University of York
England’s public health policy aims to combine overall improvements in population health with greater improvements among disadvantaged groups and communities. The most deprived areas of England have the lowest healthy life expectancy and there is a twenty year difference between people living in the most and least deprived parts of the country. Heart disease, stroke, cancer and respiratory illness are the top contributors to this difference. Risk behaviours - physical inactivity, poor diet, smoking and alcohol misuse – are major contributors..
There is a growing evidence base about the effectiveness of programmes to improve health behaviours in disadvantaged groups. In order to answer questions about what works to reduce inequalities this evidence needs to be brought together. We carried out a scoping review (phase 1) where we identified and mapped systematic reviews addressing key risk behaviours in different disadvantaged groups. This process identified both evidence gaps as well as areas where existing review evidence was plentiful. In discussion with policy teams at DHSC and PHE we prioritised options for new syntheses leading to the decision to undertake an overview (review of reviews) evaluating the effects of interventions targeting low SES groups and/or people living in deprived areas. An overview of the evidence is appropriate, as we identified approximately 70 reviews with a focus on low SES groups in our scoping review. This means we can examine a broad range of intervention types in a timely and efficient manner, highlighting knowledge gaps and priorities for new systematic reviews or primary research. Overviews bring together existing reviews in a transparent and systematic way and aid decision-making by gathering, appraising and systematically analysing this evidence.
To identify, ‘map’, and synthesise evidence on interventions to reduce risk behaviours in disadvantaged groups and among people living in deprived areas.
We will determine which interventions are likely to be effective (and ineffective) with which groups and identify barriers and facilitators to adopting healthy lifestyles.
We will identify gaps in the evidence base and make recommendations for new research.
- Overview of risk behaviour interventions targeting one or more of smoking, unhealthy diet, physical inactivity, and alcohol misuse in low SES groups and/or people living in deprived areas.
- We will follow Cochrane methods for Overviews of Reviews.
- We will assess the methodological quality of included reviews using the AMSTAR 2 tool. We will extract descriptive characteristics for each review alongside information about interventions (including underpinning theory), participants, context, and outcomes (including process and qualitative data). We will present individual narrative summaries of the data contained in each review which will be supplemented with summary tables. Interventions and policies will be grouped and synthesised according to their undepinning theory, based on the Typology of actions to tackle social inequalities in health.