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Table 2 Statements by Cluster to the focus prompt “To be useful, a health equity tool should…”

From: Critical considerations for the practical utility of health equity tools: a concept mapping study

Cluster 1: Evaluation for Improvement
 1. Be linked to Action Research
 5. Have a clear feedback loop to improve practice
 10. Have a clear intended outcome (e.g., is the tool intended to help you assess if there’s an inequity? To improve equity of an existing program? etc.)
 27. Assist program planners to improve the equity of their programs
 33. Provide further information or support after completing the tool, such as future steps and strategies to apply after identifying gaps or areas requiring attention
 34. Engage the client or patient in thinking beyond the individual to the social factors impacting health: consciousness raising or thought-inspiring.
 37. Lead to the identification of areas for improvement in policy/program
 45. Help define priorities
 47. Be useful for program evaluation
 53. Include a plan to evaluate after use
 56. Make sense to public health clients
 64. Be evaluated
Cluster 2: User Friendliness
 3. Be applicable to a diverse range of situations and program areas
 4. Be a living document that can be updated following evaluations as to how the organization/workplace is doing to live up to a policy
 12. Guide your thought process
 13. Help the user to determine relevant strategies to address the inequity
 14. Be concise
 18. Have obvious relevance
 24. Have a clear purpose and objectives
 29. Be easy to understand
 32. Be short
 36. Be useful at various levels of the organization, front line work and policy making
 39. Be easy to use
 40. Be simple
 50. Be quick for a public health practitioner to use
 59. Give practical ways for the health care sector/providers to engage patient as full partner
 62. Be clear
 66. Use plain language
Cluster 3: Explicit Theoretical Background
 6. Provide references for the theoretical foundations of the tool
 7. Have some context (e.g. background information)
 38. Provide an explanation of the theoretical foundations of the tool
 44. Be grounded in theories of health equity that illustrate how health inequities can be reduced
 46. Provide a clear definition of the fundamental principles of health equity (what is means, why it is important, practicalities, costs and limitations)
 61. Define equity
 65. Be grounded in theories of health equity that illustrate how health inequities occur
Cluster 4: Templates and Tools
 17. Provide a way of synthesizing across the steps of the process to lead to a conclusion about what needs to be done
 19. Provide examples of how the tool can be used
 20. Describe appropriate applications of the tool
 22. Describe inappropriate applications for using the tool
 23. Provide links to tangible step-by-step strategies to act on any identified barriers to health equity. Ideally, this would be interactive with tailored suggestions based on assessment results
 26. Provide examples of how the tool has been used
 28. Provide a template or worksheets that can be completed by the user
 30. Provide a clear set of steps that help the user to determine whether a health inequity exists
 51. Provide guidance on determining strategies to address inequity
 52. Provide resources where the user can go from additional information or help
 55. Show how to work through the process of defining an inequity and determining strategies to address it
 58. Provide core sets of equity indicators
 60. Provide examples of how the tool could be used
 67. Clearly define appropriate context for use of the tool (organization-level policy assessment vs. front-line direct service program assessment)
Cluster 5: Equity Competencies
 2. Extend the definition of culture to include how institutions may impact how people receive/experience care (i.e. religious upbringing, foster care, correctional institutions, street culture)
 9. Provide connections to a community of practice, or people to discuss health equity with
 11. Encourage the inclusion of harm reduction strategies to improve peoples’ health
 16. Be filtered through all the public health lenses
 25. Guide people through critical reflexivity exercise/mindfulness – how they show up to work, what things colour their lens of the world, how they may be a health care provider, but show up with their patient as a judge or minister
 31. Encourage compassion for both the health care worker and client
 35. Engage the provider in thinking beyond the individual to the social factors impacting health: consciousness raising or thought-inspiring
 41. Be grounded in quality improvement
 42. Explore how stigma from health care sector plays out in the services and supports we provide
 43. Take health literacy into account
 48. Be inclusive of users of programs
 54. Operate from a spirit of curiosity
 57. Take into account people’s trauma histories
Cluster 6: Nothing about Me without Me – Client Engaged
 8. Include the participation of those affected by health inequities
 15. Point out ways that health care may be neglecting particular populations for more “favourable” populations
 21. Be inclusive of the health needs of people who use substances
 49. Feed courage to health care providers to be able to provide some level of care to anyone who walks through the door as being in the right place
 63. Encourage health care providers to examine how they can provide more culturally competent, trauma-informed, care