美国健康社会决定因素与长效可逆避孕方法使用情况的测量及操作化：一项系统综述
Measurement and Operationalization of the Social Determinants of Health and Long-Acting Reversible Contraception Use in the U.S.: A Systematic Scoping Review.
作者信息
Downey Margaret Mary B, Patteson Poehling Catherine, O'Connell Samantha
机构信息
Tulane University School of Social Work, New Orleans, Louisiana.
School of Social Work, College of Education and Human Sciences, the University of Southern Mississippi, Hattiesburg, Mississippi.
出版信息
AJPM Focus. 2022 Sep 12;1(2):100032. doi: 10.1016/j.focus.2022.100032. eCollection 2022 Dec.
INTRODUCTION
The objective of this review was to conduct a systematic evaluation of the measurement and operationalization of the social determinants of health in research on long-acting reversible contraception use in the U.S. To contribute to the ongoing refinement of the quality of social determinants of health and long-acting reversible contraception use research, this systematic scoping review examines how social determinants of health are measured and operationalized in studies that examine long-acting reversible contraception initiation and usage at the patient level.
METHODS
A detailed search of 5 electronic databases (PubMed, Embase, Web of Science, CINAHL, and PsycINFO) was conducted between December 2020 and January 2021 according to PRISMA guidelines. Determinants were assessed using the Dahlgren and Whitehead model. The protocol and data extraction template were developed a priori.
RESULTS
A total of 27 articles representing 26 studies were included in our study. A total of 12 studies were retrospective and cross-sectional in design; the remaining studies were a combination of designs. Healthcare services and health insurance were identified as the most frequently researched categories of determinants. There was wide variation in reported operationalization of race and ethnicity, limited engagement with sexuality, and uneven geographic representation across studies.
DISCUSSION
This systematic scoping review is the first, to the best of our knowledge, to focus on the measurement and operationalization of social determinants of health and on current long-acting reversible contraception use research. Future research on the impact of social determinants of health on long-acting reversible contraception use must explore the full range of factors shaping contraceptive decision making and use and focus on equity-informed data collection methods and reporting.
引言
本综述的目的是对美国长效可逆避孕使用研究中健康社会决定因素的测量和操作化进行系统评估。为了有助于不断提高健康社会决定因素和长效可逆避孕使用研究的质量，本系统综述考察了在患者层面研究长效可逆避孕的起始和使用时，健康社会决定因素是如何被测量和操作化的。
方法
根据PRISMA指南，于2020年12月至2021年1月对5个电子数据库（PubMed、Embase、Web of Science、CINAHL和PsycINFO）进行了详细检索。使用达尔格伦和怀特黑德模型评估决定因素。方案和数据提取模板是预先制定的。
结果
我们的研究共纳入了代表26项研究的27篇文章。共有12项研究为回顾性和横断面设计；其余研究为多种设计的组合。医疗服务和健康保险被确定为研究最频繁的决定因素类别。在种族和族裔的报告操作化方面存在很大差异，对性取向的涉及有限，且各研究的地理代表性不均衡。
讨论
据我们所知，本系统综述是首次聚焦于健康社会决定因素的测量和操作化以及当前长效可逆避孕使用研究。未来关于健康社会决定因素对长效可逆避孕使用影响的研究必须探索影响避孕决策和使用的所有因素，并关注基于公平的数据收集方法和报告。
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