General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
BMJ Open. 2021 May 27;11(5):e042212. doi: 10.1136/bmjopen-2020-042212.
Combinations of unhealthy lifestyle factors are strongly associated with mortality, cardiovascular disease (CVD) and cancer. It is unclear how socioeconomic status (SES) affects those associations. Lower SES groups may be disproportionately vulnerable to the effects of unhealthy lifestyle factors compared with higher SES groups via interactions with other factors associated with low SES (eg, stress) or via accelerated biological ageing. This systematic review aims to synthesise studies that examine how SES moderates the association between lifestyle factor combinations and adverse health outcomes. Greater understanding of how lifestyle risk varies across socioeconomic spectra could reduce adverse health by (1) identifying novel high-risk groups or targets for future interventions and (2) informing research, policy and interventions that aim to support healthy lifestyles in socioeconomically deprived communities.
Three databases will be searched (PubMed, EMBASE, CINAHL) from inception to March 2020. Reference lists, citations and grey literature will also be searched. Inclusion criteria are: (1) prospective cohort studies; (2) investigations of two key exposures: (a) lifestyle factor combinations of at least three lifestyle factors (eg, smoking, physical activity and diet) and (b) SES (eg, income, education or poverty index); (3) an assessment of the impact of SES on the association between combinations of unhealthy lifestyle factors and health outcomes; (4) at least one outcome from-mortality (all cause, CVD and cancer), CVD or cancer incidence. Two independent reviewers will screen titles, abstracts and full texts of included studies. Data extraction will focus on cohort characteristics, exposures, direction and magnitude of SES effects, methods and quality (via Newcastle-Ottawa Scale). If appropriate, a meta-analysis, pooling the effects of SES, will be performed. Alternatively, a synthesis without meta-analysis will be conducted.
Ethical approval is not required. Results will be disseminated via peer-reviewed publication, professional networks, social media and conference presentations.
CRD42020172588.
不健康的生活方式因素组合与死亡率、心血管疾病 (CVD) 和癌症密切相关。社会经济地位 (SES) 如何影响这些关联尚不清楚。与 SES 较高的群体相比，SES 较低的群体可能更容易受到不健康生活方式因素的影响，这种影响可能是通过与 SES 较低相关的其他因素（如压力）的相互作用，也可能是通过加速生物学衰老。本系统评价旨在综合研究 SES 如何调节生活方式因素组合与不良健康结果之间的关系。更好地了解生活方式风险在社会经济光谱中的变化方式，可以通过以下方式减少不良健康：(1) 识别新的高风险群体或未来干预措施的目标，(2) 为旨在支持贫困社区健康生活方式的研究、政策和干预措施提供信息。
将从创建到 2020 年 3 月在三个数据库（PubMed、EMBASE、CINAHL）中进行搜索。还将搜索参考文献列表、引文和灰色文献。纳入标准是：(1) 前瞻性队列研究；(2) 两项关键暴露的调查：(a) 至少三种生活方式因素的生活方式因素组合（例如，吸烟、身体活动和饮食）和 (b) SES（例如，收入、教育或贫困指数）；(3) 评估 SES 对不健康生活方式因素组合与健康结果之间关联的影响；(4) 至少有一项结局为死亡率（全因、CVD 和癌症）、CVD 或癌症发病率。两名独立的审查员将筛选纳入研究的标题、摘要和全文。数据提取将侧重于队列特征、暴露情况、SES 效应的方向和程度、方法和质量（通过纽卡斯尔-渥太华量表）。如果合适，将进行荟萃分析，汇总 SES 效应。或者，将进行没有荟萃分析的综合。
不需要伦理批准。研究结果将通过同行评审出版物、专业网络、社交媒体和会议演讲进行传播。
PROSPERO 注册号：CRD42020172588。
