“Applying Intersectionality in designing and implementing health interventions: a scoping review”

Abstract

Background Given the potential of intersectionality to identify the causes of inequalities, there is a growing tendency toward applying it in the field of health. Nevertheless, the extent of the application of intersectionality in designing and implementing health interventions is unclear. Therefore, this study aimed to determine the extent to which previous studies have applied intersectionality and its principles in designing and implementing health interventions. Methods The title and abstract of the articles which were published in different databases e.g. PubMed, Web of Science, Proquest, Embase, Scopus, Cochrane, and PsychInfo were screened. Those articles that met the screening criteria were reviewed in full text. The data about the application of principles of intersectionality, according to the stages heuristic model (problem identification, design & implementation, and evaluation), were extracted through a 38-item researcher-made checklist. Results Initially, 2677 articles were found through reviewing the target databases. After removing the duplicated ones and screening the titles and abstracts of 1601 studies, 107 articles were selected to be reviewed in detail and 4 articles could meet the criteria. The most frequently considered intersectionality principles were “intersecting categories” and “power”, particularly at the stages of ‘problem identification’ as well as ‘design & implementation’. The results showed that “multilevel analysis” principle received less attention; most of the studies conducted the interventions at the micro level and did not aim at bringing about change at structural levels. There was a lack of clarity regarding the attention to some of the main items of principles such as “reflexivity” as well as “social justice and equity". These principles might have been implemented in the selected articles; however, the authors have not explicitly discussed them in their studies. Conclusions Given the small number of included studies, there is still insufficient evidence within empirical studies to show the implication of intersectionality in designing and conducting health interventions. To operationalize the intersectionality, there is a need to address the principles at various stages of health policies and interventions. To this end, designing and availability of user-friendly tools may help researchers and health policymakers appropriately apply the intersectionality.

Public health services and intersectional stigma: a social sciences perspective with implications for HIV service design and delivery

“…Recent work illustrates how scholars have adapted and contextualized these theories in designing and implementing health services. A recent scoping review by Ghasemi et al [41] on using intersectionality principles in designing and implementing health services only identified four studies that described the application of intersectionality to problem identification, design, implementation and evaluation of health interventions [42]. They found intersecting social identities and power were more often considered in services and programmes, especially at earlier stages of problem identification, design and implementation.…”

Work and health challenges of Indigenous people in Canada

“…In a scoping review on intersectionality in health interventions, Ghasemi and colleagues wrote that "human beings are shaped by the interaction of multiple interlocking locations (such as race/ethnicity, gender, social class, age, migration status, etc), and these interactions occur within a context of interconnected systems and power structures." 53 Indigenous people face intrinsic discrimination, which comes in addition to other social determinants of health such as low socioeconomic status, increased unemployment, gender discrimination, and ageism. For instance, Indigenous people (particularly those living on reserve) have a lower rate of completing high school than non-Indigenous people, which is then associated with higher chances of unemployment, 54 which can then negatively influence their health.…”

Quantitative criticalism: Guidelines for conducting transformative quantitative family science research

“…Second, quantitative research guided by the framework of intersectionality is often more laborious than other projects, thus reducing the number of academic projects produced by researchers in a given time frame. The additional time and attention required by the intersectionality framework is related to its principle of reflexivity, which urges researchers to incorporate local knowledge of the community of interest into all aspects of the research project (Ghasemi et al, 2021). For example, researchers interested in investigating the predictors of social mobility among Black American women in higher education may create a stakeholder consultation group comprised of Black American women of various academic levels to critically evaluate the values, experiences, beliefs, assumptions, actions, and decisions of the researchers throughout the research process.…”

“…Considering these challenges, scholars of intersectionality have developed various resources to assess the efficacious integration of intersectionality into a given research project (see Etherington et al, 2020; Ghasemi et al, 2021). Both novice and seasoned scholars can use these resources to demonstrate their transparent integration of intersectionality.…”