Ohio AAP Diversity, Equity and
Inclusion (DEI) Toolkit

The Ohio AAP DEI Toolkit is designed to not only reinforce or introduce members and speakers to key terms and concepts but more importantly, it is designed to allow participants to look at diversity and inclusion in Ohio AAP’s education and quality improvement.

We are striving to ensure Ohio AAP members have a sense of empowerment to enhance their cultural competence and utilize their lived experience to impact outcomes. As a result, we are encouraging Ohio AAP members to adopt inclusive practices that create an atmosphere of respect, support, and accountability. Our DEI Toolkit will enhance the knowledge and skills of our membership to bring this to fruition.

The DEI toolkit is designed with flexibility in mind. To best meet the needs of our members, we have developed options from which to select:

Why DEI?

Ohio AAP DEI Education Webinar

Continuous Feedback: Ohio AAP welcomes all feedback and suggestions to improve our tools and education. Please contact Elizabeth Dawson at edawson@ohioaap.org with any suggestions.

Education Planning Considerations

Planning

Consider attendee religious holidays and other cultural obligations.
Ensure the planning committee, speakers and/or facilitator represent a broad variety of gender, race, LGBTQIA+ status, national origin, geography, etc.
Consider vendor/supplier diversity.

Implementation

Ask speakers to identify their pronouns in their introductions.
Allow anonymous questions during the session.
Consider offering quiet and private spaces for nursing parent or prayer room.
Consider reserved seating for hearing or vision impaired guests.
Consider personal and religious food restrictions.
Share event menus in advance where possible.

Marketing

Utilize diverse images in marketing materials for a more equitable and inclusive promotional effort. Representation matters.
Design materials (hard copies and digital) with accessibility as a priority. Routinely audit materials for accessibility.
Ensure that text is large for everyone to read and that materials are compatible with the range of hardware and software used by persons with disabilities. Run PDFs through an Optical Character Recognition software.
Hyperlink text in documents so screen-reader users are made aware of where there are links instead of being dictated a long URL, which is difficult to follow.

Virtual/Hybrid Meetings

Use closed captions during presentations.
Spotlight speakers on video.
Save chat and share with attendees following the meeting, along with the slides.

Ohio AAP DEI Toolkit Acknowledgement Slide

Add a slide to every presentation:

- ‘I have considered the Ohio AAP Diversity, Equity, and Inclusion standards in preparing this presentation. I invite your feedback in promoting equity within this learning space. If you have suggestions, please email me atlogan@cchmc.org.’

Common Terms

Bias: An inclination, feeling, or opinion, especially one that is preconceived or unreasoned, that projects favorable or unfavorable dispositions toward people, affecting our understanding, actions, and decisions. Done consciously, it is known as explicit bias; done unconsciously, it is known as implicit bias.

Gender: Gender refers to the socially constructed characteristics, behaviors, and roles associated with being masculine or feminine (women or men; boys or girls). This is not the same thing as a person’s sex.

Gender Identity: Gender identity is a person’s innate sense of their own gender, how they perceive themselves and what they call themselves. This includes the gender binary of man and woman, as well as identities in between or outside the gender binary. One’s gender identity can be the same or different from their sex assigned at birth.

Identity First Language: “Identity-First Language” focuses first on a person’s qualifying identity, often a disability, when describing them. Their disability becomes the central component of the person’s identity and does not separate the person from their disability. This type of language allows individuals and communities to reclaim their disability as a positive social identity and express pride in their shared culture.

Identity-First Language: Autistic Person
People-First Language: Person with Autism

Inclusive: Creating intentional space, both physical and behavioral, that honors individual uniqueness and fosters a sense of belonging for anyone and everyone.

Intersectionality: The idea that multiple identities intersect to create a whole identity. These identities that can intersect include gender, race, social class, ethnicity, nationality, sexual orientation, religion, age, mental disability, physical disability, mental illness, and physical illness as well as other forms of identity. These aspects of identity are not mutually exclusive. Each element or trait of a person is inseparably linked with all other elements.

Microaggression: Indirect, subtle, and often unintentional discrimination against members of a marginalized group. Discrimination can be verbal, nonverbal, and environmental slights, snubs, or insults, whether intentional or unintentional, which communicate hostile, derogatory, or negative messages.

People First Language: “Person-First Language” is a way of communicating that acknowledges and respects the humanity of an individual first and foremost in relation to their qualifying identity, often in reference to a person’s disability. Person-First Language puts the person before the disability and describes what a person has, not who a person is.

Person-First Language: Person with a disability
Identity First Language: Disabled person

Race: A social construct used to divide people into hierarchical groups based on physical appearance, social factors, and cultural backgrounds.

Sex: Sex refers to the biological and physiological characteristics of males, females, and intersex individuals, such as reproductive organs, hormones, and chromosomes.

Sexual Orientation: A person’s sexual identity in relation to the gender to which they are attracted. Attraction includes emotional, romantic, and/or sexual attraction to other people. All three are not usually the same but all three are included in a person’s sexual orientation. Common sexual orientations include asexual, bisexual, heterosexual (or straight), homosexual (or gay or lesbian), and pansexual, among others. A person’s sexual orientation does not have to be tied to any sexual activity.

Verbal & Written Language: Communication using language in either written or spoken form.
Examples: Lecture content, handouts, clinical vignettes, discussion questions, sources, linked resources, simulations, captions.

Visual/Media: Communication that can be perceived by the eyes.

Content was inspired by the DEI toolkit created by Cincinnati Children’s Hospital Medical Center and are in evolution, revising as needed.

General Checklist

Terms to consider when planning a presentation for an audience

Equity: Attainment of the highest level of opportunity, engagement, and health for all.
Disparities: Differences in opportunity, engagement, and health based on characteristics of individual or group diversity.
Diversity: The varied identities and experiences within our teams and families and communities we serve.
Inclusion: Inviting all people to take part in building our processes and structures.
Bias: Preferences in individuals and systems or processes that can drive differences in opportunity, engagement, and health.
Social determinants of health: Conditions in which people are born, grow, live, work and age; shaped by distribution of money, power, and resources.

Which characteristics of diversity can contribute to disparities in opportunity, engagement, and health?

Age, education, jobs, income, disability, location, gender identity, sexual orientation, race/ethnicity, language, religion, and others.
How can this impact the information that you are presenting and the audience to which you are presenting?

While planning your presentation, take time to understand how above concepts impact you, your patients, the location in which you practice, your staff, and the audience to which you are presenting.

How might your experiences affect your presentation and the views of the audience?
What insight do you have into the audience and location of your presentation?
How does health equity relate to your presentation topics and how do you plan to incorporate it into your presentation?

When You are the Source of Bias

Microaggressions are indirect, subtle, and often unintentional discrimination against members of a marginalized group that can occur in everyday life. How should you respond after you’ve committed a microaggression?

Address the harmful comment and Acknowledge your bias
Seek feedback and information
Apologize
Impact not intent ‘I see now that this can be hurtful’
Say Thank You
Be willing to seek/look up other sources of information

Important to remember:

Avoid becoming defensive, and don’t rely on the recipient to be the sole source of education/information.

National Equity Project: Responding to Microaggressions and Unconscious Bias

Deep Dive by Topic

Below are DEI guidelines and considerations to include when developing education and training materials.

Content was inspired by the DEI toolkit created by Cincinnati Children’s Hospital Medical Center and are in evolution, revising as needed.

Age

Actions
- Include images of patients, providers, and professionals of all ages ranges.
- Use words such as “older, aging, senior” instead of old.
- Consider all factors that can contribute to risk.
Avoid
- Images of doctors being older and nurses being younger.
- Making comments or jokes about someone age.
- Dismissing symptoms based on age.

Disabilities

Actions
- Use images of people with and without disabilities.
- Include individuals with disabilities in various roles.
- Focus on the person, not the disability.
Avoid
- Highlighting the disabilities unless needed.
- Using negative language in regard to the disability.
- Making assumption about a disability.

Mental Health

Actions
- Images of people with a wide range of mental illness.
- Acknowledge the mental illness as a disease.
- Acknowledge how mental health can affect different groups of people.
Avoid
- Using images that could perpetuate stereotypes.
- Using judgmental language.
- Do not blame the individual.

Race

Actions
- Positive images that portray different races in a variety of roles.
- Use adjectives to describe a person’s race.
- Acknowledge overlapping identities.
Avoid
- Overusing images in the same context.
- Avoid using minority to describe a single person.
- Making assumptions.

Religion, Spirituality and Creed

Actions
- Positive images and verbiage that portray a wide variety of religions and creeds.
- Reinforce religious beliefs that correlate to medical decisions in a respectful manner.
- Inclusive language when referencing traditions and holidays.
Avoid
- Images that marginalize or mock beliefs or comical references to religious groups.
- Colloquial phrases that connote religious figures or traditions.

Sex, Gender & Orientation

Actions
- Use images and examples portraying a variety of family formats and genders.
- Default to they/them pronouns.
- Stay current with gender terminology for presentations and panels.
- Always ask your subject or guests for their pronoun and gender preference in advance.
- Current Terms:
  - *Trans(gender) man – Assigned female at birth who identifies as a man
  - *Trans(gender) woman – Assigned male at birth who identifies as a woman
  - *Cisgender – A person whose gender identity corresponds with their sex assigned at birth
  - *Gender Diverse – An umbrella term to describe people whose gender identities differ from the sex assigned at birth
  - *AFAB – Assigned female at birth
  - *AMAB – Assigned male at birth
- Recognize that overlapping/intersecting identities impact perspectives.
- Use the term “partner” to reference a couple.
- Use the term “caregiver” to avoid generalizing parents.
Avoid
- Assuming a person’s gender or sexuality.
- Characterizing a “mom” as a single parent in verbiage and images.
- Referring to gender or sexuality as a choice or personal decision.
- Categorizing any sexuality or gender as “the norm.”
- Using gender terms to address or categorize a group such as “fellows”, “girls” or “guys.”
- Using gender terms for medical supplies or procedures.
- Using disapproving language for gender or sexual activity.
- Terms to avoid:
  - Transgendered
  - Transexual
  - Transvestite
  - Homosexual

Socioeconomic Status

Actions
- Describe the situation or social determinate versus labeling person.
- Use approving or neutral language when describing employment, housing, and other socioeconomic details.
- Provide context and background regarding socioeconomic status to avoid generalizing statements and sentiments.
Avoid
- Correlating socioeconomic status to lifestyle, education level, values, medical status, and family situation.
- Terms to avoid
  - Poor
  - Ghetto
  - Country person
  - Inner-city kid

Weight & Body Size

Actions
- Use images that include all body types and sizes as healthy, active and in a positive manner
- Use medical language when referring to person’s weight status, example BMI.
- Consider all aspects of a patient’s health when discussing their weight status to avoid bias.
Avoid
- Images and language that portray overweight patients and families as lazy or unmotivated, or healthy weight as always fit and active.
- Assuming weight is representative of their lifestyle or motivation level.
- Terms to avoid
  - Fat
  - Skinny
  - Large
  - Heavy Set
  - Thin
  - Obese as an adjective
  - Morbid Obesity (use severe)

Resources and Links

Join the Social Conversation:

Forms

Ohio AAP Diversity, Equity and
Inclusion (DEI) Toolkit

The Ohio AAP DEI Toolkit is designed to not only reinforce or introduce members and speakers to key terms and concepts but more importantly, it is designed to allow participants to look at diversity and inclusion in Ohio AAP’s education and quality improvement.

The DEI toolkit is designed with flexibility in mind. To best meet the needs of our members, we have developed options from which to select:

Ohio AAP DEI Education Webinar

Planning

Implementation

Marketing

Virtual/Hybrid Meetings

Ohio AAP DEI Toolkit Acknowledgement Slide

Terms to consider when planning a presentation for an audience

Which characteristics of diversity can contribute to disparities in opportunity, engagement, and health?

While planning your presentation, take time to understand how above concepts impact you, your patients, the location in which you practice, your staff, and the audience to which you are presenting.

Below are DEI guidelines and considerations to include when developing education and training materials.

Age

Disabilities

Mental Health

Race

Religion, Spirituality and Creed

Sex, Gender & Orientation

Socioeconomic Status

Weight & Body Size

National AAP Resources

ASSIST

CDC’s Health Equity Guiding Principles for Inclusive Communication

Robert Wood Johnson Foundation

Join the Social Conversation:

DEI Content Checklist

DEI Event Planning Checklist

Social Media

Ohio Chapter, American Academy of Pediatrics

Ohio AAP Diversity, Equity and Inclusion (DEI) Toolkit

The Ohio AAP DEI Toolkit is designed to not only reinforce or introduce members and speakers to key terms and concepts but more importantly, it is designed to allow participants to look at diversity and inclusion in Ohio AAP’s education and quality improvement.

The DEI toolkit is designed with flexibility in mind. To best meet the needs of our members, we have developed options from which to select:

Ohio AAP DEI Education Webinar

Social Media

Ohio Chapter, American Academy of Pediatrics

Ohio AAP Diversity, Equity and
Inclusion (DEI) Toolkit