Guiding principles for accelerating change through health inequities research and practice: A modified Delphi consensus process.

Despite a preponderance of evidence and considerable resources, health and social inequities persist, and in many cases, are widening. These inequities are not simply the result of passive structural and economic conditions but are actively maintained through institutional processes, norms, and ideo...

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Main Authors: Farah Ahmed, Charlotte Woodhead, Ali Hossaini, Nathan Stanley, Lucy Ensum, Rebecca Rhead, Juliana Onwumere, Ghazala Mir, Jacqueline Dyer, Stephani L Hatch
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0327552
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author Farah Ahmed
Charlotte Woodhead
Ali Hossaini
Nathan Stanley
Lucy Ensum
Rebecca Rhead
Juliana Onwumere
Ghazala Mir
Jacqueline Dyer
Stephani L Hatch
author_facet Farah Ahmed
Charlotte Woodhead
Ali Hossaini
Nathan Stanley
Lucy Ensum
Rebecca Rhead
Juliana Onwumere
Ghazala Mir
Jacqueline Dyer
Stephani L Hatch
author_sort Farah Ahmed
collection DOAJ
description Despite a preponderance of evidence and considerable resources, health and social inequities persist, and in many cases, are widening. These inequities are not simply the result of passive structural and economic conditions but are actively maintained through institutional processes, norms, and ideologies that uphold the status quo. Reform within health inequities research, policy, and health and social care practice is therefore critical to disrupting these entrenched systems and catalysing both bottom-up and top-down change. We aimed to develop agreement for an iterative set of guiding principles underpinning ways of working for a newly formed Health and Social Equity Collective comprising researchers, community leaders, policymakers, and health and care professionals, seeking to address inequity by identifying and engaging the levers of change within and across institutions. The principles aim to inform a more inclusive and translational knowledge base through research practices, tackling entrenched inequalities in education, training, and capacity-building; and centring communities affected by health inequities through engagement and advocacy. We carried out a modified Delphi consensus process between March and September 2022 with Collective members and networks through online workshops and surveys. Out of 24 consensus statements developed and refined over a workshop and three successive survey rounds, we identified eleven key principles agreed upon by a majority of respondents. Two of these were rated high priority by over 75% of respondents, four by over 60% and five by over 50%. These could be grouped into three main topics detailing ways of working and change needed within: 'Knowledge and framing of health and social inequities, and incorporation into practice', 'Community engagement, involvement and peer research', and 'Organisational culture change', respectively. Given the pressing need to address inequities, these principles offer a grounding for future consensus building initiatives which also incorporate a wider diversity of perspectives, and which should be iteratively updated with ongoing learning from health equity initiatives nationally and internationally.
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spelling doaj-art-9c5b5024fb934fe0ac76a1c214dd110a2025-08-20T03:23:22ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032755210.1371/journal.pone.0327552Guiding principles for accelerating change through health inequities research and practice: A modified Delphi consensus process.Farah AhmedCharlotte WoodheadAli HossainiNathan StanleyLucy EnsumRebecca RheadJuliana OnwumereGhazala MirJacqueline DyerStephani L HatchDespite a preponderance of evidence and considerable resources, health and social inequities persist, and in many cases, are widening. These inequities are not simply the result of passive structural and economic conditions but are actively maintained through institutional processes, norms, and ideologies that uphold the status quo. Reform within health inequities research, policy, and health and social care practice is therefore critical to disrupting these entrenched systems and catalysing both bottom-up and top-down change. We aimed to develop agreement for an iterative set of guiding principles underpinning ways of working for a newly formed Health and Social Equity Collective comprising researchers, community leaders, policymakers, and health and care professionals, seeking to address inequity by identifying and engaging the levers of change within and across institutions. The principles aim to inform a more inclusive and translational knowledge base through research practices, tackling entrenched inequalities in education, training, and capacity-building; and centring communities affected by health inequities through engagement and advocacy. We carried out a modified Delphi consensus process between March and September 2022 with Collective members and networks through online workshops and surveys. Out of 24 consensus statements developed and refined over a workshop and three successive survey rounds, we identified eleven key principles agreed upon by a majority of respondents. Two of these were rated high priority by over 75% of respondents, four by over 60% and five by over 50%. These could be grouped into three main topics detailing ways of working and change needed within: 'Knowledge and framing of health and social inequities, and incorporation into practice', 'Community engagement, involvement and peer research', and 'Organisational culture change', respectively. Given the pressing need to address inequities, these principles offer a grounding for future consensus building initiatives which also incorporate a wider diversity of perspectives, and which should be iteratively updated with ongoing learning from health equity initiatives nationally and internationally.https://doi.org/10.1371/journal.pone.0327552
spellingShingle Farah Ahmed
Charlotte Woodhead
Ali Hossaini
Nathan Stanley
Lucy Ensum
Rebecca Rhead
Juliana Onwumere
Ghazala Mir
Jacqueline Dyer
Stephani L Hatch
Guiding principles for accelerating change through health inequities research and practice: A modified Delphi consensus process.
PLoS ONE
title Guiding principles for accelerating change through health inequities research and practice: A modified Delphi consensus process.
title_full Guiding principles for accelerating change through health inequities research and practice: A modified Delphi consensus process.
title_fullStr Guiding principles for accelerating change through health inequities research and practice: A modified Delphi consensus process.
title_full_unstemmed Guiding principles for accelerating change through health inequities research and practice: A modified Delphi consensus process.
title_short Guiding principles for accelerating change through health inequities research and practice: A modified Delphi consensus process.
title_sort guiding principles for accelerating change through health inequities research and practice a modified delphi consensus process
url https://doi.org/10.1371/journal.pone.0327552
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