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Can health information and decision aids decrease inequity in health care? A systematic review.

Christin Ellermann1, Jana Sophie Hinneburg1,2, Christoph Wilhelm1

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Summary
This summary is machine-generated.

Evidence-based health information (EBHI) and patient decision aids (PtDAs) can improve healthcare decisions. However, few studies examine if different sociodemographic groups benefit equally, potentially masking health inequities.

Keywords:
Health Services AccessibilityPublic HealthSociodemographic FactorsSystematic Review

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Area of Science:

  • Health Services Research
  • Health Equity
  • Patient Decision Making

Background:

  • Evidence-based health information (EBHI) and patient decision aids (PtDAs) are crucial for informed healthcare choices.
  • Sociodemographic factors can influence access to and benefit from health information, potentially creating inequities.
  • Previous evaluations have not consistently assessed these inequities.

Purpose of the Study:

  • To systematically review studies evaluating EBHI and PtDAs.
  • To determine the extent to which inequity-producing factors are considered in these studies.
  • To assess whether different sociodemographic groups benefit equally from EBHI and PtDAs in terms of informed decision-making.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs).
  • Searches conducted across multiple databases (Cochrane Library, MEDLINE, EMBASE, etc.) from inception to May 2023.
  • Included RCTs of EBHI and PtDAs that considered factors associated with unequal opportunities (PROGRESS-Plus criteria).

Main Results:

  • Only a few studies examined the impact of EBHI/PtDAs on outcomes related to informed decision-making concerning inequity-producing factors.
  • Of 12 included studies, two showed a positive association and three a negative association between intervention effectiveness and disadvantaged status.
  • Most studies found no significant differences in knowledge gain, decision conflict, or shared decision-making across sociodemographic groups, likely due to underpowered subgroup analyses.

Conclusions:

  • EBHI and PtDAs are effective in promoting healthcare decision-making.
  • Greater attention to methodological requirements in evaluations is needed to capture potential differences in access to health information.
  • Ensuring equitable healthcare improvement requires fully understanding how different populations benefit from EBHI and PtDAs.