Assessing how well interventions for migrant population have addressed inequity: a two-stage systematic review

Session: 

Oral session: Global health and equity

Date: 

Monday 17 September 2018 - 11:50 to 12:00

Location: 

Ochil 2

All authors in correct order:

Yadee J1, Bangpan M2, Thavorn K3, Welch V3, Tugwell P3, Chaiyakunapruk N4
1 Chiang Mai University, Thailand
2 EPPI-Center, University College London, UK
3 Ottawa Hospital Research Institute, Canada
4 Naresuan University, Thailand
Presenting author and contact person

Presenting author:

Jirawit Yadee

Contact person:

Nathorn Chaiyakunapruk
Jirawit Yadee
Abstract text
Background:
Migrants are considered to be vulnerable populations due to their lack of accessibility to health services and financial protection in health. A number of interventions has been developed to improve migrant population health, but these have not yet been investigated to establish whether they have considered the issue of equity as part of their outcome measurement.

Objective:
To assess the evidence of the health interventions in reducing inequity among migrants.

Methods:
We have adopted a two-stage approach to ensure a feasibility of this review. First, we searched for reviews of interventions for migrants in five databases: PubMed, CDSR, CINAHL, PsycINFO, and Embase from inception until June 2017. Second, we retrieved full articles included in identified reviews. In the second stage, we evaluated only primary studies included in the reviews identified at the first stage. The inclusion criteria were: experimental studies that included equity aspects as part of their outcome measurement, based on PROGRESS-Plus factors. We used content analysis to assess the information extracted from the selected intervention studies, following the PRISMA-Equity guidelines (Welch 2012), and based on the PROGRESS-Plus factors.

Results:
Forty-nine reviews involving 1145 primary studies met the first-stage inclusion criteria. After exclusion of 764 studies, we assessed the remaining 381 experimental studies. Thirteen studies (3.41%, 13/381) investigated equity as part of their outcome measurement. Most studies were conducted in the USA. The interventions included individual, directed, community education and peer navigator-related intervention. The outcome of interest is the reporting of the effect of intervention on an inequity aspect based on PROGRESS-Plus factors. The determinants of inequity aspects we identified in the included studies were: place of residence, language, gender, religion, education, socioeconomic status, and age.

Conclusions:
Current evidence reveals that there is a paucity of studies assessing equity outcomes of health interventions developed for migrant populations. This indicates that equity has not been receiving attention and that equity-focused outcome assessment is needed to help policy-makers to consider all relevant outcomes to ensure sound decision making.

Patient or healthcare consumer involvement:
None

Relevance to patients and consumers: 

Our research is focused on assessing how well interventions for migrant population have addressed inequity. The equity aspect of outcome is primary outcome which is very relevant to migrant population. Our work has not included patient/consumer partners to help us reach the conclusion at this point, but incorporating their perspective in the next stage of this work will improve the relevancy of our work for policy application.