BackgroundWhen designing any health intervention, it is important to respond to the unequal determinants of health by prioritising the allocation of resources and tailoring interventions based on the disproportionate burden of illness. This approach, called the targeting of priority populations, can prevent a widening of health inequities, particularly those inequities which can be further widened by differences in the uptake of an intervention. The objective of this scoping review is to describe intervention(s) designed to increase the uptake of lung cancer screening, including the health impact on priority populations and to describe knowledge and implementation gaps to inform the design of equitable lung cancer screening.MethodsWe will conduct a scoping review following the methodological framework developed by Arksey and O’Malley. We will conduct comprehensive searches for lung cancer screening promotion interventions in Ovid Medline, Embase, the Cochrane Library, Cumulative Index to Nursing & Allied Health (CINAHL) and Scopus. We will include published English language peer-reviewed and grey literature published between January 2000 and 2020 that describe an intervention designed to increase the uptake of low-dose CT (LDCT) lung cancer screening in the Organization for Economic Cooperation and Development countries. Articles not in English or not describing LDCT will be excluded. Three authors will review retrieved literature in three steps: title, abstract and then full text. Three additional authors will review discrepancies. Authors will extract data from full-text papers into a chart adapted from the Template for Intervention Description and Republication checklist, the Consolidated Standards of Reporting Trials and a Health Equity Impact Assessment tool. Findings will be presented using a narrative synthesis.Ethics and disseminationThe knowledge synthesised will be used to inform the equitable design of lung cancer screening and disseminated through conferences, publications and shared with relevant partners. The study does not require research ethics approval as literature is available online.
The Peel Region of Toronto, Canada is home to over a third of the province's South Asian population. Youth are at a vulnerable time period in terms of their mental health. South Asian youth populations may face additional challenges to their mental health such as acculturative stress, intergenerational conflict, and racism and discrimination. This qualitative study set out to understand the mental health concerns and service access barriers experienced by South Asian youth populations in the Peel Region of Toronto, Canada from the perspective of mental health service providers. In-depth semi-structured interviews were carried out with mental health service providers (n = 22) who work with South Asian youth living in Peel Region. Thematic analysis was used to elucidate themes related to mental health stressors and service access barriers experienced by youth. According to mental health service providers, South Asian youth navigate a number of unique stressors related to the domains of culture, religion, and family dynamics, experiences of discrimination, the impact of migration, beliefs around mental illness and help-seeking, help-seeking trajectories and therapy recommendations, and lastly, sex differences. Mental health service providers outlined steps needed to effectively address the unique mental health challenges, best practice guidelines, and recommendations for working with South Asian youth, families, and communities to provide a practical and nuanced overview on how a multi-level strategy for mental health care can effectively meet the needs of South Asian youth populations.
Purpose While there is literature that examines factors associated with low participation in cancer screening among Canadian ethnic groups, there is limited understanding of black visible minorities, particularly Somalis. Thus, the purpose of this study is to synthesize knowledge pertaining to the perceptions, beliefs and barriers of Somali women and men toward screening for breast, cervical and colorectal cancers in countries such as Canada. Design/methodology/approach The scoping review methodology was used to search for peer-reviewed articles that explicitly examined perceptions, beliefs and barriers among Somalis toward screening for breast, cervical and colorectal cancers in developed countries. The following electronic databases were searched without time frame restrictions, namely, OVID Medline, Embase, CINHAL, PubMed, Scopes and ProQuest. A total of 402 peer-reviewed articles were identified and screened. Three articles were identified through reference list screening (one eligible) and consultation with experts in the networks (two eligible). In total, 12 studies met the inclusion criteria for synthesis. Thematic analysis was used to analyze the selected articles for key themes and the synthesis was informed by the socio-ecological model. Findings The majority of studies originated from the USA and focused primarily on Somali women and cervical cancer screening. Themes that emerged from the literature include individual-level negative experiences and socio-cultural perceptions/beliefs; community-level barriers in cancer screening; and systemic challenges in navigating the health-care system. Many of the studies focused on individual and community-level determinants of cancer screening, with little attention to systemic level determinants. Other gaps identified include factors influencing Somali men’s low participation in cancer screening; limited studies on colorectal cancer and Somali women; and specific cancer-screening barriers faced by Somalis within the Canadian context. Originality/value The findings of the review reveal multiple cancer screening challenges for Somali communities and the gained insights should inform both health and social care practitioners and policymakers.
Background: Lung cancer screening (LCS) with low-dose CT can reduce mortality due to lung cancer by detecting early-stage tumours that are amenable to treatment. Participation in LCS programs however has not been equally distributed among at-risk groups, such that populations with the highest burden of lung cancer risk (through the social patterning of smoking behaviour) and lowest levels of healthcare utilization (through care which is structurally inaccessible) can experience a widening in healthcare disparities as a result of LCS interventions. Approach: We sought to inform equitable access to LCS by illuminating knowledge and implementation gaps in current interventions designed to increase the uptake of LCS. To do this, we conducted a scoping study using the Arksey and O'Malley methodological framework. We conducted comprehensive searches for lung cancer screening promotion interventions (Ovid Medline, Embase, the Cochrane Library, CINAHL and Scopus) and included published English language peer-reviewed and grey literature published between January 2000 and 2020 that describe an intervention designed to increase the uptake of LDCT lung cancer screening in the Organization for Economic Cooperation and Development (OECD) countries. We extracted data onto a chart modified from the Template for Intervention Description and Republication (TIDieR) checklist and the Consolidated Standards of Reporting Trials. We used the Health Equity Impact Assessment (HEIA) tool to analyse the intended/unintended and positive/negative outcomes of the interventions for populations experiencing the greatest disparities. Results: Our search yielded 2681 articles. We included 22 peer review articles dated from January 2000 to January 2020. Interventions occured primarily in the USA, Europe and Canada. We used the ‘Patient Centered Access to Healthcare' conceptual framework by Khanassov et al 2016 to synthesize our findings. Three main themes summarise current interventions designed to increase the uptake of LCS: (i) a focus on individuals and their ability to engage with the healthcare system; (ii) inadequate targeting of populations experiencing greatest disparities and (iii) a lack of conceptual underpinning in the design of interventions so that the social patterning of lung cancer risk and ability to access care is ignored. Conclusion: LCS interventions must take into consideration the disproportionate burden of lung cancer risk in populations experiencing social disadvantage. Designing interventions that are cognisant of the social distribution of risk and targeted to support the uptake in high-risk populations can prevent an inadvertent widening of health disparities. Citation Format: Ambreen Sayani, Muhanad Ahmed Ali, Pooja Dey, Ann Marie Corrado, Carolyn Ziegler, Alex Sadler, Christina Williams, Aisha Lofters. Interventions designed to increase the uptake of lung cancer screening and implications for populations experiencing the greatest burden of lung cancer disparities: A scoping study [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-262.
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