Select, Implement, and Evaluate Effective and Equitable Policy and Program Strategies

The R4P Framework uses intersectionality to acknowledge the relationship of racerelated stress with other forms of oppression (e.g., sexism) to understand health inequities among African Americans. While R4P was created using the historical and current experiences of African Americans, it can be applied when working with other populations. The five components are Remove, Repair, Remediate, Restructure, and Provide:

Remove involves identifying and removing structures, attitudes, and practices that could cause the population to be disadvantaged.

Repair refers to acknowledging and addressing historical exposures that have a current impact on the population’s ability to access healthcare or to maintain healthy lifestyle practices.

Remediate focuses on recognizing and addressing current exposures to reduce risk.

Restructure determines how to address any institutional exposures that could impact the population in the future.

Provide involves the implementation of culturally and economically feasible interventions that address the intersecting axes of disadvantage faced by the population.

The table on the next page provides guidance on how to use each component of the R4P when planning an intervention.