International Journal of Environmental Research and Public Health

Research

11 pages, 348 KiB

Open AccessArticle

Race and Ethnic Differences in the Protective Effect of Parental Educational Attainment on Subsequent Perceived Tobacco Norms among US Youth

by Edward Adinkrah, Babak Najand and Angela Young-Brinn

Int. J. Environ. Res. Public Health 2023, 20(3), 2517; https://doi.org/10.3390/ijerph20032517 - 31 Jan 2023

Cited by 3 | Viewed by 1256

Abstract

Background: Although parental educational attainment is known to be associated with a lower prevalence of behaviors such as tobacco use, these effects are shown to be weaker for Black than White youth. It is important to study whether this difference is due to [...] Read more.

Background: Although parental educational attainment is known to be associated with a lower prevalence of behaviors such as tobacco use, these effects are shown to be weaker for Black than White youth. It is important to study whether this difference is due to higher perceived tobacco use norms for Black youth. Aim: To study the association between parental educational attainment and perceived tobacco use norms overall and by race/ethnicity among youth in the US. Methods: The current study used four years of follow-up data from the Population Assessment of Tobacco and Health (PATH-Youth) study conducted between 2013 and 2017. All participants were 12- to 17-year-old non-smokers at baseline and were successfully followed for four years (n = 4329). The outcome of interest was perceived tobacco use norms risk at year four. The predictor of interest was baseline parental educational attainment, the moderator was race/ethnicity, and the covariates were age, sex, and parental marital status at baseline. Results: Our linear regressions in the pooled sample showed that higher parental educational attainment at baseline was predictive of perceived disapproval of tobacco use at year four; however, this association was weaker for Latino than non-Latino youth. Our stratified models also showed that higher parental educational attainment was associated with perceived tobacco use norms for non-Latino but not for Latino youth. Conclusion: The effect of high parental educational attainment on anti-tobacco norms differs between Latino and non-Latino youth. Latino youth with highly educated parents remain at risk of tobacco use, while non-Latino youth with highly educated parents show low susceptibility to tobacco use. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

15 pages, 741 KiB

Open AccessArticle

A Qualitative Evaluation of a Health Access Card for Refugees and Asylum Seekers in a City in Northern England

by Malcolm Moffat, Suzanne Nicholson, Joanne Darke, Melissa Brown, Stephen Minto, Sarah Sowden and Judith Rankin

Int. J. Environ. Res. Public Health 2023, 20(2), 1429; https://doi.org/10.3390/ijerph20021429 - 12 Jan 2023

Cited by 1 | Viewed by 2210

Abstract

Refugees and asylum seekers residing in the UK face multiple barriers to accessing healthcare. A Health Access Card information resource was launched in Newcastle upon Tyne in 2019 by Newcastle City Council, intended to guide refugees and asylum seekers living in the city, [...] Read more.

Refugees and asylum seekers residing in the UK face multiple barriers to accessing healthcare. A Health Access Card information resource was launched in Newcastle upon Tyne in 2019 by Newcastle City Council, intended to guide refugees and asylum seekers living in the city, and the professional organisations that support them, to appropriate healthcare services provided locally. The aim of this qualitative evaluation was to explore service user and professional experiences of healthcare access and utilisation in Newcastle and perspectives on the Health Access Card. Eleven semi-structured interviews took place between February 2020 and March 2021. Participants provided diverse and compelling accounts of healthcare experiences and described cultural, financial and institutional barriers to care. Opportunities to improve healthcare access for these population groups included offering more bespoke support, additional language support, delivering training and education to healthcare professionals and reviewing the local support landscape to maximise the impact of collaboration and cross-sector working. Opportunities to improve the Health Access Card were also described, and these included providing translated versions and exploring the possibility of developing an accompanying digital resource. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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16 pages, 814 KiB

Open AccessArticle

Who Presents Where? A Population-Based Analysis of Socio-Demographic Inequalities in Head and Neck Cancer Patients’ Referral Routes

by Jennifer Deane, Ruth Norris, James O’Hara, Joanne Patterson and Linda Sharp

Int. J. Environ. Res. Public Health 2022, 19(24), 16723; https://doi.org/10.3390/ijerph192416723 - 13 Dec 2022

Cited by 3 | Viewed by 1651

Abstract

Head and neck cancers (HNC) are often late stage at diagnosis; stage is a major determinant of prognosis. The urgent cancer referral pathway (two week wait; 2WW) within England’s National Health Service aims to reduce time to diagnosis. We investigated factors associated with [...] Read more.

Head and neck cancers (HNC) are often late stage at diagnosis; stage is a major determinant of prognosis. The urgent cancer referral pathway (two week wait; 2WW) within England’s National Health Service aims to reduce time to diagnosis. We investigated factors associated with HNC route to diagnosis. Data were obtained from the English population-based cancer registry on 66,411 primary invasive HNCs (ICD C01-14 and C31-32) diagnosed 2006–2014. Multivariable logistic regression determined the likelihood of different diagnosis routes by patients’ demographic and clinical characteristics. Significant socio-demographic inequalities were observed. Emergency presentations declined over time and 2WW increased. Significant socio-demographic inequalities were observed. Non-white patients, aged over 65, residing in urban areas with advanced disease, were more likely to have emergency presentations. White males aged 55 and older with an oropharynx cancer were more likely to be diagnosed via 2WW. Higher levels of deprivation were associated with both emergency and 2WW routes. Dental referral was more likely in women, with oral cancers and lower stage disease. Despite the decline over time in emergency presentation and the increased use of 2WW, socio-demographic variation is evident in routes to diagnosis. Further work exploring the reasons for these inequalities, and the consequences for patients’ care and outcomes, is urgently required. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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15 pages, 2810 KiB

Open AccessArticle

Serious Injury in Metropolitan and Regional Victoria: Exploring Travel to Treatment and Utilisation of Post-Discharge Health Services by Injury Type

by Jemma Keeves, Belinda Gabbe, Sarah Arnup, Christina Ekegren and Ben Beck

Int. J. Environ. Res. Public Health 2022, 19(21), 14063; https://doi.org/10.3390/ijerph192114063 - 28 Oct 2022

Cited by 3 | Viewed by 1210

Abstract

This study aimed to describe regional variations in service use and distance travelled to post-discharge health services in the first three years following hospital discharge for people with transport-related orthopaedic, brain, and spinal cord injuries. Using linked data from the Victorian State Trauma [...] Read more.

This study aimed to describe regional variations in service use and distance travelled to post-discharge health services in the first three years following hospital discharge for people with transport-related orthopaedic, brain, and spinal cord injuries. Using linked data from the Victorian State Trauma Registry (VSTR) and Transport Accident Commission (TAC), we identified 1597 people who had sustained transport-related orthopaedic, brain, or spinal cord injuries between 2006 and 2016 that met the study inclusion criteria. The adjusted odds of GP service use for regional participants were 76% higher than for metropolitan participants in the orthopaedic and traumatic brain injury (TBI) groups. People with spinal cord injury (SCI) living in regional areas had 72% lower adjusted odds of accessing mental health, 76% lower adjusted odds of accessing OT services, and 82% lower adjusted odds of accessing physical therapies compared with people living in major cities. People with a TBI living in regional areas on average travelled significantly further to access all post-discharge health services compared with people with TBI in major cities. For visits to medical services, the median trip distance for regional participants was 76.61 km (95%CI: 16.01–132.21) for orthopaedic injuries, 104.05 km (95% CI: 51.55–182.78) for TBI, and 68.70 km (95%CI: 8.34–139.84) for SCI. Disparities in service use and distance travelled to health services exist between metropolitan Melbourne and regional Victoria following serious injury. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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12 pages, 1129 KiB

Open AccessArticle

Chronic Kidney Disease and Nephrology Care in People Living with HIV in Central/Eastern Europe and Neighbouring Countries—Cross-Sectional Analysis from the ECEE Network

by Bartłomiej Matłosz, Agata Skrzat-Klapaczyńska, Sergii Antoniak, Tatevik Balayan, Josip Begovac, Gordana Dragovic, Denis Gusev, Djordje Jevtovic, David Jilich, Kerstin Aimla, Botond Lakatos, Raimonda Matulionyte, Aleksandr Panteleev, Antonios Papadopoulos, Nino Rukhadze, Dalibor Sedláček, Milena Stevanovic, Anna Vassilenko, Antonija Verhaz, Nina Yancheva, Oleg Yurin, Andrzej Horban and Justyna D. Kowalska Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2022, 19(19), 12554; https://doi.org/10.3390/ijerph191912554 - 1 Oct 2022

Cited by 2 | Viewed by 1872

Abstract

Chronic kidney disease (CKD) is a significant cause of morbidity and mortality among patients infected with human immunodeficiency virus (HIV). The Central and East Europe (CEE) region consists of countries with highly diversified HIV epidemics, health care systems and socioeconomic status. The aim [...] Read more.

Chronic kidney disease (CKD) is a significant cause of morbidity and mortality among patients infected with human immunodeficiency virus (HIV). The Central and East Europe (CEE) region consists of countries with highly diversified HIV epidemics, health care systems and socioeconomic status. The aim of the present study was to describe variations in CKD burden and care between countries. The Euroguidelines in the CEE Network Group includes 19 countries and was initiated to improve the standard of care for HIV infection in the region. Information on kidney care in HIV-positive patients was collected through online surveys sent to all members of the Network Group. Almost all centres use regular screening for CKD in all HIV (+) patients. Basic diagnostic tests for kidney function are available in the majority of centres. The most commonly used method for eGFR calculation is the Cockcroft–Gault equation. Nephrology consultation is available in all centres. The median frequency of CKD was 5% and the main cause was comorbidity. Haemodialysis was the only modality of treatment for kidney failure available in all ECEE countries. Only 39% of centres declared that all treatment options are available for HIV+ patients. The most commonly indicated barrier in kidney care was patients’ noncompliance. In the CEE region, people living with HIV have full access to screening for kidney disease but there are important limitations in treatment. The choice of dialysis modality and access to kidney transplantation are limited. The main burden of kidney disease is unrelated to HIV infection. Patient care can be significantly improved by addressing noncompliance. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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15 pages, 7646 KiB

Open AccessArticle

Development of Public Health Core Outcome Sets for Systems-Wide Promotion of Early Life Health and Wellbeing

by Liina Mansukoski, Alexandra Albert, Yassaman Vafai, Chris Cartwright, Aamnah Rahman, Jessica Sheringham, Bridget Lockyer, Tiffany C. Yang, Philip Garnett and Maria Bryant

Int. J. Environ. Res. Public Health 2022, 19(13), 7947; https://doi.org/10.3390/ijerph19137947 - 28 Jun 2022

Cited by 1 | Viewed by 2321

Abstract

We aimed to develop a core outcome set (COS) for systems-wide public health interventions seeking to promote early life health and wellbeing. Research was embedded within the existing systems-based intervention research programme ‘ActEarly’, located in two different areas with high rates of child [...] Read more.

We aimed to develop a core outcome set (COS) for systems-wide public health interventions seeking to promote early life health and wellbeing. Research was embedded within the existing systems-based intervention research programme ‘ActEarly’, located in two different areas with high rates of child poverty, Bradford (West Yorkshire) and the Borough of Tower Hamlets (London). 168 potential outcomes were derived from five local government outcome frameworks, a community-led survey and an ActEarly consortium workshop. Two rounds of a Delphi study (Round 1: 37 participants; Round 2: 56 participants) reduced the number of outcomes to 64. 199 members of the community then took part in consultations across ActEarly sites, resulting in a final COS for systems-based public health interventions of 40 outcomes. These were grouped into the domains of: Development & education (N = 6); Physical health & health behaviors (N = 6); Mental health (N = 5); Social environment (N = 4); Physical environment (N = 7); and Poverty & inequality (N = 7). This process has led to a COS with outcomes prioritized from the perspectives of local communities. It provides the means to increase standardization and guide the selection of outcome measures for systems-based evaluation of public health programmes and supports evaluation of individual interventions within system change approaches. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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18 pages, 698 KiB

Open AccessArticle

Household Tenure and Its Associations with Multiple Long-Term Conditions amongst Working-Age Adults in East London: A Cross-Sectional Analysis Using Linked Primary Care and Local Government Records

by Elizabeth Ingram, Manuel Gomes, Sue Hogarth, Helen I. McDonald, David Osborn and Jessica Sheringham

Int. J. Environ. Res. Public Health 2022, 19(7), 4155; https://doi.org/10.3390/ijerph19074155 - 31 Mar 2022

Cited by 2 | Viewed by 1534

Abstract

Multiple long-term conditions (MLTCs) are influenced in extent and nature by social determinants of health. Few studies have explored associations between household tenure and different definitions of MLTCs. This study aimed to examine associations between household tenure and MLTCs amongst working-age adults (16 [...] Read more.

Multiple long-term conditions (MLTCs) are influenced in extent and nature by social determinants of health. Few studies have explored associations between household tenure and different definitions of MLTCs. This study aimed to examine associations between household tenure and MLTCs amongst working-age adults (16 to 64 years old, inclusive). This cross-sectional study used the 2019–2020 wave of an innovative dataset that links administrative data across health and local government for residents of a deprived borough in East London. Three definitions of MLTCs were operationalised based on a list of 38 conditions. Multilevel logistic regression models were built for each outcome and adjusted for a range of health and sociodemographic factors. Compared to working-age owner-occupiers, odds of basic MLTCs were 36% higher for social housing tenants and 19% lower for private renters (OR 1.36; 95% CI 1.30–1.42; p < 0.001 and OR 0.81, 95% CI 0.77–0.84, p < 0.001, respectively). Results were consistent across different definitions of MLTCs, although associations were stronger for social housing tenants with physical-mental MLTCs. This study finds strong evidence that household tenure is associated with MLTCs, emphasising the importance of understanding household-level determinants of health. Resources to prevent and tackle MLTCs among working-age adults could be differentially targeted by tenure type. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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20 pages, 386 KiB

Open AccessArticle

‘It All Kind of Links Really’: Young People’s Perspectives on the Relationship between Socioeconomic Circumstances and Health

by Hannah Fairbrother, Nicholas Woodrow, Mary Crowder, Eleanor Holding, Naomi Griffin, Vanessa Er, Caroline Dodd-Reynolds, Matt Egan, Karen Lock, Steph Scott, Carolyn Summerbell, Rachael McKeown, Emma Rigby, Phillippa Kyle and Elizabeth Goyder

Int. J. Environ. Res. Public Health 2022, 19(6), 3679; https://doi.org/10.3390/ijerph19063679 - 19 Mar 2022

Cited by 9 | Viewed by 3687

Abstract

Meaningful inclusion of young people’s perceptions and experiences of inequalities is argued to be critical in the development of pro-equity policies. Our study explored young people’s perceptions of what influences their opportunities to be healthy within their local area and their understandings of [...] Read more.

Meaningful inclusion of young people’s perceptions and experiences of inequalities is argued to be critical in the development of pro-equity policies. Our study explored young people’s perceptions of what influences their opportunities to be healthy within their local area and their understandings of health inequalities. Three interlinked qualitative focus group discussions, each lasting 90 to 100 min, with the same six groups of young people (n = 42) aged 13–21, were conducted between February and June 2021. Participants were recruited from six youth groups in areas of high deprivation across three geographical locations in England (South Yorkshire, the North East and London). Our study demonstrates that young people understand that health inequalities are generated by social determinants of health, which in turn influence behaviours. They highlight a complex interweaving of pathways between social determinants and health outcomes. However, they do not tend to think in terms of the social determinants and their distribution as resulting from the power and influence of those who create and benefit from health and social inequalities. An informed understanding of the causes of health inequalities, influenced by their own unique generational experiences, is important to help young people contribute to the development of pro-equity policies of the future. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

12 pages, 306 KiB

Open AccessArticle

COVID-19 at the Deep End: A Qualitative Interview Study of Primary Care Staff Working in the Most Deprived Areas of England during the COVID-19 Pandemic

by Claire Norman, Josephine M. Wildman and Sarah Sowden

Int. J. Environ. Res. Public Health 2021, 18(16), 8689; https://doi.org/10.3390/ijerph18168689 - 17 Aug 2021

Cited by 24 | Viewed by 4924

Abstract

COVID-19 is disproportionately impacting people in low-income communities. Primary care staff in deprived areas have unique insights into the challenges posed by the pandemic. This study explores the impact of COVID-19 from the perspective of primary care practitioners in the most deprived region [...] Read more.

COVID-19 is disproportionately impacting people in low-income communities. Primary care staff in deprived areas have unique insights into the challenges posed by the pandemic. This study explores the impact of COVID-19 from the perspective of primary care practitioners in the most deprived region of England. Deep End general practices serve communities in the region’s most socioeconomically disadvantaged areas. This study used semi-structured interviews followed by thematic analysis. In total, 15 participants were interviewed (11 General Practitioners (GPs), 2 social prescribing link workers and 2 nurses) with Deep End careers ranging from 3 months to 31 years. Participants were recruited via purposive and snowball sampling. Interviews were conducted using video-conferencing software. Data were analysed using thematic content analysis through a social determinants of health lens. Our results are categorised into four themes: the immediate health risks of COVID-19 on patients and practices; factors likely to exacerbate existing deprivation; the role of social prescribing during COVID-19; wider implications for remote consulting. We add qualitative understanding to existing quantitative data, showing patients from low socioeconomic backgrounds have worse outcomes from COVID-19. Deep End practitioners have valuable insights into the impact of social distancing restrictions and remote consulting on patients’ health and wellbeing. Their experiences should guide future pandemic response measures and any move to “digital first” primary care to ensure that existing inequalities are not worsened. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

Review

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18 pages, 774 KiB

Open AccessReview

A Scoping Review of Approaches to Improving Quality of Data Relating to Health Inequalities

by Sowmiya Moorthie, Vicki Peacey, Sian Evans, Veronica Phillips, Andres Roman-Urrestarazu, Carol Brayne and Louise Lafortune

Int. J. Environ. Res. Public Health 2022, 19(23), 15874; https://doi.org/10.3390/ijerph192315874 - 29 Nov 2022

Cited by 2 | Viewed by 2304

Abstract

Identifying and monitoring of health inequalities requires good-quality data. The aim of this work is to systematically review the evidence base on approaches taken within the healthcare context to improve the quality of data for the identification and monitoring of health inequalities and [...] Read more.

Identifying and monitoring of health inequalities requires good-quality data. The aim of this work is to systematically review the evidence base on approaches taken within the healthcare context to improve the quality of data for the identification and monitoring of health inequalities and describe the evidence base on the effectiveness of such approaches or recommendations. Peer-reviewed scientific journal publications, as well as grey literature, were included in this review if they described approaches and/or made recommendations to improve data quality relating to the identification and monitoring of health inequalities. A thematic analysis was undertaken of included papers to identify themes, and a narrative synthesis approach was used to summarise findings. Fifty-seven papers were included describing a variety of approaches. These approaches were grouped under four themes: policy and legislation, wider actions that enable implementation of policies, data collection instruments and systems, and methodological approaches. Our findings indicate that a variety of mechanisms can be used to improve the quality of data on health inequalities at different stages (prior to, during, and after data collection). These findings can inform us of actions that can be taken by those working in local health and care services on approaches to improving the quality of data on health inequalities. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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12 pages, 916 KiB

Open AccessReview

Inequity in Access and Delivery of Virtual Care Interventions: A Scoping Review

by Sabuj Kanti Mistry, Miranda Shaw, Freya Raffan, George Johnson, Katelyn Perren, Saito Shoko, Ben Harris-Roxas and Fiona Haigh

Int. J. Environ. Res. Public Health 2022, 19(15), 9411; https://doi.org/10.3390/ijerph19159411 - 1 Aug 2022

Cited by 18 | Viewed by 3620

Abstract

The objectives of this review were to map and summarize the existing evidence from a global perspective about inequity in access and delivery of virtual care interventions and to identify strategies that may be adopted by virtual care services to address these inequities. [...] Read more.

The objectives of this review were to map and summarize the existing evidence from a global perspective about inequity in access and delivery of virtual care interventions and to identify strategies that may be adopted by virtual care services to address these inequities. We searched MEDLINE, EMBASE, and CINAHL using both medical subject headings (MeSH) and free-text keywords for empirical studies exploring inequity in ambulatory services offered virtually. Forty-one studies were included, most of them cross-sectional in design. Included studies were extracted using a customized extraction tool, and descriptive analysis was performed. The review identified widespread differences in accessing and using virtual care interventions among cultural and ethnic minorities, older people, socioeconomically disadvantaged groups, people with limited digital and/or health literacy, and those with limited access to digital devices and good connectivity. Potential solutions addressing these barriers identified in the review included having digitally literate caregivers present during virtual care appointments, conducting virtual care appointments in culturally sensitive manner, and having a focus on enhancing patients’ digital literacy. We identified evidence-based practices for virtual care interventions to ensure equity in access and delivery for their virtual care patients. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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23 pages, 741 KiB

Open AccessReview

Ethnic Inequalities in Healthcare Use and Care Quality among People with Multiple Long-Term Health Conditions Living in the United Kingdom: A Systematic Review and Narrative Synthesis

by Brenda Hayanga, Mai Stafford and Laia Bécares

Int. J. Environ. Res. Public Health 2021, 18(23), 12599; https://doi.org/10.3390/ijerph182312599 - 29 Nov 2021

Cited by 8 | Viewed by 4310

Abstract

Indicative evidence suggests that the prevalence of multiple long-term conditions (i.e., conditions that cannot be cured but can be managed with medication and other treatments) may be higher in people from minoritised ethnic groups when compared to people from the White majority population. [...] Read more.

Indicative evidence suggests that the prevalence of multiple long-term conditions (i.e., conditions that cannot be cured but can be managed with medication and other treatments) may be higher in people from minoritised ethnic groups when compared to people from the White majority population. Some studies also suggest that there are ethnic inequalities in healthcare use and care quality among people with multiple long-term conditions (MLTCs). The aims of this review are to (1) identify and describe the literature that reports on ethnicity and healthcare use and care quality among people with MLTCs in the UK and (2) examine how healthcare use and/or care quality for people with MLTCs compares across ethnic groups. We registered the protocol on PROSPERO (CRD42020220702). We searched the following databases up to December 2020: ASSIA, Cochrane Library, EMBASE, MEDLINE, PsycINFO, PubMed, ScienceDirect, Scopus, and Web of Science core collection. Reference lists of key articles were also hand-searched for relevant studies. The outcomes of interest were patterns of healthcare use and care quality among people with MLTCs for at least one minoritised ethnic group, compared to the White majority population in the UK. Two reviewers, L.B. and B.H., screened and extracted data from a random sample of studies (10%). B.H. independently screened and extracted data from the remaining studies. Of the 718 studies identified, 14 were eligible for inclusion. There was evidence indicating ethnic inequalities in disease management and emergency admissions among people with MLTCs in the five studies that counted more than two long-term conditions. Compared to their White counterparts, Black and Asian children and young people had higher rates of emergency admissions. Black and South Asian people were found to have suboptimal disease management compared to other ethnic groups. The findings suggest that for some minoritised ethnic group people with MLTCs there may be inadequate initiatives for managing health conditions and/or a need for enhanced strategies to reduce ethnic inequalities in healthcare. However, the few studies identified focused on a variety of conditions across different domains of healthcare use, and many of these studies used broad ethnic group categories. As such, further research focusing on MLTCs and using expanded ethnic categories in data collection is needed. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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21 pages, 841 KiB

Open AccessReview

Outcomes and Critical Factors for Successful Implementation of Organizational Health Literacy Interventions: A Scoping Review

by Marise S. Kaper, Jane Sixsmith, Sijmen A. Reijneveld and Andrea F. de Winter

Int. J. Environ. Res. Public Health 2021, 18(22), 11906; https://doi.org/10.3390/ijerph182211906 - 12 Nov 2021

Cited by 13 | Viewed by 3441

Abstract

Organizational health literacy (OHL)-interventions can reduce inequality and demands in health care encountered by patients. However, an overview of their impact and critical factors for organization-wide implementation is lacking. The aim of this scoping review is to summarize the evidence on: (1) the [...] Read more.

Organizational health literacy (OHL)-interventions can reduce inequality and demands in health care encountered by patients. However, an overview of their impact and critical factors for organization-wide implementation is lacking. The aim of this scoping review is to summarize the evidence on: (1) the outcomes of OHL-interventions at patient, professional and organizational levels; and (2) the factors and strategies that affect implementation and outcomes of OHL-interventions. We reviewed empirical studies following the five-stage framework of Arksey and O’Malley. The databases Scopus, PubMed, PsychInfo and CINAHL were searched from 1 January 2010 to 31 December 2019, focusing on OHL-interventions using terms related to “health literacy”, “health care organization” and “intervention characteristics”. After a full-text review, we selected 24 descriptive stu-dies. Of these, 23 studies reported health literacy problems in relation to OHL-assessment tools. Nine out of thirteen studies reported that the use of interventions resulted in positive changes on OHL-domains regarding comprehensible communication, professionals’ competencies and practices, and strategic organizational changes. Organization-wide OHL-interventions resulted in some improvement of patient outcomes but evidence was scarce. Critical factors for organization-wide implementation of OHL-interventions were leadership support, top-down and bottom-up approaches, a change champion, and staff commitment. Organization-wide interventions lead to more positive change on OHL-domains, but evidence regarding OHL-outcomes needs strengthening. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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36 pages, 1043 KiB

Open AccessReview

Relationships between Child Development at School Entry and Adolescent Health—A Participatory Systematic Review

by Michelle Black, Amy Barnes, Mark Strong, Anna Brook, Anna Ray, Ben Holden, Clare Foster and David Taylor-Robinson

Int. J. Environ. Res. Public Health 2021, 18(21), 11613; https://doi.org/10.3390/ijerph182111613 - 4 Nov 2021

Cited by 5 | Viewed by 4067

Abstract

The relationship between child development and adolescent health, and how this may be modified by socio-economic conditions, is poorly understood. This limits cross-sector interventions to address adolescent health inequality. This review summarises evidence on the associations between child development at school starting age [...] Read more.

The relationship between child development and adolescent health, and how this may be modified by socio-economic conditions, is poorly understood. This limits cross-sector interventions to address adolescent health inequality. This review summarises evidence on the associations between child development at school starting age and subsequent health in adolescence and identifies factors affecting associations. We undertook a participatory systematic review, searching electronic databases (MEDLINE, PsycINFO, ASSIA and ERIC) for articles published between November 1990 and November 2020. Observational, intervention and review studies reporting a measure of child development and subsequent health outcomes, specifically weight and mental health, were included. Studies were individually and collectively assessed for quality using a comparative rating system of stronger, weaker, inconsistent or limited evidence. Associations between child development and adolescent health outcomes were assessed and reported by four domains of child development (socio-emotional, cognitive, language and communication, and physical development). A conceptual diagram, produced with stakeholders at the outset of the study, acted as a framework for narrative synthesis of factors that modify or mediate associations. Thirty-four studies were included. Analysis indicated stronger evidence of associations between measures of socio-emotional development and subsequent mental health and weight outcomes; in particular, positive associations between early externalising behaviours and later internalising and externalising, and negative associations between emotional wellbeing and later internalising and unhealthy weight. For all other domains of child development, although associations with subsequent health were positive, the evidence was either weaker, inconsistent or limited. There was limited evidence on factors that altered associations. Positive socio-emotional development at school starting age appears particularly important for subsequent mental health and weight in adolescence. More collaborative research across health and education is needed on other domains of development and on the mechanisms that link development and later health, and on how any relationship is modified by socio-economic context. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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Other

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12 pages, 336 KiB

Open AccessProtocol

Understanding the Lives of Aboriginal and Torres Strait Islander Women with Traumatic Brain Injury from Family Violence in Australia: A Qualitative Study Protocol

by Michelle S. Fitts, Jennifer Cullen, Gail Kingston, Yasmin Johnson, Elaine Wills and Karen Soldatic

Int. J. Environ. Res. Public Health 2023, 20(2), 1607; https://doi.org/10.3390/ijerph20021607 - 16 Jan 2023

Cited by 6 | Viewed by 2658

Abstract

Globally, there is growing recognition of the connection between violence and head injuries. At present, little qualitative research exists around how surviving this experience impacts everyday life for women, particularly Aboriginal and Torres Strait Islander women. This project aims to explore the nature [...] Read more.

Globally, there is growing recognition of the connection between violence and head injuries. At present, little qualitative research exists around how surviving this experience impacts everyday life for women, particularly Aboriginal and Torres Strait Islander women. This project aims to explore the nature and context of these women’s lives including living with the injury and to identify their needs and priorities during recovery. This 3-year exploratory project is being conducted across three Australian jurisdictions (Queensland, Northern Territory, and New South Wales). Qualitative interviews and discussion groups will be conducted with four key groups: Aboriginal and Torres Strait Islander women (aged 18+) who have acquired a head injury through family violence; their family members and/or carers; and hospital staff as well as government and non-government service providers who work with women who have experienced family violence. Nominated staff within community-based service providers will support the promotion of the project to women who have acquired a head injury through family violence. Hospital staff and service providers will be recruited using purposive and snowball sampling. Transcripts and fieldnotes will be analysed using narrative and descriptive phenomenological approaches. Reflection and research knowledge exchange and translation will be undertaken through service provider workshops. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

25 pages, 1326 KiB

Open AccessSystematic Review

Workplace Interventions to Reduce Occupational Stress for Older Workers: A Systematic Review

by Daniel Subel, David Blane and Jessica Sheringham

Int. J. Environ. Res. Public Health 2022, 19(15), 9202; https://doi.org/10.3390/ijerph19159202 - 27 Jul 2022

Cited by 3 | Viewed by 2662

Abstract

The working life of individuals is now longer because of increases to state pension age in the United Kingdom. Older workers may be at particular risk in the workplace, compared with younger workers. Successful workplace interventions to reduce occupational stress amongst older workers [...] Read more.

The working life of individuals is now longer because of increases to state pension age in the United Kingdom. Older workers may be at particular risk in the workplace, compared with younger workers. Successful workplace interventions to reduce occupational stress amongst older workers are essential, but little is known about their effectiveness. The aim is to evaluate current evidence of the effectiveness of interventions for reducing stress in older workers in non-healthcare settings. Four database searches were conducted. The search terms included synonyms of “intervention”, “workplace” and “occupational stress” to identify original studies published since 2011. Dual screening was conducted on the sample to identify studies which met the inclusion criteria. The RoB 2.0 tool for RCTs was used to assess the risk of bias. From 3708 papers retrieved, ten eligible papers were identified. Seven of the papers’ interventions were deemed effective in reducing workplace stress. The sample size for most studies was small, and the effectiveness of interventions were more likely to be reported when studies used self-report measures, rather than biological measures. This review indicates that workplace interventions might be effective for reducing stress in older workers. However, there remains an absence of high-quality evidence in this field. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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9 pages, 1113 KiB

Open AccessProtocol

A Protocol for a Mixed-Methods Process Evaluation of a Local Population Health Management System to Reduce Inequities in COVID-19 Vaccination Uptake

by Georgia Watson, Cassie Moore, Fiona Aspinal, Claudette Boa, Vusi Edeki, Andrew Hutchings, Rosalind Raine and Jessica Sheringham

Int. J. Environ. Res. Public Health 2022, 19(8), 4588; https://doi.org/10.3390/ijerph19084588 - 11 Apr 2022

Cited by 1 | Viewed by 1890

Abstract

Population health management is an emerging technique to link and analyse patient data across several organisations in order to identify population needs and plan care. It is increasingly used in England and has become more important as health policy has sought to drive [...] Read more.

Population health management is an emerging technique to link and analyse patient data across several organisations in order to identify population needs and plan care. It is increasingly used in England and has become more important as health policy has sought to drive greater integration across health and care organisations. This protocol describes a mixed-methods process evaluation of an innovative population health management system in North Central London, England, serving a population of 1.5 million. It focuses on how staff have used a specific tool within North Central London’s population health management system designed to reduce inequities in COVID-19 vaccination. The COVID-19 vaccination Dashboard was first deployed from December 2020 and enables staff in North London to view variations in the uptake of COVID-19 vaccinations by population characteristics in near real-time. The evaluation will combine interviews with clinical and non-clinical staff with staff usage analytics, including the volume and frequency of staff Dashboard views, to describe the tool’s reach and identify possible mechanisms of impact. While seeking to provide timely insights to optimise the design of population health management tools in North Central London, it also seeks to provide longer term transferable learning on methods to evaluate population health management systems. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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12 pages, 886 KiB

Open AccessProtocol

Which Non-Pharmaceutical Primary Care Interventions Reduce Inequalities in Common Mental Health Disorders? A Protocol for a Systematic Review of Quantitative and Qualitative Studies

by Louise Tanner, Sarah Sowden, Madeleine Still, Katie Thomson, Clare Bambra and Josephine Wildman

Int. J. Environ. Res. Public Health 2021, 18(24), 12978; https://doi.org/10.3390/ijerph182412978 - 9 Dec 2021

Cited by 4 | Viewed by 2883

Abstract

Common mental health disorders (CMDs) represent a major public health concern and are particularly prevalent in people experiencing disadvantage or marginalisation. Primary care is the first point of contact for people with CMDs. Pharmaceutical interventions, such as antidepressants, are commonly used in the [...] Read more.

Common mental health disorders (CMDs) represent a major public health concern and are particularly prevalent in people experiencing disadvantage or marginalisation. Primary care is the first point of contact for people with CMDs. Pharmaceutical interventions, such as antidepressants, are commonly used in the treatment of CMDs; however, there is concern that these treatments are over-prescribed and ineffective for treating mental distress related to social conditions. Non-pharmaceutical primary care interventions, such as psychological therapies and “social prescribing”, provide alternatives for CMDs. Little is known, however, about which such interventions reduce social inequalities in CMD-related outcomes, and which may, unintentionally, increase them. The aim of this protocol (PROSPERO registration number CRD42021281166) is to describe how we will undertake a systematic review to assess the effects of non-pharmaceutical primary care interventions on CMD-related outcomes and social inequalities. A systematic review of quantitative, qualitative and mixed-methods primary studies will be undertaken and reported according to the PRISMA-Equity guidance. The following databases will be searched: Assia, CINAHL, Embase, Medline, PsycInfo and Scopus. Retrieved records will be screened according to pre-defined eligibility criteria and synthesised using a narrative approach, with meta-analysis if feasible. The findings of this review will guide efforts to commission more equitable mental health services. Full article

(This article belongs to the Special Issue Inequalities in Health and Healthcare)

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