OBJECTIVES Significant inequities in pediatric injury outcomes exist. We aim to develop a process to assist child death review (CDR) teams in identifying upstream factors that lead to inequitable outcomes in pediatric injuries. METHODS We spent 6 months (November 2021-April 2022) working with 3 CDR teams in Massachusetts to understand their tools and processes for CDR. During that time, we began to iteratively develop a pediatric injury equity review process and tools. Between May and October 2022, acceptability and adaptability of the resulting Massachusetts Pediatric Injury Equity Review (MassPIER) process and tools were evaluated through focus groups and a Research Electronic Data Capture survey of participants. We compared the prevention recommendations of the CDR teams before the implementation of MassPIER with those generated using MassPIER. A χ2 and Fisher's exact test assessed whether the 2 sets of recommendations differed with regard to equity. RESULTS A 7-step process was developed, along with 2 tools for use during the MassPIER process. From an acceptability and adaptability standpoint, 100% of participants strongly agreed or agreed that the MassPIER process was simple to follow and adaptable to any type of injury. Ninety-five percent of participants agreed or strongly agreed that the approach could be replicated by other teams. Furthermore, the MassPIER process increased the likelihood of generating equity-focused recommendations in general (P < .05), and particularly recommendations focusing on economic inequities (P < .05). CONCLUSIONS MassPIER is effective in facilitating equity-focused discussion and recommendation development. It is acceptable to team members, and adaptable to other types of injury.

中文翻译：

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马萨诸塞州儿科伤害公平审查 （MassPIER）：解决伤害不平等的流程。


目的 儿科损伤结果存在重大不平等。我们的目标是开发一个流程，协助儿童死亡审查 （CDR） 团队识别导致儿科伤害结果不公平的上游因素。方法 我们花了 6 个月时间（2021 年 11 月至 2022 年 4 月）与马萨诸塞州的 3 个 CDR 团队合作，以了解他们的 CDR 工具和流程。在此期间，我们开始迭代开发儿科伤害公平审查流程和工具。在 2022 年 5 月至 2022 年 10 月期间，通过焦点小组和对参与者的研究电子数据采集调查评估了由此产生的马萨诸塞州儿科伤害公平审查 （MassPIER） 流程和工具的可接受性和适应性。我们将 CDR 团队在实施 MassPIER 之前的预防建议与使用 MassPIER 生成的预防建议进行了比较。A χ2 和 Fisher 精确检验评估了两组建议在公平性方面是否不同。结果开发了一个 7 步流程，以及 2 个用于 MassPIER 流程的工具。从可接受性和适应性的角度来看，100% 的参与者强烈同意或同意 MassPIER 流程易于遵循并且适用于任何类型的伤害。95% 的参与者同意或强烈同意该方法可以被其他团队复制。此外，MassPIER 过程总体上增加了产生以公平为重点的建议的可能性 （P < .05），特别是侧重于经济不平等的建议 （P < .05）。结论 MassPIER 在促进以公平为重点的讨论和建议开发方面是有效的。它对团队成员来说是可以接受的，并且可以适应其他类型的伤害。