Gallagher Katherine S, Stojanovski Kristefer, Ogarrio Kristen, Wright Laura, Fuster Melissa, Bell Caryn N
Department of Health Policy and Management, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA.
Department of Social, Behavioral and Population Sciences, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA.
Int J Equity Health. 2025 Mar 20;24(1):79. doi: 10.1186/s12939-025-02438-x.
Health behavior theories are scientific frameworks used to inform health behavior interventions to address health-related issues, given their use in understanding and modifying behavior change.
We aimed to assess how theory-informed health behavior interventions utilize health equity frameworks and methods.
Using the PRISMA guidelines, we conducted a scoping review of ten often taught health behavior theories found in health behavior textbooks. We identified 656 intervention papers, and after the title and abstract screening and full-text review, we extracted data from 26 studies. We conducted a thematic analysis to examine 1) the prevalence and quality of behavior interventions informed by health equity frameworks and 2) the application of health equity frameworks in the design and implementation of health behavior interventions.
Theory-informed health behavior interventions incorporating equity frameworks predominately focused on two strategies. First, by incorporating multilevel frameworks via the socioecological model to influence behavior at multiple levels of risk. The second was utilizing community-based participatory methods to integrate the community's cultural, social, and lived experiences into the interventions. Creating practices and policies rooted in lived experiences, such as recording meetings, having childcare, and processes for inclusion of feedback served to embed equity into the intervention design and implementation. Studies that were more dedicated to community involvement showed greater community acceptance and improved intervention outcomes.
Our scoping review identified that incorporating equity into health behavior interventions is essential yet not widely practiced and poorly understood regarding how to "bake in equity." Enhanced training on incorporating equity into theory-informed behavioral interventions could improve health behavior and health education training, research, and practice.
健康行为理论是科学框架，鉴于其在理解和改变行为变化方面的作用，被用于为解决健康相关问题的健康行为干预提供信息。
我们旨在评估基于理论的健康行为干预如何利用健康公平框架和方法。
我们遵循PRISMA指南，对健康行为教科书中经常讲授的十种健康行为理论进行了范围综述。我们识别出656篇干预论文，经过标题和摘要筛选以及全文审查后，从26项研究中提取了数据。我们进行了主题分析，以检查：1）由健康公平框架提供信息的行为干预的普遍性和质量；2）健康公平框架在健康行为干预设计和实施中的应用。
纳入公平框架的基于理论的健康行为干预主要集中在两种策略上。首先，通过社会生态模型纳入多层次框架，以在多个风险层面影响行为。其次是利用基于社区的参与性方法，将社区的文化、社会和生活经历融入干预措施。创建基于生活经历的实践和政策，如记录会议、提供儿童保育以及纳入反馈的流程，有助于将公平纳入干预设计和实施。更致力于社区参与的研究显示出更高的社区接受度和更好的干预效果。
我们的范围综述发现，将公平纳入健康行为干预至关重要，但在如何“融入公平”方面并未得到广泛实践且理解不足。加强关于将公平纳入基于理论的行为干预的培训，可以改善健康行为以及健康教育培训、研究和实践。
