Six guiding commitments accompany the framework: reflect deeply, recognize intersectionality, anti-oppression, trauma awareness, trust-based relationships, learning and unlearning¶

Element · All elements
Evidence · 1 claim (1 for) · 1 study (1 design), q2 · 0 of 1 report an effect size · 1 claim rests on one study

Description¶

The co-design process produced a set of commitments that guide how the framework is used, developed after in-person participants emphasized the need for principles giving context for how the framework should be understood. The commitments are: reflect deeply, recognize intersectionality, adopt an anti-racism and anti-oppression approach, develop trauma awareness, build relationships based on trust and accountability, and commit to learning and unlearning. Each commitment is described in Table 3 with guidance for application.

Design Implications¶

Context¶

Requirements¶

• Users engage with the commitments as foundational principles informing how the framework is understood and applied

Constraints¶

• The commitments state that ideas and practices informing health equity work are not timeless and content must be revisited and revised

Target Learners¶

• healthcare organizations
• healthcare improvement teams

Target Goals¶

• applying the health equity framework with an intersectional, anti-oppressive lens

Claims¶

• Iterative advisory group feedback drove four framework iterations, including adding disruption and multi-level oppression [+W]

Related Patterns¶

Examples¶

• Anti-oppressive co-design meeting practices: land acknowledgements, shared roles, breakout discussions, multiple input modes

Key Sources¶

• Mehelay S, Comeau B, Chandra S, Fancott C, Gordon D, Loftgard K, Louzado C, Nixon SA, Shahid S, Tilson K, Wilson C, Shaw J. (2026). Shifting power: co-developing a framework for equity in healthcare. BMC Health Services Research. https://doi.org/10.1186/s12913-026-14964-7