516 - Determination of Research Priorities for Disparities and Inequities in Pediatric Emergency Care

Poster Number: 516
Publication Number: 516.116

Elyse N. Portillo, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, United States; Chris A. Rees, Emory University School of Medicine, ATLANTA, GA, United States; Emily A. Hartford, University of Washington, Seattle, WA, United States; Zachary C. Foughty, Baylor College of Medicine, Houston, TX, United States; Michelle L. Pickett, Medical College of Wisconsin, Milwaukee, WI, United States; Colleen K. Gutman, University of Florida College of Medicine, Gainesville, FL, United States; Bashar S. Shihabuddin, Nationwide Children's Hospital/ OSUCOM, Columbus, OH, United States; DAVID SCHNADOWER, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Tiffani J. Johnson, University of California, Davis, School of Medicine, Sacramento, CA, United States; Kathy Shaw, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States

Background: Healthcare disparities have been well-documented among children based on their race, ethnicity, and preferred language. There is growing recognition of the need to identify and rectify these disparities, but a research agenda in pediatric emergency care (PEC) that prioritizes the precise aspects in need of urgent investigation is lacking.

Objective: To establish a consensus research priorities agenda for disparities in PEC.

Design/Methods: We used a modified Delphi approach with a diverse group of experts with medical, research, and lay backgrounds to achieve consensus regarding research priorities for investigating disparities in PEC. An initial list of research priorities was developed by a group of experienced PEC investigators via online web-conferencing meetings. We iteratively assessed the list through two rounds of electronic surveys with a broad group of experts. Participants included individuals from interest groups, research groups, provider groups, non-provider healthcare partners, and laypersons with roles in community and family advisory groups. Priorities were scored by respondents on a five-point Likert scale and included in the final list if >60% of respondents identified them as “highest priority” (score 1) or “priority” (score 2).

Results:

PEC investigators generated an initial list of 27 potential priorities. Round 1 of prioritization was completed by 38 of 47 partners (80.6%) and round 2 was completed by 30 of 38 partners (81.1%). The 30 respondents who completed both rounds included 7 family/community partners and 23 medical/research partners, including 4 international PEC research networks. Of the initial list of 27 research priorities, 10 achieved the predetermined consensus threshold of at least 60% scores of “highest priority” and “priority.” These 10 consensus priorities were: 1) systematic efforts to reduce inequities; 2) race, ethnicity and language data collection and reporting; 3) recognizing and mitigating implicit bias in PEC providers; 4) mental health disparities; 5) social determinants of health; 6) language and literacy in PEC; 7) acute pain management disparities; 8) equity in emergency department quality of care metrics; 9) shared decision making; and 10) patient experience (Table).

Conclusion(s): This research priority agenda may be used as a guide for investigators, research networks, organizations, and funding agencies to engage in and support high priority disparities research topics in PEC.