Article type
Year
Abstract
Background: Young people have been identified as a key group for health promotion and public health (HP&PH) interventions due to their vulnerability to suffering unequal adverse health outcomes particularly in the areas of accidental injury, mental and emotional health and sexual health. Research, presenting coherent descriptions and measurements of individuals and groups, is needed to address the complex interrelationships of health determinants such as social class, socio-economic position, personal characteristics, and environmental context. This broad field of health determinants has been summarised in the mnemonic PROGRESS, for Place of residence, Race/ethnicity, Occupation, Gender, Religion, Education, Socio-economic positions (SES) and Social Capital. Other determinants such as sexual orientation, disability and age are also implicated and contribute to a PROGRESS-Plus categorisation. There is a need to know what research is available to address health inequalities within HP&PH. This includes the coverage of observational studies of prevalence and associations, impact studies, process evaluations, and studies of the views and experiences of young people. This presentation presents the methods and findings of a systematic mapping exercise commissioned by the English Department of Health.
Objectives: The aim of the systematic map was to identify and describe the scope and nature of HP&PH research evidence relevant to health inequalities in young people aged 11 to 21 years. Further objectives were to inform decisions about areas which would benefit from a synthesis of research findings and to identify gaps in the primary research.
Methods: Two separate but complementary approaches were taken to identify sets of studies to populate the map. Records of HP&PH research with an explicit focus on inequalities were sought through comprehensive, sensitive searches of a range of health databases (set 1). Records of HP&PH intervention research dealing with inequalities were identified in the BiblioMap database of HP&PH research Set 2). Included studies had to be relevant to HP&PH published since 1995, and about 11-21 year olds with a relevant PROGRESS-Plus comparison group. Included studies were coded descriptively according to a tool developed to enable a description of health inequalities at a broad level. This included study design, topic, population, PROGRESS- Plus characteristics, outcomes and whether the study was relevant to a 'gaps' or 'gradients' analysis of inequalities.
Results: Of 4926 records, 94 relevant studies were identified and coded, 157 of these dealt with inequalities research (set 1), and 44 with intervention research (set 2), overlap between the two groups was small (N=7). Studies relevant to a gaps or gradients analysis were equally distributed in set 1.The most frequent gradients analyses were of ethnicity, SES, and place of residence. Gender comparisons were the most frequent analysis in studies suitable for analysing health gaps (N=98). The intervention research set was dominated by studies relevant to a gaps analysis (N=40). The most common comparison was gender (N=35), followed by race/ethnicity comparisons (N=11). Process evaluations and studies incorporating the views of young people were scarce. A substantial body of UK descriptive studies of health inequalities exists, however there is little evidence on the effectiveness of interventions to reduce inequalities. There was absence of data on ethnicity in the UK research compared with the near ubiquity of ethnicity analyses in the US studies. Identifying studies, which provide data on PROGRESS-Plus comparison groups, is problematic. This is partly due to poor reporting in abstracts and was particularly related to outcome evaluations.
Conclusions: Recommendations drawn from the findings include: the need for more high quality outcome evaluations comparing different socio-economic groups; and recommendations on the use and reporting of PROGRESS-Plus in future research. The map findings have been used to inform a systematic review of school-based mental health promotion.
Objectives: The aim of the systematic map was to identify and describe the scope and nature of HP&PH research evidence relevant to health inequalities in young people aged 11 to 21 years. Further objectives were to inform decisions about areas which would benefit from a synthesis of research findings and to identify gaps in the primary research.
Methods: Two separate but complementary approaches were taken to identify sets of studies to populate the map. Records of HP&PH research with an explicit focus on inequalities were sought through comprehensive, sensitive searches of a range of health databases (set 1). Records of HP&PH intervention research dealing with inequalities were identified in the BiblioMap database of HP&PH research Set 2). Included studies had to be relevant to HP&PH published since 1995, and about 11-21 year olds with a relevant PROGRESS-Plus comparison group. Included studies were coded descriptively according to a tool developed to enable a description of health inequalities at a broad level. This included study design, topic, population, PROGRESS- Plus characteristics, outcomes and whether the study was relevant to a 'gaps' or 'gradients' analysis of inequalities.
Results: Of 4926 records, 94 relevant studies were identified and coded, 157 of these dealt with inequalities research (set 1), and 44 with intervention research (set 2), overlap between the two groups was small (N=7). Studies relevant to a gaps or gradients analysis were equally distributed in set 1.The most frequent gradients analyses were of ethnicity, SES, and place of residence. Gender comparisons were the most frequent analysis in studies suitable for analysing health gaps (N=98). The intervention research set was dominated by studies relevant to a gaps analysis (N=40). The most common comparison was gender (N=35), followed by race/ethnicity comparisons (N=11). Process evaluations and studies incorporating the views of young people were scarce. A substantial body of UK descriptive studies of health inequalities exists, however there is little evidence on the effectiveness of interventions to reduce inequalities. There was absence of data on ethnicity in the UK research compared with the near ubiquity of ethnicity analyses in the US studies. Identifying studies, which provide data on PROGRESS-Plus comparison groups, is problematic. This is partly due to poor reporting in abstracts and was particularly related to outcome evaluations.
Conclusions: Recommendations drawn from the findings include: the need for more high quality outcome evaluations comparing different socio-economic groups; and recommendations on the use and reporting of PROGRESS-Plus in future research. The map findings have been used to inform a systematic review of school-based mental health promotion.