Social determinants of health and cancer screening implementation and outcomes in the USA: a systematic review protocol

Abstract

Background Improving the delivery, uptake, and implementation of cancer screening to meet evidence-based recommendations is needed to reduce persistent cancer health disparities in the USA. Current national public health targets emphasize the role of social determinants of health (SDOH) on cancer screening. However, there remains a need to explicate these linkages, toward the goal of identifying and implementing effective interventions that target and address SDOH to reduce inequities in cancer screening. Methods We will conduct a systematic review of English language peer-reviewed original research articles published between 2010 and 2021 that describe observational (qualitative and quantitative) and intervention studies conducted in the USA. In alignment with Healthy People 2030, we will include studies of breast, cervical, colorectal, and/or lung cancer screening. Guided by multiple SDOH frameworks, we will broadly define SDOH by five domain areas: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. Following systematic literature searches in five databases (Ovid MEDLINE, Embase, CINAHL, Web of Science, Cochrane Library) and piloting of screening procedures, reviewers will independently screen titles/abstracts for potential relevance. Reviewer pairs will then screen full text articles for eligibility criteria. We will extract data items from included articles, including study characteristics, cancer screening intervention information, and coding of SDOH constructs. We will assess study quality using the Mixed Methods Appraisal Tool and synthesize our findings using narrative, descriptive statistics, tables, and figures. Our approach will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) recommendations. Discussion By completing this systematic review, we will summarize recent literature on SDOH and cancer screening, identify research gaps for inclusion of SDOH, and propose future opportunities for advancing equity in cancer screening by integrating SDOH as part of the implementation context to promote uptake, sustainability, and scale-up in the implementation of screening guidelines. Systematic review registration PROSPERO CRD42021276582.

Mammography screening beliefs and barriers through the lens of Black women during the COVID‐19 pandemic

“…9 Social determinants of health, which are "the conditions in which people live, learn, work, play, worship and age," also have been shown to play a role in access to health maintenance screening for Black women. [35][36][37][38] The type of health insurance coverage has previously been shown to be associated with receipt of preventive health services. 39,40 -3107 (30%).…”

Social determinants of health and US cancer screening interventions: A systematic review

“…The PRISMA checklist is available in Supporting Methods File . Our review methods are reported in detail in a previously published protocol 14 …”

“…We collaborated with a research librarian and experts in cancer control research to develop the search strategy 14 . Search strings included terms for cancer site, screening test, and SDOH, and US search strategies included limiters, with some variation by database: English language, publication years 2010–2021, human studies, adult studies, US studies, and journal articles or review articles (the latter to facilitate reference hand searching).…”

Rigorous theory‐based intervention research is the bold action needed to address oral health disparities and inequities

“…Literature reviews from the oral health field may be good resources for hypothesis generation and theory development, including reviews of social determinants of paediatric 32 and adult oral health 33 and disparities in oral health care 34 . Reviews from outside the oral health field may be useful for theory generation too, including related topics such as the social consequences of chronic pain, 35 ageing and caregiving 36 and an in‐progress review of social determinants of cancer screening 37 …”

“…34 Reviews from outside the oral health field may be useful for theory generation too, including related topics such as the social consequences of chronic pain, 35 ageing and caregiving 36 and an in-progress review of social determinants of cancer screening. 37 For those seeking practical guidance or resources to conduct theory-based research, several relevant initiatives are good sources of such information (e.g. National Institutes of Health Science of Behavior Change Common Fund Program, 38 University College London Human Behaviour-Change Project 39 ).…”