Interventions to Improve Minority Health Care and Reduce Racial and Ethnic Disparities

Racial and ethnic disparities are widespread in the US health care system. A 2007 report from the Portland Evidence-based Synthesis Program (ESP) similarly found disparities were prevalent in a variety of clinical arenas within Department of Veterans Affairs (VA). The report identified several promising avenues for future interventions designed to reduce racial and ethnic disparities. The extent to which such intervention research has been conducted in VA populations is unclear, though our review of published studies suggests disparities intervention research in the VA may be lagging behind research of interventions conducted outside of the VA setting. Furthermore, the approach to disparities interventions may be quite varied, and this may further complicate the development of an organized research agenda within the VA. Identifying challenges to conducting intervention research remain critical steps to informing future VA disparities intervention efforts to reduce disparities and improve health outcomes for minority Veterans. The objectives of this review are to describe the state of disparities intervention research within the VA, glean lessons from systematic reviews of intervention research not limited to VA settings, and develop an organizing framework to describe studies in this field of research. This report is also intended to inform future disparities intervention research in the VA, as well as VA policies and programs to reduce disparities. To accomplish these objectives, we will answer the following key questions: Key Question #1. What is the state of research on interventions to reduce race/ethnic disparities or to improve health and health care in minority populations within VA health care settings? Key Question #2. What are the results of interventions (within and outside the VA) to reduce race/ethnic disparities or to improve health and health care in minority populations?