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dc.contributor.authorvan Daalen, Kim Robin
dc.contributor.authorDavey, Fiona
dc.contributor.authorNorman, Claire
dc.contributor.authorFord, John Alexander
dc.date.accessioned2021-11-22T14:39:59Z
dc.date.available2021-11-22T14:39:59Z
dc.date.issued2021-11-11
dc.date.submitted2021-05-13
dc.identifier.issn2044-6055
dc.identifier.otherbmjopen-2021-053392
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/330839
dc.description.abstractOBJECTIVES: The purpose of this systematic review is to explore whether health equity audits (HEAs) are effective in improving the equity of service provision and reducing health inequalities. DESIGN: Three databases (Ovid Medline, Embase, Web of Science) and grey literature (Opengrey, Google Scholar) were systematically searched for articles published after 2000, reporting on the effectiveness of HEA. Title and abstracts were screened according to an eligibility criteria to identify studies which included a full audit cycle (eg, initial equity analysis, service changes and review). Data were extracted from studies meeting the eligibility criteria after full text review and risk of bias assessed using the ROBINS-I tool. RESULTS: The search strategy identified 596 articles. Fifteen records were reviewed in full text and three records were included in final review. An additional HEA report was identified through contact with an author. Three different HEAs were included from one peer-reviewed journal article, two published reports and one unpublished report (n=4 records on n=3 HEAs). This included 102 851 participants and over 148 practices/pharmacies (information was not recorded for all records). One study reviewed health equity impacts of HEA implementation in key indicators for coronary heart disease, type 2 diabetes and chronic obstructive pulmonary disease. Two HEAs explored Stop Smoking Services on programme access and equity. All reported some degree of reduction in health inequalities compared with prior HEA implementation. However, impact of HEA implementation compared with other concurrent programmes and initiatives was unclear. All included studies were judged to have moderate to serious risk of bias. CONCLUSIONS: There is an urgent need to identify effective interventions to address health inequalities. While HEAs are recommended, we only identified limited weak evidence to support their use. More evidence is needed to explore whether HEA implementation can reduce inequalities and which factors are influencing effectiveness. TRIAL REGISTRATION NUMBER: The study was registered prior to its conduction in PROSPERO (CRD 42020218642).
dc.languageen
dc.publisherBMJ
dc.rightsEmbargo: ends 2021-11-10
dc.subjectPublic health
dc.subject1506
dc.subject1724
dc.subjectpublic health
dc.subjectclinical audit
dc.subjectepidemiology
dc.titleHealth equity audits: a systematic review of the effectiveness.
dc.typeArticle
dc.date.updated2021-11-22T14:39:59Z
prism.issueIdentifier11
prism.publicationNameBMJ Open
prism.volume11
dc.identifier.doi10.17863/CAM.78282
dcterms.dateAccepted2021-10-25
rioxxterms.versionofrecord10.1136/bmjopen-2021-053392
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by-nc/4.0/
rioxxterms.licenseref.startdate2021-11-10
dc.contributor.orcidvan Daalen, Kim Robin [0000-0001-6955-9708]
dc.contributor.orcidFord, John Alexander [0000-0001-8033-7081]
dc.identifier.eissn2044-6055
cam.issuedOnline2021-11-11
rioxxterms.freetoread.startdate2021-11-10


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