Community-Level Interventions to Improve Minority Health and Reduce Health Disparities

Council Date: February 2, 2021

Objective

The purpose of this initiative is to support research to develop and test community-level interventions to improve minority health and reduce health disparities. Download full concept paper

Description of Initiative

For the purposes of this initiative, “community” is defined as “a social group of any size whose members reside in a specific locality, share government, and often have a common cultural and historical heritage” (Dictionary.com). Examples of communities include but are not limited to neighborhoods, towns, cities, counties, school districts, reservation or tribal communities, military bases, or college campuses. Virtual or other communities that do not reside in the same geographic location are not a priority for this initiative.

Community-level intervention projects are expected to:

• Be led by or conducted in collaboration with appropriate community partners, such as community-based organizations, faith-based organizations, local businesses, neighborhood associations, labor unions, patient or consumer advocacy groups, public health departments, health care systems, school systems, law enforcement or criminal justice agencies, social service agencies; or departments of commerce, labor, transportation, housing, or recreation. Multi-sectoral collaborations involving partnerships with multiple types of organizations in the public and private sector are strongly encouraged.
• Focus on improving health outcomes or reducing health disparities in one or more NIH-designated populations experiencing health disparities in the U.S.
• Focus on the entire population in communities (e.g., an intervention to increase the availability of fresh produce or walkable green spaces) or a specific population within communities (e.g., an intervention to improve physical activity among high school students or older adults within the community).
• Use cluster randomized trials or rigorous quasi-experimental designs with the community as the level of analysis. Individual-level randomized designs are not responsive to this initiative, though multi-level interventions also including intervention elements at the individual, interpersonal, or organizational level are encouraged.
• Include health outcomes at the individual, interpersonal/organizational, or community level, or a combination.
• Use appropriate measures and analytic methods appropriate for examining community-level mechanisms of action and health outcomes.

Examples of interventions that would not be considered community-level include the following:

• Interventions that are community-based (i.e., delivered in community rather than academic or hospital settings) but do not target community-level determinants of health.
• Interventions to help individuals to address or cope with community-level determinants without operating directly on those community-level determinants (e.g., providing a referral to a food bank for individuals living in a food desert, helping individuals cope with community racism and discrimination).
• Interventions that include community-wide elements (e.g., a public health campaign about COVID-19 vaccination), but intervention effects are tested only at the individual or interpersonal/organizational level.
• Community-wide outreach and recruitment of participants into interventions that are not community-level.

Page updated Jan. 18, 2024