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Data collection, analysis, and data driven action cycles have been viewed as vital components of healthcare for decades. Throughout the COVID-19 pandemic, case incidence and mortality data have consistently been used by various levels of governments and health institutions to inform pandemic strategies and service distribution. However, these responses are often inequitable, underscoring pre-existing healthcare disparities faced by marginalized populations. This has prompted governments to finally face these disparities and find ways to quickly deliver more equitable pandemic support. These rapid data informed supports proved that learning health systems (LHS) could be quickly mobilized and effectively used to develop healthcare actions that delivered healthcare interventions that matched diverse populations' needs in equitable and affordable ways. Within LHS, data are viewed as a starting point researchers can use to inform practice and subsequent research. Despite this innovative approach, the quality and depth of data collection and robust analyses varies throughout healthcare, with data lacking across the quadruple aims. Often, large data gaps pertaining to community socio-demographics, patient perceptions of healthcare quality and the social determinants of health exist. This prevents a robust understanding of the healthcare landscape, leaving marginalized populations uncounted and at the sidelines of improvement efforts. These gaps are often viewed by researchers as indication that more data is needed rather than an opportunity to critically analyze and iteratively learn from multiple sources of pre-existing data. This continued cycle of data collection and analysis leaves one to wonder if healthcare has a data problem or a learning problem.
In this commentary, we discuss ways healthcare data are often used and how LHS disrupts this cycle, turning data into learning opportunities that inform healthcare practice and future research in real time. We conclude by proposing several ways to make learning from data just as important as the data itself.

The global COVID-19 pandemic has led us to this current public health and political moment, bringing widespread attention to social and health inequalities and interconnecting racial discrimination faced by Black communities and other communities of colour. The pandemic has also precipitated a transition of the qualitative methodology classroom from physical to virtual spaces. At this juncture, an opportunity has emerged to amplify critical pedagogies challenging White, Eurocentric, hetero- and cis-normative epistemologies and introduce their practice into the ever-evolving classroom. Rooted within a genealogy of Black women's political and intellectual activism, Black feminist pedagogy captures their unique intersectional experiences and presents a methodology for teachers and learners alike to promote equity in the classroom and our society. In this presentation, we discuss the ways in which Black feminist pedagogy can support reflection on the inherent relations of power shaping the pedagogical practices and knowledge production of/in the classroom. We hold that Black feminist pedagogy is not simply concerned with the instruction of, for, and about Black women. It additionally puts forth learning strategies informed by Black women's historical experiences of race, gender, and class discrimination that can support the inclusion of diverse epistemological positionings and meaningfully represent the social and health inequities of marginalized communities. We affirm that a 'standpoint epistemology' is foundational to Black feminist pedagogy and that those who experience marginalization are best positioned to make claims about its meanings and impacts. The presenters draw from their epistemological standpoint as Black women, graduate and postdoctoral scholars, and Black feminist thinkers. We center our own experiential knowledge as learners and teachers to reflect on the value of Black feminist pedagogy. A major learning from our experiences in this current moment has compelled us to advocate for integrating a critical reflexivity process. This process is undertaken by teachers and learners to assess how knowledge is being produced, legitimized and/or erased as a counter to the social and institutional power and authority constituting the classroom. We also discuss considerations for teaching theoretical and methodological approaches to intersecting oppressions as elemental to Black women's experience and a cornerstone of Black feminist pedagogy. An intersectional approach supports us to take stock of the interlocking stigmas shaping health inequalities, ontologically and epistemologically (re)position the multiply marginalized communities they impact, and take up theories, methods, and practices that better align with our experiences. Intersectionality will be used to exemplify tensions as a 'travelling theory' and its strengths when rooted in a Black feminist pedagogy. At a time where Black feminist thought is at the forefront of public consciousness, we emphasize the dangers of taking up this tradition through white and patriarchal logics and pedagogies. As we rework the notion and formations of 'the classroom' in this current moment, it is important to not only recognize it as a place of intellectual advancement but also as a historical site of colonial, racial, and epistemic violence. Black feminist pedagogy holds that the experiential knowledge of racialized communities uniquely positions them for the teaching of ontologies and epistemologies characterizing their social realties and the methodological approaches employed to interpret them. To this end, redressing academic violence unequivocally requires the meaningful engagement and inclusion of Black (feminist) scholars in academic institutions and actively creating an environment that supports this pedagogical practice as an ethic and praxis towards decolonizing the classroom and qualitative health research more broadly. In this presentation, we aim to represent Black feminist thinking as a pedagogical tool to emphasize the intellectual, experiential, and cultural contributions of Black scholars to knowledge production and to help practitioners meaningfully approach teaching-learning and conducting qualitative health research in a (post-)COVID-19 reality.

AbstractIntroduction: Young men who have sex with men (MSM) in Jamaica have the highest HIV prevalence in the Caribbean. There is little information about HIV among transgender women in Jamaica, who are also overrepresented in the Caribbean epidemic. HIV‐related stigma is a barrier to HIV testing among Jamaica's general population, yet little is known of MSM and transgender women's HIV testing experiences in Jamaica. We explored perceived barriers and facilitators to HIV testing among young MSM and transgender women in Kingston, Jamaica.Methods: We implemented a community‐based research project in collaboration with HIV and lesbian, gay, bisexual and transgender (LGBT) agencies in Kingston. We held two focus groups, one with young (aged 18–30 years) transgender women (n = 8) and one with young MSM (n = 10). We conducted 53 in‐depth individual semi‐structured interviews focused on HIV testing experiences with young MSM (n = 20), transgender women (n = 20), and community‐based key informants (n = 13). We conducted thematic analysis to identify, analyze, and report themes.Results: Participant narratives revealed social‐ecological barriers and facilitators to HIV testing. Barriers included healthcare provider mistreatment, confidentiality breaches, and HIV‐related stigma: these spanned interpersonal, community and structural levels. Healthcare provider discrimination and judgment in HIV testing provision presented barriers to accessing HIV services (e.g. treatment), and resulted in participants hiding their sexual orientation and/or gender identity. Confidentiality concerns included: clinic physical arrangements that segregated HIV testing from other health services, fear that healthcare providers would publicly disclose their status, and concerns at LGBT‐friendly clinics that peers would discover they were getting tested. HIV‐related stigma contributed to fear of testing HIV‐positive; this intersected with the stigma of HIV as a "gay" disease. Participants also anticipated healthcare provider mistreatment if they tested HIV positive. Participants identified individual (belief in benefits of knowing one's HIV status), social (social support) and structural (accessible testing) factors that can increase HIV testing uptake.Conclusions: Findings suggest the need for policy and practice changes to enhance confidentiality and reduce discrimination in Jamaica. Interventions to challenge HIV‐related and LGBT stigma in community and healthcare settings can enhance access to the HIV prevention cascade among MSM and transgender youth in Jamaica.