School of Pharmacy, University of Maryland Baltimore, Baltimore, Maryland, USA.
The PATIENTS Program, University of Maryland Baltimore, Baltimore, Maryland, USA.
Cancer Med. 2024 Sep;13(17):e70160. doi: 10.1002/cam4.70160.
To better understand the SDOH-health equity landscape within a community oncology setting to answer the research question, "Which SDOH can have the highest impact in community oncology to advance patient care equity and improve health outcomes?"
Arksey and O'Malley's scoping review framework was used to identify evidence related to SDOH and health equity in community oncology. The study was guided by the "10-Step Framework for Continuous Patient Engagement" and a Community Advisory Board to assure relevance to patients and community providers. Literature was retrieved from literary databases and oncology organizations' websites. Eligible studies included discussion of SDOH and health equity as outlined by the World Health Organization and Centers for Disease Control and Prevention, respectively, and involved community oncology/cancer care in outpatient settings. Studies were excluded if the SDOH-health equity relationship was not discussed.
The review resulted in 61 exploratory and 17 confirmatory "intervention" studies addressing the impact of SDOH on health equity in community oncology settings. The most frequently SDOH-health equity pairs identified were the SDOH categories, social inclusion and non-discrimination, income and social protection, and structural conflict, all paired with the health equity category, access to care/treatment. Confirmatory studies focused on income and social protection (SDOH) and access to care/treatment (health equity); the SDOH categories, social inclusion and non-discrimination and health/general literacy-patient, paired with the health equity category, and adherence/compliance.
Literature highlights the SDOH and health equity relationship within the realm of oncology. Most studies on SDOH/health inequities in the community oncology setting are exploratory. There is the need to shift from documentation of cancer inequities to implementing solutions.
为了更好地了解社区肿瘤学环境中的社会决定因素-健康公平状况，以回答研究问题“在社区肿瘤学中，哪些社会决定因素对提高患者护理公平性和改善健康结果的影响最大？”
采用阿克塞尔和奥马利的范围综述框架来确定与社区肿瘤学中的社会决定因素和健康公平相关的证据。该研究由“持续患者参与的 10 步框架”和社区咨询委员会指导，以确保与患者和社区提供者的相关性。文献从文献数据库和肿瘤学组织的网站中检索。符合条件的研究包括世界卫生组织和疾病控制与预防中心分别概述的社会决定因素和健康公平的讨论，并涉及社区肿瘤学/癌症护理在门诊环境中。如果没有讨论社会决定因素-健康公平关系，则排除研究。
综述结果包括 61 项探索性研究和 17 项确认性“干预”研究，这些研究探讨了社会决定因素对社区肿瘤学环境中健康公平的影响。确定的最频繁的社会决定因素-健康公平对是社会决定因素类别、社会包容和非歧视、收入和社会保护以及结构冲突，这些都与获得护理/治疗的健康公平类别配对。确认性研究集中在收入和社会保护（社会决定因素）和获得护理/治疗（健康公平）；社会决定因素类别，社会包容和非歧视以及健康/一般文化素养-患者，与健康公平类别，以及坚持/遵守配对。
文献强调了肿瘤学领域中的社会决定因素和健康公平关系。大多数关于社区肿瘤学中社会决定因素-健康不平等的研究都是探索性的。有必要从记录癌症不平等现象转变为实施解决方案。
