Feldman Sarah E, Lennox Laura, Dsouza Natasha, Armani Keivan
Imperial School of Public Health, Imperial College, London, United Kingdom.
Department of Primary Care and Public Health, NIHR ARC NWL, School of Public Health, Imperial College, London, United Kingdom.
PLoS One. 2024 Dec 31;19(12):e0312515. doi: 10.1371/journal.pone.0312515. eCollection 2024.
Health Inequalities refer to disparities in healthcare access and outcomes based on social determinants of health. These inequalities disproportionately affect Black, Asian, Minority Ethnic (BAME) groups, particularly pregnant women, who face increased risks and limited access to care due to low health literacy. Maternal mortality rates for BAME women can be up to four times higher than for white women. This scoping review aimed to assess the impact of health literacy on BAME pregnant women's health outcomes and experiences. Objectives included evaluating health literacy improvement tools, engaging stakeholders through co-production, and identifying persisting health inequalities.
A scoping review using the Arksey and O'Malley's framework was conducted. A specific search strategy was developed with a research librarian across three databases: EMBASE, Medline, and the Maternity and Infant Care (MIC) database. Patient, Public Involvement, and Engagement (PPIE) members were consulted from the outset to co-design the research question and to provide feedback on the findings.
Out of 1958 articles, 19 were included in the study, with 47% from the US and 21% from Denmark. Articles were published from EMBASE. 47% of the articles measured health literacy, while 53% implemented health literacy interventions, such as digital or community-based approaches.
All 19 articles highlighted lower health literacy in BAME women compared to other groups. Ten proposed recommendations, while others emphasized the impact of social determinants of health, collectively underscoring the need for more research on BAME health.
The review underscores the inadequate health literacy and patient experience of BAME pregnant women. It also highlights the potential of digital health interventions to improve health literacy and health outcomes. The findings call for increased research into health literacy tools for BAME pregnant women. Healthcare systems, including the NHS, should allocate resources to enhance digital health interventions and address health inequalities in BAME groups during pregnancy.
健康不平等是指基于健康的社会决定因素在医疗保健可及性和结果方面存在的差异。这些不平等对黑人、亚洲人、少数族裔（BAME）群体影响尤甚，特别是孕妇，由于健康素养较低，她们面临更高的风险且获得医疗服务的机会有限。BAME女性的孕产妇死亡率可能比白人女性高出四倍。本综述旨在评估健康素养对BAME孕妇健康结果和经历的影响。目标包括评估健康素养提升工具、通过共同生产让利益相关者参与进来以及识别持续存在的健康不平等现象。
采用阿克斯西和奥马利框架进行了一项综述。与一位研究馆员共同制定了一项具体的检索策略，检索了三个数据库：EMBASE、Medline和母婴护理（MIC）数据库。从一开始就咨询了患者、公众参与和参与（PPIE）成员，以共同设计研究问题并对研究结果提供反馈。
在1958篇文章中，19篇被纳入研究，其中47%来自美国，21%来自丹麦。文章发表于EMBASE。47%的文章测量了健康素养，而53%的文章实施了健康素养干预措施，如数字或基于社区的方法。
所有19篇文章都强调，与其他群体相比，BAME女性的健康素养较低。10篇文章提出了建议，而其他文章则强调了健康的社会决定因素的影响，共同强调了对BAME健康进行更多研究的必要性。
该综述强调了BAME孕妇健康素养不足和患者体验不佳的问题。它还突出了数字健康干预措施在提高健康素养和健康结果方面的潜力。研究结果呼吁对BAME孕妇的健康素养工具进行更多研究。包括英国国家医疗服务体系（NHS）在内的医疗系统应分配资源，以加强数字健康干预措施，并解决孕期BAME群体中的健康不平等问题。
