Background Adolescence is a key period for health and development. There is evidence for interventions to promote health in adolescence, yet health inequalities persist into adulthood. Whilst there is robust data describing socioeconomic inequalities in adult health, there is comparatively less on adolescent health, and we have little insight on what works to tackle inequities in adolescence. We aimed to apply an “equity lens” to systematic review evidence on population interventions for adolescent health. Specifically, we aimed to synthesise systematic review evidence on the equity impact of population interventions designed to improve health, happiness and wellbeing in children and young adults aged 10–24 years.
Methods A rapid systematic review of reviews (an overview) was conducted. We systematically searched the Cochrane Database of Systematic Reviews; Health technology assessments (HTA); Campbell Collaboration; EPPI; Joanna Briggs Library; and Database of Reviews of Effects (DARE), MEDLINE, EMBASE, CINAHL, PsycINFO and PubMed for systematic reviews published in English between 01 January 2005 and 07 March 2016. Two reviewers independently applied pre-specified selection criteria. Methodological quality was independently assessed using the ROBIS tool. Disagreements were resolved through discussion. Key data relating to the review focus, including information on the review aim, participants, interventions, comparisons and outcomes were extracted. Data on whether reviews reported the socioeconomic characteristics of primary studies, differential effects, or the delivery of population interventions with disadvantaged groups were also collated. Data were synthesised within evidence tables, categorised according to themes and subthemes.
Results We identified 35 310 reviews, screened 1953 abstracts and retrieved 566 full text articles. 150 reviews, assessed as either low risk of bias or unclear risk of bias were included in the final synthesis. Evidence was mapped across 9 topic areas; mental health and wellbeing; tobacco free living; preventing drug abuse and excessive drinking; sexual and reproductive health; violence and abuse free living; active living; healthy eating; obesity and general health. The majority of reviews did not describe the socioeconomic characteristics of primary studies, and examination of the differential impact of population interventions varied widely across topic areas.
Conclusion Systematic review evidence on the equity impact of population interventions for adolescents is limited. To the best of our knowledge, this is the first overview to synthesise review evidence with a focus on transition from adolescence to adulthood. This work provides important insights on how we can advance a focus on equity and considers the implications for addressing inequalities in adolescent health.
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