The PROGRESS-Plus framework for assessing the equity of systematic reviews of nursing interventions published in China

Article type
Authors
Shi C1, Yu X1, Zhang C1, Ban J1, Wu J1, Tian J1
1Evidence-Based Medicine Center of Lanzhou University, China
Abstract
Background: The Campbell and Cochrane Equity Methods Group has adopted the PROGRESS-Plus to identify dimensions across which health inequities may exist. Despite the demand for equity assessment by policy makers, these assessments are rare in systematic reviews (SRs).

Objectives: To assess the report quality on health equity of Chinese SRs in nursing and to what extent studies incorporate equity factors into the effectiveness analysis by PROGRESS-Plus.

Methods: An electronic literature search of all SRs/MAs of nursing interventions from inception to October 2011 was conducted using the Chinese Biomedical Literature Database and China National Knowledge Infrastructure, using the following text and keywords in combination both MeSH terms and text words, the search strategy was (meta analysis OR meta analyses OR systematic review* OR overview) AND nurs*. Two researchers independently screened and extracted the related data, disagreements were resolved by the third author. Baseline and outcome data reported in SRs were classified by PROGRESS-Plus framework (place of residence, ethnicity, occupation, gender, religion, education, social capital, socio-economic position i.e. SEP, all SEP, age, disability, sexual orientation and other vulnerable groups).

Results: Of 713 citations from database searching, 69 SRs were included. In individual study baseline data, 73.91% studies reported at least one PROGRESS-Plus factor, 73.91% SRs reported place of residence factor, 4.35% reported ethnicity disparities, 11.59% reported gender disparities, 1.45% reported education factor, 27.54% reported age disparities, all SRs didn’t report occupation, religion, social capital, socio-economic position, all SEP, disability, sexual orientation and other vulnerable groups. Only one study incorporated age disparities into the effectiveness analysis.

Conclusions: Chinese SRs in nursing seldom addressed health equity. place of residence, ethnicity, gender, education and age were only partially reported and these factors were excluded from effectiveness analysis. Hence, the future SRs should report health equity factors better and incorporate their disparities into the effectiveness analysis.