The economics of abortion and its links with stigma: A secondary analysis from a scoping review on the economics of abortion

Background Although abortions are a common aspect of people’s reproductive lives, the economic implications of abortion and the stigmas that surround abortion are poorly understood. This article provides an analysis of secondary data from a scoping review on the economic impact of abortion to understand the intersections between stigma and economics outcomes at the microeconomic (i.e., abortion seekers and their households), mesoeconomic (i.e., communities and health systems), and macroeconomic (i.e., societies and nation states) levels. Methods and findings We conducted a scoping review using the PRISMA extension for Scoping Reviews. Studies reporting on qualitative and/or quantitative data from any world region were considered. For inclusion, studies must have examined one of the following microeconomic, mesoeconomic, or macroeconomic outcomes: costs, benefits, impacts, and/or value of abortion-related care or abortion policies. Our searches yielded 19,653 items, of which 365 items were included in our final inventory. As a secondary outcome, every article in the final inventory was screened for abortion-related stigma, discrimination, and exclusion. One quarter (89/365) of the included studies contained information on stigma, though only 32 studies included stigma findings directly tied to economic outcomes. Studies most frequently reported stigma’s links with costs (n = 24), followed by economic impact (n = 11) and economic benefit (n = 1). Abortion stigma can prevent women from obtaining correct information about abortion services and laws, which can lead to unnecessary increases in costs of care and sizeable delays in care. Women who are unable to confide in and rely on their social support network are less likely to have adequate financial resources to access abortion. Conclusions Abortion stigma has a clear impact on women seeking abortion or post-abortion care at each level. Programmatic interventions and policies should consider how stigma affects delays to care, access to accurate information, and available social and financial support, all of which have economic and health implications.

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History and scientific background on the economics of abortion

PLoS ONE ◽

10.1371/journal.pone.0257360 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257360

Author(s):

Brittany Moore ◽

Yana van der Meulen Rodgers ◽

Ernestina Coast ◽

Samantha R. Lattof ◽

Cheri Poss

Keyword(s):

Scoping Review ◽

Evidence Base ◽

Economic Outcomes ◽

Secondary Outcome ◽

Care Seeking ◽

Safe Abortion ◽

World Region ◽

Abortion Care ◽

Scientific Background ◽

Scoping Reviews

Background Approximately one quarter of all pregnancies globally end in abortion, making it one of the most common gynecological practices worldwide. Despite the high incidence of abortion around the globe, the synthesis of known economic outcomes of abortion care and policies is lacking. Using data from a systematic scoping review, we synthesized the literature on the economics of abortion at the microeconomic, mesoeconomic, and mesoeconomic levels and presented the results in a collection of studies. This article describes the history and scientific background for collection, presents the scoping review framework, and discusses the value of this knowledge base. Methods and findings We conducted a scoping review using the PRISMA extension for Scoping Reviews. Studies reporting on qualitative and/or quantitative data from any world region were considered. For inclusion, studies must have examined one of the following outcomes: costs, impacts, benefits, and/or value of abortion-related care or policies. Our searches yielded 19,653 unique items, of which 365 items were included in our final inventory. Studies most often reported costs (n = 262), followed by impacts (n = 140), benefits (n = 58), and values (n = 40). Approximately one quarter (89/365) of studies contained information on the secondary outcome on stigma. Economic factors can lead to a delay in abortion care-seeking and can restrict health systems from adequately meeting the demand for abortion services. Provision of post-abortion care (PAC) services requires more resources then safe abortion services. Lack of insurance or public funding for abortion services can increase the cost of services and the overall economic impact on individuals both seeking and providing care. Conclusions Consistent economic themes emerge from research on abortion, though evidence gaps remain that need to be addressed through more standardized methods and consideration to framing of abortion issues in economics terms. Given the highly charged political nature of abortion around the world, it is imperative that researchers continue to build the evidence base on economic outcomes of abortion services and regulations.

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Economics of healthcare access in low-income and middle-income countries: a protocol for a scoping review of the economic impacts of seeking healthcare on slum-dwellers compared with other city residents

BMJ Open ◽

10.1136/bmjopen-2020-045441 ◽

2021 ◽

Vol 11 (7) ◽

pp. e045441

Author(s):

Noemia Teixeira de Siqueira-Filha ◽

Jinshuo Li ◽

Eliud Kibuchi ◽

Zahidul Quayyum ◽

Penelope Phillips-Howard ◽

...

Keyword(s):

Economic Impact ◽

Scoping Review ◽

Low Income ◽

Purchase Power Parity ◽

Healthcare Access ◽

Well Being ◽

Power Parity ◽

Middle Income ◽

Slum Dwellers ◽

Scoping Reviews

IntroductionPeople living in slums face several challenges to access healthcare. Scarce and low-quality public health facilities are common problems in these communities. Costs and prevalence of catastrophic health expenditures (CHE) have also been reported as high in studies conducted in slums in developing countries and those suffering from chronic conditions and the poorest households seem to be more vulnerable to financial hardship. The COVID-19 pandemic may be aggravating the economic impact on the extremely vulnerable population living in slums due to the long-term consequences of the disease. The objective of this review is to report the economic impact of seeking healthcare on slum-dwellers in terms of costs and CHE. We will compare the economic impact on slum-dwellers with other city residents.Methods and analysisThis scoping review adopts the framework suggested by Arksey and O’Malley. The review is part of the accountability and responsiveness of slum-dwellers (ARISE) research consortium, which aims to enhance accountability to improve the health and well-being of marginalised populations living in slums in India, Bangladesh, Sierra Leone and Kenya. Costs of accessing healthcare will be updated to 2020 prices using the inflation rates reported by the International Monetary Fund. Costs will be presented in International Dollars by using purchase power parity. The prevalence of CHE will also be reported.Ethics and disseminationEthical approval is not required for scoping reviews. We will disseminate our results alongside the events organised by the ARISE consortium and international conferences. The final manuscript will be submitted to an open-access international journal. Registration number at the Research Registry: reviewregistry947.

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Assessing individual readiness for change in healthcare: a review of measurement scales

Journal of Health Organization and Management ◽

10.1108/jhom-10-2020-0414 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Lisa Beasley ◽

Sandra Grace ◽

Louise Horstmanshof

Keyword(s):

Scoping Review ◽

Literature Search ◽

Readiness For Change ◽

Secondary Outcome ◽

Individual Response ◽

Content Type ◽

Healthcare Environment ◽

Scoping Reviews ◽

Change Leaders ◽

Response To Change

PurposeUnderstanding how individuals respond and adapt to change is essential to assist leaders to manage transformational change effectively. Contemporary health care environments are characterised by frequent and rapid change, often with unrealistic and challenging timeframes. Researchers have employed a range of assessment scales to assess individual readiness for change. Hence, to select the appropriate scale, it is critical to compare the properties of these instruments. A scoping review will be conducted to identify scales that measure an individual's response to change in the healthcare environment.Design/methodology/approachIn this article the authors used the PIC (Population or Problem, Interest, and Context) design and undertook a comprehensive literature search conducted in Eric, MEDLINE, EmCare, CINAHL, PsychINFO and PubMed. Management databases were also searched including Business Source Premium (Ebesco) and Business Collection (InfoRMIT). Reference lists were scrutinized, and citation searches were performed of the included studies. The primary outcome was the quality of the literature searches and the secondary outcome was time spent on the literature search when the PIC model was used as a search strategy tool, compared to the use of another conceptualizing tool or unguided searching.FindingsThis scoping review identified eight scales used to measure an individual's response to change. This scoping review did not identify any individual change readiness scales specifically designed for use in the healthcare environment. However, two scales (the Acceptance of Change Scale and the Resistance to Change Scale) had applicability across a wide variety of organisational settings.Research limitations/implicationsScoping reviews do not set out to comprehensively source all relevant literature but rather to ascertain the nature and extent of the published literature in the field. Therefore, it is possible that a systematic review might uncover additional relevant papers.Practical implicationsThis scoping review will assist change leaders to gain a better understanding of the different scales used to measure individual response to change.Originality/valueTo manage change effectively, change leaders first need to develop an understanding of how individuals respond and adapt to change. Change leaders require the necessary scales to assist them to understand change processes, providing an understanding of where individuals are placed on the change continuum. To the best of the authors' knowledge, this scoping review is the first of its kind to identify and review scales to measure individual response to change.

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Economics of abortion: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2019-029939 ◽

2019 ◽

Vol 9 (7) ◽

pp. e029939 ◽

Cited By ~ 1

Author(s):

Ernestina Coast ◽

Samantha R Lattof ◽

Yana van der Meulen Rodgers ◽

Brittany Moore

Keyword(s):

Scoping Review ◽

Economic Outcomes ◽

Primary Data ◽

Science Literature ◽

Safe Abortion ◽

Economic Implications ◽

Abortion Care ◽

Scoping Reviews ◽

The Impact ◽

Analytical Approaches

IntroductionAbortion is a common feature of people’s reproductive lives. However, the economic implications of abortion and policies affecting abortion provision are poorly understood. This scoping review aims to systematically review social science literature for studies that have investigated the impact of abortion care (ie, un/safe abortion, post-abortion care) or abortion policies on economic outcomes at the micro-levels (ie, abortion seekers and their households), meso-levels (ie, communities and health systems) and macro-levels (ie, societies and nation states). Informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline for protocols, this protocol details the scoping review’s methodological and analytical approaches.Methods and analysisThis scoping review will utilise the PRISMA extension for Scoping Reviews (PRISMA-ScR) tool. Studies reporting on qualitative and/or quantitative data from any world region will be considered. For inclusion, studies must examine one of the following economic outcomes at the micro-levels, meso-levels and/or macro-levels: costs, benefits, impacts and/or value of abortion care or abortion policies. Searches will be conducted in eight electronic databases. We will conduct the searches and application of inclusion/exclusion criteria according to the PRISMA-ScR flow approach. No assessments of items’ quality will be made, as the purpose of this scoping review is to synthesise and describe the coverage of the evidence. After extracting all data, we will inductively develop an economic framework around the economics of abortion. The analysis will synthesise the evidence base and identify knowledge gaps on the costs and benefits of abortion to stakeholders at various levels.Ethics and disseminationFormal ethical approval is not required, as primary data will not be collected in this study. The findings of this study will be disseminated through peer-reviewed publications, conference presentations, and condensed summaries for key stakeholders and partners in the field.

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Use of compression therapy to treat lower limb wounds across Europe: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2020-039008 ◽

2020 ◽

Vol 10 (9) ◽

pp. e039008

Author(s):

Ray Samuriwo ◽

Natalia Christiansen ◽

Alison Hopkins

Keyword(s):

Scoping Review ◽

Lower Limb ◽

Wound Care ◽

Relevant Literature ◽

Secondary Data ◽

Population Level ◽

Compression Therapy ◽

English Summary ◽

Lower Limbs ◽

Scoping Reviews

IntroductionPoor lower wound care is an avoidable patient harm. Compression therapy is an effective way of treating non-ischaemic lower limbs wounds, but it is not always used appropriately. There are many guidelines which set out how compression therapy should be used, but there is dearth of evidence about how it is actually used at a population level across Europe.AimThe aim of this scoping review is to map the evidence published in English relating to the use of compression therapy to treat lower limb wounds across Europe.MethodsThis scoping review will be conducted in line with the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols and Scoping Reviews guidance. A search for relevant publications will be conducted on variety of databases and key websites in order to identify a comprehensive range of relevant literature. Peer reviewed empirical papers, theoretical papers and other publications in English relating to the use of compression therapy across Europe will be considered for inclusion.Ethics and disseminationEthical and research governance for this scoping review is not required because we will only gather secondary data. Our results will be disseminated to the widest possible audience through an open access paper in a peer reviewed international journal, conference presentations and a plain English summary. The results of this scoping review will be used by a panel of Key Opinion Leaders from across Europe to develop a driver diagram to underpin subsequent lower limb wound care improvement efforts.

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Combining feminist intersectional and community-engaged research commitments: Adaptations for scoping reviews and secondary analyses of national data sets

Gateways International Journal of Community Research and Engagement ◽

10.5130/ijcre.v12i1.6193 ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

Leah Levac ◽

Ann B Denis

Keyword(s):

Scoping Review ◽

Public Services ◽

Research Collaboration ◽

Secondary Data ◽

Lessons Learned ◽

Data Sets ◽

Community Engaged Research ◽

Scoping Reviews ◽

Secondary Analyses ◽

Statistics Canada

As Hankivsky & Cormier (2011) and Denis (2008) note, the theoretical evolution of intersectionality has outpaced its methodological development. While past work has contributed to our understanding of how to apply intersectionality in research (CRIAW-ICREF & DAWN-RAFH 2014; Morris & Bunjan 2007; Simpson 2009), gaps persist. Drawing on a four-year community-university research collaboration called ‘Changing public services: Women and intersectional analysis’, we explore the incorporation of feminist intersectional and community-engaged research commitments into secondary data analyses, specifically a scoping review and secondary analyses of two Statistics Canada data sets. We discuss our application of these commitments across all stages of designing and undertaking these analyses, in particular drawing into focus the importance of dialogue and deliberation throughout our process. Our application of feminist intersectional and community-engaged commitments – including prioritising community benefit and practising self-reflexivity – revealed gaps and silences in the data, in turn improving our understanding of differences in people’s experiences, our critiques of policies and our identification of new research questions. The lessons learned, we conclude, are valuable for scholars, whether or not community engagement is central to their scholarly commitment. Keywordsfeminist intersectionality, community-engaged research, scoping review, logistic regression, community-university partnerships, Canadian public services

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What is known about the LGBTQ perspective in child welfare services? A scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2019-030675 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030675 ◽

Cited By ~ 1

Author(s):

Jannike Kaasbøll ◽

Veronika Paulsen

Keyword(s):

Child Welfare ◽

Scoping Review ◽

Service Providers ◽

Grey Literature ◽

Secondary Analysis ◽

Child Welfare Services ◽

Welfare Services ◽

Policy Practice ◽

Scoping Reviews ◽

Review Protocol

IntroductionIn previous studies, it is estimated that sexual minorities (eg, lesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals) are overrepresented in the child welfare system. However, the numbers are unclear, and there are limited studies in this field. No systematic review of LGBTQ issues across a broader context (ie, youth, foster parents and service providers) of child welfare services exists. The overall objective of this scoping review is to systematically scope the existing research on LGBTQ issues in the context of child welfare services, including policy, practice, service providers and users’ perspectives.Methods and analysisThe scoping review framework outlined by the Joanna Briggs Institute (JBI) based on previous work by Arksey and O’Malley and Levac and colleagues will guide this review. In addition, the PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation will be used throughout the process. We will search electronic databases (PubMed, EMBASE, PsycINFO, Web of Science and Idunn) and grey literature sources to identify studies that are appropriate for inclusion in this review. Using inclusion and exclusion criteria based on the ‘Population–Concept–Context’ framework, two researchers will independently screen titles, abstracts and full-text articles considered for inclusion. Any qualitative, quantitative and mixed-method study of LGBTQ issues in the child welfare context will be described and synthesised using a thematic synthesis approach.Ethics and disseminationA scoping review is a secondary analysis of published literature and does not require ethics approval. This scoping review is meant to provide an overview of the existing literature, aiming to expand policy-makers’ and practitioners’ knowledge of LGBTQ issues in a child welfare context and identify research gaps that can be used as a basis for further research. The results will be disseminated through a peer-reviewed publication, a conference presentation and a presentation to the key stakeholders.

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Physical functioning limitations and physical activity of people experiencing homelessness: A scoping review

HRB Open Research ◽

10.12688/hrbopenres.13011.1 ◽

2020 ◽

Vol 3 ◽

pp. 14

Author(s):

Sinéad Kiernan ◽

David Mockler ◽

Clíona Ní Cheallaigh ◽

Julie Broderick

Keyword(s):

Physical Activity ◽

Scoping Review ◽

Functional Limitations ◽

Grey Literature ◽

Secondary Outcome ◽

Physical Factors ◽

Secondary Outcome Measure ◽

Activity Levels ◽

Scoping Reviews ◽

Physical Activity Levels

Background: Adults who are experiencing homelessness suffer higher levels of premature mortality and age-related medical conditions compared to the general population, but little is known about physical factors that influence their health experience. This review aimed to evaluate what is known about physical functional limitations and physical activity levels, and how these constructs are measured in adults experiencing homelessness. Methods: This review was conducted in accordance with the Joanna Briggs Institute’s methodology for scoping reviews. Suitable quantitative and qualitative articles were searched using PubMed, CINAHL, EMBASE, PsychInfo, Web of Science and SCOPUS databases using a combination of keywords and medical subject headings and a grey literature search was also performed. Two reviewers independently screened articles for inclusion. Inclusion criteria were studies that examined physical functional limitations and/or physical activity among homeless adults (with/without co-occurring mental illness, infectious disease, substance use disorder), as a primary or secondary outcome measure. Results: We identified 15 studies for inclusion including 2,018 participants. Studies were primarily quantitative (n=11) and there were 4 qualitative studies. The following physical focused measures were evaluated across studies; mobility levels (n=2), frailty (n=1), flexibility (n=2), strength (n=1), physical symptom burden (n=3), physical activity levels (n=6) and exercise capacity (n=3). The majority of studies reported high levels of functional limitations among participants and low physical activity levels although a spectrum of abilities was noted. Conclusion: This review showed that many adults who are homeless appear to show a high burden of physical functional limitations and low physical activity levels but more objective and consistent measures should be applied to examine these factors in future studies. This will help address and plan future care, physical rehabilitation and housing needs for this vulnerable cohort. This scoping review will help direct research and future systematic reviews in this emerging area.

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Physical functioning limitations and physical activity of people experiencing homelessness: A scoping review

HRB Open Research ◽

10.12688/hrbopenres.13011.2 ◽

2021 ◽

Vol 3 ◽

pp. 14

Author(s):

Sinéad Kiernan ◽

David Mockler ◽

Clíona Ní Cheallaigh ◽

Julie Broderick

Keyword(s):

Physical Activity ◽

Scoping Review ◽

Physical Functioning ◽

Functional Limitations ◽

Secondary Outcome ◽

Physical Factors ◽

Secondary Outcome Measure ◽

Activity Levels ◽

Scoping Reviews ◽

Physical Activity Levels

Background: Adults who are experiencing homelessness suffer higher levels of premature mortality and age-related medical conditions compared to the general population, but little is known about physical factors that influence their health experience. The aim of this scoping review was to evaluate what is known about physical functional limitations and physical activity levels and how they are measured in adults experiencing homelessness. Methods: This review was conducted in accordance with the Joanna Briggs Institute’s methodology for scoping reviews. Suitable quantitative and qualitative articles were searched using PubMed, CINAHL, EMBASE, PsychInfo, Web of Science and SCOPUS databases using a combination of keywords and a gray literature search was performed. Two reviewers independently screened articles for inclusion. Inclusion criteria were studies that examined physical functional limitations and/or physical activity among homeless adults (with/without co-occurring mental illness, infectious disease, substance use disorder), as a primary or secondary outcome measure. Results: We identified 15 studies for inclusion including 2,018 participants. Studies were primarily quantitative (n=13) and there were 2 qualitative studies. The following outcomes related to physical functioning were reported; mobility levels (n=3), frailty (n=1), flexibility (n=2), strength (n=1), physical symptom burden (n=3), and exercise capacity (n=3). Eight studies reported outcomes related to physical activity. The majority of studies reported high levels of functional limitations among participants and low physical activity levels although a spectrum of abilities was noted. Conclusion: This review showed that many adults who are homeless appear to show a high burden of physical functional limitations and low physical activity levels but more objective and consistent measures should be applied to examine these factors in future studies. This will help address and plan future care, physical rehabilitation and housing needs for this vulnerable cohort. This scoping review will help direct research and future systematic reviews in this emerging area.

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Assessment of time-related deficits in older adults: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2021-050521 ◽

2021 ◽

Vol 11 (9) ◽

pp. e050521

Author(s):

Sebestina Anita Dsouza ◽

Meena Ramachandran ◽

Yuko Nishiura ◽

Bhumika Tumkur Venkatesh ◽

Lena Dahlberg

Keyword(s):

Older Adults ◽

Scoping Review ◽

Time Management ◽

Independent Living ◽

Cognitive Impairments ◽

Secondary Data ◽

Open Science ◽

Assessment Tools ◽

Daily Activities ◽

Scoping Reviews

IntroductionPeople with cognitive impairments often have difficulties in managing their time for daily activities. In older adults with cognitive impairments such as dementia and stroke, these may present as disorientation, poor time awareness, time perception, daily time management and so on. Time-related deficits and associated behaviours impede independent living and add considerably to caregiver strain. Several interventions are being investigated to help people with cognitive impairments orient and navigate time and do their daily activities. The provision of interventions requires the use of sound assessment tools. However, it is not clear how time-related concepts are specifically evaluated in practice, what are the available assessments and how these assessments should be selected.Method and analysisThis protocol follows the Joanna Briggs Institute Reviewer’s Manual (2020) for scoping reviews and is registered with the Open Science Framework (https://osf.io/4ptgy/). We will include the following databases: PubMed, CINAHL, Scopus, Web of Science and PsycINFO. Two reviewers will independently screen eligible studies for inclusion against the selection criteria and then review the full-text of the selected studies. We will extract the bibliographic data, study design and setting, and details of assessments used in the studies to evaluate time-related concepts including format, mode and duration of administration, psychometric properties and so on. The identified assessments will be mapped with regard to time-related concepts being evaluated and described using narrative synthesis.Ethics and disseminationAs secondary data analysis, ethics approval is not required for this scoping review. We plan to disseminate the results through peer-reviewed journals and conferences targeting health professionals working with older adults.

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