Spiers Gemma, McDermott Jane, Johnson Eugenie Evelyn, Kunonga Tafadzwa Patience, Hanratty Barbara
National Institute for Health and Care Research (NIHR) Policy Research Unit in Healthy Ageing, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK.
National Institute for Health and Care Research (NIHR) Policy Research Unit in Healthy Ageing, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
J Health Equity. 2025 Jul 14;2(1):2530969. doi: 10.1080/29944694.2025.2530969. eCollection 2025.
Systematic reviews that consider the equity of interventions are an important method. However, this approach can be limited when analyses of inequity for a specific intervention are rare. We aimed to develop and pilot Equity-Focused Workshops (EFWs), a method to supplement evidence synthesis approaches when primary studies do not report data about intervention equity. A workshop protocol was developed with methods experts, focusing on understanding equitable access to interventions between socioeconomic groups. We tested the protocol in three workshops with populations experiencing material disadvantage, using two hypothetical interventions. Data were collected about participants' views of the intervention, including acceptability and accessibility. Data were summarised and reviewed to appraise the utility of the method to judge intervention equity between socioeconomic groups. Seventeen participants discussed numerous reasons why they might find it difficult to engage with the interventions. These barriers were material, non-material, and offered insight into the ways in which interventions may exclude disadvantaged populations. Issues of stigma, professionals' understanding of material difficulties, and the costs incurred by participants using the interventions were highlighted. EFWs can offer preliminary insights into whether health interventions are likely to exclude populations experiencing material disadvantage. There is value in this approach to supplement evidence syntheses.
考虑干预措施公平性的系统评价是一种重要方法。然而,当针对特定干预措施的不公平性分析很少时,这种方法可能会受到限制。我们旨在开发并试点以公平为重点的研讨会(EFWs),这是一种在原始研究未报告干预措施公平性数据时补充证据综合方法的手段。与方法专家共同制定了一个研讨会方案,重点在于理解社会经济群体之间获得干预措施的公平情况。我们使用两种假设的干预措施,在针对面临物质困境人群的三个研讨会上对该方案进行了测试。收集了关于参与者对干预措施看法的数据,包括可接受性和可及性。对数据进行了汇总和审查,以评估该方法在判断社会经济群体之间干预措施公平性方面的效用。17名参与者讨论了他们可能难以参与干预措施的诸多原因。这些障碍包括物质方面的、非物质方面的,并深入揭示了干预措施可能排斥弱势群体的方式。突出了耻辱感问题、专业人员对物质困难的理解以及参与者使用干预措施所产生的成本。以公平为重点的研讨会可以对健康干预措施是否可能排斥面临物质困境的人群提供初步见解。这种补充证据综合的方法具有价值。