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Objective: To advance equity by developing stakeholder-driven principles of shared measurement, which is using a common set of measurable goals that reflect shared priorities across communities and systems, such as health care, public health, and human and social services. Data Sources: From October 2019 to July 2021, we collected primary data from leaders in cross-systems alignment, measurement, and community engagement-including community members and community-based organization leaders-across the United States. Study Design: In partnership with equity and community engagement experts, we conducted a mixed-methods study that included multiple formative research activities and culminated in a six-week, stakeholder-engaged modified-Delphi process. Data Collection: Formative data collection occurred through an environmental scan, interviews, focus groups, and an online survey. Principles were developed using a virtual modified Delphi with iterative rapid-analysis. Feedback on the final principles was collected through virtual focus groups, an online feedback form, and during virtual presentations. Principal Findings: We developed a set of five guiding principles. Measurement that aligns systems with communities toward equitable outcomes: (1) Requires upfront investment in communities; (2) Is co-created by communities; (3) Creates accountability to communities for addressing root causes of inequities and repairing harm; (4) Focuses on a holistic and comprehensive view of communities that highlights assets and historical context; and (5) Reflects long-term efforts to build trust. Using an equity-focused process resulted in principles with broad applicability. Conclusions: Leaders across systems and communities can use these shared measurement principles to reimagine and transform how systems create equitable health by centering the needs and priorities of the communities they serve, particularly communities that historically have been harmed the most by inequities. Intentionally centering equity across all project activities was essential to producing principles that could guide others in advancing equity. KEYWORDS community health, community participation, Delphi technique, health equity, intersectoral collaboration, measurement, social determinants of health What is known on this topic * Achieving health equity requires creating aligned systems that work together with communities to meet their goals and needs. * A shared measurement system is essential to align efforts around outcomes, evaluate collective progress, improve the quality and credibility of data, and reduce costs associated with collecting and reporting data. What this study adds * Building shared measurement into systems' structure enables sustained progress toward equitable outcomes through redistribution of power, building partnerships, creating accountability to communities, and facilitating co-learning. * Five guiding principles show how community members, community-based organizations, system leaders, service providers, and policy makers can use shared measurement to align decisions, policies, and practices toward equitable health and well-being. * We found that how we approached the work--with the intention of centering equity across all project activities--was essential to producing principles that could themselves guide others in advancing equity., 1 | INTRODUCTION Achieving lasting and meaningful improvements in individual and population health requires aligning efforts across various systems--organizations, programs, and activities--within communities that directly influence the health and well-being [...]

Objective. To explore factors that may influence use of comparative public reports for hospital maternity care. Data sources. Four focus groups conducted in 2013 with 41 women and preintervention survey data collected in 2014 to 2015 from 245 pregnant women in North Carolina. Study design. As part of a larger randomized controlled trial, we conducted qualitative formative research to develop an intervention that will be evaluated through pre- and postintervention surveys. Data extraction methods. Analysis of focus group transcripts examined participants' perceptions of high-quality maternity care and the importance of different quality measures. Quantitative analysis included descriptive results of the preintervention survey and subgroup analyses to examine the impact of race, education, and being a first-time mom on outcomes. Principal findings. When describing high quality maternity care, participants focused on interactions with providers, including respect for preferences and communication. The importance of quality measures was influenced by the extent to which they focused on babies' health, were perceived as the hospital's responsibility, and were perceived as representing 'standard care.' At baseline, 28 percent of survey respondents had used quality information to choose a hospital. Survey respondents were more aware of some quality measures (e.g., breastfeeding support) than others (e.g., episiotomy rates). Conclusions. Public reporting efforts could help increase relevance of maternity care quality measures by creating measures that reflect women's concerns, clearly explaining the hospital's role in supporting quality care, and showing how available quality measures can inform decisions about childbirth. Key Words. Public reporting, maternity care, quality measurement, patient engagement, qualitative research, The Affordable Care Act of 2010 and recent initiatives to achieve the goals of better health, better health care, and lower costs have called for health system transformation, emphasizing measurement, [...]