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Background <p>Latinx communities experience significant health disparities driven by structural inequities, exclusionary policies, and social determinants of health. Barriers such as limited access to culturally competent care, language differences, geographic isolation, and socioeconomic disadvantage continue to shape inequitable health outcomes. Although implementation science frameworks such as RE-AIM, CFIR, and the Health Equity Implementation Framework provide valuable guidance for evaluating healthcare and social service interventions, their application to Latinx populations often lacks sufficient attention to cultural relevance, trust-building, migration-related realities, trauma-informed implementation, and structural inequities. The Latinx Equity and Resilience in Implementation (LERI) Framework was developed to address these gaps by offering a culturally grounded, community-centered approach to advancing health equity.</p> Methods <p>LERI was developed using a participatory, interdisciplinary, and equity-centered approach informed by over three decades of collective experience in health systems and community-based research with Latinx populations across the United States and Puerto Rico. The co-author team included Latinx implementation scientists, clinicians, and community leaders. Framework development followed an iterative, multi-phase process involving evidence synthesis of established implementation frameworks (RE-AIM, CFIR, HEIF), participatory consultation with community and organizational stakeholders, and expert review and consultation. This process identified key gaps in existing frameworks and translated community and practice-based knowledge into clearly defined implementation domains. The resulting framework integrates culturally grounded constructs across 12 domains grouped into five clusters, ensuring contextual adaptability, cultural relevance, and structural responsiveness.</p> Results <p>The LERI Framework emphasizes cultural alignment, community agency, and resilience-focused strategies. It introduces domains centered on cultural relevance, equity, and resilience while addressing structural and systemic barriers affecting Latinx populations. These domains include Cultural Relevance, which aligns programs with cultural values such as <i>familismo</i><i>, </i><i>confianza,</i> and <i>respeto</i>; Community Empowerment, which fosters leadership and co-creation of interventions; and Resilience and Adaptation, which addresses migration dynamics, sustainability, and systemic inequities. Equity-focused domains prioritize reducing structural barriers, enhancing accessibility, and promoting systemic change through research, advocacy, and policy influence. Implementation process domains emphasize adaptability to local contexts and equity-driven evaluation to ensure interventions remain practical and scalable. LERI is conceptualized primarily as a hybrid determinant and implementation process framework that also provides guidance for equity-oriented evaluation. Rather than serving as a validated evaluation framework, it offers implementation domains that can inform the selection and interpretation of evaluation measures across diverse Latinx-serving settings.</p> Conclusions <p>The LERI Framework offers a culturally grounded approach for designing, implementing, and evaluating interventions that address structural inequities while leveraging the strengths of Latinx communities. By integrating cultural relevance, resilience, and equity-oriented evaluation, LERI provides practical guidance for advancing more equitable and sustainable health and social service programs and interventions.</p>

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Advancing health equity: the Latinx Equity and Resilience in Implementation (LERI) framework for transforming healthcare and social services

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年8月5日

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  • Omar Martinez,
  • Miguel Munoz-Laboy,
  • Lisa Aponte-Soto,
  • Angela Martinez,
  • Souhail Malave-Rivera,
  • Deja Lynn Alvarez,
  • Edda I. Santiago Rodríguez,
  • Cui Yang,
  • Pedro Alonso Serrano,
  • Carlos Rodriguez-Diaz

摘要

Background

Latinx communities experience significant health disparities driven by structural inequities, exclusionary policies, and social determinants of health. Barriers such as limited access to culturally competent care, language differences, geographic isolation, and socioeconomic disadvantage continue to shape inequitable health outcomes. Although implementation science frameworks such as RE-AIM, CFIR, and the Health Equity Implementation Framework provide valuable guidance for evaluating healthcare and social service interventions, their application to Latinx populations often lacks sufficient attention to cultural relevance, trust-building, migration-related realities, trauma-informed implementation, and structural inequities. The Latinx Equity and Resilience in Implementation (LERI) Framework was developed to address these gaps by offering a culturally grounded, community-centered approach to advancing health equity.

Methods

LERI was developed using a participatory, interdisciplinary, and equity-centered approach informed by over three decades of collective experience in health systems and community-based research with Latinx populations across the United States and Puerto Rico. The co-author team included Latinx implementation scientists, clinicians, and community leaders. Framework development followed an iterative, multi-phase process involving evidence synthesis of established implementation frameworks (RE-AIM, CFIR, HEIF), participatory consultation with community and organizational stakeholders, and expert review and consultation. This process identified key gaps in existing frameworks and translated community and practice-based knowledge into clearly defined implementation domains. The resulting framework integrates culturally grounded constructs across 12 domains grouped into five clusters, ensuring contextual adaptability, cultural relevance, and structural responsiveness.

Results

The LERI Framework emphasizes cultural alignment, community agency, and resilience-focused strategies. It introduces domains centered on cultural relevance, equity, and resilience while addressing structural and systemic barriers affecting Latinx populations. These domains include Cultural Relevance, which aligns programs with cultural values such as familismo, confianza, and respeto; Community Empowerment, which fosters leadership and co-creation of interventions; and Resilience and Adaptation, which addresses migration dynamics, sustainability, and systemic inequities. Equity-focused domains prioritize reducing structural barriers, enhancing accessibility, and promoting systemic change through research, advocacy, and policy influence. Implementation process domains emphasize adaptability to local contexts and equity-driven evaluation to ensure interventions remain practical and scalable. LERI is conceptualized primarily as a hybrid determinant and implementation process framework that also provides guidance for equity-oriented evaluation. Rather than serving as a validated evaluation framework, it offers implementation domains that can inform the selection and interpretation of evaluation measures across diverse Latinx-serving settings.

Conclusions

The LERI Framework offers a culturally grounded approach for designing, implementing, and evaluating interventions that address structural inequities while leveraging the strengths of Latinx communities. By integrating cultural relevance, resilience, and equity-oriented evaluation, LERI provides practical guidance for advancing more equitable and sustainable health and social service programs and interventions.