Parent and staff focus groups to address NICU racial inequities: "There's radical optimism in that we're in a different time and we're not doing it alone"

OBJECTIVES: To understand local mechanisms of racial inequities and generate recommendations from community members regarding how to promote racial equity in the Neonatal Intensive Care Unit (NICU). METHODS: In an urban tertiary care NICU, 4 semi-structured in-person focus groups with follow-up audio diaries were conducted with NICU parents and staff from 2022-2023 with support from interpreters, a psychologist, and a family advocate. Researchers coded transcripts independently and thematic analysis was utilized to generate and refine themes. RESULTS: 16 racially diverse and multidisciplinary staff and parents participated, and six themes emerged from the data. Mechanisms of racial inequities included power dynamics, interpersonal and institutional dehumanization, and societal inequities. Recommendations included redistributing power, transforming space and staff to promote humanism, and mitigating harm through peer support and resource allocation. CONCLUSION: Focus groups are a promising strategy to identify interventions to address racial inequities. Future research should focus on intervention implementation and evaluation.