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Ward MC, Singh S. Codifying DEIJ values in a national research-informed training effort. HPHR. 2024;89. https://doi.org/10.54111/0001/KKKK4
Translating DEIJ values into practice presents significant hurdles, particularly in embedding these values into workplace culture, institutional practices, and research methodologies. Nevertheless, numerous opportunities remain available to enact meaningful change. This methods paper outlines the strategies employed to integrate institutional values of diversity, equity, inclusion, and justice (DEIJ) into the development of the Two in One: HIV and COVID-19 Screening and Testing Model, a national research-informed training effort. Named for its goal to routinize both COVID vaccine and HIV screening and testing in one primary care visit, the Two in One team prioritized DEIJ principles to collectively produce innovation, excellence, and applicability. Highlighting the deliberate translation of DEIJ institutional values, this paper emphasizes the significance of an intentional approach to cultivate equitable and inclusive research and training practices. By adopting a DEIJ perspective and acknowledging the communities most affected, we demonstrate how the Two in One Model purposefully incorporated DEIJ values into the development of our program and research initiatives.
This methods paper explains the strategies used to translate diversity, equity, inclusion, and justice (DEIJ) institutional values into the design of the Two in One: HIV and COVID-19 Screening and Testing Model, a national research-informed training effort designed to eliminate the stigma and discrimination attached to HIV and COVID prevention via standardized screening conversations for all patients in primary care settings. Our goal is to enhance the ability of primary care practitioners to routinely engage in culturally responsive and nonjudgmental communication about COVID vaccination and HIV screening and testing with their racially, ethnically, sexually, and gender minoritized patients. Below are examples of how we upheld our DEIJ values, prioritized affected populations, and mitigated harm in our research and program efforts amidst ongoing challenges.
An institutional value for diversity is not merely focused on any form of difference. Would a research team consisting of a statistician, clinician, chemist, and mathematician be considered diverse? To answer this question, we need to observe representational diversity that only exists when a range of social identities are present.1-3 The call for representational diversity is necessary for a range of perspectives, worldviews, and values to collectively produce innovation, excellence and applicability.4,5
An institutional value for equity focuses on identifying and removing barriers to ensure everyone has a fair opportunity. The politicized rhetoric of a zero-sum view on equity produces a belief that some groups lose something by redistributing more resources to other groups.7,8 On the contrary, equity is squarely focused on repairing policies and the conditions in which people live, not repairing socially disadvantaged groups. Achieving this requires eliminating obstacles such as poverty, discrimination, and their consequences: powerlessness, lack of access to fair compensation, quality education, housing, healthcare, and safe environments.9 In discussions of equity, everyone benefits.9,10
Diversity efforts fall flat without an institutional value for inclusion. To disrupt the tendency to default to the views, interests, and preferences of the dominant group, there must be careful attention to share power across all groups.11,12 Empowering diverse groups in decision-making fosters validation and safety, enhancing belonging.13-15
Regarding an institutional value for justice, attention must be paid to naming historical and contemporary harms and righting such wrongs. While there are many forms of justice, at the center lies a decolonizing aim to repair injustice and the enduring trauma and intersectional oppression that persists.16-18 At the root of injustice are macro social ills such as patriarchy, colonialism, and white supremacy, to name a few.
Translating DEIJ values is especially challenging when measurably codifying them into workplace culture, institutional practice, and research processes. Challenges include:
Though change is not linear and takes time, it is possible through coalition and community building. As more folks reflect on their privilege and bias, they can maximize their impact by removing barriers and creating opportunities within their spheres of influence to mentor and support burgeoning leaders who will champion DEIJ efforts within the foreseeable future. Doing so will allow institutions to live out their social mission, remove inequities that cause prevention efforts to fall flat, and get that much closer to the nation’s health goals to achieve health equity.
We are grateful to every member of the Two in One team as well as the Two in One National Advisory Board for their dedication and invaluable support, which has been instrumental in the success of this training endeavor. This program has been supported by an independent educational grant from Gilead Sciences, Inc. The grant funder had no role in the design of this program.
The authors have no relevant financial disclosures or conflicts of interest.
Dr. Maranda Ward is an Assistant Professor and Director of Equity in the Department of Clinical Research and Leadership in the GW School of Medicine and Health Sciences. She is an expert in advancing anti-racism efforts within health professions education to competently promote health and racial equity in practice. As the PI of the Two in One: HIV and COVID Screening & Testing Model, she led a national research-informed educational intervention aimed at eliminating HIV, PrEP, and COVID-19 vaccine stigma. She earned degrees in sociology and anthropology from Spelman College, in public health from Tulane University, and in education from The George Washington University.
Sheel Singh is a doctoral student at the MGH Institute of Health Professions.
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