Characterising the effectiveness of social determinants of health-focused hepatitis B interventions: a systematic review - 23/05/24
, Aysegul Erman, PhD e, Marian Hassan, MSc e, g, Jordan J Feld, ProfMD b, c, f, Eleanor Pullenayegum, ProfMD d, h, William W L Wong, PhD a, e, i, j, Beate Sander, ProfPhD a, e, j, kSummary |
Social determinants of health are important in designing effective interventions for hepatitis B virus (HBV) infection. This systematic review characterises equity-oriented, social determinants of health-focused HBV interventions, and describes their effectiveness in terms of the prevention, care, or treatment of HBV in high-income countries. We searched electronic databases for central concepts of 'HBV’, 'equity’, 'social determinants of health’, 'intervention’, and 'Organization for Economic Co-operation and Development (OECD) countries’. Screening and data abstraction were conducted independently by two reviewers. Data were abstracted from 66 studies; articles with a comparative study design (n=36) were included in the narrative synthesis, highlighting social determinants of health domains of interventions, HBV-relevant health outcomes, and extra-health social determinants of health effects (ie, those effects that extend beyond health outcomes). Synthesis aligned with six emergent themes corresponding to HBV prevention and care: knowledge and education, diagnosis and screening, immunisation, care initiation, engagement with clinical care and treatment, and upstream prevention. Studies presented a heterogeneous array of HBV-relevant health outcomes. Most interventions were tailored for social determinants of health domains of race, ethnicity, culture, and language; drug use; and socioeconomic status. Across the themes, at least two-thirds of interventions showed comparative effectiveness for addressing HBV. Extra-health social determinants of health outcomes were observed for two studies. Considerable diversity in population-level approaches was observed regarding intervention goals and effectiveness; most interventions were effective at enhancing the prevention, care, or treatment of HBV.
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Vol 24 - N° 6
P. e366-e385 - juin 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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