Table 1.

A Dozen Gaps in Existing Disparities Research and How Practice-based Research Could Meet the Need

Why Current Disparities Research Sometimes Falls ShortHow Practice-based Research Could Meet the Need
1. Research in academic or closed-panel settingsConduct research in real-world, limited resource, high-disparity primary care practice settings
2. Nondiverse research teamsDevelop diverse research teams that are proportionately representative of the disparity population being studied
3. Investigator-initiated researchTrue community partnership
4. Focus on changing provider behaviorsResearch on systems change involving patients, teams, and processes of care
5. ‘Inside-the-practice’ researchBlur the boundaries between practice-based research and community-based interventions
6. Focus on process measuresMeasure health outcomes at the community population health level
7. Narrowly focused single disease interventionsAddress complex mix of disparities in chronic disease outcomes, risk factors, and mental health co-morbidities
8. Experiments test one interventionTest multidimensional interventions that triangulate on improved outcomes from at least three directions—provider, patient, and community
9. Static interventions held constant throughout the study periodTest dynamic, constantly-improving interventions
10. Academic cycle timeRapid-change cycles, continuously revising intervention based on rapid-feedback health outcomes data loops
11. Randomized-controlled clinical trialsAlternative study designs to measure multidimensional, dynamic interventions repeatedly
12. Replicability without scalabilityTest interventions that are both replicable and scalable in real-world, underresourced settings that serve high-disparity populations