Kenny Meghan, Raos Rob, Ahmad Fatima, Gonzalez Andrea
Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada.
Geographic Information Systems Analyst, McMaster University, Hamilton, Canada.
Health Equity. 2024 Jun 27;8(1):419-425. doi: 10.1089/heq.2023.0143. eCollection 2024.
Understanding and addressing how an individual's social, political, economic, and cultural context affects their ability to achieve optimal health is essential to designing and implementing interventions. Before evaluating two parenting programs, in partnership with four children's mental health organizations, we used the Health Equity Impact Assessment tool (HEIA) to identify groups that may experience unintended health impacts, as well as generated mitigation strategies to address these impacts.
HEIA activities included a review of the published literature, a review of organizational documents, key informant interviews with staff ( = 12) and other related community service providers ( = 7), and a geographic information systems analysis. All sources of evidence were considered and analyzed using reflective thematic analysis. Summary reports were shared with all partners.
A range of groups were identified as at risk of experiencing unintended health impacts, including caregivers who are racialized, immigrants, Indigenous, living with mental health issues or addictions, dealing with intellectual challenges and/or low literacy levels, survivors of childhood trauma, single parent families, or families experiencing financial difficulties. Unintended health impacts were sorted into 6 main themes which fell under the overarching themes of accessibility of the programs and cultural appropriateness. Mitigation strategies as well as innovative strategies already being applied by participating organizations are discussed.
Although this HEIA focused on parenting programs, the findings address equity issues applicable to the provision of a wide spectrum of children's mental health services.
了解并应对个人的社会、政治、经济和文化背景如何影响其实现最佳健康的能力，对于设计和实施干预措施至关重要。在与四个儿童心理健康组织合作评估两项育儿项目之前，我们使用健康公平影响评估工具（HEIA）来确定可能受到意外健康影响的群体，并制定缓解策略以应对这些影响。
HEIA活动包括对已发表文献的审查、对组织文件的审查、对工作人员（n = 12）和其他相关社区服务提供者（n = 7）的关键信息访谈，以及地理信息系统分析。使用反思性主题分析考虑并分析所有证据来源。总结报告与所有合作伙伴共享。
一系列群体被确定为有受到意外健康影响的风险，包括被种族化的照顾者、移民、原住民、患有心理健康问题或成瘾问题的人、应对智力挑战和/或低识字水平的人、童年创伤幸存者、单亲家庭或经济困难的家庭。意外健康影响被归类为6个主要主题，这些主题属于项目可及性和文化适宜性这两个总体主题。讨论了缓解策略以及参与组织已经应用的创新策略。
尽管这项HEIA聚焦于育儿项目，但研究结果涉及适用于提供广泛儿童心理健康服务的公平问题。
