Increasing Diversity, Equity, and Inclusion in the Health and Health Services Research Workforce: A Systematic Scoping Review.

Health and health services research institutions seek to increase diversity, equity, and inclusion (DEI) to overcome structural bias. The objective of this review is to identify, characterize, and evaluate programs aimed to strengthen DEI in the health and health services research workforces. We conducted a systematic scoping review of literature of 2012-2022 North American peer-reviewed empirical studies in PubMed and Embase using the Arksey and O'Malley approach. This review identified 62 programs that varied in focus, characteristics, and outcomes. Programs focused on supporting a spectrum of underrepresented groups based on race/ethnicity, gender identity, sexual orientation, disability status, and socioeconomic status. The majority of programs targeted faculty/investigators, compared to other workforce roles. Most programs were 1 year in length or less. The practices employed within programs included skills building, mentoring, and facilitating the development of social networks. To support program infrastructure, key strategies included supportive leadership, inclusive climate, resource allocation, and community engagement. Most programs evaluated success based on shorter-term metrics such as the number of grants submitted and manuscripts published. Relatively few programs collected long-term outcomes on workforce pathway outcomes including hiring, promotion, and retention. This systematic scoping review outlined prevalent practices to advance DEI in the health and health services research field. As DEI programs proliferate, more work is needed by research universities, institutes, and funders to realign institutional culture and structures, expand resources, advance measurement, and increase opportunities for underrepresented groups at every career stage.