P3C200: The Pediatrics Diversity Collaborative Journal Club: A Resident-led Initiative to Raise Awareness and Educate on Racial, Social, and Economic Health Disparities at the UC San Diego Department of Pediatrics

Background: The Center for Disease Control and Prevention (CDC) called systemic racism a public health crisis in 2020. This crisis underscored the already-documented racial/ethnic and socioeconomic disparities in child health. The Pediatrics Diversity Collaborative is a resident-led initiative established in 2019 at the University of California-San Diego Department of Pediatrics/Rady Children’s Hospital. Our mission is to educate future leaders to address child health inequity and structural racism through academic activities.

Methods: The Collaborative established a quarterly health equity Journal Club to raise awareness and create discussions on racial/ethnic and socio-economic child health disparities. We conducted a 11-item cross-sectional anonymous survey with Likert-scale and free-text responses to assess impact of our Journal Club, including knowledge and practice, satisfaction, feedback, and topics of interest.

Results: Four Journal clubs have taken place since 2020. Topics included environmental factors affecting child health and health in vulnerable populations (gender diverse, migrant, families with preferred language other than English). Meetings were conducted in the homes of pediatrics faculty. Attendance per meeting ranged from 15-20 participants (65% residents, 35% faculty). Thirty-eight percent of participants (n = 24) completed the survey with 60% of respondents reporting having a “good” understanding of pediatric health disparities pre-Journal Club and 94% reporting “good/excellent” understanding post attendance. Ninety-four percent “agreed/strongly agreed” that the Journal Club improved their understanding of pediatric health disparities and “agreed/strongly agreed” the information presented was useful and relevant to their future practice as pediatricians. Ninety-four percent “agreed/strongly agreed” that the Journal Club is effective in encouraging residents/faculty to conduct research, quality improvement, or changes in clinical practice focused on diversity, inclusion, and social justice, while 71% stated that they were “likely/extremely likely” to incorporate health disparities into future research, quality improvement or clinical projects. One hundred percent “agreed/strongly agreed” that the Journal Club is effective in educating residents on pediatric health disparities and recommended that the residency program continues to have Journal Clubs focused on health disparities. One hundred percent reported “high/very high” satisfaction and “agreed/strongly agreed” that they would recommend attendance to trainees/colleagues. The Journal Club has led to requests to hospital administration for resources for vulnerable patients (in-person Spanish interpreters and increase hospital signage regarding rights to an interpreter), and involvement in quality improvement projects (improving discharge processes for Spanish-speaking families).

Conclusion: We successfully established a resident-driven health equity-focused Journal Club. Acceptability and satisfaction are high and survey findings show potential impact on knowledge gain in health disparities, changes in clinical practice and future incorporation of health equity into projects. Our Journal Club provides a safe environment to engage in sensitive discussions with support from topic-expert faculty. Promoting pediatrics residents’ awareness of health inequities can help address structural racism and child health disparities.