Re-envisioning, Retooling, and Rebuilding Prevention Science Methods to Address Structural and Systemic Racism and Promote Health Equity

Abstract

The historic momentum from national conversations on the roots and current impacts of racism in the USA presents an incredible window of opportunity for prevention scientists to revisit how common theories, measurement tools, methodologies, and interventions can be radically re-envisioned, retooled, and rebuilt to dismantle racism and promote equitable health for minoritized communities. Recognizing this opportunity, the NIH-funded Prevention Science and Methodology Group (PSMG) launched a series of presentations focused on the role of Prevention Science to address racism and discrimination guided by a commitment to social justice and health equity. The current manuscript aims to advance the field of Prevention Science by summarizing key issues raised during the series’ presentations and proposing concrete research priorities and steps that hold promise for promoting health equity by addressing systemic racism. Being anti-racist is an active practice for all of us, whether we identify as methodologists, interventionists, practitioners, funders, community members, or an intersection of these identities. We implore prevention scientists and methodologists to take on these conversations with us to promote science and practice that offers every life the right to live in a just and equitable world.

Critical examination of resilience and resistance in African American families: Adaptive capacities to navigate toxic oppressive upstream waters

“…Moreover, as this study illustrates these findings point to more subtle, person-specific, and positive development/resilience-oriented interventions” (p. 4). Murry, Bradley, and colleagues (2022) critique this intersection further, adding that Prevention Science’s focus on individualistic frameworks or micro-level instead of macro-level interventions is “reinforced by existing service systems, including schools and public health agencies, that emphasize individual responsibility for health or education without attending to the social and economic conditions that increase health risk and disrupt individual resilience (Murry et al, 2022, p. 5). These authors noted that “programs that focus on building individual and family resilience often ignore the upstream environmental factors and processes that create and sustain chronic exposure to discrimination and systemic racism, or the social structures necessary to sustain” (Murry et al, 2022, p. 5).…”

“…Murry, Bradley, and colleagues (2022) critique this intersection further, adding that Prevention Science’s focus on individualistic frameworks or micro-level instead of macro-level interventions is “reinforced by existing service systems, including schools and public health agencies, that emphasize individual responsibility for health or education without attending to the social and economic conditions that increase health risk and disrupt individual resilience (Murry et al, 2022, p. 5). These authors noted that “programs that focus on building individual and family resilience often ignore the upstream environmental factors and processes that create and sustain chronic exposure to discrimination and systemic racism, or the social structures necessary to sustain” (Murry et al, 2022, p. 5). Thus, while there is a need for preventive interventions that move beyond families and individuals to increase resilience and include skill and capacity building to promote resistance, the greatest need is for system-level action-oriented change that eliminates the need to navigate oppressive toxic waters.…”

HIV pre‐exposure prophylaxis programme preferences among sexually active HIV‐negative transgender and gender diverse adults in the United States: a conjoint analysis

“…Importantly, socio-economic deprivation resulting from stigma and discrimination also impedes people's access to the resources needed to support their wellbeing, particularly among trans people experiencing multiple intersecting forms of oppression [75,76]. For example, anti-trans stigma has been shown to disrupt people's educational trajectories and adversely affect educational attainment in adulthood, subsequently limiting access to employment opportunities and stable housing, which in turn perpetuates high rates of poverty and financial precarity relative to cisgender people [30,70,[77][78][79][80][81][82][83][84][85][86]. This precarity may also lead to participation in sex work-thus conveying increased vulnerability to HIV transmission if engaging in condomless sex with clients and increased risk of surveillance, profiling, carceral system involvement due to the widespread criminalization of sex work [84,87].…”

Self-understanding, envisioning the future, and prevention: An appreciation and a reflection on the occasion of the 100th anniversary.

“…This is true even in rethinking methods in prevention research. The journal Prevention Science published a special issue on addressing racism and equity, and a group of us contributed an article on addressing systemic racism in research and achieving equity (Murry et al, 2022).…”