Healthcare Professionals’ Attitudes and Perspectives on Diversity, Equity and Inclusion in an Academic Culture: A Freelisting Study

Objectives: Successful implementation of diversity, equity, and inclusion (DEI) initiatives requires understanding the perspectives of diverse student populations. This study explored how graduate health and public health professionals perceive DEI and their implementation barriers and facilitators. Methods: This qualitative freelisting study was conducted from June to August 2024 at a single urban academic institution in Pennsylvania. Eligible participants were current or recent graduate students in health or public health programs. Participants engaged in structured freelisting exercises, where they listed words, themes, and reflections related to 5 different DEI domains. Responses were coded by multiple researchers, and the Smith Salience Index was applied to quantify the importance of themes across participants. Results: Thirty participants completed the study. The most salient themes were "inclusivity and representation" and "diverse and receptive leadership" as essential components of DEI. Participants expressed both positive and negative experiences. White and man-identifying participants more often emphasized positive aspects, while older, woman-identifying, and participants from racial and ethnic minority backgrounds highlighted the need for institutional "commitment, accountability, and buy-in." The most frequently cited barrier to DEI was "lack of adequate funding and resources." Conclusion: Graduate health and public health professionals emphasized the importance of representation and leadership diversity in fostering inclusive environments. Institutional investment in DEI-particularly through recruitment, retention, leadership representation, and sustained funding-is critical to cultivating a workforce prepared to advance health equity for the communities they serve. Differences in perceptions by race, gender, and age underscore the need for tailored approaches to DEI implementation.