The BIAS FREE Framework

Canadian Journal of Public Health - Tập 97 - Trang 63-68 - 2006
Margrit Eichler1, Mary Anne Burke2
1Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
2Global Forum for Health Research, Geneva 2, Switzerland

Tóm tắt

Objective: To test the applicability of the BIAS FREE Framework in African settings. Participants: Researchers from the Tanzanian National Institute for Medical Research, university and community-based researchers from Tanzania, the Gambia and South Africa. Setting: National Institute for Medical Research, Dar es Salaam - Tanzania. Intervention: An intensive two-day workshop to examine the applicability of the BIAS FREE Framework within an African setting. This involved clarification of the following concepts: construction of knowledge, objectivity, logic of domination, hierarchy, power, sex and gender, disability, and race/ethnicity. The Framework identifies three types of bias problems that derive from social hierarchies based on gender, race and disability: maintaining hierarchy, failing to examine differences, and using double standards. Participants used the 20 diagnostic questions at the heart of the Framework to analyze various research publications, including some authored by participants. Outcomes: Participants uniformly stated that the Framework is useful for uncovering bias in public health research, policy and programs; that it is immediately applicable in their work settings; and that doing so would improve equity in research and, ultimately, in health. One participant re-analyzed published data using the Framework and submitted a supplementary report with some new recommendations. Implications: The applicability of the BIAS FREE Framework has been demonstrated in diverse settings. It is now being offered for broader application as a tool for uncovering and eliminating biases in health research that derive from social hierarchies and for addressing the persistence of global health inequities.

Tài liệu tham khảo

VanderPlaat M, Teles N. Mainstreaming social justice: human rights and public health. (Commentary. Can J Public Health 2005;96(1):34–36. Banett I. Health care professionals and their attitudes toward and decisions affecting disabled people. In: Albrecht GL, Seelman KD, Bury M (Eds.). Handbook of Disability Studies. Thousand Oaks, CA: Sage, 2002;450–67. Brett PJ, Graham K, Smythe C. An analysis of specialty journals on alcohol, drugs and addictive behaviors for sex bias in research methods and reporting. J Stud Alcohol 1995;56(1):24–34. Groce NE, Chamie M, Me A. Measuring the quality of life: Rethinking the World Bank’s Disability Adjusted Life Years. Int J Educ Res 1999;49:1–2. Gustafson, DL. Understanding women and health. In: Mandell N (Ed.). Feminist Issues: Race, Class and Sexuality. Toronto, ON: Pearson, 2004;266–86. Messing K, Punnett L, Bond M, Alexanderson K, Pyle J, Zahm S, et al. Be the fairest of them all: Challenges and recommendations for the treatment of gender in occupational health research. Am J Ind Med 2003;43:618–29. Smedley BD, Stith AY, Nelson AR (Eds.). Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academies Press, 2003. Smith, LT. Decolonizing Methodologies: Research and Indigenous Peoples. London, UK and New York, NY: Zed Books, 1999. Barnes C. Disabling Imagery and the Media: An Exploration of the Principles for Media Representations of Disabled People. British Council of Organisations of Disabled People and Ryburn Publ. Ltd., 1992. British Sociological Association. BSA Anti-racist Language: Guidance for Good Practice. British Sociological Association, 1997. Burke, MA. Health Canada’s Gender-based Analysis Policy. Health Canada, 2000. Dei GJS. Towards an anti-racism discursive framework. In: Dei GJS, Calliste A (Eds.). Power, Knowledge and Anti-racism Education: A Critical Reader. Halifax, NS: Fernwood, 2000;23–40. Commonwealth Secretariat. A Quick Guide to Gender Mainstreaming in the Public Service. Commonwealth Secretariat, 1999. Leo-Rhynie E, Institute of Development and Labour Law University of Cape Town. A Quick Guide to Gender Mainstreaming in Education. Commonwealth Secretariat, 1999. Liverpool School of Tropical Medicine. Guideline for the Analysis of Gender & Health. Department for International Development, 1999. Saskatchewan, Women’s Secretariat. Gender-Inclusive Analysis: A Guide for Policy Analysts, Researchers, Program Managers and Decision-Makers. Regina, SK: Saskatchewan Women’s Secretariat, 1998. Sen G. A Quick Guide to Gender Mainstreaming in Finance. Commonwealth Secretariat, 1999. Bach M, Burke, MA. Toward an Inclusive Approach to Monitoring Investments and Outcomes in Child Development and Learning. North York, ON: The Roeher Institute, 2002. Burke, MA. Child Institutionalisation and Child Protection in Central and Eastern Europe, Innocenti Occasional Paper EPS 52, Florence, Italy: UNICEF Innocenti Research Centre, 1995. Burke, MA. Developing Gender-based Analysis (GBA) tools for the health sector. Health in the Commonwealth Sharing Solutions 1999/2000, Kensington Publications Limited for the Commonwealth Secretariat, 1999. Burke, MA. Health Canada’s achievements to date in mainstreaming gender. Proceedings from the Commonwealth Workshop on Gender Management Systems for the Health Sector, St. Kitts and Nevis. London: Commonwealth Secretariat, 1999. Burke, MA. Gender management system for the health sector in Canada. Proceedings from the Commonwealth Workshop on Gender Management Systems for the Health Sector, St. Kitts and Nevis. London: Commonwealth Secretariat, 1999. Burke MA, Bach M, Coleman R, McKie DC, Stewart G. Dynamic Model of Health. Commonwealth Working Group on Gender Equality and Health Indicators. 2000. Available online at: http://www.cwhn.ca (Accessed on June 5, 2005). Eichler M. And the work never ends: Feminist contributions. Can Rev Sociol Anthropol 1985;22(5):619–44. Eichler M. Nonsexist Research Methods: A Practical Guide. New York: Routledge, 1991. Eichler M, et al. Zu mehr Gleichberechtigung zwischen den Geschlechtern: Erkennen und Vermeiden von Gender Bias in der Gesundheitsforschung. Deutsche Bearbeitung eines vom kanadischen Gesundheitsministerium herausgegebenen Handbuchs. Berliner Zentrum Public Health, 2002. Eichler M, Reisman AL, Manace Borins E. Gender bias in medical research. Women and Therapy 1992;12(4):61–70. Lapointe J, Eichler M. Le traitement objectif des sexes dans la recherche. Ottawa, ON: Conseil des recherches en sciences humaines, 1985. Eichler M. Offener und versteckter Sexismus. Methodisch-methodologische Anmerkungen zur Gesundheitsforschung. In: Arbeitskreis Frauen und Gesundheit im Norddeutschen Forschungsverbund (Ed.). Frauen und Gesundheit(en) in Wissenschaft, Praxis und Politik. Public Health. Bern, Switzerland: Verlag Hans Huber,1998;34–49. Bhavnani KK (Ed.). Feminism and ‘Race’. New York: Oxford University Press, 2001. Gaertner SL, Dovidio JF, Banker S, Rust MC, Nier JA, Mottola GR, Ward, CM. Does white racism necessarily mean antiblackness? Aversive racism and prowhiteness. In: Fine M, Weis L, Powell LC, Wong LM (Eds.). Off White: Readings on Race, Power, and Society, New York: Routledge, 1997;167–78. Messing K. One-eyed Science: Occupational Health and Women Workers. Philadelphia, PA: Temple University Press, 1998. Schriner K. A Disability Studies perspective on employment issues and policies for disabled people. In: Albrecht GL, Seelman KD, Bury M (Eds.). Handbook of Disability Studies. Thousand Oaks: Sage, 2001;642–62. Smedley BD, Stith AY, Nelson AR, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Board on Health Sciences Policy, and Institute of Medicine of the National Academies. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington: National Academies Press, 2003;160–79. Spivak G. Subaltern studies: Deconstructing historiography. In: Landry D, Maclean G (Eds.). The Spivak Reader. New York: Routledge, 1996;203–35. Thomson, RG. Integrating disability, transforming feminist theory. NWSA Journal 2002;14:1–32. Wendell S. “Toward a feminist theory of disability.” In: Davis LJ (Ed.). The Disability Studies Reader. New York: Routledge, 1997;260–78. Wolbring G. University of Calgary, Founder and Executive director of the International Center for Bioethics, Culture and Disability. Founder and Coordinator of the International Network on Bioethics and Disability; and Chair: Disabled People’s International Bioethics Taskforce. Personal communication, 2005. Armstrong D, Earnshaw G. A comparison of GPs and nurses in their approach to psychological disturbance in primary care consultations. Health and Social Care in the Community 2005;13(2):108–11. Boonsawat W, Charoenphan P, Kiatboosri S, Wongtim S, Viriyachaiyo V, Pothirat D, Thanomsieng N. Survey of asthma control in Thailand. Respirology 2004;9:373–78. Cambanis A, Yassin MA, Ramsay A, Bertel Squire S, Arbide I, Cuevas, LE. Rural poverty and delayed presentation to tuberculosis services. Tropical Medicine and International Health 2005; 10(4):330–35. Leeder SR, Sominello A. Health, equity and intellectual disability. J Appl Res in Intellectual Disabilities 2005;18:97–100. Tsai YF, Wong TKS. Strategies for resolving aboriginal adolescent pregnancy in eastern Taiwan. Issues and Innovations in Nursing Practice. 2005;41(4):351–57. Eichler M. Feminist methodology. Current Sociology 1997;45:9–36. Longino H. Essential tensions, phase two: Feminist, philosophical, and social studies of science. In: Antony LM, Witt C, A Mind of One’s Own: Feminist Essays on Reason and Objectivity. Boulder, CO: Westview Press, 1993:257–72. Warren, KJ. The power and promise of ecological feminism. In: Zimmerman ME, Callicott JB, Sessions G, Warren KJ, Clark J. Environmental Philosophy: From Animal Rights to Radical Ecology. Englewood Cliffs, NJ: Prentice Hall, 1993;320–41. Burke MA (Ed.). The Construction of Disability and Risk in Genetic Counselling Discourse. North York: The Roeher Institute, 2002. Eichler M, Burke, MA. Towards BIAS FREE Research for Health. The Global Forum for Health Research, forthcoming. Levin, RI. The puzzle of aspirin and sex. N Engl J Med 2005;352:1366–68. Available online at: www.nejm.org (Accessed on March 8, 2005. (10.1056/NEJMe058051). Ridker PM, Cook NR, Lee IM, Gordon D, Gaziano JM, Manson JE, et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med 2005;352:1293–304. Available online at: www.nejm.org (Accessed on March 7, 2005. (10.1056/NEJMoa050613). Peck P, Web, MD. Aspirin won’t prevent 1st heart attack in women. Medical News, March 07, 2005. Available online at: http://www.medicinenet.com (Accessed on June 11, 2005). Barnes C. Disabling Imagery and the Media: An Exploration of the Principles for Media Representations of Disabled People. Halifax, British Council of Organisations of Disabled People and Ryburn Publ. Ltd., 1992. Canadian Down Syndrome Society. Redefining Down Syndrome: Position Statement on Redefining Down Syndrome. 2003. Shiva V. Biopiracy: The Plunder of Nature and Knowledge. Toronto: Between the Lines, 1997. Shiva V. Stolen Harvest: The Hijacking of the Global Food Supply. Cambridge, MA: South End Press, 2000. Tsing, AL. Environmentalisms: Transitions as translations. In: Scott J, Caplan C, Keates D (Eds.). Transitions, Translations, Environments: International Feminism in Contemporary Politics. New York: Routledge, 1997. Brillhart, BS. Attitudes toward people with disabilities. Rehabilitation Nursing 1990;15(2):80–82,85. Hurtado A, Stewart, AJ. Through the looking glass: Implications of studying whiteness for feminist methods. In: Fine M, Weis L, Powell LC, Wong LM (Eds.). Off White: Readings on Race, Power, and Society. New York: Routledge,1997;297–311. Health Canada. Health Canada’s Women’s Health Strategy. Minister of Public Works and Government Services, 1999. Essed P. Understanding Everyday Racism. An Interdisciplinary Theory. Newbury Park, CA: Sage, 1991. Gaskell J, Eichler MJ, Pan J, Xu J, Zhang X. The participation of women faculty in Chinese universities: Paradoxes of globalization. Gender and Education 2004;16(4):511–29. Henry F, Tator C, Mattis W, Rees T (Eds.). The ideology of racism. The Colour of Democracy: Racism in Canadian Society. Toronto: Harcourt and Brace Canada, 2000;15-34. MacFarlane A. Disability and ageing. In: Swain J, French S, Barnes C, Thomas C (Eds.). Disabling Barriers—Enabling Environments. London: Sage, 2004;189–94. Burke MA, Eichler M. Summary of Evaluations Received. BIAS FREE Workshop, Dar es Salaam, Tanzania, 17–18 May 2005, The Global Forum for Health Research, unpublished. Manzi F, Mbuyita S, Urassa H. Development of a Standardized Exemption Mechanism for Kilombero District, Tanzania, 2003. Mbuyita S. The importance of routine inclusion of gender analysis in all stages of the research process: A case study of an analysis of a final report on the development of a Standardized Exemption Mechanism for Kilombero District, Tanzania. Forthcoming CD-ROM. Poverty, Equity and Health Research: Final documents from Forum 9, Mumbai, India, 12–16 September 2005, Global Forum for Health Research, 2005.