Browsing by Author "Kristjansson, Elizabeth"

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    Community-level interventions for improving access to food in low- and middle-income countries
    (Cochrane, 2015-02-02) Schoonees, Anel; Durao, Solange; Ramokolo, Vundli; Oliveira, Julicristie Machado De; Kristjansson, Elizabeth
    This is the protocol for a review and there is no abstract. The objectives are as follows: Primary objective : To determine the effects of community-level interventions that aim to improve access to nutritious food in LMICs, for both the whole community and for disadvantaged or at-risk individuals or groups within a community, such as infants and children, women, the elderly, the poor, the unemployed, or minority groups. Secondary objectives : To determine the features of community-level interventions that enable or impede the effective implementation of these interventions to improve access to food. To identify unintended consequences of interventions to improve access to food.
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    Reporting of health equity considerations in cluster and individually randomized trials
    (BMC (part of Springer Nature), 2020-04-03) Petkovic, Jennifer; Jull, Janet; Yoganathan, Manosila; Dewidar, Omar; Baird, Sarah; Grimshaw, Jeremy M.; Johansson, Kjell A.; Kristjansson, Elizabeth; McGowan, Jessie; Moher, David; Petticrew, Mark; Robberstad, Bjarne; Shea, Beverley; Tugwell, Peter; Volmink, Jimmy; Wells, George A.; Whitehead, Margaret; Cuervo, Luis G.; White, Howard; Taljaard, Monica; Welch, Vivian
    Background: The randomized controlled trial (RCT) is considered the gold standard study design to inform decisions about the effectiveness of interventions. However, a common limitation is inadequate reporting of the applicability of the intervention and trial results for people who are “socially disadvantaged” and this can affect policy-makers’ decisions. We previously developed a framework for identifying health-equity-relevant trials, along with a reporting guideline for transparent reporting. In this study, we provide a descriptive assessment of healthequity considerations in 200 randomly sampled equity-relevant trials. Methods: We developed a search strategy to identify health-equity-relevant trials published between 2013 and 2015. We randomly sorted the 4316 records identified by the search and screened studies until 100 individually randomized (RCTs) and 100 cluster randomized controlled trials (CRTs) were identified. We developed and pilottested a data extraction form based on our initial work, to inform the development of our reporting guideline for equity-relevant randomized trials. Results: In total, 39 trials (20%) were conducted in a low- and middle-income country and 157 trials (79%) in a high-income country focused on socially disadvantaged populations (78% CRTs, 79% RCTs). Seventy-four trials (37%) reported a subgroup analysis across a population characteristic associated with disadvantage (25% CRT, 49% RCTs), with 19% of included studies reporting subgroup analyses across sex, 9% across race/ethnicity/culture, and 4% across socioeconomic status. No subgroup analyses were reported for place of residence, occupation, religion, education, or social capital. One hundred and forty-one trials (71%) discussed the applicability of their results to one or more socially disadvantaged populations (68% of CRT, 73% of RCT). Discussion: In this set of trials, selected for their relevance to health equity, data that were disaggregated for socially disadvantaged populations were rarely reported. We found that even when the data are available, opportunities to analyze health-equity considerations are frequently missed. The recently published equity extension of the Consolidated Reporting Standards for Randomized Trials (CONSORT-Equity) may help improve delineation of hypotheses related to socially disadvantaged populations, and transparency and completeness of reporting of health-equity considerations in RCTs. This study can serve as a baseline assessment of the reporting of equity considerations.