Identification and inclusion of gender factors in retrospective cohort studies: the GOING-FWD framework

Gender refers to the socially constructed roles, behaviours, expressions and identities of girls, women, boys, men and gender diverse people. Gender-related factors are seldom assessed as determinants of health outcomes, despite their powerful contribution. The Gender Outcomes INternational Group: to Further Well-being Development (GOING-FWD) project developed a standard five-step methodology applicable to retrospectively identify gender-related factors and assess their relationship to outcomes across selected cohorts of non-communicable chronic diseases from Austria, Canada, Spain, Sweden. Step 1 (identification of gender-related variables): Based on the gender framework of the Women Health Research Network (ie, identity, role, relations and institutionalised gender), and available literature for a certain disease, an optimal ‘wish-list’ of gender-related variables was created and discussed by experts. Step 2 (definition of outcomes): Data dictionaries were screened for clinical and patient-relevant outcomes, using the International Consortium for Health Outcome Measurement framework. Step 3 (building of feasible final list): a cross-validation between variables per database and the ‘wish-list’ was performed. Step 4 (retrospective data harmonisation): The harmonisation potential of variables was evaluated. Step 5 (definition of data structure and analysis): The following analytic strategies were identified: (1) local analysis of data not transferable followed by a meta-analysis combining study-level estimates; (2) centrally performed federated analysis of data, with the individual-level participant data remaining on local servers; (3) synthesising the data locally and performing a pooled analysis on the synthetic data and (4) central analysis of pooled transferable data. The application of the GOING-FWD multistep approach can help guide investigators to analyse gender and its impact on outcomes in previously collected data.

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The Gender Outcomes International Group: to Further Well-being Development (Going-fwd) Methodology on Identification and Inclusion of Gender Factors in Retrospective Cohort Studies

10.21203/rs.3.rs-51246/v1 ◽

2020 ◽

Author(s):

Valeria Raparelli Raparelli ◽

Colleen M. Norris ◽

Uri Bender ◽

Maria Trinidad Herrero ◽

Alexandra Kautzky-Willer ◽

...

Keyword(s):

Data Structure ◽

Meta Analysis ◽

Synthetic Data ◽

Well Being ◽

Pooled Analysis ◽

Research Network ◽

Local Analysis ◽

Related Factors ◽

Individual Level ◽

Definition Of

Abstract Background: Gender refers to the socially constructed roles, behaviors, expressions, and identities of girls, women, boys, men, and gender diverse people. It influences self-perception, individual’s actions and interactions, as well as the distribution of power and resources in society. Gender-related factors are seldom assessed as determinants of health outcomes, despite their powerful contribution.Methods: Investigators of the GOING-FWD project developed a standard methodology applicable for observational studies to retrospectively identify gender-related factors to assess their relationship to outcomes and applied this method to selected cohorts of non-communicable chronic diseases from Austria, Canada, Spain, Sweden.Results: The following multistep process was applied. Step 1 (Identification of Gender-related Variables): Based on the gender framework of the Women Health Research Network (i.e. gender identity, role, relations, and institutionalized gender), and available literature for a certain disease, an optimal “wish-list” of gender-related variables/factors was created and discussed by experts. Step 2 (Definition of Outcomes): each of the cohort data dictionaries were screened for clinical and patient relevant outcomes, using the ICHOM framework. Step 3 (Building of Feasible Final List): A cross-validation between gender-related and outcome variables available per database and the “wish-list” was performed. Step 4 (Retrospective Data Harmonization): The harmonization potential of variables was evaluated. Step 5 (Definition of Data Structure and Analysis): Depending on the database data structure, the following analytic strategies were identified: (1) local analysis of data not transferable followed by a meta-analysis combining study-level estimates; (2) centrally performed federated analysis of anonymized data, with the individual-level participant data remaining on local servers; (3) synthesizing the data locally and performing a pooled analysis on the synthetic data; and (4) central analysis of pooled transferable data.Conclusion: The application of the GOING-FWD systematic multistep approach can help guide investigators to analyze gender and its impact on outcomes in previously collected data.

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Well-Being and Romantic Relationships: A Systematic Review in Adolescence and Emerging Adulthood

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16132415 ◽

2019 ◽

Vol 16 (13) ◽

pp. 2415 ◽

Cited By ~ 7

Author(s):

Mercedes Gómez-López ◽

Carmen Viejo ◽

Rosario Ortega-Ruiz

Keyword(s):

Systematic Review ◽

Romantic Relationships ◽

Emerging Adulthood ◽

Emerging Adults ◽

Meta Analysis ◽

Well Being ◽

The Other ◽

The One ◽

Definition Of ◽

The Relationship

Adolescence and emerging adulthood are both stages in which romantic relationships play a key role in development and can be a source of both well-being and negative outcomes. However, the limited number of studies prior to adulthood, along with the multiplicity of variables involved in the romantic context and the considerable ambiguity surrounding the construct of well-being, make it difficult to reach conclusions about the relationship between the two phenomena. This systematic review synthesizes the results produced into this topic over the last three decades. A total of 112 studies were included, following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. On the one hand, these works revealed the terminological heterogeneity in research on well-being and the way the absence of symptoms of illness are commonly used to measure it, while on the other hand, they also showed that romantic relationships can be an important source of well-being for both adolescents and emerging adults. The findings underline the importance of providing a better definition of well-being, as well as to attribute greater value to the significance of romantic relationships. Devoting greater empirical, educational, and community efforts to romantic development in the stages leading up to adulthood are considered necessary actions in promoting the well-being of young people.

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The Aging Experiences of LGBTQ Ethnic Minority Older Adults: A Systematic Review

The Gerontologist ◽

10.1093/geront/gnaa134 ◽

2020 ◽

Author(s):

Jinwen Chen ◽

Helen McLaren ◽

Michelle Jones ◽

Lida Shams

Keyword(s):

Systematic Review ◽

Older Adults ◽

Ethnic Minority ◽

Sexual Identity ◽

Meta Analysis ◽

Well Being ◽

Related Factors ◽

Gerontological Research ◽

Industrialized Nations ◽

Design And Methods

Abstract Background and Objectives In gerontological research and practice, an increasing amount of attention is being paid to lesbian, gay, bisexual, transgender, and queer (LGBTQ) older people and how their experiences differ from their heterosexual and cisgender counterparts. However, LGBTQ older adults themselves are not a homogenous group. Moreover, as the immigrant populations in industrialized nations age, the number of LGBTQ older adults from ethnic minority backgrounds will only grow. This systematic review hence investigates the experiences of LGBTQ ethnic minority older adults. Research Design and Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we conducted a systematic search in 5 databases for English peer-reviewed studies. The retrieved articles were coded and analyzed inductively using an intersectional framework to tease out the varying influences of ethnicity, age, gender, and sexual identity on the LGBTQ ethnic minority older adults’ experiences. Results A total of 30 articles across 21 studies (13 qualitative, 7 quantitative, and 1 mixed-methods) were identified. Six key themes emerged from the studies: stigma and discrimination; isolation, support and belonging; interactions with services and institutions; self-acceptance, resilience, and agency; mental health and well-being; and uncertain futures. Discussion and Implications The experiences of LGBTQ ethnic minority older adults echo those of LGBTQ ethnic majority older adults when they are shaped by gender and sexual identity factors. Nevertheless, significant differences in experiences—both positive and negative—emerge when cultural and ethnicity-related factors come to the fore. These findings emphasize the need for intersectional aging policies and services that go beyond catering for LGBTQ older adults to include the diversity within this subpopulation.

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Framing holistic indoor environment: Definitions of comfort, health and well-being

Indoor and Built Environment ◽

10.1177/1420326x19875795 ◽

2019 ◽

Vol 29 (8) ◽

pp. 1118-1136 ◽

Cited By ~ 2

Author(s):

Lasse Rohde ◽

Tine Steen Larsen ◽

Rasmus Lund Jensen ◽

Olena Kalyanova Larsen

Keyword(s):

Meta Analysis ◽

Well Being ◽

Indoor Environmental Quality ◽

Ontological Approach ◽

Formal Definitions ◽

Positive Experiences ◽

Enriched Environments ◽

Definition Of ◽

Positive Stimuli ◽

Health And Well Being

In research and assessment of indoor environmental quality (IEQ), the terms ‘Comfort’, ‘Health’ and ‘Well-being’ are often used interchangeably without a clear definition of terms or effects on conditions for occupants. This calls for a systematic restructuring of the ontological approach to IEQ and, based on a meta-analysis of recent IEQ literature, the authors suggest three substantial contributions: 1) A framework consisting of comfort, health and well-being as three equal branches of IEQ to increase focus on previously neglected aspects and make inter-domain relations more transparent. 2) The identification of key IEQ trends and by extension suggestions for formal definitions of three main domains as part of a multidisciplinary conceptual framework for working holistically with IEQ. 3) The introduction of positive stimuli to IEQ assessment as opposed to the predominance of focus on the absence of negative parameters of current practice. Through including this positive stimuli dimension, the field of IEQ shifts from ‘not bad’ to ‘truly good’, encouraging the design of enriched environments to further positive experiences improving occupant well-being.

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Text messages to reduce depressive symptoms: Do they work and what makes them effective? A systematic review

Health Education Journal ◽

10.1177/0017896920959368 ◽

2020 ◽

pp. 001789692095936

Author(s):

Katherine L Cox ◽

Sabine M Allida ◽

Maree L Hackett

Keyword(s):

Systematic Review ◽

Depressive Symptoms ◽

Text Messaging ◽

Meta Analysis ◽

Text Message ◽

Well Being ◽

Behavioural Therapy ◽

Pooled Analysis ◽

Text Messages ◽

World Health

Objective: In this systematic review and meta-analysis, we aimed to quantify the effects of text messaging interventions to reduce depressive symptoms and identify variables that might influence the effectiveness of the intervention. Design: Electronic databases including EMBASE, CENTRAL, MEDLINE, CINAHL, PsycINFO and SCOPUS, as well as Clinicaltrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) were searched for randomised controlled trials that sent one or more text messages with health-related content to adults who had been identified by a healthcare provider. Results: Seven trials (nine comparisons), with 1,918 participants, were included in the review, and the pooled analysis revealed a borderline statistically significant reduction in depressive symptom scores between the text messaging intervention and control groups (standardised mean difference [SMD], −0.27; 95% confidence interval [CI], −0.54 to 0.00; p = .00) favouring intervention at the end. Statistically significant reductions were shown in important subgroups, for example, where the primary aim of the messages was to reduce depressive symptoms; in those using the Beck Depression Inventory (BDI) or 9-item Patient Health Questionnaire (PHQ-9) questionnaires; where text message content was targeted at mental well-being, mood improvement and cognitive behavioural therapy information; and when the message frequency was ⩾2 times per week. Conclusion: Text messaging has potential to reduce depressive symptoms. The results of this review should be interpreted with caution, however, due to the methodological limitations of included trials. More research is required before recommendations can be made about the routine use of text messaging for the management of depressive symptoms.

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Factors Affecting Quality of Life in Patients with Unruptured Intracranial Aneurysm: A Systematic Review

Journal of Korean Academy of Fundamentals of Nursing ◽

10.7739/jkafn.2020.27.1.81 ◽

2020 ◽

Vol 27 (1) ◽

pp. 81-94

Author(s):

Hayoung Park ◽

Jinyoung Choi ◽

Sang Hui Chu

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Intracranial Aneurysm ◽

Short Form ◽

Meta Analysis ◽

Well Being ◽

Unruptured Intracranial Aneurysm ◽

Related Factors ◽

Factors Affecting

Purpose: The purpose of this study was to comprehensively explore factors affecting quality of life in patients with unruptured intracranial aneurysm (UIA).Methods: This study was conducted base on the National Evidence-based Healthcare Collaborating Agency (NECA) and Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). To search studies related to quality of life in patients with UIA. KoreaMed, Kmbase, Kiss, Pubmed, EMBASE, Cochrane Central and CINAHL were used. Key words were 'unruptured intracranial aneurysm', 'quality of life' and 'well-being'. A total of 136 studies were identified. After confirming duplication and abstracts, 15 studies were selected for analysis.Results: As a result, factors affecting the quality of life in patients with UIA were categorized into individual factors, disease related factors, symptom related factors, and functional related factors. The Short form-36 was one of the most frequently used measurements.Conclusion: To improve the quality of life of patients with UIA, researchers need to explore the multiple factors affecting quality of life in patients with UIA, and consider application of tools that can reflect the disease specific quality of life in patients with UIA.

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ETHICAL ISSUES IN CLINICAL TRIALS: A REVIEW OF THE RECENT LITERATURE, AN ETHICAL ARGUMENTATION

International Journal of Advanced Research ◽

10.21474/ijar01/12393 ◽

2021 ◽

Vol 9 (01) ◽

pp. 1079-1086

Author(s):

Maria Aziz ◽

◽

Azma J. Khan ◽

Sefia Khan ◽

◽

...

Keyword(s):

Clinical Trials ◽

Patient Care ◽

Ethical Issues ◽

Meta Analysis ◽

Clinical Care ◽

Well Being ◽

Best Interest ◽

Inform Consent ◽

Definition Of ◽

Ethical Oversight

Purpose: To identify ethical issues and risks involved in clinical trials and develop a conceptual model of identified issues in patient safety in clinical trials. Methodology: The review comprises of qualitative meta-analysis of available literature to identify potential ethical issues involved in the field of clinical trials. Findings: Our review identifies gaps in following core areas: 1) Research vs. Practice; 2) Inform Consent; 3) Ethical Oversight. Existing literature shows gaps in the true definition of research and does not clarify points of difference to clinical care. Existing guidelines are still confusing about the requirement of inform consent, in which cases it is mandatory and in which cases it should be waived off. There are indiscripencies, how much information should be provided in the inform consent disclosure. Is ethical oversight required in all research studies and if so at what level. We will build a streamline ethical argumentation to identify gaps in the existing literature, evaluate existing guidelines, analyze the contents to reach a conclusion and put forward recommendations for quality improvement. Conclusions: For the definition of research and its difference with clinical practice, decision should be taken in the best interest of the patient whether it is patient care or it is research.For ethical overview oversight, we suggest concept of proportionate review. Inform consent should be seeked in all researches but if becomes a barrier in patient care then waiver should be granted for the well-being of the patient. All information should be disclosed to the research participants so that they make an informed decision for their participation.

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