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Organizational Practices Advancing Racial Equity (OPARE): Development of a Tool Using an Implementation Science Approach

Publication: Canadian Journal of Community Mental Health
23 May 2023

Abstract

Organizational practices to advance racial equity are needed to address the systemic nature of racism. Implementation science frameworks offer a comprehensive approach when implementing complex initiatives. We describe the development of a tool to assess organizational practices in advancing racial equity (OPARE). Findings on the acceptability, reliability and preliminary validity are presented based on 98 responses from child and youth mental health agencies across Ontario. The OPARE shows promise as a valid and reliable organizational assessment tool for helping plan, implement and evaluate racial equity efforts in community mental health settings.

Résumé

Les pratiques organisationnelles de promotion de l’égalité raciale sont nécessaires pour aborder la nature systémique du racisme. Les méthodes scientifiques d’implantation participent d’une approche globale quant à la mise en place d’initiatives complexes. Nous décrivons le développement d’un outil pour évaluer les pratiques organisationnelles visant à promouvoir l’égalité raciale (Organizational Practices in Advancing Racial Equity [OPARE]). Les résultats portant sur l’acceptabilité, la fiabilité et la validité préalable résultent d’un sondage auquel ont répondu 98 agences de santé mentale pour enfants et adolescents d’Ontario. L’OPARE apparaît être un outil prometteur de validation et d’analyse de la fiabilité organisationnelle d’un plan portant sur la mise en place et l’évaluation de la promotion de l’égalité raciale au sein de communautés en santé mentale.

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References

Aarons G. A., Ehrhart M. G., Farahnak L. R., and Hurlburt M. S. 2015 Leadership and organizational change for implementation (LOCI): A randomized mixed method pilot study of a leadership and organization development intervention for evidence-based practice implementation Implementation Science 10 1 11 https://doi.org/10.1186/s13012-014-0192-y
Bailey Z. D., Krieger N., Agénor M., Graves J., Linos N., and Bassett M. T. 2017 Structural racism and health inequities in the USA: Evidence and interventions The Lancet 389 10077 1453 -1463 https://doi.org/10.1016/S0140-6736(17)30569-X
Blakeslee, J. E., & Walker, J. S. (2018). Assessing the meaningful inclusion of youth voice in policy and practice: State of the science. Portland, OR: Research and Training Center for Pathways to Positive Futures, Portland State University. http://archives.pdx.edu/ds/psu/25114
Bhui K., Mohamud S., Warfa N., Craig T., and Stansfeld S. 2003 Cultural adaptation of mental health measures: Improving the quality of clinical practice and research The British Journal of Psychiatry 183 3 184 -186 https://doi.org/10.1192/bjp.183.3.184
Bombard Y., Baker G. R., Orlando E., Fancott C., Bhatia P., Casalino S., Onate K., Denis J.L, and Pomey M. P. 2018 Engaging patients to improve quality of care: A systematic review Implementation Science 13 1 1 -22 https://doi.org/10.1186/s13012-018-0784-z
Burton W. M. 2022 Gendered racism: A call for an intersectional approach Journal of Psychosocial Nursing and Mental Health Services 60 12 3 -4 https://doi.org/10.3928/02793695-20221109-01
Cénat J. M., Kouamou L. N., Farahi S. M. M. M., Darius W. P., Dalexis R. D., Charles M., and Kogan C. S. 2022 Perceived racial discrimination, psychosomatic symptoms, and resilience among Black individuals in Canada: A moderated mediation model Journal of Psychosomatic Research 163 111053 https://doi.org/10.1016/j.jpsychores.2022.111053
Coalition of Communities of Color & All Hands Raised (CCC AHR). (2014, January). Tool for organizational self-assessment related to racial equity. https://racc.org/wp-content/uploads/buildingblocks/foundation/CCC%20-%20Tool%20for%20Organizational%20Self-Assessment%20Related%20to%20Racial%20Equity.pdf
Cha E. S., Kim K. H., and Erlen J. A. 2007 Translation of scales in cross-cultural research: Issues and techniques Journal of Advanced Nursing 58 4 386 -395
Comas-Díaz L., Hall G. N., and Neville H. A. 2019 Racial trauma: Theory, research, and healing: Introduction to the special issue American Psychologist 74 1 1 https://doi.org/10.1037/amp0000442
Corneau S. and Stergiopoulos V. 2012 More than being against it: Anti-racism and anti-oppression in mental health services Transcultural Psychiatry 49 2 261 -282 https://doi.org/10.1177/1363461512441594
Crenshaw K. W. 2006 Intersectionality, identity politics and violence against women of color Kvinder, kön & forskning 2–3 https://doi.org/10.7146/kkf.v0i2-3.28090
Damschroder L. J., Aron D. C., Keith R. E., Kirsh S. R., Alexander J. A., and Lowery J. C. 2009 Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science Implementation Science 4 1 50 https://doi.org/10.1186/1748-5908-4-50
Danseco E., Notarianni M. A., and Kocourek J. 2020 Quality standards on youth engagement and family engagement: Defining excellence for engagement Canadian Journal of Community Mental Health 39 2 59 -64 https://doi.org/10.7870/cjcmh-2020-011
Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., Wallace, F., Burns, B., & Chambers, D. (2009). Implementation research: A synthesis of the literature. The National Research Implementation Network. https://nirn.fpg.unc.edu/sites/nirn.fpg.unc.edu/files/resources/NIRN-MonographFull-01-2005.pdf
Gill G. K., McNally M. J., and Berman V. 2018 Effective diversity, equity, and inclusion practices Healthcare Management Forum 31 5 196 -199 https://doi.org/10.1177/0840470418773785
Gone J. P., Hartmann W. E., Pomerville A., Wendt D. C., Klem S. H., and Burrage R. L. 2019 The impact of historical trauma on health outcomes for indigenous populations in the USA and Canada: A systematic review American Psychologist 74 1 20 https://doi.org/10.1037/amp0000338
Hagopian A., West K. M., Ornelas I. J., Hart A. N., Hagedorn J., and Spigner C. 2018 Adopting an anti-racism public health curriculum competency: The University of Washington experience Public Health Reports 133 4 507 -513 https://doi.org/10.1177/0033354918774791
Halton Equity and Diversity Roundtable (HEDR). (n.d.). Organizational self-assessment tool for equity, diversity and inclusion. http://hedroundtable.com/organizational-self-assessment-tool/#1486653426610-20c632e4-af47
Hardeman R. R., Medina E. M., and Kozhimannil K. B. 2016 Structural racism and supporting Black lives: The role of health professionals New England Journal of Medicine 375 22 2113 -2115 https://doi.org/10.1056/NEJMp1609535
Hardeman R. R., Homan P. A., Chantarat T., Davis B. A., and Brown T. H. 2022 Improving the measurement of structural racism to achieve antiracist health policy: Study examines measurement of structural racism to achieve antiracist health policy Health Affairs 41 2 179 -186 https://doi.org/10.1377/hlthaff.2021.01489
Hassen N., Lofters A., Michael S., Mall A., Pinto A. D., and Rackal J. 2021 Implementing anti-racism interventions in healthcare settings: A scoping review International Journal of Environmental Research and Public Health 18 2993 https://doi.org/10.3390/ijerph18062993
Janzen R., Ochocka J., Jacobson N., Maiter S., Simich L., Westhues A., and Fleras A. 2010 Synthesizing culture and power in community mental health: An emerging framework Canadian Journal of Community Mental Health 29 1 51 -67 https://doi.org/10.7870/cjcmh-2010-0005
Khanijahani A., Iezadi S., Gholipour K., Azami-Aghdash S., and Naghibi D. 2021 A systematic review of racial/ethnic and socioeconomic disparities in COVID-19 International Journal for Equity in Health 20 1 248 https://doi.org/10.1186/s12939-021-01582-4
King A. J., Brophy L. M., Fortune T. L., and Byrne L. 2020 Factors affecting mental health professionals’ sharing of their lived experience in the workplace: A scoping review Psychiatric Services 71 10 1047 -1064 https://doi.org/10.1176/appi.ps.201900606
Kirmayer L. J., Gone J. P., and Moses J. 2014 Rethinking historical trauma Transcultural Psychiatry 51 3 299 -319 https://doi.org/10.1177/1363461514536358
Kirmayer L. J. and Jarvis G. E. 2019 Culturally responsive services as a path to equity in mental healthcare Healthcare Papers 18 2 11 -23 https://www.longwoods.com/content/25925/healthcarepapers/culturally-responsive-services-as-a-path-to-equity-in-mental-healthcare
Kirmayer L. J., Fernando S., Guzder J., Lashley M., Rousseau C., Schouler-Ocak M., Lewis-Fernandez R., Fung K., and Jarvis G. E. 2021 A call to action on racism and social justice in mental health: Un appel à l’action en matière de racisme et de justice sociale en santé mentale The Canadian Journal of Psychiatry 66 6 590 -593 https://journals.sagepub.com/doi/pdf/10.1177/0706743720964333
Knopf A., Budhwani H., Logie C. H., Oruche U., Wyatt E., and Draucker C. B. 2021 A review of nursing position statements on racism following the murder of George Floyd and other Black Americans Journal of the Association of Nurses in AIDS Care 32 4 453 -466 https://journals.lww.com/janac/Abstract/2021/08000/A_Review_of_Nursing_Position_Statements_on_Racism.5.aspx
Kurzawa J., Danseco E., Lucente G., Sundar P., and Huang C. 2022 Advancing racial equity, diversity and inclusion in Ontario’s child and youth mental health sector: Perspectives of agency leaders Canadian Psychology/Psychologie Canadienne 63 4 500 -510 https://doi.org/10.1037/cap0000336
Kurzawa, J., Lucente, G., Danseco, E. & Sundar, P. (2021). Racial equity efforts in child and youth mental health agencies across Ontario: Final report. Ottawa, ON: The Knowledge Institute on Child and Youth Mental Health and Addictions. https://www.cymha.ca/equity
Lucente, G., Danseco, E., Kurzawa, J., & Sundar, P. (2021a). Advancing racial equity together: A review of the literature on effective organizational practices. Ottawa, ON: The Ontario Centre of Excellence for Child and Youth Mental Health. https://www.cymha.ca/equity
Lucente G., Kurzawa J., and Danseco E. 2021b Moving towards racial equity in the child and youth mental health sector in Ontario, Canada Administration and Policy in Mental Health and Mental Health Services Research 49 2 153 -156 https://doi.org/10.1007/s10488-021-01153-3
Marrie, H., & Marrie, A. (2014). A matrix for identifying, measuring and monitoring institutional racism within public hospitals and health services. Bukal Consultancy Services. https://acquire.cqu.edu.au/ndownloader/files/25798685
Mental Health Technology Transfer Center Network (MHTTCN). (2018, December). Assessing workforce diversity: A tool for mental health organizations on the path to health equity. http://www.cars-rp.org/_MHTTC/docs/Assessing-Workforce-Diversity-Tool.pdf
Metz A., Woo B., and Loper A. 2021 Equitable implementation at work Stanford Social Innovation Review 19 3 A29 -A31
Nawaz S., Moon K. J., Seiber E., Trinh A., Bennett S., and Joseph J. J. 2020 Racism measurement framework: A tool for public health action and accountability Ohio Journal of Public Health 3 3 16 -28 https://doi.org/10.18061/ojph.v3i3.8037
Schouler-Ocak M., Bhugra D., Kastrup M. C., Dom G., Heinz A., Küey L., and Gorwood P. 2021 Racism and mental health and the role of mental health professionals European Psychiatry 64 1 e42 1–8. https://doi.org/10.1192/j.eurpsy.2021.2216
Shahi A., Karachiwalla F., and Grewal N. 2019 Walking the walk: The case for internal equity, diversity, and inclusion work within the Canadian public health sector Health Equity 3 1 183 -185 https://doi.org/10.1089/heq.2019.0008
Spitzer-Shohat S. and Chin M. H. 2019 The “Waze” of inequity reduction frameworks for organizations: A scoping review Journal of General Internal Medicine 34 4 604 -617 https://link.springer.com/article/10.1007/s11606-019-04829-7
Talley R. M., Shoyinka S., and Minkoff K. 2021 The self-assessment for modification of anti-racism tool (SMART): Addressing structural racism in community behavioral health Community Mental Health Journal 57 6 1208 -1213 https://doi.org/10.1007/s10597-021-00839-0
The Annie C. Casey Foundation. (2006, January). Race matters: Organizational self-assessment. https://www.aecf.org/resources/race-matters-organizational-self-assessment/
Westhues A., Janzen R., Roth D., and Grant J. G. 2011 Community mental health organizations in Ontario: Perceptions of cultural responsiveness Canadian Journal of Community Mental Health 29 2 99 -111 https://doi.org/10.7870/cjcmh-2010-0025
Wilcox M. M. 2022 Oppression is not “culture”: The need to center systemic and structural determinants to address anti-Black racism and racial trauma in psychotherapy Psychotherapy Advanced online publication. https://doi.org/10.1037/pst0000446

Information & Authors

Information

Published In

cover image Canadian Journal of Community Mental Health
Canadian Journal of Community Mental Health
Volume 42Number 1May 2023
Pages: 97 - 118

History

Version of record online: 23 May 2023

Key Words

  1. antiracism
  2. equity
  3. organizational change
  4. implementation
  5. organizational assessment

Mots-clés

  1. antiracisme
  2. égalité
  3. changements organisationnels
  4. implantation
  5. évaluation organisationnelle

Authors

Affiliations

Evangeline Danseco [email protected]
Knowledge Institute on Child and Youth Mental Health and Addictions
Gabrielle Lucente
Knowledge Institute on Child and Youth Mental Health and Addictions
Julia Kurzawa
Knowledge Institute on Child and Youth Mental Health and Addictions

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