit positive, negative or neutral health outcomes for disparity populations, can we identify why? How do we identify the individual or combined impacts of theory and design?
• Sociotechnical Systems to Inform Theory: “How do the data that sociotechnical systems collect impact theory? How do we negotiate the dosing of sociotechnical systems from what is clinically needed to what people are willing to use? “
• Multidimensional Evaluation to Reduce Health Disparities at the Population Level: Sociotechnical interventions hold promise for reducing disparities and improving the health of marginalized populations, however interventions can generate unintended consequences that exacerbate disparities. To prevent this, we considered optimal methods for engaging health disparity populations at all stages of intervention design, implementation, and evaluation.

At the workshop, participants noted that researchers from different fields are largely developing separate approaches from scratch and in relative isolation or in small interdisciplinary teams, which makes it difficult to make scalable progress and larger real-world impacts. One step towards prompting interdisciplinary conversation and exchange is to bring researchers together in publication venues focused on a shared application area. Therefore, as a follow-up to the workshop, several attendees and researchers working in cognate areas from around the world have joined forces on a Special Focus Issue of the Journal of the American Medical Informatics Association (JAMIA) on “Health Informatics and Health Equity: Improving Our Reach and Impact.” A portion of the call can be read below:

Description of Special Focus Issue
While investments in health and healthcare continue to grow, certain negative health outcomes are disproportionately experienced by specific groups in the United States and other countries, a phenomenon called health disparities. Health informatics interventions hold promise for enabling health equity and improving the health of marginalized groups — but this potential is yet to be fully realized. The goal of this proposed special focus issue is to highlight health informatics research that focuses on marginalized and underserved groups, and health equity. Expectations are that submissions will involve groups that experience health disparities as participants and/or focus on informatics-relevant policies, practices, interventions, environments, and institutions that (re-) produce disparities in health and healthcare. Contributions that involve both observational and interventional methods are welcome, and submitted papers may utilize qualitative and/or quantitative data. Research reports must include thorough explanations of study participant demographics, setting, methods, and data analysis. For interventional research, contributions that focus on health equity-relevant independent or outcome variables, and that conduct analyses regarding treatment effect heterogeneity are especially encouraged. We also encourage researchers to reflect on their methods of recruitment and enrollment, their intervention designs, and analytical methods to discuss how health equity-related issues affected their research. As part of this, we welcome reflections upon ways to improve upon past efforts. Relevant methodological contributions and equity-focused systematic reviews are also desired.

 

General Information about the journal can be found on the JAMIA website.

 

Topics of Interest

This Special Focus Issue aims to collect novel health informatics research focused on marginalized and underserved groups, health disparities, and health equity. This special issue welcomes original research papers, perspectives, conceptual papers, case reports and systematic review articles addressing a range of topics associated with this area including, but are not limited to, the following areas:

– designing interventions for marginalized and underserved groups

– methods for engaging marginalized and underserved groups in design and research

– access to, and uptake of, informatics interventions for marginalized and underserved groups

– methods for engaging marginalized and underserved groups in the longer-term use of informatics interventions

– non-use and non-adherence to interventions in marginalized and underserved groups

– evaluations of interventions that address outcomes of interest to marginalized and underserved groups, or that assess heterogeneity of treatment effects for subgroups (see ^1,2 for suggested guidelines on reporting for equity-relevant trials)

– collection and analysis of social determinants of health and other contextual data

– clinical informatics interventions that highlight and/or address disparities in healthcare access and quality

– developing and validating theories that address health disparities that can inform informatics interventions

– ethical and policy studies focused on marginalized and underserved groups and disparities, including the potential role of technology in widening inequality

– upstream interventions that target the social origins of health disparities

– unintended consequences of interventions for health equity

– health equity-focused systematic reviews (see ³ for suggested guidelines on reporting)”

We encourage researchers and practitioners in the field to review the call for papers and consider submitting to this special issue of the top journal in health informatics. The due date for submissions is January 9, 2019. To submit a paper visit the submission site.

A workshop report summarizing the discussions and conclusions from the Sociotechnical Interventions workshop is in progress and will be released soon – it will be posted on the workshop website and CCC blog once it is finished.