About 2 years ago, the National Board of Directors of the American Heart Association (AHA) asked volunteer leaders to develop new goals to address health equity and provide sound science to reduce health care disparities, including consideration of social determinants of health, structural racism and rural health. inequality. This effort culminated in the 2024 impact goal,1 which states that “every person deserves the opportunity to lead a full and healthy life. As champions of health equity, by 2024, the AHA will advance heart health for all, including identifying and removing barriers to health care access and quality. One of the 10 commitments set out in the 2024 impact goal is to focus our AHA (https://www.ahajournals.org) scientific journals on disparities, health equity, anti-racism, participatory/community-engaged research, and implementation science.
To achieve this goal, the Scientific Publications Committee has worked closely with the editors of AHA’s 13 original research journals on several initiatives. First, through optional self-reported demographics that users provided in our manuscript tracking system, we collected and measured the composition of editorial boards, guest authors, and guest reviewers for gender, racial, and ethnic. We have made this information publicly available at large (along with additional information on terms and demographic categories) and intend to provide annual updates at https://www.ahajournals.org/journal -demographics. While we have had some success, such as a slight increase in the percentage of people participating who report being female or from an underrepresented racial and ethnic group, there is room for progress, which is a major goal. for 2024. Going forward, we will look at how this information is collected as well as the types of demographic categories and editorial roles captured. By collecting and reviewing this data regularly, we can better identify weaknesses and work systematically to improve diversity.
Next, we created an online collection of all articles related to the 2024 impact goal, called the “Health Equity Collection” (https://www.ahajournals.org/health-equity), which includes AHA’s key scientific statements, original research, reviews, editorials, and other articles published since 2015 on topics related to health equity. There are thematic issues, including an annual issue on health equity/disparities in Traffic and targeted update in StrokeGo Red questions about women and heart disease across the portfolio, a special issue on the science of implementation in Circulation: quality and cardiovascular results scheduled for late 2022, and publications on the inaugural development of the disparities research guidelines2 and the goal of addressing structural racism as a major contributor to cardiovascular inequality.3Stroke is piloting an initiative to survey authors about the diversity of research participants and the composition of the clinical trial steering committee. We have also established an author name change policy that makes it easier for authors to change their name in AHA journal publications for reasons such as, but not limited to, gender identity, marriage , divorce and religious conversion (https://www.ahajournals.org/name change).
To help support and coordinate these growing efforts, the next logical step was to invest time, effort, and funds to create the AHA Equity, Diversity, and Inclusion (EDI) Editorial Board (https://www .ahajournals.org/ edi-editorial-committee). The role of the EDI Editorial Board is to facilitate bigger and better science in the health equity and diversity space and to increase representation across the entire editorial pool, authors and reviewers. With input from the editors, the EDI Editorial Board was formed and met regularly over the past year to develop a workflow, standardize the nomenclature of published manuscripts, and minimize the effect on the duration of the overhaul (figure). Upon submission, authors will be asked if their manuscript focuses on demographic differences or other EDI-related issues (for examples, see Breathett et al).2 and Boyd et al4) and complete a brief checklist. Most manuscripts will undergo an initial review without any changes to the submission process. For manuscripts invited to reviews, editors may optionally request additional review by a member of the EDI editorial board who would view the work through an “EDI lens”.
To better understand the role of the EDI editorial board, it helps to understand what is meant by the EDI lens. The EDI reviewer can support the journal editorial team and reviewers, who may not have specific expertise in disparity research, by reinforcing the need for appropriate conceptual models, using consistent terminology, and avoiding to confuse biology with the social constructions of race and ethnicity. If applicable, submitting authors will be asked to complete a checklist based on the disparity research guidelines2 for manuscripts that deal with EDI-related issues at the review/provisional acceptance stage. The EDI editorial board will also be able to help AHA journal editors include impactful research on health equity and disparities and support the editorial and publication board. science in establishing processes to improve the diversity of guest authors, reviewers and the editorial board. Members. The EDI Editorial Board is intended to be a resource for AHA journal editors and editorial teams, and we expect active knowledge sharing within the EDI Editorial Board. In addition to the manuscript workflow component, other roles for the EDI editorial board, such as consulting on potential peer reviewers for articles, advising on the relevance of editorials, and Development of additional strategies to increase author diversity, including for guest editorials and reviews, will be considered.
Increasing global diversity and improving health equity for all is hard work involving a multitude of stakeholders,5 but it is important, essential and urgent work to be done well. As we move forward with the EDI Editorial Board, we look forward to establishing more concrete measures of success, better assessing author and reviewer diversity, and leading these efforts by serving as example to other journals.
The authors thank NA Mark Estes, MD, Khadijah Breathett, MD, MS, Bruce Ovbiagele, MD, MSc, MAS, MBA, Erica Spatz, MD, MHS, and Rishi Wadhera, MD, MPP, MPhil for their assistance in the development of AHAs Journals Editorial Board on Equity, Diversity and Inclusion.
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