Abstract
Objectives
To develop a theory-led framework to inform reviewers’ understanding of what, how,
and why health care interventions may lead to differential effects across socioeconomic
groups.
Study Design and Setting
A metaframework approach combined two theoretical perspectives (socioeconomic health
inequalities and complex interventions) into a single framework to inform socioeconomic
health inequality considerations in systematic reviews.
Results
Four theories relating to complexity within systematic reviews and 16 health inequalities
intervention theories informed the development of a metaframework. Factors relating
to the type of intervention, implementation, context, participant response, and mechanisms
associated with differential effects across socioeconomic groups were identified.
The metaframework can inform; reviewer discussions around how socioeconomic status
(SES) can moderate intervention effectiveness during question formulation, approaches
to data extraction and help identify a priori analysis considerations.
Conclusion
The metaframework offers a transparent, practical, theory-led approach to inform a
program theory for what, how, and why interventions work for different SES groups
in systematic reviews. It can enhance existing guidance on conducting systematic reviews
that consider health inequalities, increase awareness of how SES can moderate intervention
effectiveness, and encourage a greater engagement with theory throughout the review
process.
Keywords
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Maden M, McMahon N, Booth A, Dickson R, Paisley S, Gabbay M. Methodological challenges when developing meta-frameworks in evidence synthesis: a worked example of a socio-economic health inequalities meta-framework. Manuscript in preparation.
Article info
Publication history
Published online: August 17, 2018
Accepted:
August 12,
2018
Footnotes
Conflict of interest: None.
Identification
Copyright
Crown Copyright © 2018 Published by Elsevier Inc. All rights reserved.
