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      Socioeconomic gradients in the effects of universal school-based health behaviour interventions: a systematic review of intervention studies.

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          Abstract

          Socioeconomic inequalities in health behaviour emerge in early life before tracking into adulthood. Many interventions to improve childhood health behaviours are delivered via schools, often targeting poorer areas. However, targeted approaches may fail to address inequalities within more affluent schools. Little is known about types of universal school-based interventions which make inequalities better or worse.

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          Translating social ecological theory into guidelines for community health promotion.

          D Stokols (2015)
          Health promotion programs often lack a clearly specified theoretical foundation or are based on narrowly conceived conceptual models. For example, lifestyle modification programs typically emphasize individually focused behavior change strategies, while neglecting the environmental underpinnings of health and illness. This article compares three distinct, yet complementary, theoretical perspectives on health promotion: behavioral change, environmental enhancement, and social ecological models. Key strengths and limitations of each perspective are examined, and core principles of social ecological theory are used to derive practical guidelines for designing and evaluating community health promotion programs. Directions for future health promotion research are discussed, including studies examining the role of intermediaries (e.g., corporate decision-makers, legislators) in promoting the well-being of others, and those evaluating the duration and scope of intervention outcomes.
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            The harvest plot: A method for synthesising evidence about the differential effects of interventions

            David Ogilvie, Debra Fayter, Mark Petticrew … (2008)
            Background One attraction of meta-analysis is the forest plot, a compact overview of the essential data included in a systematic review and the overall 'result'. However, meta-analysis is not always suitable for synthesising evidence about the effects of interventions which may influence the wider determinants of health. As part of a systematic review of the effects of population-level tobacco control interventions on social inequalities in smoking, we designed a novel approach to synthesis intended to bring aspects of the graphical directness of a forest plot to bear on the problem of synthesising evidence from a complex and diverse group of studies. Methods We coded the included studies (n = 85) on two methodological dimensions (suitability of study design and quality of execution) and extracted data on effects stratified by up to six different dimensions of inequality (income, occupation, education, gender, race or ethnicity, and age), distinguishing between 'hard' (behavioural) and 'intermediate' (process or attitudinal) outcomes. Adopting a hypothesis-testing approach, we then assessed which of three competing hypotheses (positive social gradient, negative social gradient, or no gradient) was best supported by each study for each dimension of inequality. Results We plotted the results on a matrix ('harvest plot') for each category of intervention, weighting studies by the methodological criteria and distributing them between the competing hypotheses. These matrices formed part of the analytical process and helped to encapsulate the output, for example by drawing attention to the finding that increasing the price of tobacco products may be more effective in discouraging smoking among people with lower incomes and in lower occupational groups. Conclusion The harvest plot is a novel and useful method for synthesising evidence about the differential effects of population-level interventions. It contributes to the challenge of making best use of all available evidence by incorporating all relevant data. The visual display assists both the process of synthesis and the assimilation of the findings. The method is suitable for adaptation to a variety of questions in evidence synthesis and may be particularly useful for systematic reviews addressing the broader type of research question which may be most relevant to policymakers.
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              A typology of actions to tackle social inequalities in health.

              Margaret Whitehead (2007)
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                Author and article information

                Journal
                Journal ID (iso-abbrev): BMC Public Health
                Title: BMC public health
                Publisher: Springer Science and Business Media LLC
                ISSN (Electronic): 1471-2458
                ISSN (Print): 1471-2458
                Publication date (Electronic): Sep 17 2015
                Volume: 15
                Affiliations
                [1 ] DECIPHer, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK. MooreG@cardiff.ac.uk.
                [2 ] DECIPHer, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK. LittlecottH@cardiff.ac.uk.
                [3 ] DECIPHer, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK. TurleyRL@cardiff.ac.uk.
                [4 ] Jack Brockhoff Child Health and Wellbeing Program, School of Population and Global Health, University of Melbourne, Melbourne, Australia. ewaters@unimelb.edu.au.
                [5 ] DECIPHer, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK. MurphyS7@cardiff.ac.uk.
                Article
                Publisher Item ID: 10.1186/s12889-015-2244-x
                DOI: 10.1186/s12889-015-2244-x
                PMC ID: 4574356
                PubMed ID: 26381233
                SO-VID: d94e6542-01b6-486a-9fed-e00b96846603
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