RSNA2023 Leading Through Change
Daily Bulletin

Focus Groups on Health Equity Speak to Need For Change

Thursday, Nov. 30, 2023

By Melissa Silverberg

Years ago, Esteban Barreto, PhD, was a first-generation college student in the U.S., navigating the health care and educational system and the inequities within both. That experience led to a lifelong passion for diversity and inclusion work and his recent efforts to develop a health equity curriculum for radiology professionals.



"My experience provided me with a unique lens I can use to tackle health disparities," said Barreto, who is director of Research Evaluation at Massachusetts General Hospital (MGH) in Boston. He also knew that he was not alone in this experience and was interested in learning other perspectives. He presented the results of a large multi-institutional qualitative study at a Wednesday session.

Focus Groups Drilled Down Into Awareness and Empathy

The project, a collaboration between MGH and Vanderbilt University Medical Center in Nashville, TN, convened four community-based focus group discussions between December 2022 and April 2023 with participants from large academic medical centers, community organizations, medical schools and radiology trainee programs. The groups included 19 medical students, six radiology residents and 14 community members, who were patients themselves, representing underserved communities in the Boston area.

The conclusions of the focus groups fell into three major categories: Awareness of health inequities; Bridging the gap between knowledge and practice; and Leading with empathy.

One of the first questions asked in the focus groups was how the participants define health disparities. The team heard a variety of answers related to implicit bias and unequal treatment, including patients not feeling heard or seen when receiving medical care. Participants also discussed health care access and its inequities, and the importance of ensuring equitable care access for all patients.

In conversations with medical students and radiology residents, there was a sentiment that there was a lot of talking about equity in the classroom, but a disconnect between what they learned and actual practice.

"How do we make sure students have the tools they need to care for patients experiencing barriers to accessing care?" Dr. Barreto said.

When asked about what information providers need to understand health equity, focus group members pointed to a lack of empathy in health care. In particular, community members noted that providers often seem rushed and not able to give their full attention to a patient's needs and perspectives.

"Many community members emphasized the need for patients to be heard and seen when being cared for based on their lived experiences. Radiology residents and medical students also emphasized the importance of considering the social determinants of their patients' health to provide equitable care," Dr. Barreto said. "We concluded that it is crucial to partner with diverse communities and hear from underserved patient populations to understand their health needs, which in turn can help us develop educational resources to bridge knowledge and practice."

New Generation Passionate About Change

After 15 years of working in the diversity and inclusion space, Dr. Barreto said he knows this is a complex issue, but he was surprised by the urgency he heard from medical students and radiology residents about the importance of including health equity as part of the educational curriculum for future professionals.

"Maybe it is a generational thing," he said. "Their sentiments echoed an impatience in wanting to see change happen and a real sense of urgency and frustration at 'why has this taken so long?'"

Access the presentation, "Community-Based Qualitative Study to Inform a Health Equity Curriculum for Radiologists: Project HEALTH (Health Equity Assessment Learning & Training Hub)," (W1-SSNPM03-4) on demand at