首页 > 最新文献

International Journal for Equity in Health最新文献

英文 中文
Correction: Refraining from seeking dental care among the Sámi in Sweden: a cross-sectional study. 更正:瑞典萨米人拒绝看牙医:一项横断面研究。
IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-14 DOI: 10.1186/s12939-024-02329-7
Negin Yekkalam, Christina Storm Mienna, Jon Petter Anders Stoor, Miguel San Sebastian
{"title":"Correction: Refraining from seeking dental care among the Sámi in Sweden: a cross-sectional study.","authors":"Negin Yekkalam, Christina Storm Mienna, Jon Petter Anders Stoor, Miguel San Sebastian","doi":"10.1186/s12939-024-02329-7","DOIUrl":"10.1186/s12939-024-02329-7","url":null,"abstract":"","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"23 1","pages":"238"},"PeriodicalIF":4.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Retraction Note: Bridge the gap caused by public health crises: medical humanization and communication skills build a psychological bond that satisfies patients. 撤稿说明:弥合公共卫生危机造成的鸿沟:医学人性化与沟通技巧建立起令患者满意的心理纽带。
IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-13 DOI: 10.1186/s12939-024-02316-y
Xiaoou Bu, Yao Wang, Yawen Du, Chuanglu Mu, Wenjun Zhang, Pei Wang
{"title":"Retraction Note: Bridge the gap caused by public health crises: medical humanization and communication skills build a psychological bond that satisfies patients.","authors":"Xiaoou Bu, Yao Wang, Yawen Du, Chuanglu Mu, Wenjun Zhang, Pei Wang","doi":"10.1186/s12939-024-02316-y","DOIUrl":"10.1186/s12939-024-02316-y","url":null,"abstract":"","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"23 1","pages":"236"},"PeriodicalIF":4.5,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adapting and pilot testing a tool to assess the accessibility of primary health facilities for people with disabilities in Luuka District, Uganda. 在乌干达卢卡区改编并试点测试一种工具,用于评估残疾人使用初级保健设施的无障碍性。
IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-13 DOI: 10.1186/s12939-024-02314-0
Islay Mactaggart, Andrew Sentoogo Ssemata, Abdmagidu Menya, Tracey Smythe, Sara Rotenberg, Sarah Marks, Femke Bannink Mbazzi, Hannah Kuper

Background: People with disabilities frequently experience barriers in seeking healthcare that lead to poorer health outcomes compared to people without disabilities. To overcome this, it is important to assess the accessibility of primary health facilities - broadly defined to include a disability-inclusive service provision - so as to document present status and identify areas for improvement. We aimed to identify, adapt and pilot test an appropriate tool to assess the accessibility of primary health facilities in Luuka District, Uganda.

Methods: We conducted a rapid literature review to identify appropriate tools, selecting the Disability Awareness Checklist (DAC) on account of its relative brevity and development as a sensitization and action tool. We undertook three rounds of adaptation, working together with youth researchers (aged 18-35) with disabilities who then underwent 2 days of training as DAC facilitators. The adapted tool comprised 71 indicators across four domains and 12 sub-domains. We also developed a structured feedback form for facilitators to complete with healthcare workers. We calculated median accessibility scores overall, per domain and per sub-domain, and categorised feedback form suggestions by type and presumed investment level. We pilot-tested the adapted tool in 5 primary health facilities in one sub-district of Luuka, nested within a pilot healthcare worker training on disability.

Results: The median overall facility accessibility score was 17.8% (range 12.3-28.8). Facility scores were highest in the universal design and accessibility domain (25.8%, 22.6-41.9), followed by reasonable accommodation (20.0%, 6.7-33.3). Median scores for capacity of facility staff (6.67%, 6.7-20.0), and linkages to other services were lower (0.0%, 0-25.0). Within the feedback forms, there were a median of 21 suggestions (range 14-26) per facility. Most commonly, these were categorised as minor structural changes (20% of suggestions), with a third categorised as no (2%) or low (33%) cost, and the majority (40%) medium cost.

Conclusions: Overall accessibility scores were low, with many opportunities for low-cost improvement at the facility level. We did not identify any issues with the implementation of the tool, suggesting few further adaptations are required for its future use in this setting.

背景:与非残疾人相比,残疾人在寻求医疗保健服务时经常会遇到障碍,导致他们的健康状况较差。为了克服这一问题,必须对初级卫生设施的无障碍性进行评估--广义上的无障碍性包括提供兼顾残疾人的服务--以便记录现状并确定需要改进的地方。我们的目标是确定、调整和试点测试一个合适的工具,以评估乌干达卢卡区初级卫生设施的可及性:我们进行了快速文献综述,以确定合适的工具,并选择了残疾意识检查表(DAC),因为它相对简洁,而且是作为宣传和行动工具开发的。我们与残疾青年研究人员(18-35 岁)合作,进行了三轮改编,然后对他们进行了为期两天的培训,使他们成为 DAC 的主持人。改编后的工具包括 4 个领域和 12 个子领域的 71 个指标。我们还开发了一份结构化反馈表,供促进者与医护人员填写。我们计算了总体、每个领域和每个子领域的可及性得分中位数,并按类型和假定投资水平对反馈表建议进行了分类。我们在卢卡(Luuka)一个分区的 5 家基层医疗机构试点测试了改编后的工具,并在试点医疗工作者中开展了残疾问题培训:结果:设施无障碍总体得分的中位数为 17.8%(范围为 12.3-28.8)。通用设计和无障碍领域的设施得分最高(25.8%,22.6-41.9 分),其次是合理便利(20.0%,6.7-33.3 分)。设施工作人员能力(6.67%,6.7-20.0 分)和与其他服务的联系方面的得分中位数较低(0.0%,0-25.0 分)。在反馈表中,每个机构提出的建议中位数为 21 条(14-26 条不等)。最常见的是,这些建议被归类为轻微的结构性改变(占建议的 20%),三分之一的建议被归类为无成本(2%)或低成本(33%),大多数建议(40%)为中等成本:无障碍设施的总体得分较低,在设施层面有许多低成本改进的机会。我们没有发现该工具在实施过程中存在任何问题,这表明今后在这种环境下使用该工具几乎不需要进一步调整。
{"title":"Adapting and pilot testing a tool to assess the accessibility of primary health facilities for people with disabilities in Luuka District, Uganda.","authors":"Islay Mactaggart, Andrew Sentoogo Ssemata, Abdmagidu Menya, Tracey Smythe, Sara Rotenberg, Sarah Marks, Femke Bannink Mbazzi, Hannah Kuper","doi":"10.1186/s12939-024-02314-0","DOIUrl":"10.1186/s12939-024-02314-0","url":null,"abstract":"<p><strong>Background: </strong>People with disabilities frequently experience barriers in seeking healthcare that lead to poorer health outcomes compared to people without disabilities. To overcome this, it is important to assess the accessibility of primary health facilities - broadly defined to include a disability-inclusive service provision - so as to document present status and identify areas for improvement. We aimed to identify, adapt and pilot test an appropriate tool to assess the accessibility of primary health facilities in Luuka District, Uganda.</p><p><strong>Methods: </strong>We conducted a rapid literature review to identify appropriate tools, selecting the Disability Awareness Checklist (DAC) on account of its relative brevity and development as a sensitization and action tool. We undertook three rounds of adaptation, working together with youth researchers (aged 18-35) with disabilities who then underwent 2 days of training as DAC facilitators. The adapted tool comprised 71 indicators across four domains and 12 sub-domains. We also developed a structured feedback form for facilitators to complete with healthcare workers. We calculated median accessibility scores overall, per domain and per sub-domain, and categorised feedback form suggestions by type and presumed investment level. We pilot-tested the adapted tool in 5 primary health facilities in one sub-district of Luuka, nested within a pilot healthcare worker training on disability.</p><p><strong>Results: </strong>The median overall facility accessibility score was 17.8% (range 12.3-28.8). Facility scores were highest in the universal design and accessibility domain (25.8%, 22.6-41.9), followed by reasonable accommodation (20.0%, 6.7-33.3). Median scores for capacity of facility staff (6.67%, 6.7-20.0), and linkages to other services were lower (0.0%, 0-25.0). Within the feedback forms, there were a median of 21 suggestions (range 14-26) per facility. Most commonly, these were categorised as minor structural changes (20% of suggestions), with a third categorised as no (2%) or low (33%) cost, and the majority (40%) medium cost.</p><p><strong>Conclusions: </strong>Overall accessibility scores were low, with many opportunities for low-cost improvement at the facility level. We did not identify any issues with the implementation of the tool, suggesting few further adaptations are required for its future use in this setting.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"23 1","pages":"237"},"PeriodicalIF":4.5,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mobile outreach clinics for improving health care services accessibility in vulnerable populations of the Diffa Region in Niger: a descriptive study. 流动外展诊所改善尼日尔迪法地区弱势群体获得医疗服务的机会:一项描述性研究。
IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-12 DOI: 10.1186/s12939-024-02322-0
Lawali Mahaman Rabiou, Batoure Oumarou, Diaw Mor, Maman Abdou, Camara Ibrahim, Jacques Lukenze Tamuzi, Patrick D M C Katoto, Charles S Wiysonge, Blanche-Philomene Melanga Anya, Tshikolasoni Casimir Manengu

Background: Niger is a large country with many distant locations that can be difficult to access because the Sahara Desert covers 80% of the country's land. In Niger, just 49% of residents have access to a health centre within 5 km of their house. Health care may be difficult to access in the Diffa region of Niger, as non-state armed groups strike on a regular basis and floods cause a high rate of vulnerability. This study looked at how mobile clinics can improve healthcare accessibility for vulnerable populations in the Diffa region.

Methods: This was a descriptive-comparative study conducted over the period from 15 August 2022 to 15 October 2022, using three months' mobile outreach clinic to improve health outcomes in five districts of the Diffa region, including Bosso, Diffa, Goudoumaria, Mainé Soroa, and N'guigmi.

Results: During the three months of mobile outreach clinic, 42,251 people were sensitized about mobile outreaches and 12,004 were treated. A total of 18,708 vaccine doses were delivered to children aged 0-11 months, with Maine Soroa, Goudoumaria, Bosso, Diffa, and N'guigmi districts accounting for 29.24%, 24.62%, 18.54%, 18.05%, and 9.5%, respectively. In the same line, Goudoumaria, Bosso, and Maine Soroa districts recorded relatively high antenatal clinic (ANC) attendance percentages of 27.85%, 25.62%, and 21.89%, respectively. Furthermore, mobile clinic outreach provided a variety of healthcare treatments, both curative and preventative. Mobile Clinic 2 increased vaccine dose received among children aged 0-11 months by 1.11% (95%CI: 0.15%-2.06%, P = 0.023) when compared to Mobile Clinic 1. In the same line, mobile clinic showed a statistically significant increase of ANC between the three clinical rotations (P = 0001), showing an increased ANC update over time.

Conclusion: This study found that mobile outreach clinic can play an important role in improving healthcare access for vulnerable populations in the Diffa region. However, well-designed, and frequent mobile clinic outreach should be planned and included in the country's public health policy.

背景:尼日尔幅员辽阔,撒哈拉沙漠覆盖了全国 80% 的土地,因此有许多偏远地区交通不便。在尼日尔,只有 49% 的居民能在离家 5 公里的范围内获得医疗中心的服务。在尼日尔的迪法地区,由于非国家武装组织经常发动袭击,洪水又造成了极高的易受伤害性,因此可能很难获得医疗服务。本研究探讨了流动诊所如何改善迪法地区弱势群体的医疗服务:这是一项描述性比较研究,从 2022 年 8 月 15 日至 2022 年 10 月 15 日,在迪法地区的博索、迪法、古杜马里亚、马内索罗阿和恩吉格米等五个县开展了为期三个月的流动外联诊所活动,以改善医疗成果:在为期三个月的流动外展诊所活动中,42 251 人了解了流动外展活动,12 004 人接受了治疗。共为 18 708 名 0-11 个月大的儿童接种了疫苗,其中缅因州索罗亚、古杜马里亚、博索、迪法和恩吉格米地区分别占 29.24%、24.62%、18.54%、18.05% 和 9.5%。同样,古杜马里亚、博索和缅因索罗阿地区的产前检查(ANC)就诊率相对较高,分别为 27.85%、25.62% 和 21.89%。此外,流动诊所外联活动还提供了各种医疗保健治疗,包括治疗和预防。与流动诊所 1 相比,流动诊所 2 使 0-11 个月儿童接种的疫苗剂量增加了 1.11%(95%CI:0.15%-2.06%,P = 0.023)。同样,流动诊所的新生儿破伤风率在三次临床轮转之间有显著的统计学增长(P = 0001),表明新生儿破伤风率随着时间的推移而增加:这项研究发现,流动外展诊所在改善迪法地区弱势群体的医疗服务方面可以发挥重要作用。然而,应该对流动诊所进行精心设计,并经常开展外展活动,并将其纳入国家公共卫生政策。
{"title":"Mobile outreach clinics for improving health care services accessibility in vulnerable populations of the Diffa Region in Niger: a descriptive study.","authors":"Lawali Mahaman Rabiou, Batoure Oumarou, Diaw Mor, Maman Abdou, Camara Ibrahim, Jacques Lukenze Tamuzi, Patrick D M C Katoto, Charles S Wiysonge, Blanche-Philomene Melanga Anya, Tshikolasoni Casimir Manengu","doi":"10.1186/s12939-024-02322-0","DOIUrl":"10.1186/s12939-024-02322-0","url":null,"abstract":"<p><strong>Background: </strong>Niger is a large country with many distant locations that can be difficult to access because the Sahara Desert covers 80% of the country's land. In Niger, just 49% of residents have access to a health centre within 5 km of their house. Health care may be difficult to access in the Diffa region of Niger, as non-state armed groups strike on a regular basis and floods cause a high rate of vulnerability. This study looked at how mobile clinics can improve healthcare accessibility for vulnerable populations in the Diffa region.</p><p><strong>Methods: </strong>This was a descriptive-comparative study conducted over the period from 15 August 2022 to 15 October 2022, using three months' mobile outreach clinic to improve health outcomes in five districts of the Diffa region, including Bosso, Diffa, Goudoumaria, Mainé Soroa, and N'guigmi.</p><p><strong>Results: </strong>During the three months of mobile outreach clinic, 42,251 people were sensitized about mobile outreaches and 12,004 were treated. A total of 18,708 vaccine doses were delivered to children aged 0-11 months, with Maine Soroa, Goudoumaria, Bosso, Diffa, and N'guigmi districts accounting for 29.24%, 24.62%, 18.54%, 18.05%, and 9.5%, respectively. In the same line, Goudoumaria, Bosso, and Maine Soroa districts recorded relatively high antenatal clinic (ANC) attendance percentages of 27.85%, 25.62%, and 21.89%, respectively. Furthermore, mobile clinic outreach provided a variety of healthcare treatments, both curative and preventative. Mobile Clinic 2 increased vaccine dose received among children aged 0-11 months by 1.11% (95%CI: 0.15%-2.06%, P = 0.023) when compared to Mobile Clinic 1. In the same line, mobile clinic showed a statistically significant increase of ANC between the three clinical rotations (P = 0001), showing an increased ANC update over time.</p><p><strong>Conclusion: </strong>This study found that mobile outreach clinic can play an important role in improving healthcare access for vulnerable populations in the Diffa region. However, well-designed, and frequent mobile clinic outreach should be planned and included in the country's public health policy.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"23 1","pages":"235"},"PeriodicalIF":4.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Strategies to optimise the health equity impact of digital pain self-reporting tools: a series of multi-stakeholder focus groups. 优化数字疼痛自我报告工具对健康公平影响的策略:一系列多方利益相关者焦点小组。
IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-11 DOI: 10.1186/s12939-024-02299-w
Syed Mustafa Ali, Amanda Gambin, Helen Chadwick, William G Dixon, Allison Crawford, Sabine N Van der Veer

Background: There are avoidable differences (i.e., inequities) in the prevalence and distribution of chronic pain across diverse populations, as well as in access to and outcomes of pain management services. Digital pain self-reporting tools have the potential to reduce or exacerbate these inequities. This study aimed to better understand how to optimise the health equity impact of digital pain self-reporting tools on people who are experiencing (or are at risk of) digital pain inequities.

Methods: This was a qualitative study, guided by the Health Equity Impact Assessment tool-digital health supplement (HEIA-DH). We conducted three scoping focus groups with multiple stakeholders to identify the potential impacts of digital pain self-reporting tools and strategies to manage these impacts. Each group focused on one priority group experiencing digital pain inequities, including older adults, ethnic minorities, and people living in socio-economically deprived areas. A fourth consensus focus group was organised to discuss and select impact management strategies. Focus groups were audio-recorded, transcribed verbatim, and analysed using a framework approach. We derived codes, grouped them under four pre-defined categories from the HEIA-DH, and illustrated them with participants' quotes.

Results: A total of fifteen people living with musculoskeletal pain conditions and thirteen professionals took part. Participants described how digital pain self-reports can have a positive health equity impact by better capturing pain fluctuations and enriching patient-provider communication, which in turn can enhance clinical decisions and self-management practices. Conversely, participants identified that incorrect interpretation of pain reports, lack of knowledge of pain terminologies, and digital (e.g., no access to technology) and social (e.g., gender stereotyping) exclusions may negatively impact on people's health equity. The participants identified 32 strategies, of which 20 were selected as being likely to mitigate these negative health equity impacts. Example strategies included, e.g., option to customise self-reporting tools in line with users' personal preferences, or resources to better explain how self-reported pain data will be used to build trust.

Conclusion: Linked to people's personal and social characteristics, there are equity-based considerations for developing accessible digital pain self-reporting tools, as well as resources and skills to enable the adoption and use of these tools among priority groups. Future research should focus on implementing these equity-based considerations or strategies identified by our study and monitoring their impact on the health equity of people living with chronic pain.

背景:在不同人群中,慢性疼痛的发病率和分布以及疼痛管理服务的获取和结果都存在可避免的差异(即不公平)。数字疼痛自我报告工具有可能减少或加剧这些不平等现象。本研究旨在更好地了解如何优化数字疼痛自我报告工具对正在经历(或有可能经历)数字疼痛不平等的人群的健康公平影响:这是一项定性研究,以健康公平影响评估工具--数字健康补充(HEIA-DH)为指导。我们与多个利益相关者开展了三个范围界定焦点小组,以确定数字疼痛自我报告工具的潜在影响以及管理这些影响的策略。每个小组重点关注一个经历数字疼痛不平等的优先群体,包括老年人、少数民族和社会经济贫困地区的居民。组织了第四个共识焦点小组,以讨论和选择影响管理策略。我们对焦点小组进行了录音、逐字记录,并采用框架法进行了分析。我们从 HEIA-DH 中提取代码,将其归入四个预定义类别,并用参与者的引语加以说明:共有 15 名肌肉骨骼疼痛患者和 13 名专业人员参与了此次研究。参与者描述了数字化疼痛自我报告如何通过更好地捕捉疼痛波动和丰富患者与医护人员之间的交流来对健康公平产生积极影响,进而加强临床决策和自我管理实践。相反,与会者指出,对疼痛报告的错误解读、缺乏疼痛术语知识、数字(如无法使用技术)和社会(如性别成见)排斥可能会对人们的健康公平产生负面影响。与会者提出了 32 项策略,其中 20 项被认为有可能减轻这些对健康公平的负面影响。策略范例包括:根据用户的个人偏好定制自我报告工具,或提供资源更好地解释如何使用自我报告的疼痛数据以建立信任:与人们的个人和社会特征相关联,在开发可访问的数字疼痛自我报告工具时需要考虑公平性问题,还需要提供资源和技能,以便优先群体能够采纳和使用这些工具。未来的研究应侧重于实施我们的研究确定的这些基于公平的考虑因素或策略,并监测它们对慢性疼痛患者健康公平的影响。
{"title":"Strategies to optimise the health equity impact of digital pain self-reporting tools: a series of multi-stakeholder focus groups.","authors":"Syed Mustafa Ali, Amanda Gambin, Helen Chadwick, William G Dixon, Allison Crawford, Sabine N Van der Veer","doi":"10.1186/s12939-024-02299-w","DOIUrl":"10.1186/s12939-024-02299-w","url":null,"abstract":"<p><strong>Background: </strong>There are avoidable differences (i.e., inequities) in the prevalence and distribution of chronic pain across diverse populations, as well as in access to and outcomes of pain management services. Digital pain self-reporting tools have the potential to reduce or exacerbate these inequities. This study aimed to better understand how to optimise the health equity impact of digital pain self-reporting tools on people who are experiencing (or are at risk of) digital pain inequities.</p><p><strong>Methods: </strong>This was a qualitative study, guided by the Health Equity Impact Assessment tool-digital health supplement (HEIA-DH). We conducted three scoping focus groups with multiple stakeholders to identify the potential impacts of digital pain self-reporting tools and strategies to manage these impacts. Each group focused on one priority group experiencing digital pain inequities, including older adults, ethnic minorities, and people living in socio-economically deprived areas. A fourth consensus focus group was organised to discuss and select impact management strategies. Focus groups were audio-recorded, transcribed verbatim, and analysed using a framework approach. We derived codes, grouped them under four pre-defined categories from the HEIA-DH, and illustrated them with participants' quotes.</p><p><strong>Results: </strong>A total of fifteen people living with musculoskeletal pain conditions and thirteen professionals took part. Participants described how digital pain self-reports can have a positive health equity impact by better capturing pain fluctuations and enriching patient-provider communication, which in turn can enhance clinical decisions and self-management practices. Conversely, participants identified that incorrect interpretation of pain reports, lack of knowledge of pain terminologies, and digital (e.g., no access to technology) and social (e.g., gender stereotyping) exclusions may negatively impact on people's health equity. The participants identified 32 strategies, of which 20 were selected as being likely to mitigate these negative health equity impacts. Example strategies included, e.g., option to customise self-reporting tools in line with users' personal preferences, or resources to better explain how self-reported pain data will be used to build trust.</p><p><strong>Conclusion: </strong>Linked to people's personal and social characteristics, there are equity-based considerations for developing accessible digital pain self-reporting tools, as well as resources and skills to enable the adoption and use of these tools among priority groups. Future research should focus on implementing these equity-based considerations or strategies identified by our study and monitoring their impact on the health equity of people living with chronic pain.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"23 1","pages":"233"},"PeriodicalIF":4.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An innovative gamification tool to enhance intercultural competence and self-efficacy among healthcare professionals caring for vulnerable migrants and refugees. 一种创新的游戏化工具,用于提高护理弱势移民和难民的医疗保健专业人员的跨文化能力和自我效能。
IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-11 DOI: 10.1186/s12939-024-02304-2
Ruben Moreno-Comellas, Adria Murias-Closas, Stella Evangelidou, Lloy Wylie, Núria Serre-Delcor

Background: The growing number of vulnerable migrants and refugees (VMRs) in the European Union presents challenges to healthcare systems, emphasizing the need for enhanced intercultural competence training for healthcare professionals. Educational escape rooms, using gamification-based principles, may offer an innovative solution to improve these competencies.

Objective: This pilot study evaluates the acceptability and preliminary effectiveness of an educational escape room aimed at improving intercultural competence, self-efficacy, and knowledge among healthcare students and professionals caring for VMRs.

Methods: A pre-post, single-group pilot study was conducted with 101 healthcare students and professionals, recruited through convenience sampling. Participants engaged in an educational escape room simulating a migratory crisis, designed to foster collaborative problem-solving under pressure. A newly validated questionnaire was administered before and after the intervention to measure changes in intercultural competence, self-efficacy, and knowledge. Paired t-tests were used to analyze pre-post differences, and thematic analysis explored participant feedback on the learning experience and the acceptability of the intervention.

Results: Significant improvements were observed in intercultural competence (d = 1.13, p < 0.001), self-efficacy (d = 0.38, p = 0.001), and knowledge (d = 1.19, p < 0.001). Participants reported high engagement, satisfaction, and an enhanced understanding of healthcare challenges related to VMRs. The escape room was deemed acceptable.

Conclusions: This pilot study provides evidence of the acceptability and effectiveness of an educational escape room in enhancing intercultural competence, self-efficacy, and knowledge. Further research with larger, more rigorous studies is recommended to confirm these findings and explore scalability.

背景:在欧盟,弱势移民和难民(VMRs)的数量不断增加,这给医疗保健系统带来了挑战,强调了加强医疗保健专业人员跨文化能力培训的必要性。采用游戏化原则的教育逃生室可为提高这些能力提供创新解决方案:本试验性研究评估了教育性逃脱室的可接受性和初步有效性,该教育性逃脱室旨在提高医护学生和护理 VMR 的专业人员的跨文化能力、自我效能和知识:方法:通过方便抽样的方式招募了 101 名医护学生和专业人员,对他们进行了一项前-后、单组试点研究。参与者参与了一个模拟移民危机的教育逃生室,旨在培养在压力下合作解决问题的能力。在干预前后进行了最新验证的问卷调查,以测量跨文化能力、自我效能和知识方面的变化。采用配对 t 检验分析干预前后的差异,并通过主题分析探讨参与者对学习体验和干预可接受性的反馈:结果:在跨文化能力方面观察到了显著的改善(d = 1.13,p 结论:这一试点研究为跨文化干预的可接受性提供了证据:这项试点研究证明了教育逃生室在提高跨文化能力、自我效能和知识方面的可接受性和有效性。建议进一步开展更大规模、更严格的研究,以确认这些发现并探索可扩展性。
{"title":"An innovative gamification tool to enhance intercultural competence and self-efficacy among healthcare professionals caring for vulnerable migrants and refugees.","authors":"Ruben Moreno-Comellas, Adria Murias-Closas, Stella Evangelidou, Lloy Wylie, Núria Serre-Delcor","doi":"10.1186/s12939-024-02304-2","DOIUrl":"10.1186/s12939-024-02304-2","url":null,"abstract":"<p><strong>Background: </strong>The growing number of vulnerable migrants and refugees (VMRs) in the European Union presents challenges to healthcare systems, emphasizing the need for enhanced intercultural competence training for healthcare professionals. Educational escape rooms, using gamification-based principles, may offer an innovative solution to improve these competencies.</p><p><strong>Objective: </strong>This pilot study evaluates the acceptability and preliminary effectiveness of an educational escape room aimed at improving intercultural competence, self-efficacy, and knowledge among healthcare students and professionals caring for VMRs.</p><p><strong>Methods: </strong>A pre-post, single-group pilot study was conducted with 101 healthcare students and professionals, recruited through convenience sampling. Participants engaged in an educational escape room simulating a migratory crisis, designed to foster collaborative problem-solving under pressure. A newly validated questionnaire was administered before and after the intervention to measure changes in intercultural competence, self-efficacy, and knowledge. Paired t-tests were used to analyze pre-post differences, and thematic analysis explored participant feedback on the learning experience and the acceptability of the intervention.</p><p><strong>Results: </strong>Significant improvements were observed in intercultural competence (d = 1.13, p < 0.001), self-efficacy (d = 0.38, p = 0.001), and knowledge (d = 1.19, p < 0.001). Participants reported high engagement, satisfaction, and an enhanced understanding of healthcare challenges related to VMRs. The escape room was deemed acceptable.</p><p><strong>Conclusions: </strong>This pilot study provides evidence of the acceptability and effectiveness of an educational escape room in enhancing intercultural competence, self-efficacy, and knowledge. Further research with larger, more rigorous studies is recommended to confirm these findings and explore scalability.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"23 1","pages":"234"},"PeriodicalIF":4.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Economic evaluations of eye care services for Indigenous populations in high-income countries: a scoping review. 高收入国家土著居民眼保健服务的经济评估:范围界定审查。
IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-09 DOI: 10.1186/s12939-024-02307-z
Marcel Maziyar Nejatian, Andrei Sincari, Khyber Alam, Ian Li, Hessom Razavi

Background: Indigenous people in high-income countries have worse eye health outcomes when compared to non-Indigenous people, contributing to ongoing socioeconomic disadvantage. Although services have been designed to address these disparities, it is unclear if they have undergone comprehensive economic evaluation. Our scoping review aimed to identify the number, type, quality, and main findings of such evaluations.

Methods: MEDLINE, Embase, Web of Science, Cochrane Library Database, the National Health Service Economic Evaluation Database, EconLit, and relevant grey literature were systematically searched as per our pre-registered protocol. All economic evaluations of real or model services designed to meet the eye care needs of Indigenous populations in high-income countries were included. Two reviewers independently screened studies, extracted data, and assessed quality using the Quality of Health Economic Studies instrument.

Results: We identified 20 studies evaluating services for Indigenous populations in Australia (n = 9), Canada (n = 7), and the United States of America (n = 4). Common services included diabetic retinopathy (DR) screening through fundus photographs acquired in local primary health care clinics (n = 7) or by mobile teams (n = 6), and general eye care through teleophthalmology (n = 2), outreach ophthalmology (n = 2) or an Indigenous health care clinic optometrist (n = 1). These services were economically favourable in 85% of comparisons with conventional alternatives, mainly through reduced costs of travel, in-person consults, and vision loss. Only four studies assessed the benefits of increased patient uptake. Only five included patient evaluations, but none integrated these into their quantitative analysis. Methodological issues included no stated economic perspective (n = 10), no sensitivity analysis (n = 12), no discounting (n = 9), inappropriate measurement of costs (n = 13) or outcomes (n = 5), and unjustified assumptions (n = 15).

Conclusion: Several Indigenous eye care services are cost-effective, particularly remote DR screening. Other services are promising but require evaluation, with attention to avoid common methodological pitfalls. Well-designed evaluations can guide the allocation of scarce resources to services with demonstrated effectiveness and sustainability.

Trial registration: Our scoping review protocol was pre-registered (Open Science Framework DOI: https://doi.org/10.17605/OSF.IO/YQKWN ).

背景:与非土著人相比,高收入国家的土著人的眼健康状况更差,这也是他们在社会经济方面一直处于不利地位的原因之一。尽管已经设计了一些服务来解决这些差异,但尚不清楚这些服务是否经过了全面的经济评估。我们的范围综述旨在确定此类评估的数量、类型、质量和主要结论:按照我们预先登记的协议,系统检索了 MEDLINE、Embase、Web of Science、Cochrane 图书馆数据库、国家卫生服务经济评估数据库、EconLit 以及相关灰色文献。所有旨在满足高收入国家土著居民眼保健需求的实际或示范服务的经济评估均被纳入其中。两名审稿人独立筛选研究、提取数据,并使用卫生经济研究质量工具进行质量评估:我们确定了 20 项评估澳大利亚(9 项)、加拿大(7 项)和美国(4 项)土著居民服务的研究。常见的服务包括通过当地初级医疗诊所(n = 7)或流动医疗队(n = 6)获得的眼底照片进行糖尿病视网膜病变(DR)筛查,以及通过远程眼科(n = 2)、外联眼科(n = 2)或土著医疗诊所验光师(n = 1)进行的普通眼科护理。在与传统替代方法的比较中,85%的研究发现这些服务在经济上是有利的,主要是通过降低旅行、亲自咨询和视力损失的成本。只有四项研究评估了患者使用率提高的益处。只有五项研究对患者进行了评估,但没有一项研究将这些评估纳入定量分析。研究方法上的问题包括未说明经济学观点(10 项)、未进行敏感性分析(12 项)、未进行贴现(9 项)、对成本(13 项)或结果(5 项)的衡量不当以及假设不合理(15 项):结论:一些本土眼科保健服务具有成本效益,尤其是远程 DR 筛查。其他服务很有前景,但需要进行评估,并注意避免常见的方法陷阱。精心设计的评估可指导将稀缺资源分配给那些已证明有效且可持续的服务:我们的范围界定综述方案已预先注册(开放科学框架 DOI: https://doi.org/10.17605/OSF.IO/YQKWN )。
{"title":"Economic evaluations of eye care services for Indigenous populations in high-income countries: a scoping review.","authors":"Marcel Maziyar Nejatian, Andrei Sincari, Khyber Alam, Ian Li, Hessom Razavi","doi":"10.1186/s12939-024-02307-z","DOIUrl":"10.1186/s12939-024-02307-z","url":null,"abstract":"<p><strong>Background: </strong>Indigenous people in high-income countries have worse eye health outcomes when compared to non-Indigenous people, contributing to ongoing socioeconomic disadvantage. Although services have been designed to address these disparities, it is unclear if they have undergone comprehensive economic evaluation. Our scoping review aimed to identify the number, type, quality, and main findings of such evaluations.</p><p><strong>Methods: </strong>MEDLINE, Embase, Web of Science, Cochrane Library Database, the National Health Service Economic Evaluation Database, EconLit, and relevant grey literature were systematically searched as per our pre-registered protocol. All economic evaluations of real or model services designed to meet the eye care needs of Indigenous populations in high-income countries were included. Two reviewers independently screened studies, extracted data, and assessed quality using the Quality of Health Economic Studies instrument.</p><p><strong>Results: </strong>We identified 20 studies evaluating services for Indigenous populations in Australia (n = 9), Canada (n = 7), and the United States of America (n = 4). Common services included diabetic retinopathy (DR) screening through fundus photographs acquired in local primary health care clinics (n = 7) or by mobile teams (n = 6), and general eye care through teleophthalmology (n = 2), outreach ophthalmology (n = 2) or an Indigenous health care clinic optometrist (n = 1). These services were economically favourable in 85% of comparisons with conventional alternatives, mainly through reduced costs of travel, in-person consults, and vision loss. Only four studies assessed the benefits of increased patient uptake. Only five included patient evaluations, but none integrated these into their quantitative analysis. Methodological issues included no stated economic perspective (n = 10), no sensitivity analysis (n = 12), no discounting (n = 9), inappropriate measurement of costs (n = 13) or outcomes (n = 5), and unjustified assumptions (n = 15).</p><p><strong>Conclusion: </strong>Several Indigenous eye care services are cost-effective, particularly remote DR screening. Other services are promising but require evaluation, with attention to avoid common methodological pitfalls. Well-designed evaluations can guide the allocation of scarce resources to services with demonstrated effectiveness and sustainability.</p><p><strong>Trial registration: </strong>Our scoping review protocol was pre-registered (Open Science Framework DOI: https://doi.org/10.17605/OSF.IO/YQKWN ).</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"23 1","pages":"232"},"PeriodicalIF":4.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Precision medicine and Friedreich ataxia: promoting equity, beneficence, and informed consent for novel gene therapies. 精准医疗与弗里德里希共济失调:促进公平、惠益和新型基因疗法的知情同意。
IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-08 DOI: 10.1186/s12939-024-02318-w
Faith A A Kwa, Evie Kendal

Friedreich Ataxia (FA) is an incurable neurodegenerative disease with systemic consequences affecting vital organs including those of the central and peripheral nervous systems. This article will use FA as an example to explore some of the practical and ethical issues emerging in precision medicine for rare diseases. It will first describe the existing management strategies available for FA patients, before considering the potential impact of gene therapy trials on the prevention and treatment of disease symptoms. Finally, ethical considerations will be discussed, including equity of access and managing resource allocation dilemmas; balancing benefits, burdens and harms; and gaining informed consent for novel treatments.

弗里德里希共济失调症(Friedreich Ataxia,FA)是一种无法治愈的神经退行性疾病,会对包括中枢神经系统和周围神经系统在内的重要器官造成全身性影响。本文将以弗里德雷共济失调为例,探讨罕见病精准医疗中出现的一些实际和伦理问题。文章将首先介绍 FA 患者现有的治疗策略,然后考虑基因治疗试验对预防和治疗疾病症状的潜在影响。最后,还将讨论伦理方面的考虑因素,包括公平获取和管理资源分配困境;平衡益处、负担和危害;以及获得对新型疗法的知情同意。
{"title":"Precision medicine and Friedreich ataxia: promoting equity, beneficence, and informed consent for novel gene therapies.","authors":"Faith A A Kwa, Evie Kendal","doi":"10.1186/s12939-024-02318-w","DOIUrl":"10.1186/s12939-024-02318-w","url":null,"abstract":"<p><p>Friedreich Ataxia (FA) is an incurable neurodegenerative disease with systemic consequences affecting vital organs including those of the central and peripheral nervous systems. This article will use FA as an example to explore some of the practical and ethical issues emerging in precision medicine for rare diseases. It will first describe the existing management strategies available for FA patients, before considering the potential impact of gene therapy trials on the prevention and treatment of disease symptoms. Finally, ethical considerations will be discussed, including equity of access and managing resource allocation dilemmas; balancing benefits, burdens and harms; and gaining informed consent for novel treatments.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"23 1","pages":"230"},"PeriodicalIF":4.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11545357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lived experiences of palliative care physicians on the impacts of language and cultural discordance on end-of-life care across Ontario, Canada: a qualitative study using the intersectionality-based policy framework. 加拿大安大略省姑息关怀医生关于语言和文化差异对生命末期关怀的影响的生活经验:一项采用基于交叉性政策框架的定性研究。
IF 5.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-08 DOI: 10.1186/s12939-024-02312-2
Seung Heyck Lee, Maya Gibb, Sathya Karunananthan, Margaret Cody, Peter Tanuseputro, Claire E Kendall, Daniel Bédard, Stephanie Collin, Krystal Kehoe MacLeod

Background: Language and cultural discordance refer to when a physician and patient do not share the same language or culture. This can create barriers to providing high-quality care at the end-of-life (EoL). This study explores the intersections of language, culture, geography, and care model in EoL care from the perspectives of palliative care physicians.

Methods: In this exploratory-descriptive qualitative study, semi-structured interviews (1-h) were conducted virtually between July and November 2023. We interviewed 16 family physicians with experience providing linguistic and/or culturally discordant palliative/EoL care in various urban, suburban, and rural regions of Ontario, who practiced at community and hospital outpatient clinics, home-based care, or long-term care homes. We used reflexive thematic analysis to identify themes across the interviews guided by the intersectionality theoretical framework.

Results: We identified three themes 1) Visible barriers to care access due to the inability to communicate accurate information and insufficient time spent during appointments with patients; 2) Invisible barriers to care access, shaped by the Eurocentric approach to palliative care and physicians' lack of awareness on cultural discordance; 3) Workplace supports that currently exist and interventions that physicians would like to see. Community physicians following fee-for-service models were less likely to have access to professional interpreter services. Physicians in long-term care emphasized resource limitations to providing culturally-appropriate care environments.

Conclusion: Cultural discordance required awareness of personal biases, while language discordance hindered basic communication. These findings will be useful in informing clinical practice guidelines and mobilizing policy-level change to improve palliative/EoL care for patients from linguistic and cultural minority groups.

背景:语言和文化差异是指医生和患者的语言或文化背景不同。这会对提供高质量的临终关怀(EoL)造成障碍。本研究从姑息关怀医生的角度出发,探讨了临终关怀中语言、文化、地理和关怀模式的交叉问题:在这项探索性-描述性定性研究中,我们在 2023 年 7 月至 11 月期间通过虚拟方式进行了半结构化访谈(1 小时)。我们采访了 16 名家庭医生,他们在安大略省的城市、郊区和农村地区提供语言和/或文化不和谐的姑息治疗/EoL 护理,他们在社区和医院门诊诊所、家庭护理或长期护理之家执业。在交叉性理论框架的指导下,我们采用反思性主题分析法确定了整个访谈的主题:我们确定了三个主题:1)由于无法传达准确的信息以及与患者预约的时间不足,导致患者在获取医疗服务时遇到明显的障碍;2)由于以欧洲为中心的姑息关怀方法以及医生缺乏对文化差异的认识,导致患者在获取医疗服务时遇到隐形的障碍;3)目前存在的工作场所支持以及医生希望看到的干预措施。采用收费服务模式的社区医生不太可能获得专业口译服务。长期护理领域的医生强调,在提供与文化相适应的护理环境方面存在资源限制:文化差异需要意识到个人偏见,而语言差异则阻碍了基本的沟通。这些发现将有助于为临床实践指南提供信息,并推动政策层面的变革,以改善语言和文化少数群体患者的姑息治疗/长者照护。
{"title":"Lived experiences of palliative care physicians on the impacts of language and cultural discordance on end-of-life care across Ontario, Canada: a qualitative study using the intersectionality-based policy framework.","authors":"Seung Heyck Lee, Maya Gibb, Sathya Karunananthan, Margaret Cody, Peter Tanuseputro, Claire E Kendall, Daniel Bédard, Stephanie Collin, Krystal Kehoe MacLeod","doi":"10.1186/s12939-024-02312-2","DOIUrl":"10.1186/s12939-024-02312-2","url":null,"abstract":"<p><strong>Background: </strong>Language and cultural discordance refer to when a physician and patient do not share the same language or culture. This can create barriers to providing high-quality care at the end-of-life (EoL). This study explores the intersections of language, culture, geography, and care model in EoL care from the perspectives of palliative care physicians.</p><p><strong>Methods: </strong>In this exploratory-descriptive qualitative study, semi-structured interviews (1-h) were conducted virtually between July and November 2023. We interviewed 16 family physicians with experience providing linguistic and/or culturally discordant palliative/EoL care in various urban, suburban, and rural regions of Ontario, who practiced at community and hospital outpatient clinics, home-based care, or long-term care homes. We used reflexive thematic analysis to identify themes across the interviews guided by the intersectionality theoretical framework.</p><p><strong>Results: </strong>We identified three themes 1) Visible barriers to care access due to the inability to communicate accurate information and insufficient time spent during appointments with patients; 2) Invisible barriers to care access, shaped by the Eurocentric approach to palliative care and physicians' lack of awareness on cultural discordance; 3) Workplace supports that currently exist and interventions that physicians would like to see. Community physicians following fee-for-service models were less likely to have access to professional interpreter services. Physicians in long-term care emphasized resource limitations to providing culturally-appropriate care environments.</p><p><strong>Conclusion: </strong>Cultural discordance required awareness of personal biases, while language discordance hindered basic communication. These findings will be useful in informing clinical practice guidelines and mobilizing policy-level change to improve palliative/EoL care for patients from linguistic and cultural minority groups.</p>","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"23 1","pages":"229"},"PeriodicalIF":5.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trends and inequalities in anaemia prevalence among children aged 6-59 months in Ghana, 2003-2022. 2003-2022 年加纳 6-59 个月儿童贫血患病率的趋势和不平等现象。
IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-08 DOI: 10.1186/s12939-024-02315-z
Augustus Osborne, Khadijat Adeleye, Camilla Bangura, Florence Gyembuzie Wongnaah
<p><strong>Background: </strong>Anaemia, characterised by a deficiency in red blood cells or haemoglobin, is a public health issue in Ghana, particularly among children. The prevalence of anaemia in this age group has been a longstanding concern due to its adverse effects on cognitive development, physical growth, and well-being. This study examined the trends and inequalities in anaemia prevalence among children aged 6-59 months in Ghana between 2003 and 2022.</p><p><strong>Methods: </strong>Data from the Ghana Demographic Health Survey conducted between 2003 and 2022 was used to analyse the prevalence of anaemia in children aged 6-59 months. The World Health Organization's Health Equity Assessment Toolkit software calculated several inequality measures, including difference, ratio, population-attributable risk, and population-attributable percentage. An inequality assessment was performed for six stratifiers: child's age, mother's economic status, maternal educational level, place of residence, child's sex, and sub-national region.</p><p><strong>Results: </strong>Anaemia prevalence among children aged 6-59 months in Ghana declined from 76.1% in 2003 to 48.9% by 2022. The results revealed an age-related inequality in anaemia prevalence among children in Ghana, with younger age group ( 6-11 months) consistently showing higher rates. The age-related inequality Difference was 24.6 percentage points in 2022, indicating that age is crucial to understanding anaemia risk. Economic-related inequality between children of mothers in Quintile 5 (richest) and Quintile 1 (poorest) increased from a Difference of 21.1 percentage points in 2003 to 32.7 percentage points in 2022 highlighting the stark inequalities across wealth quintiles. Education inequality between children of mothers with higher education and no education decreased from a Difference of 29.4 percentage points in 2003 to 25.3 percentage points in 2022, suggesting that children from less educated households are still at higher risk. Place of residence inequality between children of mothers living in urban areas and rural areas increased from a Difference of 12.3 percentage points in 2003 to 14.8 percentage points in 2022 reflecting urban-rural disparities. Sex-related inequality between male and female children decreased from a Difference of -0.3 percentage points in 2003 to -5.5 percentage points in 2022 indicating the absence of inequality based on sex of the child. Lastly, regional inequalities are pronounced, as indicated by an increase in the Difference from 21.2 percentage points in 2003 to 34.0 percentage points in 2022, highlighting that children in certain regions like the Northern and Upper East are more affected by anaemia.</p><p><strong>Conclusion: </strong>The decline in anaemia prevalence among children aged 6-59 months in Ghana, reflects substantial progress; however, notable inequalities persist across age, economic status, education, place of residence, and region. To address th
背景:贫血是加纳的一个公共卫生问题,其特征是缺乏红细胞或血红蛋白,尤其是在儿童中。由于贫血对儿童的认知发展、身体发育和幸福感有不利影响,因此该年龄段儿童的贫血患病率一直是个令人担忧的问题。本研究探讨了 2003 年至 2022 年间加纳 6-59 个月大儿童贫血患病率的趋势和不平等现象:方法:采用 2003 年至 2022 年期间进行的加纳人口健康调查数据,分析 6-59 个月大儿童的贫血患病率。世界卫生组织的健康公平评估工具包软件计算了几种不平等度量,包括差异、比率、人口可归因风险和人口可归因百分比。对以下六个分层因素进行了不平等评估:儿童年龄、母亲经济状况、母亲教育水平、居住地、儿童性别和国家以下地区:加纳 6-59 个月儿童的贫血患病率从 2003 年的 76.1%下降到 2022 年的 48.9%。结果显示,加纳儿童贫血患病率存在与年龄相关的不平等现象,较小年龄组(6-11 个月)的患病率一直较高。到 2022 年,与年龄相关的不平等差值为 24.6 个百分点,这表明年龄对于了解贫血风险至关重要。五等分层 5(最富有)和五等分层 1(最贫穷)母亲的子女之间与经济有关的不平等从 2003 年的 21.1 个百分点增加到 2022 年的 32.7 个百分点,凸显了财富五等分层之间的严重不平等。母亲受过高等教育和未受过教育的儿童之间的教育不平等从 2003 年的 29.4 个百分点的差异下降到 2022 年的 25.3 个百分点,这表明教育程度较低的家庭的儿童仍然面临较高的风险。居住在城市地区和农村地区的母亲的子女在居住地方面的不平等从 2003 年的 12.3 个百分点增加到 2022 年的 14.8 个百分点,反映了城乡差别。男女儿童之间与性别有关的不平等从 2003 年的差值-0.3 个百分点下降到 2022 年的-5.5 个百分点,表明不存在基于儿童性别的不平等。最后,地区不平等也很明显,差值从 2003 年的 21.2 个百分点增加到 2022 年的 34.0 个百分点,这突出表明北部和上东部等某些地区的儿童受贫血影响更严重:加纳 6-59 个月大儿童贫血患病率的下降反映出取得了实质性进展;然而,不同年龄、经济状况、教育程度、居住地和地区之间仍存在明显的不平等。为解决这些不平等问题,在医疗服务不足的地区加强医疗保健服务的普及、实施社区教育计划以提高人们对营养和健康的认识,以及促进经济赋权倡议等策略都是行之有效的。此外,社区教育在抵消家庭教育水平低的影响方面也能发挥关键作用,培养更多知情的人群,从而倡导更好的健康实践和政策。通过解决这些关键领域的问题,我们可以努力降低贫血患病率,改善加纳所有人口的儿童健康状况。
{"title":"Trends and inequalities in anaemia prevalence among children aged 6-59 months in Ghana, 2003-2022.","authors":"Augustus Osborne, Khadijat Adeleye, Camilla Bangura, Florence Gyembuzie Wongnaah","doi":"10.1186/s12939-024-02315-z","DOIUrl":"10.1186/s12939-024-02315-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Anaemia, characterised by a deficiency in red blood cells or haemoglobin, is a public health issue in Ghana, particularly among children. The prevalence of anaemia in this age group has been a longstanding concern due to its adverse effects on cognitive development, physical growth, and well-being. This study examined the trends and inequalities in anaemia prevalence among children aged 6-59 months in Ghana between 2003 and 2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from the Ghana Demographic Health Survey conducted between 2003 and 2022 was used to analyse the prevalence of anaemia in children aged 6-59 months. The World Health Organization's Health Equity Assessment Toolkit software calculated several inequality measures, including difference, ratio, population-attributable risk, and population-attributable percentage. An inequality assessment was performed for six stratifiers: child's age, mother's economic status, maternal educational level, place of residence, child's sex, and sub-national region.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Anaemia prevalence among children aged 6-59 months in Ghana declined from 76.1% in 2003 to 48.9% by 2022. The results revealed an age-related inequality in anaemia prevalence among children in Ghana, with younger age group ( 6-11 months) consistently showing higher rates. The age-related inequality Difference was 24.6 percentage points in 2022, indicating that age is crucial to understanding anaemia risk. Economic-related inequality between children of mothers in Quintile 5 (richest) and Quintile 1 (poorest) increased from a Difference of 21.1 percentage points in 2003 to 32.7 percentage points in 2022 highlighting the stark inequalities across wealth quintiles. Education inequality between children of mothers with higher education and no education decreased from a Difference of 29.4 percentage points in 2003 to 25.3 percentage points in 2022, suggesting that children from less educated households are still at higher risk. Place of residence inequality between children of mothers living in urban areas and rural areas increased from a Difference of 12.3 percentage points in 2003 to 14.8 percentage points in 2022 reflecting urban-rural disparities. Sex-related inequality between male and female children decreased from a Difference of -0.3 percentage points in 2003 to -5.5 percentage points in 2022 indicating the absence of inequality based on sex of the child. Lastly, regional inequalities are pronounced, as indicated by an increase in the Difference from 21.2 percentage points in 2003 to 34.0 percentage points in 2022, highlighting that children in certain regions like the Northern and Upper East are more affected by anaemia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The decline in anaemia prevalence among children aged 6-59 months in Ghana, reflects substantial progress; however, notable inequalities persist across age, economic status, education, place of residence, and region. To address th","PeriodicalId":13745,"journal":{"name":"International Journal for Equity in Health","volume":"23 1","pages":"231"},"PeriodicalIF":4.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11545159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
International Journal for Equity in Health
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1