Evaluating an Innovative Health Equity Curriculum

Abstract

Racism, classism, and gender discrimination—compounded by heterosexism, gender binarism, weight-bias, etc. are social forces that undermine equitable distribution of the social determinants of health and result in health disparities, afflicting historically marginalized populations most severely. When health professionals do not effectively confront these social forces in the care of their patients, detrimental systems are reinforced and become normative. An innovative health equity curriculum (HEC) was designed and implemented in a graduate nursing program for midwifery and women’s health nurse practitioner students. As an upstream intervention, the HEC aims to mitigate racism and biases in clinical practice through promotion of patient-centered care and knowledge-building around structural competency and intersectionality across topical areas in midwifery and women’s health. Using the Kirkpatrick-Barr Evaluation Model, this study aimed to indirectly evaluate behavior in the clinical setting among program graduates through 1) evaluation of self-efficacy in patient-centeredness and 2) behaviors/attitudes, norms, and control beliefs regarding health equity and topical areas addressed in the HEC. In this descriptive analysis, data was collected from an online survey in a convenience sample including 99 participants, 42 in the HEC group and 57 in the non-HEC group. The survey included demographic questions, the Self-Efficacy in Patient-Centeredness Questionnaire (SEPCQ-27), and questions evaluating beliefs. Though statistical analyses revealed no statistically significant differences between HEC and non-HEC groups in terms of self-efficacy in patient-centeredness, HEC participants were more likely to express greater interest in health equity (X2 = 16.02, p = .003) and felt more prepared across topical areas (U = 580.5, p =