New CTSI Core Dedicated to Integrating Equity Throughout Research Enterprise

As the COVID-19 pandemic and racial reckoning unfolded side-by-side during the summer of 2020, a common thread emerged that prompted an intentional shift at the Duke Clinical and Translational Science Institute (CTSI) and Clinical and Translational Science Award (CTSA).

“Although equity is something that Duke CTSA has always been interested in, during the summer of 2020, a more organized initiative to integrate equity throughout CTSI and CTSA was deemed necessary,” said Keisha Bentley-Edwards, PhD, a Duke developmental psychologist and member of CTSI.

This call to intentionally incorporate equity throughout CTSI led to the creation of a new CTSA core. Inspired by CTSI Director L. Ebony Boulware, MD, with senior advisors Nadine J. Barrett, PhD, and Pamela Maxson, PhD, and in partnership with the School of Medicine’s Chief Diversity Officer, Judy Seidenstein, the new Equity in Research (EIR) core launched in July 2020 and aims to elevate, advance, and accelerate equitable, inclusive, and anti-racist research.

With the profound challenges of 2020 still driving conversations, innovation, and necessary change, CTSI has created a longitudinal strategy to fully integrate equity at every level. The strategy applies an equity lens to existing services and infrastructure, and builds as new initiatives and projects are launched and expanded.

“The whole focus of this is a comprehensive model of how we will address anti-bias and anti-racism and promote equity within anything that we do as CTSI,” said Barrett, director of the new Center for Equity in Research, which is supported by the EIR core. “That includes our environment, our culture and how we engage with one another, and also the products that we put out.”

The EIR core is at the heart of this work.

“Everyone will remember 2020 as the year of COVID and racial reckoning. We have everyone’s attention. This is something that people are thinking about and talking about, a reckoning with not just racial bias but all forms of bias,” said Bentley-Edwards, now co-director of EIR. “People want to be on the right side of history, including their research.”

The new core provides infrastructure support for research teams and other CTSA cores to promote equity, anti-bias, and anti-racism across the research enterprise and environment. Services include ongoing and evolving development opportunities for staff, faculty, and researchers, as well as consultations with investigators and teams about the urgent need to increase diversity in clinical research.

“We want to help researchers from the very beginning of their projects think about equity, anti-bias, and anti-racism and how to incorporate these into a project, before they’ve even written the grant or developed research questions,” said Dane Whicker, PhD, co-director of EIR.

These consultations will shift the culture toward proactive and robust planning for diversity, equity, and inclusion in research. The sessions will help research teams think strategically about diversifying clinical research participation using best practices and innovative solutions, and give them the tools to implement an equity lens across the lifecycle of a project from idea generation through dissemination.

Specific work accomplished thus far:

Developing and providing tools and resources:

• Anti-bias/anti-racism continuous learning environment: longitudinal curricula for all science trainees; curricula and tools for faculty, faculty mentors, and staff at Duke; featuring tailored learning tools and venues for various audiences
• Tools and resources to promote anti-bias and anti-racism culture in science teams: deepen the expertise and in anti-bias and anti-racism and to create change agents capable of generating an equitable, anti-biased/anti-racist research environment
• Consultations and resources to ensure diversity and cultural competency in biomedical research studies: direct engagement with CTSI cores as well as key school of medicine/ school of nursing research resources to create tools and accountability around participant recruitment and engagement practices

Reframing constructs around bias and race in research:

• Convene biomedical researchers, social scientists and ethicists to deconstruct traditional uses of race and other harmful identifiers in research: a ‘think-tank’ for experts to discuss and develop new conceptual frameworks for scientists and to guide future research; promote new grants; fund pilots
• Develop cutting-edge anti-bias/anti-racism frameworks for researchers: advance the field through transdisciplinary collaborations that re-think scientific practices that may unwittingly reinforce racism or bias

Creating accountability to ensure an anti-biased/anti-racist research enterprise

• Evaluate and guide anti-bias/anti-racism research policies and practices: ongoing formal evaluation of policies and practices for research quality improvement
• Promote and support actions to dismantle biased and racist institutional practices in research: provide senior leadership with strategic guidance and actionable recommendations to thwart bias and racism in research

Supporting efforts to establish an equity lens around clinical care

• Further a learning health system around equity, anti-bias/anti-racism. Develop ongoing collaborations with Duke Health leaders to establish equity lens around clinical care delivery and process improvement and clinical research: connect directly with Duke leaders focused on quality improvement with an equity lens
• Promote implementation research studies that focus on equity and anti-bias