# Mitigating Structural Racism to Reduce Inequities in Sepsis Outcomes

> **NIH NIH R01** · YALE UNIVERSITY · 2023 · $633,820

## Abstract

PROJECT ABSTRACT
Sepsis affects approximately 1.7 million patients in the US annually, is one of the leading causes of mortality,
and is a major driver of US healthcare costs. African American/Black (AA/B) and LatinX populations
experience higher rates of sepsis complications, deviations from standard care, and all-cause and sepsis
readmissions compared with Non-Hispanic White (NHW) populations. Despite clear evidence of the ways in
which structural racism compounds factors at the hospital and community levels to generate poorer sepsis
care and outcomes for AA/B and LatinX patients, there are no evidence-based, prospective interventions to
name and address structural racism in sepsis care, nor are we aware of studies that report reductions in racial
inequities in sepsis care as an outcome. Naming and addressing the impact of structural racism on sepsis care
will require collective action across health systems and community institutions, supported by ways of working
(e.g., organizational culture) to collaborate effectively across historical, political, and organizational boundaries.
Our prior research has shown that coalition-based leadership development approaches can be effective in
cultivating organizational culture that can improve complex health outcomes. We propose to adapt, deliver, and
evaluate a coalition-based intervention to equip health systems and their surrounding communities to name
and address structural racism and drive measurable reductions in inequities in sepsis outcomes. Our specific
aims are to: (1) Adapt and deliver a coalition-based leadership intervention in eight U.S. health systems and
their surrounding communities to improve domains of organizational culture that are required to name and
address structural racism; (2) Evaluate the impact of the intervention using a longitudinal, convergent mixed
methods approach to quantify change in domains of organizational culture that are required to name and
address structural racism using a novel survey instrument and describe the experience of culture change
within each system, integrating quantitative and qualitative data at the analysis phase in order to develop a
comprehensive understanding of the intervention impact and mechanisms by which the impact may have
occurred; and (3) Evaluate the impact of the intervention on reduction of racial inequities in three clinical
outcomes: a) early identification (time to antibiotic), b) clinical management (in-hospital sepsis mortality) and c)
standards-based follow up (same-hospital, all-cause sepsis readmissions) using interrupted time series
analysis and comparing clinical outcomes from systems that achieved meaningful change in domains of culture
required to address structural racism with those that did not achieve meaningful change. The proposed study is
timely, highly relevant, and fully aligned with calls to action by the NIH and the Sepsis Alliance to address
inequities in sepsis care and outcomes. It is also highly innovative, a...

## Key facts

- **NIH application ID:** 10597706
- **Project number:** 5R01GM146463-02
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Dowin Boatright
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $633,820
- **Award type:** 5
- **Project period:** 2022-04-01 → 2027-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10597706

## Citation

> US National Institutes of Health, RePORTER application 10597706, Mitigating Structural Racism to Reduce Inequities in Sepsis Outcomes (5R01GM146463-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10597706. Licensed CC0.

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