Applying a health equity tool to assess a public health nursing guideline for practice in sexually transmitted infection assessment in British Columbia

Background: Systematic guidance for considering health equity in guidelines is lacking. This scoping review aims to synthesize current best practices for integrating health equity into guideline development and the benefits or drawbacks of these practices. Methods: We searched Ovid MEDLINE ALL and Embase Classic+Embase on the Ovid platform, CINAHL on EBSCO, and Web of Science (Core Collection) from 2010 to 2022. We searched grey literature from 2015 to 2022, using the Canadian Agency for Drugs and Technologies in Health Grey Matters checklist and searches of potentially relevant websites. Articles were screened independently by 1 reviewer. Proposed best practices, advantages and disadvantages, and tools were extracted independently by 1 reviewer and qualitatively synthesized based on the relevant steps of a comprehensive checklist covering the stages of guideline development. Results: We included 26 articles that proposed best practices for incorporating health equity within the guideline development process. These practices were organized under different stages of the development process, including guideline planning, evidence review, guideline development and dissemination. Included studies provided best practices from guideline producers, articles discussing health equity in current guidelines, articles addressing strategies to increase equity in the guideline implementation process, and literature reviews of promising health equity practices. Interpretation: Our scoping review identified best practices to incorporate health equity considerations at each phase of guideline development. Identified practices may be used to inform equity-promoting strategies with the guideline development process; however, guideline producers should carefully consider the advantages and disadvantages of best practices when integrating health equity.

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“…Formulate equitable recommendations by, for example, considering barriers and facilitators of interventions 50 – 52 , 55 …”

Section: Resultsmentioning

confidence: 99%

“…Focuses on biomedical considerations and may miss population-level inequities related to broader sociocultural factors 52 …”

Section: Resultsmentioning

confidence: 99%

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Health equity considerations in guideline development: a rapid scoping review

Shaver

Bennett

Beck

et al. 2023

cmajo

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“…The 16 articles originated from several countries including Canada (Magwood et al, 2020; Prescott et al, 2020), the United States (Kahn & Beauhemin, 2021; Zamor et al, 2020), the United Kingdom (Lorenc et al, 2013; Mizen et al, 2012), and Australia (Beauchamp et al, 2010). Many of the articles were authored by teams of international and interdisciplinary scholars (Akl et al, 2017; Dans et al, 2007; Eslava‐Schmalbach et al, 2017; Petkovic et al, 2020; Pottie et al, 2017; Schunemann et al, 2014; Shi et al, 2014; Welch, Akl, Guyatt, et al, 2017; Welch, Akl, Pottie, et al, 2017).…”

Section: Resultsmentioning

confidence: 99%

“…Users of CPGs can also use the five questions to evaluate how well a CPG addresses equity issues. The Equity Lens tool has been employed by other researchers interested in assessing the inclusion or omission of an equity focus in CPGs (Eslava‐Schmalbach et al, 2017; Mizen et al, 2012; Prescott et al, 2020; Shi et al, 2014). For example, Mizen and colleagues, who utilized the equity lens to evaluate how well CPGs consider equity, revealed that of 36 CPGs they identified, 35 CPGs met the first criterion of the equity lens ( Do the public health recommendations in the guideline address a priority problem for disadvantaged populations? )…”

Section: Resultsmentioning

confidence: 99%

Representations of clinical practice guidelines and health equity in healthcare literature: An integrative review

Boyles

Spoel

Montgomery

et al. 2022

J of Nursing Scholarship

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Aim: This paper reports an integrative review of international health literature that discusses health equity in relation to clinical practice guidelines (CPGs).Background: Healthcare professionals (HCPs), policy makers, and decision makers rely on sound empirical evidence to make fiscally responsible and appropriate decisions about the allocation of health resources and health service delivery. CPGs provide statements and recommendations that aim to standardize care with an implicit goal of achieving equity of care among diverse populations. Developers of CPGs must be careful not to exacerbate inequity when making recommendations. As such, it is important to determine how equity is discussed within the context of CPGs.Design: This integrative review was conducted according to integrative review methods as outlined by Whittemore and Knafl (2005), and Toronto and Remington (2020).These authors outlined a systematic process for the identification of relevant literature across health disciplines to examine the state of knowledge pertaining to a phenomenon such as health equity.Search Methods: The computerized databases PubMed, CINAHL, Cochrane, Embase, Medline, and Web of Science were searched using a combination of keywords. Search parameters included international peer-reviewed published, full-text, English language articles, editorials, and reports over the last decade (January 2011 to February 2022). A reference search of included articles was conducted to identify any additional articles. Dissertations and theses were not included.Search Outcome: A total of 139 peer-reviewed English language articles were identified. Results:The findings of this review revealed five main ways in which health equity is in context of CPGs including if they target or exacerbate inequity among disadvantaged populations, equity and CPG development, implementation, and evaluation, and checklists and tools to assist developers and users of CPG to consider equity.Although critical appraisal tools exist to assist users of CPGs assess and to evaluate how well CPGs address issues of equity, the definition of equity and how CPG development panels should incorporate and articulate it remains unclear and haphazard.As such, recommendations intended to be implemented by HCPs to optimize health equity remains diverse and unclear.

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Applying a health equity tool to assess a public health nursing guideline for practice in sexually transmitted infection assessment in British Columbia

Cited by 2 publications

References 14 publications

Health equity considerations in guideline development: a rapid scoping review

Health equity considerations in guideline development: a rapid scoping review

Representations of clinical practice guidelines and health equity in healthcare literature: An integrative review

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