- Title
- Do health education initiatives assist socioeconomically disadvantaged populations? A systematic review and meta-analyses
- Creator
- Karran, E. L.; Grant, A. R.; Lee, H.; Kamper, S. J.; Williams, C. M.; Wiles, L. K.; Shala, R.; Poddar, C. V.; Astill, T.; Moseley, G. L.
- Relation
- NHMRC.APP1126767 http://purl.org/au-research/grants/nhmrc/1126767
- Relation
- BMC Public Health Vol. 23, Issue 1, no. 453
- Publisher Link
- http://dx.doi.org/10.1186/s12889-023-15329-z
- Publisher
- BioMed Central (BMC)
- Resource Type
- journal article
- Date
- 2023
- Description
- Background: Health education interventions are considered critical for the prevention and management of conditions of public health concern. Although the burden of these conditions is often greatest in socio-economically disadvantaged populations, the effectiveness of interventions that target these groups is unknown. We aimed to identify and synthesize evidence of the effectiveness of health-related educational interventions in adult disadvantaged populations. Methods: We pre-registered the study on Open Science Framework https://osf.io/ek5yg/. We searched Medline, Embase, Emcare, and the Cochrane Register from inception to 5/04/2022 to identify studies evaluating the effectiveness of health-related educational interventions delivered to adults in socio-economically disadvantaged populations. Our primary outcome was health related behaviour and our secondary outcome was a relevant biomarker. Two reviewers screened studies, extracted data and evaluated risk of bias. Our synthesis strategy involved random-effects meta-analyses and vote-counting. Results: We identified 8618 unique records, 96 met our criteria for inclusion – involving more than 57,000 participants from 22 countries. All studies had high or unclear risk of bias. For our primary outcome of behaviour, meta-analyses found a standardised mean effect of education on physical activity of 0.05 (95% confidence interval (CI) = -0.09–0.19), (5 studies, n = 1330) and on cancer screening of 0.29 (95% CI = 0.05–0.52), (5 studies, n = 2388). Considerable statistical heterogeneity was present. Sixty-seven of 81 studies with behavioural outcomes had point estimates favouring the intervention (83% (95% CI = 73%-90%), p < 0.001); 21 of 28 studies with biomarker outcomes showed benefit (75% (95%CI = 56%-88%), p = 0.002). When effectiveness was determined based on conclusions in the included studies, 47% of interventions were effective on behavioural outcomes, and 27% on biomarkers. Conclusions: Evidence does not demonstrate consistent, positive impacts of educational interventions on health behaviours or biomarkers in socio-economically disadvantaged populations. Continued investment in targeted approaches, coinciding with development of greater understanding of factors determining successful implementation and evaluation, are important to reduce inequalities in health.
- Subject
- health education; socio-economic disadvantage; systematic review; social determinants of health; health promotion; SDG 3; SDG 10; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1482482
- Identifier
- uon:50943
- Identifier
- ISSN:1471-2458
- Rights
- © 2023 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made availablein this article, unless otherwise stated in a credit line to the data.
- Language
- eng
- Full Text
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Goal 10: Reduced Inequalities
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