Massachusetts Pediatric Injury Equity Review (MassPIER): A Process to Address Injury Inequities.

Area of Science:

• Public Health
• Pediatric Injury Prevention
• Health Equity

Background:

• Significant inequities in pediatric injury outcomes are a critical public health concern.
• Existing child death review (CDR) processes may not adequately identify upstream factors contributing to these disparities.

Purpose of the Study:

• To develop and evaluate a novel process to assist CDR teams in identifying upstream factors leading to inequitable pediatric injury outcomes.
• To assess the acceptability, adaptability, and impact of the Massachusetts Pediatric Injury Equity Review (MassPIER) process on recommendation development.

Main Methods:

• A 7-step MassPIER process and associated tools were iteratively developed over 6 months with 3 Massachusetts CDR teams.
• Acceptability and adaptability were evaluated via focus groups and surveys (May-October 2022).
• Prevention recommendations pre- and post-MassPIER implementation were compared using statistical tests (χ2, Fisher's exact test) to assess equity focus.

Main Results:

• The MassPIER process and tools were found to be simple, adaptable to any injury type, and replicable by other teams (100% and 95% agreement, respectively).
• MassPIER significantly increased the generation of equity-focused recommendations overall (P < .05).
• The process particularly enhanced recommendations addressing economic inequities (P < .05).

Conclusions:

• The Massachusetts Pediatric Injury Equity Review (MassPIER) process is effective in facilitating equity-focused discussions and recommendation development within CDR teams.
• MassPIER demonstrates high acceptability and adaptability, making it a valuable tool for improving pediatric injury prevention strategies.
• This approach holds promise for reducing inequities in pediatric injury outcomes by addressing root causes.