How effects on health equity are assessed in systematic reviews of interventions

Welch, Vivian; Dewidar, Omar; Ghogomu, Elizabeth Tanjong; Abdisalam, Salman; Ameer, Abdulah Al; Barbeau, Victoria; Brand, Kevin; Kebedom, Kisanet; Benkhalti, Maria; Kristjansson, Elizabeth; Madani, Mohamad Tarek; Antequera, Alba; Mathew, Christine; McGowan, Jessie; McLeod, W. R.; Park, Hanbyoul Agatha; Petkovic, Jennifer; Riddle, Alison; Tugwell, Peter; Petticrew, Mark; Trawin, Jessica; Wells, George

doi:10.1002/14651858.mr000028.pub3

Cited by 22 publications

(19 citation statements)

References 215 publications

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“…There may also be a differential effect related to gender and substance use on housing stability, although the results were mixed and require further study. Future research should focus on examining the equity impact of PSH and how patient characteristics affect the magnitude of effect as it relates to housing stability (Welch et al, 2010). The housing‐intervention models studied included both single‐site models with on‐site support and scattered‐site models with portable support.…”

Section: Discussionmentioning

confidence: 99%

A comprehensive review of prioritised interventions to improve the health and wellbeing of persons with lived experience of homelessness

Moledina

Magwood

Agbata

et al. 2021

Campbell Systematic Reviews

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Background: Homelessness has emerged as a public health priority, with growing numbers of vulnerable populations despite advances in social welfare. In February 2020, the United Nations passed a historic resolution, identifying the need to adopt social-protection systems and ensure access to safe and affordable housing for all.The establishment of housing stability is a critical outcome that intersects with other social inequities. Prior research has shown that in comparison to the general population, people experiencing homelessness have higher rates of infectious diseases, chronic illnesses, and mental-health disorders, along with disproportionately poorer outcomes. Hence, there is an urgent need to identify effective interventions to improve the lives of people living with homelessness.Objectives: The objective of this systematic review is to identify, appraise, and synthesise the best available evidence on the benefits and cost-effectiveness of interventions to improve the health and social outcomes of people experiencing homelessness.Search Methods: In consultation with an information scientist, we searched nine bibliographic databases, including Medline, EMBASE, and Cochrane CENTRAL, from database inception to February 10, 2020 using keywords and MeSH terms. We conducted a focused grey literature search and consulted experts for additional studies.Selection Criteria: Teams of two reviewers independently screened studies against our inclusion criteria. We included randomised control trials (RCTs) and quasi-experimental studies conducted among populations experiencing homelessness in high-income countries. Eligible interventions included permanent supportive housing (PSH), income assistance, standard case management (SCM), peer support, mental health interventions such as assertive community treatment (ACT), intensive case management (ICM), critical time intervention (CTI) and injectable antipsychotics, and substance-use interventions, including supervised consumption facilities (SCFs), managed alcohol programmes and opioid

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Section: Discussionmentioning

confidence: 99%

A comprehensive review of prioritised interventions to improve the health and wellbeing of persons with lived experience of homelessness

Moledina

Magwood

Agbata

et al. 2021

Campbell Systematic Reviews

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“…In the absence of qualitative evidence from low- and middle-income settings, it is even more important to maximize the usefulness of the quantitative evidence for evaluation of impacts on equity. This can be done by undertaking subgroup analyses considering relative and absolute effects based on key indicators, such as those proposed by PROGRESS-Plus, if the primary studies present disaggregated data [ 72 ]. At a minimum, undertaking a subgroup analysis based on country income level can indicate whether there is any important variation in health outcomes for the intervention of interest to inform consideration of resources, equity and feasibility [ 65 ].…”

Section: Discussionmentioning

confidence: 99%

Using the WHO-INTEGRATE evidence-to-decision framework to develop recommendations for induction of labour

Murano

Costa

Turner

2022

Health Res Policy Sys

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Background In 2019, WHO prioritized updating recommendations relating to three labour induction topics: labour induction at or beyond term, mechanical methods for labour induction, and outpatient labour induction. As part of this process, we aimed to review the evidence addressing factors beyond clinical effectiveness (values, human rights and sociocultural acceptability, health equity, and economic and feasibility considerations) to inform WHO Guideline Development Group decision-making using the WHO-INTEGRATE evidence-to-decision framework, and to reflect on how methods for identifying, synthesizing and integrating this evidence could be improved. Methods We adapted the framework to consider the key criteria and sub-criteria relevant to our intervention. We searched for qualitative and other evidence across a variety of sources and mapped the eligible evidence to country income setting and perspective. Eligibility assessment and quality appraisal of qualitative evidence syntheses was undertaken using a two-step process informed by the ENTREQ statement. We adopted an iterative approach to interpret the evidence and provided both summary and detailed findings to the decision-makers. We also undertook a review to reflect on opportunities to improve the process of applying the framework and identifying the evidence. Results Using the WHO-INTEGRATE framework allowed us to explore health rights and equity in a systematic and transparent way. We identified a lack of qualitative and other evidence from low- and middle-income settings and in populations that are most impacted by structural inequities or traditionally excluded from research. Our process review highlighted opportunities for future improvement, including adopting more systematic evidence mapping methods and working with social science researchers to strengthen theoretical understanding, methods and interpretation of the evidence. Conclusions Using the WHO-INTEGRATE evidence-to-decision framework to inform decision-making in a global guideline for induction of labour, we identified both challenges and opportunities relating to the lack of evidence in populations and settings of need and interest; the theoretical approach informing the development and application of WHO-INTEGRATE; and interpretation of the evidence. We hope these insights will be useful for primary researchers as well as the evidence synthesis and health decision-making communities, and ultimately contribute to a reduction in health inequities.

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“…However, few of these studies assess the outcomes of the interventions with a health equity lens. 86 In recognition of the importance of reporting health equity results, the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-analyses) was revised in 2012 to provide guidance on how to report the methods and results of equity-focused systematic reviews and meta-analyses. 83 Of note, an equityfocused systematic review was directed to meet these criteria: Objectives (4, 4A) Describe how disadvantage was defined and research questions addressed.…”

Section: Addressing Health Inequity In Studies Of Health Care Interve...mentioning

confidence: 99%

“…Systematic reviews and meta‐analyses are regarded as important sources of evidence for clinical decision making. However, few of these studies assess the outcomes of the interventions with a health equity lens 86 . In recognition of the importance of reporting health equity results, the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta‐analyses) was revised in 2012 to provide guidance on how to report the methods and results of equity‐focused systematic reviews and meta‐analyses 83 .…”

Section: Addressing Health Inequity In Studies Of Health Care Interve...mentioning

confidence: 99%

Evidence‐Based Medicine in Otolaryngology, Part XIII: Health Disparities Research and Advancing Health Equity

Megwalu¹,

Bergmark

Osazuwa‐Peters

et al. 2022

Otolaryngol.--head neck surg.

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Objective To provide a contemporary resource for clinicians and researchers on health equity research and implementation strategies to mitigate or eliminate disparities in health care. Data Sources Published studies and literature on health disparities, applicable research methodologies, and social determinants of health in otolaryngology. Review Methods Literature through October 2021 was reviewed, including consensus statements, guidelines, and scientific publications related to health care equity research. This research focus provides insights into existing disparities, why they occur, and the outcomes of interventions designed to resolve them. Progress toward equity requires intentionality in implementing quality improvement initiatives, tracking data, and fostering culturally competent care. Priority areas include improving access, removing barriers to care, and ensuring appropriate and effective treatment. Although research into health care disparities has advanced significantly in recent years, persistent knowledge gaps remain. Applying the lens of equity to data science can promote evidence-based practices and optimal strategies to reduce health inequities. Conclusions Health disparities research has a critical role in advancing equity in otolaryngology–head and neck surgery. The phases of disparities research include detection, understanding, and reduction of disparities. A multilevel approach is necessary for understanding disparities, and health equity extensions can improve the rigor of evidence-based data synthesis. Finally, applying an equity lens is essential when designing and evaluating health care interventions, to minimize bias. Implications for Practice Understanding the data and practices related to disparities research may help promote an evidence-based approach to care of individual patients and populations, with the potential to eventually surmount the negative effects of health care disparities.

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How effects on health equity are assessed in systematic reviews of interventions

Abstract: This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2010, Issue 12 http://www.thecochranelibrary.com How effects on health equity are assessed in systematic reviews of interventions (Review)

Cited by 22 publications

References 215 publications

A comprehensive review of prioritised interventions to improve the health and wellbeing of persons with lived experience of homelessness

A comprehensive review of prioritised interventions to improve the health and wellbeing of persons with lived experience of homelessness

Using the WHO-INTEGRATE evidence-to-decision framework to develop recommendations for induction of labour

Evidence‐Based Medicine in Otolaryngology, Part XIII: Health Disparities Research and Advancing Health Equity

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