Clinical practice guideline recommendations can promote or undermine health equity

Deleted Journal, Journal Year: 2025, Volume and Issue: 2(2)

Published: March 28, 2025

ABSTRACT While clinical practice guideline makers and methodologists signal the importance of considering inequities, recommendations often have little or nothing to do with fairness. Since inequities are, by definition avoidable, guidance on is a prime opportunity make health care more fair. Equity should be central consideration when deciding who involve in process, guideline's scope, type information consider, how share recommendations. Guideline producers select topics where can actually address then use about disparities helpful Funders journal editors insist that guidelines explain panels were formed why new topic needed. Changes will not enough promote equity, but part solution if they are thoughtfully produced acted clinicians governments.

Language: Английский

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Important and Feasible Actions to Address Cervical Screening Participation amongst South Asian Women in Ontario: A Concept Mapping Study with Service Users and Service Providers

Current Oncology, Journal Year: 2024, Volume and Issue: 31(7), P. 4038 - 4051

Published: July 17, 2024

Regular cervical screening can largely prevent the development of cancer and innovative methods are needed to better engage people in screening. In Ontario, Canada, South Asian women have some lowest rates province. this study, we used concept mapping two stakeholder groups—South service users providers—to identify prioritize points intervention encourage uptake After participants brainstormed a master list statements, 45 rated statements based off ‘importance’ ‘ease address’ relation encouraging A bivariate plot (X-Y graph) that shows average rating values for each statement across variables (a ‘go-zone’ display) was produced display priorities implementation. Statements were considered high priority address reflected issues around education awareness including understanding communication related preventative care, as well need trusted sources information. but challenging implement centered fear, stigma, discomfort, family personal priorities. This study highlighted norms social relations impact must be addressed order raising effective move from conviction action.

Language: Английский

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Strategies to accelerate the elimination of cervical cancer in British Columbia, Canada: a modelling study

Canadian Medical Association Journal, Journal Year: 2024, Volume and Issue: 196(21), P. E716 - E723

Published: June 2, 2024

Background:

To eliminate cervical cancer in Canada by 2040, defined as an annual age-standardized incidence rate (ASIR) lower than 4.0 per 100 000 women, the Canadian Partnership Against Cancer (CPAC) identified 3 priorities for action: increasing human papillomavirus (HPV) vaccine coverage, implementing HPV-based screening and participation, improving follow-up after abnormal screen results. Our objective was to explore impact of these on projected time elimination British Columbia.

Methods:

We used OncoSim-Cervical, a microsimulation model led supported CPAC developed Statistics that simulates HPV transmission natural history population. updated parameters reflect BC's historical participation rates program design. simulated transition scenarios additional achieving 90% vaccination 95% recruitment, ontime screening, compliance. incidence, ASIR, year population BC 2023–2050.

Results:

at current vaccination, can 2034. Increasing on-time compliance could achieve this target 2031. coverage has small over horizon.

Interpretation:

With implementation be eliminated before 2040. Efforts increase through potentially accelerate timeline, but from cytology- is fundamental goal.

Language: Английский

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Seven Principles for Integrating Health Equity Considerations in the Practice Guideline Enterprise

Published: Jan. 1, 2025

BackgroundHealth equity aims to provide all individuals with equal and fair opportunities achieve optimal health. Practice guidelines can play a pivotal role in advancing health equity, yet, few organizations utilize tools systematically integrate considerations. Thus, it is important establish foundation for practical support the systematic integration of This manuscript proposes principles considerations practice guideline enterprise.MethodsIn process developing an extension GIN-McMaster development checklist, we established diverse advisory group developers, patients, members public experiencing inequities, researchers developers. We formulated informed by methodological review handbooks, iterative discussions between working members.ResultsWe identified seven considering integrating enterprise. 1) Articulating 2) priori planning 3) Selection engagement lived experiences 4) Equity evidence synthesis, 5) Developing equity-informed recommendations, 6) Inclusive knowledge mobilization, 7) Evaluating impact elaborated on importance using published examples mapped them different phases process.ConclusionsGuideline developers should adhere these appraisal tools. These are foundational concepts items checklist.

Language: Английский

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Investigation of rural–urban differences in hospitalization for ambulatory care‐sensitive conditions: Analysis of linked survey, hospitalization, and tax data from Canada

The Journal of Rural Health, Journal Year: 2025, Volume and Issue: 41(1)

Published: Jan. 1, 2025

Hospitalizations for ambulatory care sensitive conditions (ACSCs) reflect the efficiency of primary system, as these are preventable with timely and effective management chronic conditions. We examined ACSC hospitalization trends in Canada's rural urban areas, excluding Quebec, from 2007 to 2019. The data came Canadian Community Health Surveys linked hospitalizations household income tax records. study focused on adults aged 18-74 years used logit zero-inflated Poisson models analyze costs. A non-linear decomposition method quantified explained unexplained rural-urban gaps found persistent disparities between although gap has narrowed since 2010. Even after adjusting socio-demographic factors, conditions, risky health behaviors, rates remained, highlighting unequal access areas. results revealed that were driven mainly by differences observed characteristics. Further investigation due populations lower education, residents Atlantic provinces. This underscores importance a strong system minimize ACSC-related Canada. Our highlight benefits reforms undertaken provinces over past decade reducing hospitalizations. Future policy interventions targeting disadvantaged populations, such those vital avoidable enhancing population outcomes

Language: Английский

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Ethnic disparities in STEMI outcomes among older adults: a comparative study of bedouins and jews

International Journal for Equity in Health, Journal Year: 2025, Volume and Issue: 24(1)

Published: March 10, 2025

Abstract Background ST-Elevation Myocardial Infarction (STEMI) is a critical condition, especially in the older population, who are at increased risk due to comorbidities and delayed diagnosis. This study aimed investigate impact of ethnicity on clinical characteristics, treatment timelines, outcomes patients with STEMI southern Israel, comparing Jewish Bedouin populations. Methods We conducted retrospective cohort Soroka University Medical Center from 2016 2022, including (≥ 65 years) diagnosed STEMI. Patients were grouped by ethnicity: Jews Bedouins. Data demographics, comorbidities, collected. Statistical analysis included comparison multivariable logistic regression, adjusting for potential confounders. Results 575 study, them 469 (81.6%) 106 Bedouins (18.4%). The mean age was 74.35 ± 7.33 years, no significant difference between (74.56 years 7.53) (73.40 5.99 p = 0.139). had higher rates diabetes (53.8% vs. 40.7%, 0.019) smoking (40.6% 27.9%, 0.015) less likely arrive ambulance (39.6% 62.5%, < 0.00). also experienced longer median times pain onset first medical contact (126.5 min 90.0 min, 0.006) total ischemic time (240.0 205.0 0.003). Despite these differences, there differences in-hospital mortality (13.2% 10.9% Jews, 0.606), 30-day (14.2% 11.5% 0.556), or one-year (21.7% 20.9% 0.959). Multivariable confirmed association outcomes. Conclusions prevalence among patients, ambulance, delays receiving care, their comparable patients. These findings highlight effectiveness acute care system Israel. However, further research needed explore other outcomes, such as quality life functional recovery, better address healthcare disparities this population.

Language: Английский

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Why We Need to Think Differently About Self‐Care and Self‐Management

Nursing Inquiry, Journal Year: 2025, Volume and Issue: 32(2)

Published: March 26, 2025

Language: Английский

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Perceptions of breast cancer screening programs and breast health among immigrant women

Canadian Family Physician, Journal Year: 2024, Volume and Issue: 70(7-8), P. 491 - 496

Published: July 1, 2024

To examine how women who have emigrated from the Middle East and North Africa (MENA) region perceive breast cancer risk screening in Canada they approach health, to explore barriers this population.

Language: Английский

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BETTER LIFE- guidelines for chronic disease preventive care for people aged 18–39 years: a literature review

BMC Primary Care, Journal Year: 2024, Volume and Issue: 25(1)

Published: June 22, 2024

The original 'BETTER' (Building on Existing Tools To Improve Chronic Disease Prevention and Screening in Primary Care) approach consisted of a prevention-focused visit between participants aged 40-65 years "Prevention Practitioner" (PP), who empowered the participant to set achievable prevention screening goals for cancers chronic diseases. BETTER was successfully adapted economically deprived communities (BETTER HEALTH) Canada. Our objective conduct review guidelines preparation adapting 'BETTER HEALTH' younger adults 18-39 living with lower income, group known have earlier mortality due higher prevalence preventable diseases than their peers income.

Language: Английский

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Social media use in HPV-, cervical cancer-, and cervical screening-related research: A scoping review

Preventive Medicine, Journal Year: 2023, Volume and Issue: 179, P. 107798 - 107798

Published: Dec. 7, 2023

Language: Английский

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