A Delphi Consensus on Recommendations for Improving Research Processes and Infrastructure to Address Health Disparities

Abstract

Background

Racial and ethnic disparities in critical care medicine remain poorly understood, making them difficult to address. This initiative developed a thought leader consensus with recommendations for critical care research to document, assess, and understand potential disparities.

Research Question

What key areas should future critical care research focus on to better identify and address disparities related to race, ethnicity, and language?

Study Design and Methods

A modified Delphi-based method was used to form a consensus about addressing racial disparities through future critical care research. Nine thought leaders discussed aspects related to 4 topics: collection of race, ethnicity, and language variables; establishing recruitment plans for researchers from racial and ethnic minority groups; designating minority serving institutions; and health disparity education and community engagement. Consensus was reached when ≥ 80% of members agreed (answered with yes or with 4 to 5 points on a Likert scale).

Results

Thought leaders arrived at a consensus agreement (100%) that improved data quality, achieved by more robust recruitment of research participants from racial and ethnic minority groups and standardization of race and ethnicity data, is crucial as the initial step of uncovering health disparities. They agreed that collection of language preferences should be part of all research studies to expose potential biases and disparities in non-English speakers (100% agreement). Engagement of racial and ethnic minority communities was agreed to be essential to obtain involvement of research participants from such minoritized groups (100%).

Interpretation

This consensus revealed the notable data deficiency impacting health disparities within critical care research especially when compared with other settings, highlighting the crucial need for comprehensive focus on this domain. Standardization of race, ethnicity, and language data collection, with the goal of increasing the number of research participants from racial and ethnic minority groups, is vital for understanding health disparities in critical care research and its potential causes.