Equity Frameworks Research Articles

Review of gender, socioeconomic status, and ethnic background considerations reported in active school travel intervention studies

IntroductionTrends over the last half century have shown that fewer children today are engaging in active modes of travel to and from school than in previous generations. Interventions promoting active school travel (AST) can be effective at reversing these trends and increasing rates of AST among children. This paper aims to explore (1) how studies of AST interventions have considered or framed multiple equity factors, namely those related to gender, socioeconomic status (SES), and ethnic background, in the design and evaluation of AST interventions, and (2) to what extent studies of AST interventions report these equity considerations in their analyses, outcomes, programming, and discussions. MethodsSix databases were used (BIOSIS Previews, GeoBase, PubMed, SCOPUS, SPORTDiscus, and Web of Science) to obtain AST literature published between 2010 and 2019 from around the world. The inclusion criteria applied in this review included a focus on an AST intervention for children (aged 5–19 years), quantitative results, and a primary outcome related to AST. A total of 69 papers were included in the review. ResultsAcross AST intervention studies, equity considerations were scarcely reported. Among the explicit mentions, gender and socioeconomic status were reported most often compared to ethnic background. Some papers reported differential effects among groups. Gender, SES, and ethnic background were, when reported, generally considered as variables that were controlled for within study samples. ConclusionsSuggestions to address equity within studies of AST interventions include reporting equity considerations made throughout the intervention and its evaluation in the published article. Using and reporting equity frameworks to develop AST interventions and conducting sub-group analyses during evaluation allows for greater assessment of equity effects and improved utility and applicability of the AST intervention. Ensuring the integration of equity into AST literature is needed to support evidence-based and equitable practices.

‘It’s how the world around you treats you for being trans’: mental health and wellbeing of transgender people in Aotearoa New Zealand

ABSTRACT Globally, transgender people have been described as a highly marginalised population due to cisgenderism that delegitimises their gender identities and expressions. Despite robust evidence from many countries noting the association of discrimination and stigma for being transgender with heightened mental health risks, qualitative research that examines the nuances of mental health indicators using health equity frameworks has been scant both in Aotearoa/New Zealand and overseas. Using an inductive thematic approach, this paper analysed 222 open-text responses in the mental health section of the 2018 Counting Ourselves: Aotearoa New Zealand, Trans and Non-binary Health Survey. Our findings showed four overarching themes: gender-affirming healthcare, mental healthcare services and accessibility, gender minority stress, and self-affirmation and social support. Participants’ narratives described pervasive gender minority stress experiences in gender-affirming and mental healthcare services, including unmet healthcare needs, lack of competency in healthcare delivery, and pathologisation of their genders. In social settings, our participants commonly reported discrimination and violence, although they also reported that self-affirmation strategies and social support offset the impacts of gender minority stress on their mental health. The current findings indicate the importance of exploring mental health outcomes for transgender people in relation to cisgenderism and resultant gender minority stress.

Learning From the Past and Working in the Present to Create an Antiracist Future for Academic Medicine.

Learning From the Past and Working in the Present to Create an Antiracist Future for Academic Medicine.

Masquerading as equitable: using white teachers’ racist communication to guide diversity course revisions

ABSTRACT Graduate programs for inservice teachers seeking additional credentialing often include a mandatory diversity course. One aim of these types of courses is to help teachers recognize and dismantle their racial biases in hopes that this self-reflection process will enable teachers to use antiracist teaching approaches and create classroom communities where all students feel safe, respected, and justly included in the classroom. We, two practitioner-researchers, both taught separate sections of one such mandatory graduate diversity course for inservice teachers. Instructor photos revealing our race (Author 1: Black, Author 2: White) were the only differences in the fully online, asynchronous course sections. After experiencing/witnessing graduate students’ racial bias towards the Black instructor captured via informal communication posted to the ‘Ask the Instructor’ board, we investigated whether students’ racial bias would be captured in graded coursework. Using both Cultural Historical Activity Theory (CHAT) and Critical Race Theory (CRT) we compared students’ work samples from each course section and found that students’ racial biases were not captured. Our findings help us problematize diversity courses hinged on broad-stroke equity frameworks. Thus, we use CRT to posit course revisions aimed at helping students develop post-racist mindsets and commit to anti-racist practices.

Decentralization Process in Portugal: impact in the health care system

Abstract Problem Different countries have incorporated models of decentralization in their health reforms to achieve efficiency, by increasing the training of local governments, responsibility and gains in areas such as quality, costs and equity. In Portugal, the 21st government program established the autonomy of local authorities and the democratic decentralization of public administration. Accordingly, a decentralization law was approved and local governments have now a crucial role on health policies. Description of the Problem For this framework, a situational diagnosis and an intersectoral approach to policies are needed. This is an observational, analytical and cross-sectional study developed at council level in two Portuguese municipalities. This study aims to: Adjust responses to health needs at the local level; Set priorities by taking into account installed capacity and responses to populations; Promote the articulation between entities; Strengthen the focus on health promotion and healthy lifestyles; Strengthen health interventions in educational communities; Promote the creation of programs at local level, in conjunction with the national level, to reduce inequalities. Results The preliminary results in health, social and economic indicators show that this framework, while taking in consideration population characteristics, allows the development of local strategies regarding health services coverage, health services type and medication. At council level, the preliminary results also show a lack of data on healthy lifestyles and social indicators. Lessons The implementation of a decentralization process involves a broad range of requirements such as a situational diagnosis, strategies development and a periodic update of quality life and health indicators. Those are needed to assess council level priorities, which allow the development of public policies and interventions, in line with population characteristics, to tackle health inequalities and inequities. Key messages Performance improvement of health system is linked to the implementation of local citizen centred policies. These are actions which promote quality of life through health-friendly ecosystems. The local health intervention has contributed to promote inequalities reduction, increasing equity and dynamize new frameworks of organization with individual and community participation.

Analyzing Instructionally Focused Education Systems: Exploring the Coordinated Use of Complementary Frameworks

ABSTRACT Public school districts have been operating under a decade’s long press to move beyond functioning as engines of access-oriented mass public schooling to functioning as instructionally focused education systems pursuing educational excellence and equity. This press has researchers developing analytic frameworks useful for examining different ways that districts are responding. Even so, limitations in individual frameworks suggest a need to explore the coordinate use of complementary frameworks to support more comprehensive examinations of districts. This analysis explores the coordinated use of a “coupling framework” and a “systems framework” to analyze efforts in two districts to improve educational quality and to reduce disparities. Findings suggests that the coordinated use of the coupling and systems frameworks supports deeper analyses of instructional organization and management than either framework would on its own, and that further incorporating quality and equity frameworks would support still-deeper analyses. From the perspective of this issue of the Peabody Journal of Education (PJE), the implication is that elaborating new institutional theory to capture micro-level variation in response to macro-level dynamics is but one challenge faced by organizational researchers in education, and that the deeper challenge lies in considering alternative world views—paradigmatic assumptions—underlying the use of singular and complementary analytic frameworks.

Equity in allocating carbon dioxide removal quotas

The first nationally determined contributions to the Paris Agreement include no mention of the carbon dioxide removal (CDR) necessary to reach the Paris targets, leaving open the question of how and by whom CDR will be delivered. Drawing on existing equity frameworks, we allocate CDR quotas globally according to Responsibility, Capability and Equality principles. These quotas are then assessed in the European Union context by accounting for domestic national capacity of a portfolio of CDR options, including bioenergy with carbon capture and storage, reforestation and direct air capture. We find that quotas vary greatly across principles, from 33 to 325 GtCO2 allocated to the European Union, and, due to biophysical limits, only a handful of countries could meet their quotas acting individually. These results support strengthening cross-border cooperation while highlighting the need to urgently deploy CDR options to mitigate the risk of failing to meet the climate targets equitably. Carbon dioxide removal (CDR) will be necessary to meet climate targets. Applying equity principles to allocate national CDR quotas shows a large variation across countries and principles, while within the EU domestic biophysical limits constrain individual capacity to achieve them.

Retail brand equity: moderating role of retail price deals on retail brand association and retail brand equity relationship

The online retail industry is a unique setup with high market potential and the low entry barriers where most of the retailers sell the same products under different price points. Though the price of the products is same for all the retailers, they use discounts, offers, price cuts, refunds and other methods to acquire and retain customers. Under these conditions, this research is emphasised on demonstrating the sources of retailer equity and intended to test the moderating effect of price deals on retailer association and retailer brand equity relationship. This paper contributed to the existing retail brand equity frameworks by adding 'price deal' as a new dimension and explored the necessity of the e-tail quality dimension instead of perceived quality dimension in traditional brand equity frameworks. The results from this study will help online retailers and researchers to recognise the importance of the retailer equity dimensions and their criticality in creating a long-term relationship.

Retail brand equity: moderating role of retail price deals on retail brand association and retail brand equity relationship

The online retail industry is a unique setup with high market potential and the low entry barriers where most of the retailers sell the same products under different price points. Though the price of the products is same for all the retailers, they use discounts, offers, price cuts, refunds and other methods to acquire and retain customers. Under these conditions, this research is emphasised on demonstrating the sources of retailer equity and intended to test the moderating effect of price deals on retailer association and retailer brand equity relationship. This paper contributed to the existing retail brand equity frameworks by adding 'price deal' as a new dimension and explored the necessity of the e-tail quality dimension instead of perceived quality dimension in traditional brand equity frameworks. The results from this study will help online retailers and researchers to recognise the importance of the retailer equity dimensions and their criticality in creating a long-term relationship.

Drought in Ethiopia: A Population Health Equity Approach to Build Resilience for the Agro-Pastoralist Community

BACKGROUND: A devastating drought is ravaging Africa, with Ethiopia being the worst-hit country. Ethiopia’s economy is predominantly reliant on rain-fed farming and livestock. The agriculture sector contributes up to 85% of the country’s livelihoods. The drought has threatened agro-economy and health of over 15 million agro-pastoralist population who herd the largest livestock in Africa. Some governments announced its commitment in the UN to extend support for the drought-affected people. The Sendai framework for Disaster Risk Reduction prioritizes proactive rather than reactive relief response that can promote health resilience. Applying population health matrices can serve the purpose by exploring the determinants of health, their impacts on the differential health outcomes for population sub-groups and to improve the overall health of the population by addressing the health inequity. 
 
 OBJECTIVE: This study aims to identify the critical population health outcomes, underlying determinants, and the leverage points for actions that can guide effective policies and interventions for building health resilience for the vulnerable agro-pastoralist population in Ethiopia. 
 
 METHODS: Two researchers searched nine academic and grey literature bibliographic databases for drought literature and related health interventions. We used the PRISMA checklist to synthesize data and Hamilton tools to evaluate individual study quality. We analyzed data employing disaster vulnerability and WHO’s social determinants of health and health equity frameworks. Socioeconomic, political and cultural backgrounds are examined to identify policy and leverage points for effective population health interventions. 
 
 RESULTS: Health issues are diverse that revolve around the major determinants of health such as food security, infrastructure, health systems, disaster preparedness, household productivity-income, livestock dependence and access to the market economy. These determinants are further affected by socioeconomic, political and cultural contexts. Despite dire vulnerability and health inequity, some potentials evolved from recent public health field practices as the leverage points for policy actions and interventions. 
 
 CONCLUSION: The recommended interventions can be implemented through an interdisciplinary population health approach to get the maximum impacts on health resilience. Evidence gathered from the worst drought niche in Africa can be useful to tackle similar droughts induced health issues in other parts of the continent. Future intervention research on the ground can generate robust evidence for action to build health resilience.

Working Together to Improve Community-Level Health: The Evolution of the New York City Food & Fitness Partnership.

The New York City Food & Fitness Partnership case study discusses how the scope and abundance of diverse community stakeholders can create difficulties when addressing and conducting work in a large city landscape. We describe our 9-year journey, from initial citywide planning, to early challenges, to rebirth as a Central Brooklyn-focused effort led by a community development corporation. We describe difficult and transparent conversations, and the various leadership changes and organizational transitions that have helped the partnership embrace equity frameworks. We illustrate how these principles have been demonstrated in their efforts to be community driven, ensuring that intended beneficiaries would be involved in every stage of decision making.

HEIA tools: inclusion of migrants in health policy in Canada.

This paper introduces the Migrant Populations Equity Extension for Ontario's Health Equity Impact Assessment (HEIA) initiatives. It provides a mechanism to address the needs of migrant populations, within a program and policy framework. Validation of an equity extension framework using community leaders and health practitioners engaged in HEIA workshops across Ontario. Participants assessed migrants' health needs and discussed how to integrate these needs into health policy. The Migrant Populations Equity Extension's framework assists decision makers assess relevant populations, collaborate with immigrant communities, improve policy development and mitigate unintended negative impacts of policy initiatives. The tool framework aims to build stakeholder capacity and improve their ability to conduct HEIAs while including migrant populations. The workshops engaged participants in equity discussions, enhanced their knowledge of migrant policy development and promoted HEIA tools in health decision-making. Prior to these workshops, many participants were unaware of the HEIA tool. The workshops informed the validation of the equity extension and support materials for training staff in government and public health. Ongoing research on policy implementation would be valuable. Public health practitioners and migrant communities can use the equity extension's framework to support decision-making processes and address health inequities. This framework may improve policy development and reduce health inequities for Ontario's diverse migrant populations. Many countries are now using health impact assessment and health equity frameworks. This migration population equity extension is an internationally unique framework that engages migrant communities.

A Cross-Cultural Study of Collective Brand Perceptions Within The Brand Equity Framework

Brand equity frameworks conceptualize consumer metrics as individual brand perceptions that are relevant in individualistic cultures. These frameworks require extension to collectivistic cultures to understand collective brand perceptions. Collective brand perceptions form through brand information to which consumers in collectivistic cultures are more susceptible. Are such perceptions culture-bound? Multilevel analysis links two unique consumer samples to answer the question. One represents individual consumer metrics (N = 4,593); the other reflects collective brand perceptions (N = 10,090). Collective brand perceptions affect brand choices in collectivistic societies but not individualistic ones. Managerial implications emerge on adapting branding strategies to collectivistic cultures.

An integrated retailer image and brand equity framework: Re-examining, extending, and restructuring retailer brand equity

Retailers are amongst the world's strongest brands, but little is known about retailer brand equity. In spite of their extensive use, we argue that current operational models are too abstract for understanding the uniqueness of the retail industry and too simplistic to understand the interrelationships among the dimensions in the retailer brand equity building process. This study contributes to the existing and largely generic retailer equity frameworks in three ways: first, by incorporating retail specific dimensions from the retailer image literature; second, by re-examining and developing the structures and relationships between the dimensions of retailer equity by testing alternative structures commonly used in the more general brand equity literature; and finally by creating a short and parsimonious scale for assessing retailer brandequity in different contexts. Three alternative models are compared and tested on six brands in both convenience and shopping goods categories, ranging from discount to middle range price levels. The outcome is an operational framework supporting the main building blocks of the conceptual brand resonance model presented in Keller (2001) with seven dimensions structured in a four-step sequence as awareness → pricing policy, customer service, product quality, physical store → retailer trust → retailer loyalty, thereby describing retailer brand equity as a four-step process. The extended, although parsimonious, 17-item retailer equity scale can be used by academics as well as practitioners to examine the underlying values of retailer brands and has the potential to incorporate additional dimensions and attributes to investigate specific retail contexts without creating lengthy questionnaires.

Interprofessional Education: A Summary of Reports and Barriers to Recommendations.

Effective, quality care to achieve the newly developed sustainable development goals requires the development of collaborative teams and is predicated on implementing transformative interprofessional education and on team members who are equally empowered. This is a report on The Lancet commission on transformative education for health professionals and the National Academy of Medicine's dialogues on developing and implementing innovations to enhance collaborations and to facilitate the effectiveness of healthcare teams. Using postcolonial feminist theory for critical analysis and integrations of findings from both reports, as well as for identification of barriers to achieving equity in team functioning. The global Lancet commission and the National Academy of Medicine/Institute of Medicine forum developed frameworks that could be used to educate the next generation of professionals based on identifying the local needs of communities within a global context. Recommendations included breaking down silos that exists between schools and using an equity and justice framework in developing educational programs; utilizing contemporary innovations in teaching that correspond with innovations in healthcare systems; and insuring investments in time, energy, and resources in interprofessional education. However, without addressing the silos created through professional identities and power differentials, goals of interprofessional education and collaborative practice may not be achieved. While a great deal has been written about interprofessional education, it is imperative for faculty in the different professional schools and for members of healthcare teams to engage in dialogues that address the fundamental and most obstinate barriers to forming equitable teams, which is the consistent narrative of medical privilege and centrism. The dialogues about medical privilege and physician centrism in education and health care could drive the development of programmatic approaches to enhancing interprofessional education and teamwork based on justice and equity frameworks.

The quest for equity in Latin America: a comparative analysis of the health care reforms in Brazil and Colombia

IntroductionBrazil and Colombia have pursued extensive reforms of their health care systems in the last couple of decades. The purported goals of such reforms were to improve access, increase efficiency and reduce health inequities. Notwithstanding their common goals, each country sought a very different pathway to achieve them. While Brazil attempted to reestablish a greater level of State control through a public national health system, Colombia embraced market competition under an employer-based social insurance scheme. This work thus aims to shed some light onto why they pursued divergent strategies and what that has meant in terms of health outcomes.MethodsA critical review of the literature concerning equity frameworks, as well as the health care reforms in Brazil and Colombia was conducted. Then, the shortfall inequality values of crude mortality rate, infant mortality rate, under-five mortality rate, and life expectancy for the period 1960-2005 were calculated for both countries. Subsequently, bivariate and multivariate linear regression analyses were performed and controlled for possibly confounding factors.ResultsWhen controlling for the underlying historical time trend, both countries appear to have experienced a deceleration of the pace of improvements in the years following the reforms, for all the variables analyzed. In the case of Colombia, some of the previous gains in under-five mortality rate and crude mortality rate were, in fact, reversed.ConclusionsNeither reform seems to have had a decisive positive impact on the health outcomes analyzed for the defined time period of this research. This, in turn, may be a consequence of both internal characteristics of the respective reforms and external factors beyond the direct control of health reformers. Among the internal characteristics: underfunding, unbridled decentralization and inequitable access to care seem to have been the main constraints. Conversely, international economic adversities, high levels of rural and urban violence, along with entrenched income inequalities seem to have accounted for the highest burden among external factors.

Learning Health Equity Frameworks Within a Community of Scholars

Scholars in nursing science have long espoused the concept of health equity without specifically using the term or dialoguing about the social determinants of health and social justice. This article describes the development, implementation, and evaluation of a doctoral and postdoctoral seminar collective entitled "Health Equity: Conceptual, Linguistic, Methodological, and Ethical Issues." The course enabled scholars-in-training to consider the construct and its nuances and frame a personal philosophy of health equity. An example of how a group of emerging scholars can engage in the important, but difficult, discourse related to health equity is provided. The collective provided a forum for debate, intellectual growth, and increased insight for students and faculty. The lessons learned by all participants have the potential to enrich doctoral and postdoctoral scientific training in nursing science and may serve as a model for other research training programs in the health sciences.

Gender and leadership in Turkish and Australian universities

PurposeThe purpose of this paper is to analyse the factors in the under‐representation of female Rectors/Vice‐Chancellors (VCs), Vice‐Rectors/Deputy Vice‐Chancellors (DVCs), and Pro‐Rectors/Pro Vice‐Chancellors (PVCs) – collectively described as the University Executive or senior management – in Turkey and Australia. This includes support and mentoring, recruitment and selection processes, and the role of Rectors/VCs.Design/methodology/approachQualitative interviews are conducted with both male and female senior managers in old and new and metropolitan and regional universities in Turkey and Australia.FindingsIt is found that some women have difficulty getting into senior management, and generally their support or mentoring came from further down the organization than for men. In both countries male and female managers consider that Rectors/VCs are particularly influential in senior management appointments, with women perceiving this as a barrier. The particularly low representation of women in senior management in Turkey reflects the absence of equity frameworks, but also role conflict which is more likely to impact on women in relation to senior management rather than academic appointments.Practical implicationsThis research indicates that it is still difficult for women in both countries to be appointed to senior management roles in Universities and that support, networks and the role of Rectors/VCs in the appointment process are important factors. Awareness about gender in senior management links back to legislative frameworks or lack of them. Universities in Australia – unlike Turkey – are required to report annually on their commitment to addressing under representation of women in their workforce. The impact of legislative compliance has been to sensitise both men and women in universities to gender issues. Turkey, by contrast, continues to have low representation of women in senior management and no legislative imperative to address this inequality. And because many women in Turkey decide not to apply for senior management positions due to conflict between work and family responsibilities, their representation remains low and fails to challenge the prevalent view that gender is not an issue in senior management.Originality/valueThe paper demonstrates that equity frameworks –or lack of them – may have an impact on the representation of women in higher education (HE) senior management in Turkey and Australia but that cultural factors such as role conflict may also prevent women in Turkey from applying for senior management positions.

Does brand social power mean market might? Exploring the influence of brand social power on brand evaluations

AbstractThe importance of brand equity has been recognized in the marketing literature for years. Although researchers generally agree there is a social component to brand equity, empirical work in this area stops short of exploring the brand's ability to exert a social influence on consumers and their choices. The present manuscript attempts to address this deficit and extend the brand equity literature by proposing a new construct—brand social power. Drawing from research on social influence and perceived power, five bases of brand social power are identified and a conceptual attempt is made to integrate brand social power with existing brand equity frameworks. The impact of brand social power is also examined empirically at the level of individual power bases, for overall brand social power, and in terms of brand equity. © 2009 Wiley Periodicals, Inc.

Innovation and Disability

Innovation and Disability