Background The National Health Service (NHS) has the most diverse workforce in the United Kingdom (UK), 25% (n= 309,532/1,200,000) of staff belong to ethnic minority groups. However, there is evidence of longstanding issues of racism within the NHS and discrimination towards ethnic minority healthcare staff has been rising since 2016. In the first wave of the COVID-19 pandemic, 95% of COVID-19 deaths among doctors were in an ethnic minority group. There has been no definitive answer for the disproportionate COVID-19 mortality but socioeconomic factors due to structural racism have been suggested as the main drivers. No studies have assessed the effectiveness of antiracist interventions for healthcare staff.
Methods We conducted a systematic review; databases searched included: AMED, Medline via OVID, CINAHL, APA Pyscinfo, Web of Science and OVID Emcare 25th– 31st January 2022. The interventions were structured using a model of antiracist interventions and analysed using narrative synthesis methods.
Results 16 papers were reviewed with interventions at different levels: personally mediated (n=9), multilevel (n=4) and institutional (n=3). Personally mediated interventions were workshops (n=8) and a mentorship scheme (n=1). Institutional interventions were policies (n=2) and increasing diversity initiative (n=1). Multilevel interventions were a mix of both. Study designs and risk of bias tools indicated that the quality of evidence was of low quality. Only two studies included control groups. Countries included the USA (n=11), Canada (n=1) and the UK (n=4).
Conclusion There is a lack of robust evidence for antiracist interventions for healthcare staff, especially at an institutional level. High quality research is required to evaluate the long-term effects of interventions.
Funding statement The Wales COVID-19 Evidence Centre was funded for this work by Health and Care Research Wales on behalf of Welsh Government.
Competing Interest StatementThe authors have declared no competing interest.
Funding StatementThe Wales COVID-19 Evidence Centre was funded for this work by Health and Care Research Wales on behalf of Welsh Government.
Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.
Yes
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
Yes
I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.
Yes
Data AvailabilityAll data produced in the present study are available upon reasonable request to the authors
Comments (0)