Centering racial health equity in systematic reviews Paper 4

Abstract

Objectives: To identify evidence syntheses of health interventions addressing racial health equity reporting the use of equity-focused frameworks and logic models. Study Design and Setting: The search strategy included three sources; a search of three bibliographic databases to identify systematic reviews assessing interventions to improve racial health equity, semistructured interviews with diverse group and a targeted organization website searches (eg, National Institute of Health, United States Preventive Services Task Force) to identify relevant logic models and frameworks. The searches were conducted between January 1, 2020, and January 25, 2023. We used a qualitative approach to identify and describe key characteristics of equity-focused logic models and frameworks used in evidence syntheses. Results: Of the 153 racial health equity-focused evidence syntheses identified, two explicitly used logic models to describe the intervention mechanism. We identified seven existing health equity frameworks from semistructured interviews and electronic search of key websites that were categorized by stated purpose as providing guidance for 1) research, 2) health policy, 3) digital health-care solutions, and 4) clinical preventive services. Two out of seven frameworks included guidance on integrating frameworks or logic models in evidence synthesis while the majority provided contextual information on how to define or consider race or racism as a structural determinant of health. Conclusion: There is limited use of logic models and frameworks in evidence syntheses addressing racial health equity. There is a need for more applied frameworks providing guidance for framing, conducting and interpreting findings of evidence syntheses addressing racial health equity. (c) 2024 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).