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Health equity audits: a systematic review of the effectiveness

OBJECTIVES: The purpose of this systematic review is to explore whether health equity audits (HEAs) are effective in improving the equity of service provision and reducing health inequalities. DESIGN: Three databases (Ovid Medline, Embase, Web of Science) and grey literature (Opengrey, Google Schola...

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Autores principales: van Daalen, Kim Robin, Davey, Fiona, Norman, Claire, Ford, John Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8587574/
https://www.ncbi.nlm.nih.gov/pubmed/34764176
http://dx.doi.org/10.1136/bmjopen-2021-053392
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author van Daalen, Kim Robin
Davey, Fiona
Norman, Claire
Ford, John Alexander
author_facet van Daalen, Kim Robin
Davey, Fiona
Norman, Claire
Ford, John Alexander
author_sort van Daalen, Kim Robin
collection PubMed
description OBJECTIVES: The purpose of this systematic review is to explore whether health equity audits (HEAs) are effective in improving the equity of service provision and reducing health inequalities. DESIGN: Three databases (Ovid Medline, Embase, Web of Science) and grey literature (Opengrey, Google Scholar) were systematically searched for articles published after 2000, reporting on the effectiveness of HEA. Title and abstracts were screened according to an eligibility criteria to identify studies which included a full audit cycle (eg, initial equity analysis, service changes and review). Data were extracted from studies meeting the eligibility criteria after full text review and risk of bias assessed using the ROBINS-I tool. RESULTS: The search strategy identified 596 articles. Fifteen records were reviewed in full text and three records were included in final review. An additional HEA report was identified through contact with an author. Three different HEAs were included from one peer-reviewed journal article, two published reports and one unpublished report (n=4 records on n=3 HEAs). This included 102 851 participants and over 148 practices/pharmacies (information was not recorded for all records). One study reviewed health equity impacts of HEA implementation in key indicators for coronary heart disease, type 2 diabetes and chronic obstructive pulmonary disease. Two HEAs explored Stop Smoking Services on programme access and equity. All reported some degree of reduction in health inequalities compared with prior HEA implementation. However, impact of HEA implementation compared with other concurrent programmes and initiatives was unclear. All included studies were judged to have moderate to serious risk of bias. CONCLUSIONS: There is an urgent need to identify effective interventions to address health inequalities. While HEAs are recommended, we only identified limited weak evidence to support their use. More evidence is needed to explore whether HEA implementation can reduce inequalities and which factors are influencing effectiveness. TRIAL REGISTRATION NUMBER: The study was registered prior to its conduction in PROSPERO (CRD 42020218642).
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spelling pubmed-85875742021-11-15 Health equity audits: a systematic review of the effectiveness van Daalen, Kim Robin Davey, Fiona Norman, Claire Ford, John Alexander BMJ Open Public Health OBJECTIVES: The purpose of this systematic review is to explore whether health equity audits (HEAs) are effective in improving the equity of service provision and reducing health inequalities. DESIGN: Three databases (Ovid Medline, Embase, Web of Science) and grey literature (Opengrey, Google Scholar) were systematically searched for articles published after 2000, reporting on the effectiveness of HEA. Title and abstracts were screened according to an eligibility criteria to identify studies which included a full audit cycle (eg, initial equity analysis, service changes and review). Data were extracted from studies meeting the eligibility criteria after full text review and risk of bias assessed using the ROBINS-I tool. RESULTS: The search strategy identified 596 articles. Fifteen records were reviewed in full text and three records were included in final review. An additional HEA report was identified through contact with an author. Three different HEAs were included from one peer-reviewed journal article, two published reports and one unpublished report (n=4 records on n=3 HEAs). This included 102 851 participants and over 148 practices/pharmacies (information was not recorded for all records). One study reviewed health equity impacts of HEA implementation in key indicators for coronary heart disease, type 2 diabetes and chronic obstructive pulmonary disease. Two HEAs explored Stop Smoking Services on programme access and equity. All reported some degree of reduction in health inequalities compared with prior HEA implementation. However, impact of HEA implementation compared with other concurrent programmes and initiatives was unclear. All included studies were judged to have moderate to serious risk of bias. CONCLUSIONS: There is an urgent need to identify effective interventions to address health inequalities. While HEAs are recommended, we only identified limited weak evidence to support their use. More evidence is needed to explore whether HEA implementation can reduce inequalities and which factors are influencing effectiveness. TRIAL REGISTRATION NUMBER: The study was registered prior to its conduction in PROSPERO (CRD 42020218642). BMJ Publishing Group 2021-11-11 /pmc/articles/PMC8587574/ /pubmed/34764176 http://dx.doi.org/10.1136/bmjopen-2021-053392 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Public Health
van Daalen, Kim Robin
Davey, Fiona
Norman, Claire
Ford, John Alexander
Health equity audits: a systematic review of the effectiveness
title Health equity audits: a systematic review of the effectiveness
title_full Health equity audits: a systematic review of the effectiveness
title_fullStr Health equity audits: a systematic review of the effectiveness
title_full_unstemmed Health equity audits: a systematic review of the effectiveness
title_short Health equity audits: a systematic review of the effectiveness
title_sort health equity audits: a systematic review of the effectiveness
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8587574/
https://www.ncbi.nlm.nih.gov/pubmed/34764176
http://dx.doi.org/10.1136/bmjopen-2021-053392
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