The ConNECT Framework: a model for advancing behavioral medicine science and practice to foster health equity

Abstract

Health disparities persist despite ongoing efforts. Given the United States’ rapidly changing demography and socio-cultural diversity, a paradigm shift in behavioral medicine is needed to advance research and interventions focused on health equity. This paper introduces the Con-NECT Framework as a model to link the sciences of behavioral medicine and health equity with the goal of achieving equitable health and outcomes in the twenty-first century. We first evaluate the state of health equity efforts in behavioral medicine science and identify key opportunities to advance the field. We then discuss and present actionable recommendations related to ConNECT’s five broad and synergistic principles: (1) Integrating Context; (2) Fostering a Norm of Inclusion; (3) Ensuring Equitable Diffusion of Innovations; (4) Harnessing Communication Technology; and (5) Prioritizing Specialized Training. The framework holds significant promise for furthering health equity and ushering in a new and refreshing era of behavioral medicine science and practice.

Motivating future directions of behavioral medicine

“…Most designs may be particularly applicable in the eHealth or technology based interventions (Moller et al 2016). Alcaraz et al (2016) introduce the ConNECT Framework to link behavioral medicine and health equity in order to achieve equitable health and outcomes in the 21st century. ConNECT's five broad and synergistic principles: (1) Integrating Context; (2) Fostering a Norm of Inclusion; (3) Ensuring Equitable Diffusion of Innovations; (4) Harnessing Communication Technology; and (5) Prioritizing Specialized Training are promising in promoting health equity across behavioral medicine areas.…”

Highlighting Health Disparities in Racial and Ethnic Minorities and Other Underserved Populations

“…1 Yet more than 30 years after the report from Heckler 2 in 1985 on the national state of minority health in the United States, inequities in cancer care have persisted, widened, and, in some cases, emerged in new areas. [3][4][5][6][7] Disparities in health status refer to the variation in rates of disease occurrence and disabilities between populations defined by demographical, socioeconomical, or geographical factors, most of which exist in populations referred to as minorities and underserved groups. [3][4][5] These groups may be classified by race (eg, black, Asian), ethnicity (eg, Hispanic, Ashkenazi Jewish), sexual orientation (eg, gay, lesbian), gender (eg, transgender, gender queer), socioeconomic status (eg, low income, poor, underserved), or age (eg, seniors, adolescents and young adults [AYAs]).…”

“…[3][4][5][6][7] Disparities in health status refer to the variation in rates of disease occurrence and disabilities between populations defined by demographical, socioeconomical, or geographical factors, most of which exist in populations referred to as minorities and underserved groups. [3][4][5] These groups may be classified by race (eg, black, Asian), ethnicity (eg, Hispanic, Ashkenazi Jewish), sexual orientation (eg, gay, lesbian), gender (eg, transgender, gender queer), socioeconomic status (eg, low income, poor, underserved), or age (eg, seniors, adolescents and young adults [AYAs]). [3][4][5][6][7] Evidence suggests that health disparities in the United States result from a combination of poverty, limited access to quality care, perceived racism/discrimination, genetics, biology, and environmental exposure.…”

“…[3][4][5] These groups may be classified by race (eg, black, Asian), ethnicity (eg, Hispanic, Ashkenazi Jewish), sexual orientation (eg, gay, lesbian), gender (eg, transgender, gender queer), socioeconomic status (eg, low income, poor, underserved), or age (eg, seniors, adolescents and young adults [AYAs]). [3][4][5][6][7] Evidence suggests that health disparities in the United States result from a combination of poverty, limited access to quality care, perceived racism/discrimination, genetics, biology, and environmental exposure. 8,9 A common thread in health disparities specific to cancer is their multidimensionality and complex nature: covering the lifespan, across the continuum of cancer care from prevention to survivorship, and transcending socioecological and transcultural contexts.…”

“…8,9 A common thread in health disparities specific to cancer is their multidimensionality and complex nature: covering the lifespan, across the continuum of cancer care from prevention to survivorship, and transcending socioecological and transcultural contexts. 5,8,9 A growing body of literature suggests that cancer-related disparities are fueled by a multifaceted and concurrent interplay of factors that range from biology and genetics to lifestyle and behavior. 5,[8][9][10] As such, intersectionality, a theoretical focus on the interlocking factors of cultural influence and the multiple identities perceived by patients (eg, a racial/ethnic minority who also identifies as a sexual minority), helps explain how these complex realities exacerbate disparities.…”