Mobile Health Interventions to Support Caregivers of Older Adults: An Equity-Focused Systematic Review (Preprint)

2021 ◽  
Author(s):  
Anna Garnett ◽  
Melissa Northwood ◽  
Justine Ting ◽  
Ruheena Sangrar
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Social Determinants Of Health ◽  
Mobile Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Health Technologies ◽  
Health And Wellbeing ◽  
The Social ◽  
The Impact

BACKGROUND Caregivers provide crucial support to older adults so they can remain safely in their homes as they age. Over time, caregivers’ own health can be negatively impacted by their caregiving role. The social determinants of health, such as gender and socioeconomic status, can influence assuming a caregiving role as well as the impacts of caregiving on the caregiver. While programs exist to support caregivers, uptake of these services does not match the need for services expressed by caregivers. Research suggests that supportive interventions offered via mobile health technologies have the potential to increase caregiver accessibility of supportive services. However, a knowledge gap exists regarding the extent to which the social determinants of health are considered in the design, implementation, and evaluation of mobile health (mHealth) interventions intended to support caregivers of older adults. Furthermore, a comprehensive review of the impact of mHealth interventions in this population does not exist. OBJECTIVE To conduct a systematic review to: (1) determine how health inequities are considered in the design, implementation, and evaluation of mHealth interventions for caregivers of older adults using Cochrane-Equity's PROGRESS-Plus framework; and (2) synthesize evidence of the impacts of caregiver-focused mHealth interventions. METHODS A systematic review was conducted in five databases and articles published between January 2010 and June 2021 were included if they evaluated or explored the impacts of mHealth interventions on the health and wellbeing of informal caregivers of older adults. mHealth interventions were defined as those that caregivers of older adults accessed via mobile or wireless devices. RESULTS A total of 28 articles met the inclusion criteria and were included in the systematic review. The interventions evaluated by the included studies sought to help caregivers make connections with services, facilitate the caregiving process, and promote the caregivers’ health and wellbeing. The PROGRESS-Plus framework factors were mainly considered in the results, discussion, and limitations sections of included studies. Some PROGRESS-Plus factors such as sexual orientation, religion and occupation, received little to no consideration in all phases of intervention design, implementation, or evaluation. Overall, findings of this review suggest that mHealth interventions were positively received by users. Such interventions may have the potential to reduce caregiver burden and positively impact caregivers’ physical and mental health while supporting them in their caregiving role. Study findings highlight the importance of available supports to help facilitate caregivers’ use of mHealth interventions particularly early on as well as the use of appropriate language and text. CONCLUSIONS Successful uptake and spread of mHealth interventions to support caregivers of older adults will depend on creating opportunities for inclusive involvement of a broad range of stakeholders at all stages of design, implementation, and assessment. CLINICALTRIAL PROSPERO CRD42021239584; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=239584

scholarly journals Teaching the social determinants of health through medical legal partnerships: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristian Welch ◽  
Benjamin Robinson ◽  
Michaela Lieberman Martin ◽  
Amy Salerno ◽  
Drew Harris
Keyword(s):  
Systematic Review ◽  
Medical Education ◽  
Social Determinants Of Health ◽  
Graduate Medical Education ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Graduate Medical ◽  
The Social ◽  
The Impact ◽  
Future Practice

Abstract Background Undergraduate and graduate medical education often includes the social determinants of health, but questions remain regarding how best to ensure that trainees become empowered to take action on the social determinants of health in their future practice. The authors conducted a systematic review to better define the impact that educational programs centered on medical legal partnerships have on trainees’ knowledge, attitudes and future practice. The authors sourced data from PubMed, Web of Science, Index to Legal Periodicals, LegalTrac, Google Scholar, Academic Search Complete, Business Source Complete, SocINDEX, SSRN, and Proquest Social Sciences. Selected studies included those centered on Medical Legal Partnerships in undergraduate or graduate medical education and that measured outcomes of the participating trainees. Two abstractors independently extracted information about the study population, setting, design, intervention and outcomes. Results Six out of 483 studies met the inclusion criteria. One study highlighted four different MLPs, thus nine total MLP programs were included. Trainees included medical students as well as interns and residents from pediatrics, family medicine and internal medicine. Interventions ranged from didactic sessions, to advocacy projects, to hands-on community-based learning, to poverty simulation trainings. Benefits to trainees were wide in scope but all programs showed improvements in participants’ understanding, comfort, confidence, and/or abilities in identifying and intervening on the social determinants of health in their patients. Conclusion As medical schools and residency programs are increasingly considering how to effectively teach trainees to understand and address the social determinants of health, the findings in this systematic review suggest that inclusion of Medical Legal Partnerships into training programs is an effective approach.

scholarly journals Impact of the Peace Agreement on the social determinants of health in Colombia

2021 ◽  
Vol 74 (2) ◽  
Author(s):  
Edna Johana Mondragón-Sánchez ◽  
Reinaldo Gutiérrez Barreiro ◽  
Marcos Venícios de Oliveira Lopes ◽  
Ana Karina Bezerra Pinheiro ◽  
Priscila de Souza Aquino ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Inequalities ◽  
Positive Impact ◽  
Peace Process ◽  
Determinants Of Health ◽  
Structural Determinants ◽  
Peace Agreement ◽  
The Social ◽  
The Impact

ABSTRACT Objectives: to analyze the impact of the Colombian Peace Agreement on the structural social determinants of health. Methods: a descriptive, ecological study, based on documentary data from 2008 to 2018. The records of victims, epidemiological indicators, and structural social determinants of health in Colombia were analyzed. Results: there was a correlation between the period in which the Peace Agreement process was developed and the indicators of structural determinants in health with p<0.05. With the Poisson regression analysis, the favorable correlations between the peace process and the determinants were confirmed, besides allowing the understanding of the changes in these indicators before the Peace Agreement. Conclusions: the implementation of the peace process has a positive impact on structural social determinants of health, which is observed by the beginning of the decrease of economic, educational, health, and social inequalities and inequities, a fact that offers the possibility of living in peace.

scholarly journals How can social enterprises impact health and well-being?

2018 ◽  
Vol 24 (3) ◽  
pp. 697-713 ◽  
Author(s):  
Katy Gordon ◽  
Juliette Wilson ◽  
Andrea Tonner ◽  
Eleanor Shaw
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Enterprise ◽  
Well Being ◽  
Social Enterprises ◽  
Determinants Of Health ◽  
Content Type ◽  
The Social ◽  
The Impact ◽  
Health And Well Being

Purpose The purpose of this paper is to examine the impacts of social enterprise on individual and community health and well-being. It focusses on community food initiatives, their impact on the social determinants of health and the influence of structure on their outcomes. Design/methodology/approach Using an interpretive qualitative approach through case studies focussed on two community food social enterprises, the research team conducted observations, interviews and ad hoc conversations. Findings Researchers found that social enterprises impacted all layers of the social determinants of health model but that there was greater impact on individual lifestyle factors and social and community networks. Impact at the higher socio-economic, cultural and environmental layer was more constrained. There was also evidence of the structural factors both enabling and constraining impact at all levels. Practical implications This study helps to facilitate understanding on the role of social enterprises as a key way for individuals and communities to work together to build their capabilities and resilience when facing health inequalities. Building upon previous work, it provides insight into the practices, limitations and challenges of those engaged in encouraging and supporting behavioural changes. Originality/value The paper contributes to a deeper insight of the use, motivation and understanding of social enterprise as an operating model by community food initiatives. It provides evidence of the impact of such social enterprises on the social determinants of health and uses structuration theory (Giddens, 1984) to explore how structure both influences and constrains the impact of these enterprises.

Social Forces and Their Impact on Health

2017 ◽  
Author(s):  
Joia S. Mukherjee
Keyword(s):  
Social Determinants Of Health ◽  
Health Equity ◽  
Social Determinants ◽  
Premature Death ◽  
Social Medicine ◽  
Determinants Of Health ◽  
Biomedical Science ◽  
Adverse Health Effects ◽  
The Social ◽  
The Impact

This chapter focuses on the social determinants of health. The phrase—the social determinants of health—is used to describe the factors and forces in society that cause ill health and premature death. To achieve health equity, it is important to understand the impact of social determinants and work to mitigate their adverse health effects. The practice of social medicine uses a biosocial approach that merges biomedical science with social analysis to design programs that strive for health equity. Because of the historical and geopolitical forces that have shaped global inequities, social medicine and a biosocial approach are important in global health and health equity and are addressed in this chapter.

scholarly journals Are COVID-19 models blind to the social determinants of health? A systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048995
Author(s):  
Ava John-Baptiste ◽  
Marc S Moulin ◽  
Shehzad Ali
Keyword(s):  
Infectious Disease ◽  
Systematic Review ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Factors ◽  
Determinants Of Health ◽  
Disease Models ◽  
The Social ◽  
Modelling Studies ◽  
Infectious Disease Models

IntroductionInfectious disease models are important tools to inform public health policy decisions. These models are primarily based on an average population approach and often ignore the role of social determinants in predicting the course of a pandemic and the impact of policy interventions. Ignoring social determinants in models may cause or exacerbate inequalities. This limitation has not been previously explored in the context of the current pandemic, where COVID-19 has been found to disproportionately affect marginalised racial, ethnic and socioeconomic groups. Therefore, our primary goal is to identify the extent to which COVID-19 models incorporate the social determinants of health in predicting outcomes of the pandemic.Methods and analysisWe will search MEDLINE, EMBASE, Cochrane Library and Web of Science databases from December 2019 to August 2020. We will assess all infectious disease modelling studies for inclusion of social factors that meet the following criteria: (a) focused on human spread of SARS-CoV-2; (b) modelling studies; (c) interventional or non-interventional studies; and (d) focused on one of the following outcomes: COVID-19-related outcomes (eg, cases, deaths), non-COVID-19-related outcomes (ie, impacts of the pandemic or control policies on other health conditions or health services), or impact of the pandemic or control policies on economic outcomes. Data will only be extracted from models incorporating social factors. We will report the percentage of models that considered social factors, indicate which social factors were considered, and describe how social factors were incorporated into the conceptualisation and implementation of the infectious disease models. The extracted data will also be used to create a narrative synthesis of the results.Ethics and disseminationEthics approval is not required as only secondary data will be collected. The results of this systematic review will be disseminated through peer-reviewed publication and conference proceedings.PROSPERO registration numberCRD42020207706.

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