Feasibility and acceptability of an equity and diversity maturity matrix applied in heterogeneous public health contexts across 18 European countries.
1
Social Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
2
ASL TO3 Epidemiologia, Collegno (TO), Piedmont, Italy
3
Biosistemak Institute for Health Systems Research, Basque country, Spain
4
Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Basque country, Spain
5
Istituto Superiore di Sanità, Rome, Italy
6
National Institute of Public Health, Ljubljana, Slovenia
7
Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
8
Universita Cattolica del Sacro Cuore, Rome, Italy
9
La Trobe Rural Health School, La Trobe University, La Trobe, Victoria, Australia
Popul. Med. 2026;8(Supplement Supplement 1):A2716
ABSTRACT
INTRODUCTION:
While equity, diversity, and inclusion are priority areas in public health, many professionals struggle to translate these principles into practice (1, 2). We evaluated the feasibility and acceptability of an equity and diversity maturity matrix (2) designed to support integration of these principles across 143 pilot projects across 18 countries participating in the EU Joint Action on Cardiovascular Diseases and Diabetes (JACARDI).
METHODS:
Of the 143 pilot projects, 53% completed a questionnaire assessing feasibility and acceptability of the maturity matrix following Flottorp et al. criteria for determinant frameworks. Additionally, in-depth interviews were conducted with 15 projects. Projects were selected using stratified sampling based on their reported maturity level in the matrix. Questionnaire data were analysed descriptively. Interview data were transcribed verbatim and analysed using inductive thematic analysis.
RESULTS:
In the questionnaire responses, majority reported that the maturity matrix helped identify and prioritise areas relevant to equity and diversity (yes 70%; partially 26%) and improved understanding of equity, diversity, and inclusion (yes 62%; partially 28%). The matrix was considered logically structured and easy to understand (yes 62%; partially 32%), relevant to their work (yes 49%; partially 40%), and useful for future projects (yes 54%; partially 21%). These findings were echoed in the interviews and open-ended responses to the questionnaire. Some participants reported challenges in understanding the matrix’s relevance, particularly when project goals and implementation plans were already fixed prior to its introduction. Suggested improvements focused on increasing practicality and user-friendliness, clearer guidance, simplification, and inclusion of more concrete, real-life examples.
CONCLUSIONS:
The equity and diversity maturity matrix appears to be a feasible tool for supporting the operationalisation of equity and diversity principles in public health initiatives across diverse national contexts. Further refinements to enhance simplicity, clarity, and contextual relevance may increase its acceptability and usefulness for future public health programmes.
While equity, diversity, and inclusion are priority areas in public health, many professionals struggle to translate these principles into practice (1, 2). We evaluated the feasibility and acceptability of an equity and diversity maturity matrix (2) designed to support integration of these principles across 143 pilot projects across 18 countries participating in the EU Joint Action on Cardiovascular Diseases and Diabetes (JACARDI).
METHODS:
Of the 143 pilot projects, 53% completed a questionnaire assessing feasibility and acceptability of the maturity matrix following Flottorp et al. criteria for determinant frameworks. Additionally, in-depth interviews were conducted with 15 projects. Projects were selected using stratified sampling based on their reported maturity level in the matrix. Questionnaire data were analysed descriptively. Interview data were transcribed verbatim and analysed using inductive thematic analysis.
RESULTS:
In the questionnaire responses, majority reported that the maturity matrix helped identify and prioritise areas relevant to equity and diversity (yes 70%; partially 26%) and improved understanding of equity, diversity, and inclusion (yes 62%; partially 28%). The matrix was considered logically structured and easy to understand (yes 62%; partially 32%), relevant to their work (yes 49%; partially 40%), and useful for future projects (yes 54%; partially 21%). These findings were echoed in the interviews and open-ended responses to the questionnaire. Some participants reported challenges in understanding the matrix’s relevance, particularly when project goals and implementation plans were already fixed prior to its introduction. Suggested improvements focused on increasing practicality and user-friendliness, clearer guidance, simplification, and inclusion of more concrete, real-life examples.
CONCLUSIONS:
The equity and diversity maturity matrix appears to be a feasible tool for supporting the operationalisation of equity and diversity principles in public health initiatives across diverse national contexts. Further refinements to enhance simplicity, clarity, and contextual relevance may increase its acceptability and usefulness for future public health programmes.
| eISSN: | 2654-1459 |
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