Towards a theory-led meta-framework for considering socioeconomic health inequalities within systematic reviews



Maden, Michelle ORCID: 0000-0003-4419-6343, McMahon, Naoimh, Booth, Andrew, Dickson, Rumona ORCID: 0000-0003-1416-0913, Paisley, Suzy and Gabbay, Mark ORCID: 0000-0002-0126-8485
(2018) Towards a theory-led meta-framework for considering socioeconomic health inequalities within systematic reviews. Journal of Clinical Epidemiology, 104. 84 - 94.

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Abstract

Objective To develop a theory-led framework to inform reviewers’ understanding of what, how and why healthcare interventions may lead to differential effects across socio-economic groups. Study Design and Setting A meta-framework approach combined two theoretical perspectives (socio-economic health inequalities and complex interventions) into a single framework to inform socio-economic health inequality considerations in systematic reviews. Results Four theories relating to complexity within systematic reviews and 16 health inequalities intervention theories informed the development of a meta-framework. Factors relating to the type of intervention, implementation, context, participant response and mechanisms associated with differential effects across socio-economic groups were identified. The meta-framework can inform; reviewer discussions around how socio-economic status can moderate intervention effectiveness during question formulation, approaches to data extraction and help identify a priori analysis considerations. Conclusion The meta-framework offers a transparent, practical, theory-led approach to inform a programme theory for what, how and why interventions work for different socio-economic status groups in systematic reviews. It can enhance existing guidance on conducting systematic reviews that consider health inequalities, increase awareness of how socio-economic status can moderate intervention effectiveness and encourage a greater engagement with theory throughout the review process.

Item Type: Article
Uncontrolled Keywords: Systematic review, Equity, Methodology, Framework, Program theory
Depositing User: Symplectic Admin
Date Deposited: 15 Nov 2018 09:52
Last Modified: 16 Apr 2021 11:17
DOI: 10.1016/j.jclinepi.2018.08.008
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3028884