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Research Question

  1. What are the key factors in framework design for the Health System–Community Pathways Program for African American/Black children and young adults?

Many of the ethnic and racial workforce inequities in the United States are present in health care systems. Low representation of African American/Black individuals in the health care system workforce can be traced to a history of exclusionary practices that leave such individuals less likely to pursue health careers. Past research found that low representation is driven by inequities in health, education, and employment that are a result of structural racism.

Pathways programs have been identified as one of the methods to increase recruitment, retention, and promotion in health-related career fields for African American/Black individuals. As prior research has shown, these programs recruit and support the graduation of students from underrepresented communities at all educational stages to increase their representation in specific fields.

This report describes the development of key factors in framework design for the Health System–Community Pathways Program (HCPP), which aims to increase representation of African American/Black communities in the health care system workforce and improve the quality of their experience in pursuing careers in these fields. The HCPP framework of key factors is informed by an environmental scan, interviews and focus groups, and an expert discussion panel session.

The report's authors come from diverse backgrounds; the team included African American/Black physicians and members of other historically marginalized communities. The qualitative research drew insights from diverse African American/Black community stakeholders; the report was reviewed by many stakeholders to ensure that the design of the research and the end product maximally benefits the community on which it focuses.

Key Findings

  • To boost the number and quality of experience of African American/Black learners and ultimately their representation in health care, the following factors are key to program design: (1) student recruitment, admission, and retention, (2) mentor recruitment and training, (3) programming, (4) program outcome measurement, and (5) long-term program sustainability strategies.
  • Admissions committees should be more diverse, social and financial support should be provided to students, and students should be encouraged to participate in decisionmaking and leadership of curriculum committees and oversight boards.
  • Different types of mentor-mentee relationships should be encouraged to support student success in the program, including peer-peer, near-peer, and senior, and mentors should be trained in racism, microaggression, unconscious bias, and cultural understanding.
  • Institutional changes in hiring practices would encourage a more diverse faculty and future mentorship pool.
  • Program evaluation plans should be established to capture feedback on program administration.
  • Programming should include educational and noneducational support and clinical experiences to expose students to opportunities in health care professions.
  • Longitudinal financial support is crucial to eliminate budgetary constraints and maintain program continuity.

Table of Contents

  • Chapter One

    Background and Objectives

  • Chapter Two

    Environmental Scan

  • Chapter Three

    Key Informant Interviews and Focus Groups

  • Chapter Four

    Key Takeaways and Program Framework

  • Appendix A

    Environmental Scan Search Strategy

  • Appendix B

    Semistructured Focus Group and Interview Guide

Research conducted by

Funding for this research was provided by unrestricted gifts from RAND supporters and income from operations. This research was carried out within the Access and Delivery Program in RAND Health Care with support from the RAND Center to Advance Racial Equity Policy.

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