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Resource Library

Explore this comprehensive collection of articles, tools, and resources relevant to health equity, health literacy, implicit bias, medical injustices, social determinants of health, vulnerable populations, language and cultural barriers, psychosocial care, and culturally competent care.

Recognize Signs and Employ Strategies to Overcome Implicit Bias

Centers for Disease Control and Prevention. Health Equity
The Centers for Disease Control and Prevention (CDC) Office of Minority Health and Health Equity (OMHHE) provides featured articles, a “Conversations in Equity” blog, reports on leading causes of death, and continuing education on current health equity topics. OMHHE’s webpage highlights women’s health, minority health, and diversity and inclusion management as current health equity issues. This website can be a useful starting point for learning about health equity and accessing resources to explore subtopics of health equity.

Centers for Disease Control and Prevention. Gateway to Health Communication: Resources & References
The Centers for Disease Control and Prevention (CDC) have created a resource page providing guidelines, webinars, playbooks, and various other resources to address the promotion of health equity. Link topics include inclusive communication principles, preferred patient terms, how to use a health equity lens, how to develop inclusive communications, and key principles. Additionally, there are links to references and other resources to frame health equity and avoid stigmatizing language within 17 different topics.

World Health Organization. Health Equity
The World Health Organization (WHO) website offers a brief overview of health and health equity, along with resources that identify methods for collecting and using data to monitor health inequity. Additionally, the WHO offers approaches and tools for equity, gender, and rights-based assessments. This website is a useful place to start for information on tools that assess organizational health equity.

World Health Organization. Health Equity Assessment Toolkit
The World Health Organization (WHO) has created the Health Equity Assessment Toolkit (HEAT), a software application for computer or mobile device use that allows the assessment of health inequalities in various settings. WHO offers two HEAT databases available for download. These databases provide assessments and summaries in a variety of interactive graphs, maps, and tables. The results of these assessments are available for export for users, with user manuals readily available.

American Society of Clinical Oncology. Health Equity
The American Society of Clinical Oncology (ASCO) has created an Equity, Diversity, and Inclusion (EDI) Action Plan which details priority activities across three key areas: research, education, and quality and includes links a wide range of resources and tools to help organizations understand and address health equity issues in cancer research and care.

Association of Community Cancer Centers. Health Equity
The Association of Community Cancer Centers has developed a wide range of resources and tools to better understand and support health equity initiatives in cancer prevention and detection, diagnosis and treatment, and cancer care. This resource page provides access to several comprehensive education projects focused on health equity and addressing cancer care disparities, including on-demand webinars, evidence-based articles, podcasts, vodcasts, and other downloadable resources.

Association of Community Cancer Centers. ASCO-ACCC Initiative
The Association of Community Cancer Centers and the American Society of Clinical Oncology (ASCO) jointly released a suite of resources to promote racial and ethnic diversity, equity, and inclusion in cancer clinical trials. This includes the Just ASK™ Training Program, Site Self-Assessment, and Training Facilitation guide, which can help research sites address barriers to participation in cancer clinical trials among populations that have been historically underrepresented. 

American Cancer Society. Advancing Health Equity- Addressing Cancer Disparities
This resource page provides tools for understanding and addressing social determinants in cancer health with links to patient support, including ACS patient support programs and services and a video meant to prompt a discussion on health equity in cancer care with a downloadable discussion guide. This resource can help provide principles for organizational health equity, along with inclusive language and writing guides to promote equitable communication specifically in cancer care.

Association of Community Cancer Centers. Just Ask: Increasing Diversity in Cancer Clinical Research- An ACCC-ASCO Training Program
The Association of Community Cancer Center, in partnership with the American Society of Clinical Oncology, has created an online implicit bias training program designed for all members of the cancer research team. Just Ask: Increasing Diversity in Cancer Clinical Research was developed to address the lack of diversity in clinical research participation and includes a series of interactive modules which outline key concepts such as diversity, equity, health disparities, and the role of implicit bias in clinical trial selection. This link also includes access to an 8-page training facilitation guide for organizations seeking to facilitate discussions among staff around implicit bias.

American Hospital Association Institute for Diversity and Health Equity. The Health Equity Roadmap
The American Hospital Association (AHA) Institute for Diversity and Health Equity (IFDHE) has created a health equity roadmap to provide a framework for hospitals and healthcare systems to become more equitable and inclusive. This webpage provides a short video summarizing AHA’s IFDHE health equity roadmap and goals, along with a health equity transformation assessment, tools and resources for promoting organizational health equity, and a link for additional guides and toolkits from AHA.

Health Quality Innovation Network. Health Equity Guide
The Health Quality Innovation Network (HQIN) has created a seven-page guide that integrates why health equity is necessary with the steps needed to begin quality improvement projects to reduce health inequities. HQIN has divided this guide into three parts—an introduction to health equity, how to begin integrating policies that promote health equity, and a toolbox that includes many templates and worksheets to guide the identification of contributing factors to health inequity.

U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion. Health Equity in Healthy People 2030
The U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion (OASH) has created a Healthy People 2030 initiative which sets data-driven national objectives to improve health and well-being over the next decade. Eliminating health disparities and achieving health equity is a key priority of this initiative and the Healthy People 2030 website provides several tools for action including evidence-based resources, action stories, frameworks, objectives, downloadable fact sheets, graphics and other useful resources.

Government of the District of Columbia. Implicit Bias
The government of the District of Columbia has created a comprehensive course module that provides an overview of implicit bias and how it is manifested in everyday clinical decision-making. The course includes useful debiasing strategies and best practices to mitigate the risks of the impact of bias on treatment and care.

Institute for Healthcare Improvement. Improving Health Equity: Assessment Tool for Health Care Organizations
The Institute for Healthcare Improvement (IHI) has created an eleven-page guide and assessment tool that can help healthcare organizations improve health equity at their institutions. IHI provides five framework components in which organization leaders and staff can rate their level of progress to help assess their organization’s current health equity efforts. These assessment scales can also assist with identifying opportunities for improvement within the organization.

Oregon Health Authority. 2020 Health Equity Plan Evaluation Tool
The Oregon Health Authority (OHA) created a 2020 Health Equity Plan Evaluation Tool for coordinated care organizations (CCOs) to advance health equity that provides specific measurements to determine if health equity plans are meeting expectations. This tool is useful in providing a checklist of standards that highlight organizational deficiencies in health equity.

Prevention Institute. Health Equity and Prevention Primer
The Health Equity and Prevention Primer (HEPP), created by the Prevention Institute provides health equity training through modules that include strategies for eliminating inequalities in health, safety via policy advocacy, multi-sector engagement, and community change. HEPP provides a seven-part web-based training series geared toward public health practitioners. This series is useful for health equity education through interactive presentations and various resources on health equity, which users can work through at their preferred order and pace.

National Institutes of Health. Implicit Bias
The National Institutes of Health’s Chief Officer for Scientific Workforce Diversity (COSWD) office  features comprehensive tools and resources related to promoting diversity, inclusiveness, and equity throughout the biomedical research enterprise. Among these resources is a useful overview of implicit bias and a 3-module implicit bias training course to help users learn what bias is, how to recognize it, and how to minimize its impact.

Sabin, JA. Tackling implicit bias in health care
This journal explores implicit bias in healthcare and how bias-driven discriminatory practices and policies negatively affect patient care, medical training, diversity of the health care workforce, and inequitable distribution of research funding.

University of Washington School of Medicine. Healthcare Equity
The University of Washington School of Medicine has created a bias reporting tool for sharing incidents of bias, including racism, sexism, ableism, discrimination of any form, or other behaviors that do not reflect the prioritization of inclusion and equity. This tool provides a practical example of how healthcare organizations can develop their own bias reporting systems.

Edgoose, JYC, Quiogue M, Sidhar K. How to identify, understand, and unlearn implicit bias in patient care.
This journal article highlights steps to recognize and correct unconscious assumptions towards groups to promote health equity by exploring the definition of implicit bias, discovering blind spots and working to dismiss stereotypes and attitudes that affect interactions, and eliminating systemic problems organization-wide.

Project Implicit. Resources
Project Implicit is a non-profit organization and international collaborative network of researchers investigating implicit social cognition, new ways of understanding attitudes, stereotypes, and other hidden biases that influence perception, judgment, and action. The website offers a series useful resources including an online Implicit Association Test (IAT), study materials, a virtual laboratory to conduct surveys, and publications.

Centers for Disease Control and Prevention. Health Literacy
Health literacy can be defined as one’s ability to understand and to use health information, culminating in the ability to make well-informed health decisions. The Centers for Disease Control and Prevention (CDC) website provides multiple clear definitions of health literacy and topics of health equity. Rationales for changing previously used health literacy definitions are given, and the importance of health literacy is emphasized. This website is useful in providing a foundation for the meaning of health literacy and how it relates to health equity.

Association of Community Cancer Centers. Let’s Be Clear: Communicating to Improve the Cancer Patient Experience
The Association of Community Cancer Centers has curated a series of resources and tools to help cancer programs assess and improve their health literacy and communication with patients. These include an interactive eCourse featuring methods to improve patient-provider communication, the Ask Me 3® tool developed by the Institute of Healthcare Improvement (IHI) which encourages patients to ask three simple questions each time they talk to a care team member, and an on-demand webinar and gap assessment tool to help cancer programs identify areas to improve health literacy and communication.

Holden C, Wheelwright S, Harle A, Wagland R. The role of health literacy in cancer care: A mixed studies systematic review. 
This mixed study systematic review highlights the role and consequences that health literacy has in an oncology setting. Four electronic databases were used to access publications on the effect of health literacy on various cancer care outcomes, with most patients residing in the United States. This article is useful in highlighting the importance of health literacy in a cancer care setting.

Papadakos J, Hasan S, Barnsley J et al. Health literacy and cancer self-management behaviors: A scoping review. 
This journal article provides a scoping literature review, examining and summarizing associations between health literacy and self-management behaviors. This review was conducted on literature involving adult patients with cancer, of all races and ethnicities, in inpatient and outpatient health care settings. This review is useful in reviewing the effects of inadequate health literacy specifically in cancer self-management.

Santana S, Brach C, Harris L, et al. Updating health literacy for Healthy People 2030
The US Department of Health and Human Services Office of Disease Prevention and Health Promotion launched Healthy People 2030 as an initiative involving health literacy objectives. This journal article emphasizes health literacy definitions, including the benefits of personal and organizational focuses on health literacy. This article is useful in providing steps for using Healthy People 2030 to advance health literacy within organizations.

Agency for Healthcare Research and Quality. Health Literacy Measurement Tools (Revised)
The Agency for Healthcare Research and Quality (AHRQ) has developed four tools to measure patients’ health literacy in terms of medical reading comprehension. The AHRQ tools are provided for English and Spanish speakers and assess a patient’s comprehension and pronunciation of health-related terms. This measurement tool is intended to quickly determine the degree of health literacy in patients.

Centers for Disease Control and Prevention. Health Literacy: Measuring Skills & Experiences
The Centers for Disease Control and Prevention (CDC) have created surveys and tools to measure patients’ health literacy skills, which include surveys of adults’ literacy and numeracy skills, a survey of K-12 literacy, numeracy, and science skills, a patient experience survey, and additional measures of individuals’ health literacy.

Centers for Medicare & Medicaid Services. Toolkit for Making Written Material Clear and Effective
The Centers for Medicare and Medicaid Services (CMS) have created a health literacy resource toolkit to assist healthcare providers in making written and printed health information easier for patients to read, understand, and use. This toolkit provides an 11-part document available for download which includes guidelines for writing, how to collect feedback from readers, how to use readability formulas, tools for writing materials for older adults, and culturally appropriate translation. Written health material includes brochures, booklets, fact sheets, posters, application forms, instruction sheets, and health questionnaires.

U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion. Health Equity in Healthy People 2030
The U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion (OASH) has created a Healthy People 2030 initiative which sets data-driven national objectives to improve health and well-being over the next decade. Health literacy is a key priority of this initiative and the Healthy People 2030 website provides several tools for action including evidence-based resources, action stories, frameworks, objectives, downloadable fact sheets, graphics and other useful resources.

Association of Community Cancer Centers. Health Literacy and Clear Communication eCourse
The Association of Community Cancer Centers has developed a 30-minute eCourse designed to provide cancer care team members with tools and strategies to be clear and concise in communications with patients and improve health equity in various situations. Actionable strategies include using clear communication and body language, translating complex oncology concepts into plain language, and enhancing cultural competency.

Translated Labs. Readability Analyzer
Translated Labs provides a readability analyzer where users can submit a writing sample for assessment of reading ease and measurement of grade-level reading. This readability analyzer offers various analyzing formulas, including the SMOG Index and Flesch-Kincaid.

Jaiswal J, Halkitis P. Towards a more inclusive and dynamic understanding of medical mistrust informed by science.
This journal article identifies two scales to measure medical mistrust and highlights how the scales can be utilized in diverse patient populations. This article is useful for identifying how organizations and researchers can meaningfully identify, understand, and address the social inequalities that lead to medical mistrust.

Naldemirci Ö, Britten N, Lloyd H, Wolf A. Epistemic injustices in clinical communication: the example of narrative elicitation in person‐centred care.
This journal article offers in-depth examples of epistemic injustices. It delves into sources of failing medical communication and how health professionals can work to fix this issue. This article is useful for identifying and addressing narrative elicitation, along with providing methods for clinicians to develop greater awareness of medical injustices caused by credibility deficits.

Alcaraz K, Wiedt T, Daniels E, Yabroff K, Guerra C, Wender R. Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy.
This journal article provides evidence that social determinants of health and related disparities in the United States contribute to the overall burden of cancer. The article is useful in providing recommendations for addressing social determinants of health in cancer care, intended for broad audiences of healthcare professionals and policymakers.

Islam M. Social determinants of health and related inequalities: confusion and implications. 
This journal article offers several definitions and examples of social determinants of health. It emphasizes the many points of ambiguity, and how they can be solved for this concept. This article is useful in highlighting the importance of social determinants of health in public policy and how to create a clear understanding of the concept.

Build Conversations and Personalize Care Around Patient Identity

Alliance for Healthier Communities. Resource Package to Support Sociodemographic Collection and Use
The Alliance for Healthier Communities has created a resource package supporting the collection and use of sociodemographic data in practice. This one-sheet resource provides several links to resources for implementing sociodemographic data collection in practice, including sample workflows for data collection. The resources provided include scripts on how to navigate common client questions about sociodemographic data use, how to ask sociodemographic questions, and a plain language glossary. A guide showing how demographic data was collected in 2021 at the Harrow Health Centre in Canada is also included.

Alcaraz K, Wiedt T, Daniels E, Yabroff K, Guerra C, Wender R. Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy. 
This journal article provides future steps for the expansion of healthcare coverage, prevention and screening for cancer types, and research investments. This article is useful in providing resources for targeting cancer disparities among marginalized groups, including website links.

Minnesota Department of Health. Racial Equity Assessment Toolkit
The Minnesota Department of Health has created a toolkit for assessing racial equity and analyzing the impact that policies, procedures, services, and budget decisions have upon people of color. This toolkit includes a downloadable PowerPoint training presentation intended for racial equity training sessions, including a script to go with the slides and a racial equity assessment worksheet. This training session was developed for the city of St. Paul, Minnesota, but can be adapted for other healthcare organizations aiming to align its programs, policies, and decisions with its racial equity goals.

Zavala V, Bracci P, Carethers J et al. Cancer health disparities in racial/ethnic minorities in the United States. 
This journal article summarizes reported disparities and their associated factors in the United States. This article is useful in focusing on disparities within breast, prostate, lung, and colon cancers in commonly identified racial and ethnic minorities—specifically Black, Hispanic and Latinx, American Indian and Alaska Native, Asian, and Pacific Islander populations.

The value and process of inclusion: Using sensitive, respectful, and inclusive language and images in NCCN content.
This journal article highlights recent changes that have been made in the language and images utilized by the NCCN to promote justice, respect, and inclusion for all patients with cancer. This article provides detailed information and examples of language and image improvements that can be made at the provider and institutional levels to facilitate equitable cancer care.

Bhatt J, Bathija P. Ensuring access to quality health care in vulnerable communities. 
Vulnerable populations in America are identified by many factors: a lack of access to primary care services, limited economic resources, un- or underinsurance, low education or health literacy, cultural or linguistic barriers, or living challenges like housing instability. This journal article provides definitions and examples of vulnerable communities in American healthcare. This article is useful in providing recommendations on strategies to reform health care delivery to these populations, including the specific health care services that are necessary for all communities.

McClelland S, Petereit D, Zeitlin R et al. Improving the clinical treatment of vulnerable populations in radiation oncology
This journal article centers around the vulnerable populations of Northern Plains American Indian, Black, Hispanic and Latinx, and sexual or gender minority patients in the United States. This article is useful in providing information on health disparities in radiation oncology and the need for the inclusion of vulnerable populations in cancer care.

Chinn J, Martin I, Redmond N. Health equity among Black women in the United States. 
This journal article provides in-depth discussions on the history of health disparities for Black women, along with the effects on current health care. This article is useful in highlighting disparities in weathering, obesity, cardiovascular disease, bleeding and blood disorders, maternal morbidity and mortality, mental health, and maternal mental health in Black women.

Torre L, Islami F, Siegel R, Ward E, Jemal A. Global cancer in women: burden and trends. 
Addressing cancer burden in women is important for confronting gender inequalities and should have a place in healthcare. This journal article provides a summary of worldwide trends, burdens, prevention, early detection, and survival rates of all cancers. This article is useful in providing statistics for breast, cervical, uterine corpus, ovarian, colorectal, lung, and liver cancers in women.

Kamen CS, Pratt-Chapman ML, Meersman SC, et al. Sexual orientation and gender identity data collection in oncology practice. Findings of an ASCO survey.
This journal article explores how the lack of sexual orientation and gender identity (SOGI) data in oncology practices limits assessment of sexual and gender minority (SGM) cancer patients’ experiences and restricts opportunities to improve health outcomes of SGM patients. This article highlights the individual-level and institutional barriers hindering SOGI data collection.

Pratt-Chapman M, Alpert A, Castillo D. Health outcomes of sexual and gender minorities after cancer: a systematic review.
Lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) populations have a history of being ignored in medical research and there are few studies investigating disparities in cancer-related health outcomes for this population. This systematic review summarizes the differences between LGBTQI patients and their heterosexual and cisgender counterparts. This study is useful in providing explanations of terminology that is relevant to LGBTQI patients with a focus on the oncology setting.

Inclusive Language Playbook: Writing for LGBTQ+ Communities
Communicate Health has prepared a comprehensive guide to inclusive language for LGBTQ+ communities that offers best practices, strategies, and examples providers can utilize when developing inclusive materials for use at the patient, provider, and institutional levels.

Cancer Care Considerations for Sexual and Gender Minority Patients
This journal article highlights care considerations for sexual and gender minority patients and includes helpful provider tools such as a guide to basic terminology, a sample intake form, cancer screening considerations, and recommendations to improve communication with patients. This article is useful in providing detailed strategies for improvements in cancer care at the patient, provider, and institutional levels.

Tamargo C, Quinn G, Sanchez J, Schabath M. Cancer and the LGBTQ population: Quantitative and qualitative results from an oncology providers’ survey on knowledge, attitudes, and practice behaviors. 
This journal article provides an analysis of quantitative and qualitative responses given by providers who self-identify as specialists in the types of cancers that disproportionately affect lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patients. This study is useful in identifying gaps in oncology providers’ knowledge of LGBTQ issues, and how to address them.

Grassi L, Riba M. Disparities and inequalities in cancer care and outcomes in patients with severe mental illness: Call to action.
This journal article evaluates the current landscape of cancer care in patients with severe mental illnesses. This article is useful in providing information on the marginalization, poor access to care, suicide risk, cancer mortality, and inequalities of cancer care for this patient population.

Weinstein L, Stefancic A, Cunningham A, Hurley K, Cabassa L, Wender R. Cancer screening, prevention, and treatment in people with mental illness.
This journal article documents cancer disparities and the limitations of current healthcare systems for improving cancer control in patients with mental illness. This article is useful in providing detailed recommendations for improvements in cancer care at the patient, provider, and institutional levels.

Flint S. Time to end weight stigma in healthcare.
Exposure to consistent and widespread weight stigma, along with a lack of training and education for healthcare providers on the complexity of obesity, perpetuates the conscious and unconscious stigmatizing attitudes of healthcare professionals. This journal article details the impact that weight stigma has on health equity. This article is useful in providing information on the origin of weight stigma and discrimination in healthcare, along with recommendations for implementing a “zero discrimination in healthcare” policy.

Obesity Action Coalition. Weight Bias Resources and Guides
The Obesity Action Coalition (OAC) has created a resource page to provide direct links for education on weight bias in healthcare. These resources provide education on “people-first language for obesity” for guidance on referring to individuals with obesity in healthcare and in written health materials.

Weissman J, Russell D, Ansah P, Jay M. Disparities in healthcare utilization among adults with obesity in the United States, findings from the NHIS: 2006–2015. 
This study compares adults with obesity to adults without obesity on self-reported aspects of receiving health care, including over 200,000 adults in the United States. This study is useful in providing information on health disparities, chronic health conditions, serious psychological distress, and demographic characteristics of patients with obesity.

Association of Community Cancer Centers. Geriatric Oncology
The Association of Community Cancer Centers has developed a wide range of resources and tools to support older adult patients with cancer. This resource page provides access to several comprehensive education projects focused on geriatric oncology, including on-demand webinars, evidence-based articles, blogs, and other downloadable resources.

Association of Community Cancer Centers. Practical application of geriatric assessment: a how to guide for the multidisciplinary care team.
The Association of Community Cancer Centers has prepared a comprehensive geriatric oncology how-to-guide for the multidisciplinary team to help cancer care teams improve treatment decision-making, guide supportive care interventions, and improve patient and caregiver satisfaction.

Hill C. At the intersection of rigor and equity: health disparities research related to aging. 
This journal article emphasizes the need for biomedical research to be accountable for equity and understanding of the health and aging issues that disproportionately affect aging groups. This article is useful in providing information on health disparity research related to aging and the intersectionality of race.

Hoogland A, Mansfield J, Lafranchise E, Bulls H, Johnstone P, Jim H. eHealth literacy in older adults with cancer.
Access to health information technology (HIT) for patients with cancer improves feelings of empowerment and allows further education on their cancer diagnosis. However, two-thirds of older adults with cancer did not feel confident in their ability to find and evaluate online health resources and cite many barriers when using HIT. This study compares and evaluates survey results from older and younger adults with cancer at the Moffitt Cancer Center in Tampa, Florida. This study is useful in providing information on disparities in eHealth literacy and HIT in adults aged 65 years or older in the cancer care setting.

Husson O, Zebrack B, Block R et al. Posttraumatic growth and well-being among adolescents and young adults (AYAs) with cancer: a longitudinal study. 
This journal article is a prospective follow-up study, emphasizing psychosocial oncology research in adolescents and young adults (AYAs). This article is useful for information on posttraumatic growth and psychological distress in AYAs who have been diagnosed and treated for cancer, along with ways to identify AYAs who could benefit from targeted interventions.

Association of Community Cancer Centers. Adolescent and Young Adult (AYA) Resources
The Association of Community Cancer Centers provides several resources to help cancer care providers better serve the unique needs of adolescent and young adult (AYA) patients with cancer, including links to several journal articles and publications focused on supporting AYA patients.

Moke D, Tsai K, Hamilton A et al. Emerging cancer survival trends, disparities, and priorities in adolescents and young adults: A California cancer registry-based study. 
This study provides insight into adolescent and young adult (AYA) cancer survival trends from California-based data. This study is useful in emphasizing differences between AYA subgroups in treatment access and outcomes, along with improvements that can be made in the cancer care setting.

Enhance Provider and Patient Communication

Genoff M, Zaballa A, Gany F et al. Navigating language barriers: A systematic review of patient navigators’ impact on cancer screening for limited English proficient patients.
More than 20% of the United States population speaks a language other than English in their home, yet language barriers still exist in patients accessing cancer preventative services. This journal article details a systematic review and literature search evaluating language assistance interventions in cancer screenings for patients with limited English proficiency (LEP). This article is useful in providing methods for patient navigator programs to assist patients with LEP in cancer screenings for breast, colorectal, and cervical cancers.

Agency for Healthcare Research and Quality. Improving Patient Safety Systems for Patients With Limited English Proficiency
The Agency for Healthcare Research and Quality (AHRQ) has created an appendix with resources and tools to address language and cultural barriers to improve patient safety. AHRQ’s appendix includes resources and direct links to tools and information for language access, patient safety, cultural barriers, and medical interpreting.

Staples J, Lester J, Li A et al. Language as a barrier to cancer clinical trial accrual: assessing consenting team knowledge and practices for cancer clinical trial consent among low English fluency patients.
Knowledge of cancer care is heavily influenced by clinical trials, but participation rates among ethnic and racial minorities are low. This journal article, based upon an anonymous web-based survey given to research members (including principal investigators, research coordinators, research nurses, and translator services) at Cedars-Sinai Medical Center in Los Angeles, California, provides useful for information on the enrollment of non-English speaking patients in cancer clinical trials.

Handtke O, Schilgen B, Mösko M. Culturally competent healthcare – A scoping review of strategies implemented in healthcare organizations and a model of culturally competent healthcare provision. 
Society diversification provides opportunities for social growth, but inequalities and discrimination can be consequences. This is prominent in healthcare, as patients who are culturally and linguistically diverse (CLD) tend to experience barriers in accessing health care. This journal article provides definitions for cultural competency and differentiates between organizational, structural, and clinical cultural competencies. This article is useful in providing strategies for implementing culturally competent care in healthcare organizations.

Üzar-Özçetin Y, Tee S, Kargın M. Achieving culturally competent cancer care: A qualitative study drawing on the perspectives of cancer survivors and oncology nurses.
Culture is an important social determinant of health, influencing access and delivery of appropriate health care. This journal article provides a descriptive qualitative study on cancer survivors and oncology nurses. This article emphasizes the ethics behind culturally competent care, recognizing language barriers and work overload as factors. This article is useful in providing information on cultural competency specifically in the cancer care setting.

Association of Community Cancer Centers. Delivery of psychosocial care in oncology
The Association of Community Cancer Centers is curating a range of resources and tools to support the delivery of psychosocial care in oncology, including distress screening and addressing the emotional and mental health of patients with cancer as well as their caregivers and providers. This site provides access to education projects focused on psychosocial care, which include links to evidence-based articles, blogs, distress screening tools, standards, and other useful resources.

Association of Community Cancer Centers. Telehealth
The Association of Community Cancer Centers has documented successes in the cancer care community’s rapid adoption of telehealth to maintain patient care during the COVID-19 public health emergency and has several projects dedicated to the optimization and use of telehealth in cancer care. This webpage provides resources and links to several webinars, podcasts, publications that highlight successful strategies for the use, implementation, and expansion of telehealth.

Katz A, Haynes K, Du S, Barron J, Kubik R, Chen R. Evaluation of telemedicine use among US patients with newly diagnosed cancer by socioeconomic status.
This study focuses on patients newly diagnosed with cancer who received telemedicine visits within 30 days of diagnosis. This study is useful in providing information on telemedicine challenges and the role that SES has upon receipt of timely telemedicine within cancer care.

Center for Care Innovations. Telemedicine for Health Equity Toolkit
The Center for Care Innovations (CCI), in a partnership with UCSF’s Center for Vulnerable Populations (CVP), has created a toolkit providing guidance on promoting health equity in telemedicine. This toolkit includes tools such as scripts and workflows to help disseminate best practices for health equity in telemedicine in a post-COVID healthcare system, resources for reimbursement, chapters for leadership considerations when beginning a telemedicine service, considerations for providers when using telemedicine, considerations for reaching diverse patient populations, and optimizing telemedicine in the future.

Health Information Technology, Evaluation, and Quality Center. Telehealth and Digital Tools Equity Assessment
The Health Information Technology, Evaluation, and Quality (HITEQ) Center, established within the U.S. Department of Health and Human Services, has created a Telehealth and Digital Tools Equity Assessment with the goal of supporting equitable telehealth access to the most marginalized patients. This assessment tool is available for download and contains an easy-to-read questionnaire that assesses the technology needs of patients which are likely to create barriers, language and communication accessibility, patient data privacy, and the needs of users who will use the telehealth product.

Qian A, Schiaffino M, Nalawade V et al. Disparities in telemedicine during COVID‐19. 
The COVID-19 pandemic has exacerbated health disparities in cancer care telemedicine among ethnically diverse communities. This study examines oncology physician-patient encounters at UC San Diego Health, excluding encounters where patients received procedures or infusions. This study is useful for providing information on the effects of health disparities in ethnic minority patients with cancer on receiving telemedicine and emphasizes the need for promotion of health equity within telemedicine infrastructures.

Dover D, Belon A. The health equity measurement framework: a comprehensive model to measure social inequities in health
The Health Equity Measurement Framework (HEMF) is designed to guide a quantitative analysis that highlights public policy areas of intervention within health organizations. This journal article introduces the HEMF, identifying ways of measuring the effects of social determinants of health (SDOH) to improve health equity. This article is useful in providing a detailed model for health equity measurements and policymaking that incorporates SDOH.

Martino S, Ahluwalia S, Harrison J, Kim A, Elliott M. Developing Health Equity Measures.
The Developing Health Equity Measure project report from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) provides identification of existing health equity measurements. This report provides ten identified health equity measurement approaches for systematic performance assessment. This report is useful in providing guidelines for measurements of personal and organizational health equity.

U.S. Department of Health and Human Services Office of Minority Health. National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. U.S. Department of Health and Human Services website.
The National Standards for Culturally and Linguistically Appropriate Services (CLAS) aim to improve health care quality, eliminate healthcare disparities, and advance health equity. The National CLAS Standards provide a blueprint for healthcare organizations to provide effective quality care and services inclusive of diverse cultural health beliefs, languages, and health literacy. This tool is useful in providing a succinct fact sheet that offers a structure for implementing health equity services, and guidance on improving organizations’ capacity to address healthcare disparities.

Weaver S, Verhoeven D, Castro K, Adjei B, Geiger A. Thematic analysis of organizational characteristics in NCI community oncology research program cancer care delivery research. 
Cancer stakeholders have identified a need to understand and improve multilevel organizational characteristics that influence cancer care quality and outcomes. This journal article provides a thematic analysis of organizational characteristics of cancer care, promoting shared language and coherence in organizational structures. This article is useful for information on gaps in cancer care and future research opportunities, along with providing framework examples of organizational health equity in cancer care.

 

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