A Dozen Gaps in Existing Disparities Research and How Practice-based Research Could Meet the Need
| Why Current Disparities Research Sometimes Falls Short | How Practice-based Research Could Meet the Need |
|---|---|
| 1. Research in academic or closed-panel settings | Conduct research in real-world, limited resource, high-disparity primary care practice settings |
| 2. Nondiverse research teams | Develop diverse research teams that are proportionately representative of the disparity population being studied |
| 3. Investigator-initiated research | True community partnership |
| 4. Focus on changing provider behaviors | Research on systems change involving patients, teams, and processes of care |
| 5. ‘Inside-the-practice’ research | Blur the boundaries between practice-based research and community-based interventions |
| 6. Focus on process measures | Measure health outcomes at the community population health level |
| 7. Narrowly focused single disease interventions | Address complex mix of disparities in chronic disease outcomes, risk factors, and mental health co-morbidities |
| 8. Experiments test one intervention | Test multidimensional interventions that triangulate on improved outcomes from at least three directions—provider, patient, and community |
| 9. Static interventions held constant throughout the study period | Test dynamic, constantly-improving interventions |
| 10. Academic cycle time | Rapid-change cycles, continuously revising intervention based on rapid-feedback health outcomes data loops |
| 11. Randomized-controlled clinical trials | Alternative study designs to measure multidimensional, dynamic interventions repeatedly |
| 12. Replicability without scalability | Test interventions that are both replicable and scalable in real-world, underresourced settings that serve high-disparity populations |