Implementing intersectionality-based sex and gender analysis in a public health research institute

An extensive knowledge and evidence base underscores the value of sex and gender analyses and intersectional approaches in health research. Implementing sex and gender across their intersections (intersectionality) into public health research can help explain differences in public health outcomes, improve the validity of research findings, and thus contribute to more tailored programs and policies for the monitoring, prevention and maintenance of population health. However, in the Netherlands, intersectionality-based sex and gender analysis (ISGA) is not structurally incorporated into study designs, prevention and promotion programs, education and training, impact evaluations, and health policies. A general lack of awareness in public health communities as well as misconceptions about ISGA prevent its adoption in research practice. To further strengthen and safeguard sex, gender and diversity-responsive public health research and practices, concerted effort is required. With this collaborative, participatory implementation project, we aim to implement ISGA in the Amsterdam UMC APH research institute by building capacity and fostering institutional awareness, implementation of existing knowledge by means of a PhD training program, and empowering stakeholders and facilitating their role as change agents. This project proposes to upskill early career researchers in a participatory way and in a multidisciplinary context by implementing and disseminating existing ISGA knowledge and skills locally. In addition, with this projects we seek to foster interdisciplinary exchange, e.g. between genomics researchers, statisticians and qualitative researchers, which encourages theoretical, methodological and translational innovation and further sustains ISGA implementation. We will develop a PhD-training program by engaging a core group of PhD students with ISGA and move toward a shared ownership of the project’s objectives, its content and its implementation. We will work in a co-collaborative process, in which PhD students co-develop the training and become empowered to engage in a dialogue about the relevance of ISGA for their own project and the field in general. PhD students who take the training also receive a short ‘train-the-trainer’ module at the end of the training, which prepares them to disseminate their knowledge locally. Senior research staff within the APH institute (researchers, principal investigators, program leaders) will be engaged by establishing a project advisory board. Board members are involved in monitoring and evaluating the training program, and will be consulted during several stages of the implementation project. This way, we optimally benefit from their knowledge of research methodologies and institutional culture and policy, offer transparency regarding implementation activities, and create sustained, top level support for our objectives. In collaboration with the advisory board, we will seek opportunities to embed guidelines within local platforms for quality support and research excellence. ISGA relies on researcher competencies and the extent to which these competencies become part of daily research routines and institutional cultures. To sustain our implementation efforts, we will therefore: (1) collaborate with and build on the work of existing change agents and experts within and outside our institution, and (2) focus on strengthening the APH institution’s capacity for change by incorporating stakeholders in the project. This way, we aim to contribute to a culture of change within the institution where adequately accounting for sex, gender and other aspects of diversity becomes the norm, and where capacity-building activities extend beyond the funded period. We are in an optimal position to roll out and embed sex/gender and intersectionality-based research approaches within the APH institute, turn APH into a proof of principle, and develop a blueprint for educating a cohort of public health researchers sensitive to ISGA. We will carry out a RE-AIM process evaluation to assess process outcomes and identify whether implementation endpoints were achieved as intended, including an investigation of barriers and facilitators.