Assistant Professor Georgetown University Georgetown University Baltimore, Maryland, United States
Proposal: Purpose: The 5D Cycle for Health Equity addresses health inequities by applying practices that emerge from social justice movements to the Appreciative Inquiry change management framework. The 5D cycle for Health Equity takes the 5D cycle of Appreciate Inquiry (Define, Discover, Dream, Design & Deliver) and grounds it in Black Feminism and radical imagination to serve as a conduit for creating equitable care. There is an opportunity to apply this framework to health professional education and give educators and learners a tool to design health equity initiatives rooted in emancipatory praxis.
APPROACH: An educator used The 5D Cycle for Health Equity to facilitate discussions about equity-focused implementation strategies with Doctor of Nursing Practice learners and support learner implementation of equity-focused interventions.
FINDINGS: The number of equity-focused interventions in Doctor of Nursing Practice Scholarly Projects increased significantly. Equity-focused interventions did not consistently align with the 5D Cycle for Health Equity steps: redefine measures of harm and health equity; discover new understandings of wellness across the past, present, and future; dream of equitable care with the principles of antioppression and collectivity; design solutions that embody the liberatory practices of oppressed groups; and deliver solutions that strive to free everyone by freeing the most oppressed.
IMPLICATIONS: Equipping health professional learners to design and implement healthcare improvement strategies grounded in social justice principles requires, at a minimum, a curriculum that supports collaboration with patients and community members who experience health inequities. Questions to consider: What health professional curriculum components can be redesigned to support meaningful community collaboration? What are the best practices for mutually beneficial partnerships between learners and community members? How can learners center patient experience, not just outcomes data, in health equity initiatives?
The author is an Assistant Professor in a Doctor of Nursing Program, a Commissioner for the Accreditation Commission for Midwifery Education, a practicing midwife, and a consultant for state health equity initiatives. The author is an editor of a Maternal Health Equity Toolkit and is co-leading a community-engaged Maternal Health Equity Community of Learning.
Arrington LA. The 5D Cycle for Health Equity: Combining Black Feminism, Radical Imagination, and Appreciative Inquiry to Transform Perinatal Quality Improvement. J Midwifery Womens Health. 2022;67(6):720-727. doi:10.1111/jmwh.13418 Arrington, L.A., Kramer, B., Ogunwole, S.M., Harris, T.L., Dankwa, L., Knight, S., Creanga, A., Bower, K.M. Interrupting false narratives: Applying a racial equity lens to healthcare quality data. (In Press). BMJ Quality & Safety. doi.org/10.1136/bmjqs-2023-016612
Learning Objectives:
Describe how combining Black feminism, radical imagination, and Appreciative Inquiry can facilitate healthcare improvements grounded in justice, imagination, and the priorities of individuals and groups that experience oppression.
Coach health professional learners to re-frame a health equity problem into a possibility-focused question.
Facilitate a discussion with health professional learners on implementation strategies to increase health equity using the 5D Cycle for Health Equity Guiding Questions
