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      Health promotion programme design and efficacy in relation to ageing persons with culturally and linguistically diverse backgrounds: a systematic literature review and meta-analysis

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          Abstract

          Background

          Health promotion has the potential to empower people to develop or maintain healthy lifestyles. However, previous research has visualised serious health and healthcare inequities associated with ageing, cultural affiliations and linguistic preferences. Therefore, this study was part of a larger health promotion project, set out to bridge barriers to health for ageing persons who have migrated to Sweden. More specifically, the present study aimed to elucidate the content and effects of multidimensional health promotion programmes in the context of ageing persons with culturally and linguistically diverse backgrounds.

          Methods

          Databases were systematically searched to identify relevant randomised controlled trial publications. All potentially relevant publications were assessed for relevance and design and after this screening, a final sample of eight publications could be included in the review. Those publications evaluated six different programmes and a mixed-methods approach to data analysis was applied, using a combination of narrative synthesis, meta-analyses and evidence grading.

          Results

          The findings suggest a multidimensional health promotion programme design for ageing persons with culturally and linguistically diverse backgrounds, involving culturally and linguistically modified activities and health information that should be provided by professionals with a person-centred approach. In addition, the meta-analyses revealed statistically significant effects in favour of health promotion on: general health, depression, mental health, physical health, and vitality. However, the evidence for the identified effects is low, and further research findings are likely to change the estimations.

          Conclusions

          The present study provides an aggregation of health promotion intervention research with older persons with culturally and linguistically diverse backgrounds; a group of people who are commonly excluded from research, and marginalised when it comes to health and healthcare. By visualising the core components of health promotion programmes with proven efficacy, the findings provide guidance for further explorations of how health promotion should be designed to minimise inequities in health.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12913-015-1222-4) contains supplementary material, which is available to authorized users.

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          Most cited references29

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          Health disparities and health equity: the issue is justice.

          Eliminating health disparities is a Healthy People goal. Given the diverse and sometimes broad definitions of health disparities commonly used, a subcommittee convened by the Secretary's Advisory Committee for Healthy People 2020 proposed an operational definition for use in developing objectives and targets, determining resource allocation priorities, and assessing progress. Based on that subcommittee's work, we propose that health disparities are systematic, plausibly avoidable health differences adversely affecting socially disadvantaged groups; they may reflect social disadvantage, but causality need not be established. This definition, grounded in ethical and human rights principles, focuses on the subset of health differences reflecting social injustice, distinguishing health disparities from other health differences also warranting concerted attention, and from health differences in general. We explain the definition, its underlying concepts, the challenges it addresses, and the rationale for applying it to United States public health policy.
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            Ottawa charter for health promotion.

            (2015)
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              Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care.

              Socioeconomic and racial/ethnic disparities in health care quality have been extensively documented. Recently, the elimination of disparities in health care has become the focus of a national initiative. Yet, there is little effort to monitor and address disparities in health care through organizational quality improvement. After reviewing literature on disparities in health care, we discuss the limitations in existing quality assessment for identifying and addressing these disparities. We propose 5 principles to address these disparities through modifications in quality performance measures: disparities represent a significant quality problem; current data collection efforts are inadequate to identify and address disparities; clinical performance measures should be stratified by race/ethnicity and socioeconomic position for public reporting; population-wide monitoring should incorporate adjustment for race/ethnicity and socioeconomic position; and strategies to adjust payment for race/ethnicity and socioeconomic position should be considered to reflect the known effects of both on morbidity. JAMA. 2000;283:2579-2584
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                Author and article information

                Contributors
                qarin.lood@neuro.gu.se
                greta.haggblom-kronlof@neuro.gu.se
                synneve.dahlin-ivanoff@neuro.gu.se
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                16 December 2015
                16 December 2015
                2015
                : 15
                : 560
                Affiliations
                [ ]Institute of Neuroscience and Physiology, Section for Health and Rehabilitation, The Sahlgrenska Academy, University of Gothenburg, Box 455, SE-405 30 Gothenburg, Sweden
                [ ]University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden
                [ ]University of Gothenburg Centre for Ageing and Health (Agecap), Gothenburg, Sweden
                Article
                1222
                10.1186/s12913-015-1222-4
                4682220
                8df29543-b833-4942-bdb6-1903c33d38fa
                © Lood et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 26 November 2014
                : 8 December 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Health & Social care
                aged,emigrants and immigrants,global health,healthcare disparities,minority health

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