A framework to integrate equity in public health emergency response dashboards: Dashboard instrument to review equity (DIRE)

Abstract

Objectives

COVID-19 created an urgent element of clinical and financial strain to the public health system, forcing it into rapid response mode. Key public health decisions were quickly made, with limited data and guidance to address decision trade-offs and community inequities. Gaps identified in the pandemic confirmed the need for a new tool, like this study's Dashboard Instrument to Review Equity (DIRE) Framework, to ensure decision-makers are given quick and equitable decision-making guidance.

Study design

Scoping review and tool development.

Methods

The scoping review was conducted through PRISMA-ScR, and by utilizing tools like PubMed, Scopus, and Paper Piles to compile and cite. Three levels of thematic analysis were completed. Tool development consisted of building a conceptual model on the DIKW Pyramid and Informatics Stack. Then the review's five themes were integrated into DIRE.

Results

The review closed at a final count of 102 articles, with five themes emerging: COVID-19 impact, Health Equity, Decisions During Emergencies, Dashboards and Decision Support, and Frameworks. COVID-19 dashboards were also reviewed. DIRE was designed into three layers (context, data flow, and dashboard users) and three data flow buckets (data sources, DIK pillars, and interventions).

Conclusions

This study aimed to (1) Establish a research foundation of health equity, COVID-19 lessons learned, and decision support, and (2) Develop an evidence-based framework. Though further research is still recommended, DIRE is now the first 3-point framework aimed at preparing decision-makers to respond quickly and equitably to future emergencies.