The ConNECT Framework: a Model for Advancing Behavioral Medicine Science and Practice to Foster Health Equity

Overview

Journal J Behav Med

Specialty Social Sciences

Date 2016 Aug 12

PMID 27509892

Citations 27

Authors

Kassandra I Alcaraz

Jamilia Sly

Kimlin Ashing

Linda Fleisher

Virginia Gil-Rivas

Sabrina Ford

Jean C Yi

Qian Lu

Cathy D Meade

Usha Menon

Clement K Gwede

Affiliations

Soon will be listed here.

Abstract

Health disparities persist despite ongoing efforts. Given the United States' rapidly changing demography and socio-cultural diversity, a paradigm shift in behavioral medicine is needed to advance research and interventions focused on health equity. This paper introduces the ConNECT Framework as a model to link the sciences of behavioral medicine and health equity with the goal of achieving equitable health and outcomes in the twenty-first century. We first evaluate the state of health equity efforts in behavioral medicine science and identify key opportunities to advance the field. We then discuss and present actionable recommendations related to ConNECT's five broad and synergistic principles: (1) Integrating Context; (2) Fostering a Norm of Inclusion; (3) Ensuring Equitable Diffusion of Innovations; (4) Harnessing Communication Technology; and (5) Prioritizing Specialized Training. The framework holds significant promise for furthering health equity and ushering in a new and refreshing era of behavioral medicine science and practice.

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References

Teal C, Street R . Critical elements of culturally competent communication in the medical encounter: a review and model. Soc Sci Med. 2008; 68(3):533-43. DOI: 10.1016/j.socscimed.2008.10.015. View

DeSantis C, Siegel R, Sauer A, Miller K, Fedewa S, Alcaraz K . Cancer statistics for African Americans, 2016: Progress and opportunities in reducing racial disparities. CA Cancer J Clin. 2016; 66(4):290-308. DOI: 10.3322/caac.21340. View

Diez-Roux A . Bringing context back into epidemiology: variables and fallacies in multilevel analysis. Am J Public Health. 1998; 88(2):216-22. PMC: 1508189. DOI: 10.2105/ajph.88.2.216. View

Greiner K, Friedman D, Adams S, Gwede C, Cupertino P, Engelman K . Effective recruitment strategies and community-based participatory research: community networks program centers' recruitment in cancer prevention studies. Cancer Epidemiol Biomarkers Prev. 2014; 23(3):416-23. PMC: 3971731. DOI: 10.1158/1055-9965.EPI-13-0760. View

Lu Q, Yeung N, You J, Dai J . Using expressive writing to explore thoughts and beliefs about cancer and treatment among Chinese American immigrant breast cancer survivors. Psychooncology. 2015; 25(11):1371-1374. PMC: 4925308. DOI: 10.1002/pon.3991. View

Gorin S, Badr H, Krebs P, Das I . Multilevel interventions and racial/ethnic health disparities. J Natl Cancer Inst Monogr. 2012; 2012(44):100-11. PMC: 3482960. DOI: 10.1093/jncimonographs/lgs015. View

Glickman S, Ndubuizu A, Weinfurt K, Hamilton C, Glickman L, Schulman K . Perspective: The case for research justice: inclusion of patients with limited English proficiency in clinical research. Acad Med. 2011; 86(3):389-93. DOI: 10.1097/ACM.0b013e318208289a. View

Njeru J, Patten C, Hanza M, Brockman T, Ridgeway J, Weis J . Stories for change: development of a diabetes digital storytelling intervention for refugees and immigrants to minnesota using qualitative methods. BMC Public Health. 2015; 15:1311. PMC: 4696160. DOI: 10.1186/s12889-015-2628-y. View

Dankwa-Mullan I, Rhee K, Stoff D, Pohlhaus J, Sy F, Stinson Jr N . Moving toward paradigm-shifting research in health disparities through translational, transformational, and transdisciplinary approaches. Am J Public Health. 2010; 100 Suppl 1:S19-24. PMC: 2837422. DOI: 10.2105/AJPH.2009.189167. View

10.

Kumanyika S . Health Equity Is the Issue We Have Been Waiting for. J Public Health Manag Pract. 2015; 22 Suppl 1:S8-S10. DOI: 10.1097/PHH.0000000000000363. View

11.

Sprague D, Russo J, LaVallie D, Buchwald D . Barriers to cancer clinical trial participation among American Indian and Alaska Native tribal college students. J Rural Health. 2013; 29(1):55-60. PMC: 3539223. DOI: 10.1111/j.1748-0361.2012.00432.x. View

12.

Diez Roux A . Conceptual approaches to the study of health disparities. Annu Rev Public Health. 2012; 33:41-58. PMC: 3740124. DOI: 10.1146/annurev-publhealth-031811-124534. View

13.

Quinn G, Sanchez J, Sutton S, Vadaparampil S, Nguyen G, Green B . Cancer and lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. CA Cancer J Clin. 2015; 65(5):384-400. PMC: 4609168. DOI: 10.3322/caac.21288. View

14.

Kleinman A . Concepts and a model for the comparison of medical systems as cultural systems. Soc Sci Med (1967). 1978; 12(2B):85-95. DOI: 10.1016/0160-7987(78)90014-5. View

15.

Scholmerich V, Kawachi I . Translating the Socio-Ecological Perspective Into Multilevel Interventions: Gaps Between Theory and Practice. Health Educ Behav. 2016; 43(1):17-20. DOI: 10.1177/1090198115605309. View

16.

Yancey A, Ortega A, Kumanyika S . Effective recruitment and retention of minority research participants. Annu Rev Public Health. 2006; 27:1-28. DOI: 10.1146/annurev.publhealth.27.021405.102113. View

17.

Glasgow R, Lichtenstein E, Marcus A . Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. Am J Public Health. 2003; 93(8):1261-7. PMC: 1447950. DOI: 10.2105/ajph.93.8.1261. View

18.

Wells K, Lima D, Meade C, Munoz-Antonia T, Scarinci I, McGuire A . Assessing needs and assets for building a regional network infrastructure to reduce cancer related health disparities. Eval Program Plann. 2014; 44:14-25. PMC: 4360072. DOI: 10.1016/j.evalprogplan.2013.12.003. View

19.

Montague E, Perchonok J . Health and wellness technology use by historically underserved health consumers: systematic review. J Med Internet Res. 2012; 14(3):e78. PMC: 3799608. DOI: 10.2196/jmir.2095. View

20.

Vidal A, Smith J, Valea F, Bentley R, Gradison M, Yarnall K . HPV genotypes and cervical intraepithelial neoplasia in a multiethnic cohort in the southeastern USA. Cancer Causes Control. 2014; 25(8):1055-62. PMC: 4082644. DOI: 10.1007/s10552-014-0406-2. View