Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka.
Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka.
Soc Sci Med. 2015 Mar;128:95-104. doi: 10.1016/j.socscimed.2015.01.005. Epub 2015 Jan 8.
Social capital is a neglected determinant of health in low and middle income countries. To date, majority of evidence syntheses on social capital and health are based upon high income countries. We conducted this systematic review to identify the methods used to measure social capital in low and middle-income countries and to evaluate their relative strengths and weaknesses. An electronic search was conducted using Pubmed, Science citation index expanded, Social science citation index expanded, Web of knowledge, Cochrane, Trip, Google scholar and selected grey literature sources. We aimed to include all studies conducted in low and middle-income countries, published in English that have measured any aspect of social capital in relation to health in the study, from 1980 to January 2013. We extracted data using a data extraction form and performed narrative synthesis as the measures were heterogeneous. Of the 472 articles retrieved, 46 articles were selected for the review. The review included 32 studies from middle income countries and seven studies from low income countries. Seven were cross national studies. Most studies were descriptive cross sectional in design (n = 39). Only two randomized controlled trials were included. Among the studies conducted using primary data (n = 32), we identified18 purposely built tools that measured various dimensions of social capital. Validity (n = 11) and reliability (n = 8) of the tools were assessed only in very few studies. Cognitive constructs of social capital, namely trust, social cohesion and sense of belonging had a positive association towards measured health outcome in majority of the studies. While most studies measured social capital at individual/micro level (n = 32), group level measurements were obtained by aggregation of individual measures. As many tools originate in high income contexts, cultural adaptation, validation and reliability assessment is mandatory in adapting the tool to the study setting. Evidence on causality and assessing predictive validity is a problem due to the scarcity of prospective study designs. We recommend Harpham et al. s' Adapted Social Capital Assessment Tool (A-SCAT), Hurtado et al. s' six item tool and Elgar et al. s' World Value Survey Social Capital Scale for assessment of social capital in low and middle income countries.
社会资本是中低收入国家健康的一个被忽视的决定因素。迄今为止，大多数关于社会资本与健康的综合证据研究都是基于高收入国家的。我们进行了这项系统评价，以确定在中低收入国家测量社会资本的方法，并评估它们的相对优势和劣势。我们使用 Pubmed、科学引文索引扩展、社会科学引文索引扩展、Web of Knowledge、Cochrane、Trip、Google Scholar 和选定的灰色文献来源进行了电子搜索。我们的目标是包括所有在中低收入国家进行的、发表在英语期刊上的、与健康有关的任何方面的社会资本的研究，时间范围是 1980 年至 2013 年 1 月。我们使用数据提取表提取数据，并进行了叙述性综合，因为这些措施是异质的。在检索到的 472 篇文章中，有 46 篇被选入了综述。综述包括来自中等收入国家的 32 项研究和来自低收入国家的 7 项研究。其中有 7 项是跨国研究。大多数研究是描述性的横断面设计（n=39）。只有两项随机对照试验被纳入。在使用原始数据进行的研究中（n=32），我们确定了 18 种专门用于测量社会资本不同维度的工具。只有少数研究评估了工具的有效性（n=11）和可靠性（n=8）。社会资本的认知结构，即信任、社会凝聚力和归属感，在大多数研究中与所测量的健康结果呈正相关。虽然大多数研究都是在个体/微观层面上测量社会资本（n=32），但通过个体测量的聚合来获得群体层面的测量。由于许多工具源自高收入背景，因此在将工具适应当地研究环境时，必须进行文化适应、验证和可靠性评估。由于前瞻性研究设计的稀缺，因果关系的证据和预测有效性的评估是一个问题。我们建议使用 Harpham 等人的适应性社会资本评估工具（A-SCAT）、Hurtado 等人的六项目工具和 Elgar 等人的世界价值观调查社会资本量表来评估中低收入国家的社会资本。
