FAIR Database

Finding Answers Intervention Research (FAIR) Database

The FAIR Database contains 388 journal article summaries from 11 systematic reviews of racial and ethnic health disparities intervention literature. The systematic reviews were published as a Special Supplement to the October 2007 issue of Medical Care Research and Review, and a August 2012 Symposium in the Journal of General Internal Medicine.

Read more about Finding Answers’ systematic reviews, and access free copies of all of the 11 publications here.

Systematic literature reviews were conducted for the following health topics and intervention strategies: asthma, cervical cancer, colorectal cancer (CRC), HIV prevention, prostate cancer, cardiovascular disease (CVD), depression, diabetes mellitus, breast cancer, cultural leverage and pay-for-performance incentives. Diseases examined in this database were chosen because they have a known high prevalence, cause significant morbidity and mortality, have clear standards of care, and have large documented disparities in care. Diseases outside the scope of the supplement (e.g., stroke, lung cancer) are not included in this database.

The FAIR Database was designed to provide a customized list of interventions that match a user’s interest in the following areas: disease area, racial/ethnic population, organizational setting, and intervention strategy.

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Inclusion Criteria

Articles published between 1950 and 2010 were included; inclusion criteria were: 1) adult population (age 18 or older); 2) intervention studies with greater than 50% minority participants or with a subset analysis of minority patients by race/ethnicity were included; and 3) intervention studies affiliated with a health care delivery setting (i.e., outpatient clinic, ED, hospital).

Breast cancer
Articles published from 1986 through December 2005, in English, that included human data, represented a published report. People of color receiving care were either the focus of studies, representing over 50% of study subjects, or subgroups of larger trials, where data for ethnic/racial subgroups were specifically described. Studies were conducted in the U.S., included an intervention which was health care organization-based, and utilized a randomized or concurrent controlled trial design.

Cervical Cancer
Eligible studies had to meet all five inclusion criteria: 1) represent an original study; 2) include at least one intervention designed to improve cervical cancer prevention, screening, diagnosis or treatment that linked participants to the healthcare system; 3) present data for racial and/or ethnic minority populations in the US; 4) measure direct outcomes such as HPV vaccination (cervical cancer prevention), Pap tests (cervical cancer screening), follow up of abnormal Pap smears (cervical cancer diagnosis or treatment of premalignant disease of the cervix) or treatment of cervical cancer; and 5) report findings in English. Articles published between 1988 and 2010 were included.

Cardiovascular disease
Articles published from 1995 to 2006 that were designed to improve delivery of care addressing hypertension, lipid abnormalities, tobacco use, sedentary behavior, coronary artery disease, and heart failure for adult patients of color. People of color receiving care were either the focus of studies, representing over 50% of study subjects, or subgroups of larger trials, where data for ethnic/racial subgroups were specifically described. We required that interventions be based in North America and have a connection with a health care setting.

Colorectal Cancer
Articles and abstracts were assessed for inclusion based on pre-specified criteria. Study populations were required to be composed of patient groups with greater than 50% minority representation (defined as >50% racial/ethnic minority patients) or, if less than 50%, the study must include subgroup analysis by race or ethnicity with documentation of sufficient statistical power. Articles must report on an experimental intervention (purely descriptive studies were excluded). Articles were not excluded based solely on the type of experimental study design or measured outcome. Study interventions were required to take place within the context of a consistent source of health care (community interventions must directly integrate a system of ongoing medical care). Lastly, studies were required to be conducted in the United States and to be published in English. Articles published between 1989 and 2010 were included.

Articles published from January 1995 to January 2006, in English, that pertained to humans, were conducted in the United States or Canada, had a full text article, and had an intervention component with minority group participants and described a mechanism for reducing disparities.

Diabetes mellitus
Articles published from from 1985 to 2006 which were designed to improve diabetes care for adults of color living with type 2 diabetes mellitus. People of color receiving care were either the focus of studies, representing over 50% of study subjects, or subgroups of larger trials, where data for ethnic/racial subgroups were specifically described. We excluded reports of interventions that were not based in health care settings, involved children, or exclusively addressed diabetes prevention.

HIV Prevention
The operational definition of intervention used was an explicitly stated intervention designed to decrease the sexual acquisition of HIV within a racial or ethnic minority population in the United States.17 Inclusion criteria included the following: 1) Population composed of at least 50% minority adults or adolescents of any ethnic or cultural background, or race/ethnicity sub-analyses. 2) Formal health care association, either through participant recruitment (e.g. sexually transmitted infection clinics, health center outpatients) or location of intervention implementation (e.g. community health center, clinic waiting room). 3) Conducted in the United States 4) Condom use or biological endpoint 5) Publication as a full manuscript or brief report in English. Articles published between 1981 and 2011 were included.

Prostate Cancer
We included studies on humans, in English language that were conducted in the US and
published between 1985 and 2010. Articles had to include at least one ethnic minority group (overall patient population more than 50% minority or, if less than 50% minority, include specific analysis by race/ethnicity) and an informed decision making (IDM) or QOL-affecting intervention taking place within an identified health care setting.

Cultural interventions
Articles published after 1985 that describe an intervention arising from a health care organization or connecting community/patients of color to a health care organization, evaluate an intervention, focus on a population of at least fifty percent people of color, and take place within the United States.

Pay-for-Performance incentives
Articles published from 1966 through March 2006, in English and conducted in the United States that explicitly link rewards and sanctions to performance on measures of specific health care processes and/or outcomes. We excluded programs that used implicit incentives related to the overall payment structure (e.g. capitation), promoted quality without directly assessing care processes or outcomes (e.g. information technology grants), or only provided educational inducements (e.g. continuing medical education credits).