The Innovations Fund

Phases: 2018, 2021

Building Diversity and Health Equity Competence into the Pipeline of Utah’s Nursing Workforce

Project Description:



The Utah Action Coalition for Health, working with Holy Cross Ministries, will pursue a two-part project designed to build diversity and health equity competence in Utah’s nursing workforce pipeline. The project will increase exposure to nursing careers in predominantly Hispanic communities, and embed Certified Health Workers’ knowledge of health equity/disparities into Certified Nursing Assistant training programs. The Campaign for Action’s Health Equity Toolkit will be interwoven in the project’s implementation phase, and a steering committee composed of key partners will be created for guidance. The project will focus on two school districts initially, with the opportunity for expansion later.



The Utah Action Coalition had four main goals including: 1) increasing diversity in nursing by implementing strategies to encourage diverse students to pursue a nursing education through outreach to middle and high school counselors; 2) implementing a student mentoring and support system to ensure retention and completion of  nursing academic programs; 3) implementing support programs and systems for diverse early career professionals to assume their first leadership position; and 4) increasing the number of diverse nurses on community boards to promote the culture of health in underserved or under-insured Utah communities.

Summary of completed project

The Utah Action Coalition sought to increase the diversity of the nursing workforce by using a multipronged approach. The Action Coalition utilized a research-based framework to examine the literature, collect and analyze data, conduct site visits, and share its results with partners and other leaders throughout the state. The Action Coalition developed comprehensive reports on methods and results for each goal.

For the first goal, the Utah Action Coalition reached out to middle school counselors, high school counselors, and science teachers to assess high school minority students’ perceptions about attending college and their beliefs in self-efficacy and personal abilities. Students were able to complete the survey online or in a paper format.

For the second goal, the Action Coalition collaborated with the Academic Leadership Committee of the Utah Organization of Nurse Leaders to circulate the Robert Wood Johnson Foundation diversity survey to 13 of the 18 Utah nursing programs, focusing on identifying barriers and strategies to recruitment and retention of diverse students.

For the third goal, the Utah Action Coalition evaluated the challenges facing diverse first year nurses. The Action Coalition worked with a large metropolitan tertiary teaching hospital to survey all first year diverse nurses.  The information collected was so compelling to Action Coalition practice partners that it will be replicating the work in other hospital settings statewide.

For the fourth goal, the Action Coalition partnered with Springboard, a Utah based organization with a mission to promote, train, connect and advocate for more women to be appointed to boards and commission. Additionally, the Action Coalition also completed an in-depth analysis of the Nurses on Boards Coalition registry data for Utah.


The Action Coalition met or exceeded all but one of their goals. These outcomes include:

  • Goal One: The outreach was primarily high school students using health career day activities to survey all students who were interested in participating. The student health career days at Utah State University (45 participants) and Salt Lake Community College (80 students) were utilized for preliminary surveys. The revised surveys were sent to Uintah High School (16 students) and 12 schools where Native American students represented eight percent of the student population. As an example of the results, 61 percent of the students surveyed responded that they had either not or somewhat considered nursing as a career choice. Results of the surveys also found that 43 percent of the students were unaware of the benefits of a career in nursing. The Action Coalition then did an analysis of the remaining set of questions on self-efficacy (belief in self) and self-efficacy (belief in effort). The Action Coalition continued to identify event opportunities in diverse middle and high schools. They are also sharing the results with other school districts to encourage action planning to increase counselor and educator engagement with diverse students.
  • While the original goal of establishing a mentoring system was not met, a broad-based assessment of recruitment, retention, and inclusion in nursing programs was completed and outlined priorities for future nursing diversity work.
  • Goal three exceeded the original plan with a thorough evaluation of barriers of first year diverse nurses’ challenges and commitments from practice partners to implement interventions to address barriers identified. A proposal to have the survey sent out on an ongoing basis to each newly hired nurse on the one-year mark from date of hire is being evaluated.
  • The key findings for goal four demonstrated that registered nurses (RNs) with higher educational backgrounds were disproportionally represented on Boards by 33 percent. Male RNs in Utah are also disproportionally represented on Boards by 12 percent when compared to overall practicing RNs in Utah. RNs serving on Boards located within urban communities were overrepresented by 53 percent, compared to the typical RN working in rural locations. Utah’s Nurses on Boards effort is ongoing, and this survey provided the Action Coalition with insights into how to reach diverse nurses to offer them skills training to prepare them for Board opportunities.  While the current number of diverse nurses serving on boards is representative of Utah’s population, there is a hope that this work will increase the number of diverse nurses serving in this capacity in the future.

The Action Coalition used Doctor of Nursing Practice students from the University of Utah College of Nursing to help with their overall project and provided experiences that directly benefited the students’ education clinical experiences. As many organizations in Utah are working on diversity and inclusion, the Action Coalition found that it is imperative to hold regular coordinating meetings to avoid duplication and effectively leverage these community partnerships. By using a multipronged approach, the process provided useful information for the Action Coalition to move forward in increasing the diversity of the nursing workforce in their state.