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P40 Is there an evidence base on reducing lifestyle risk behaviours in disadvantaged groups? A scoping review of systematic reviews
  1. Mark Rodgers1,
  2. Emily South1,
  3. Kath Wright1,
  4. Margaret Whitehead2,
  5. Amanda Sowden1
  1. 1Centre for Reviews and Dissemination, University of York, York, UK
  2. 2Department of Public Health and Policy, University of Liverpool, Liverpool, UK


Background Lifestyle risk behaviours are associated with an increased risk of non-communicable disease and mortality. There are socio-economic inequalities in these behaviours, with some behaviours being more prevalent in particular groups, such as prisoners, homeless people and Gyspies, Travellers and Roma. The aim of this scoping review was to identify and bring together existing evidence from systematic reviews on reducing risk behaviours in disadvantaged groups and highlight where there is insufficient evidence to inform policy.

Methods MEDLINE and Embase were searched up to October 2020 for English language reviews, with supplementary searching in Epistemonikos and Health Systems Evidence. Systematic reviews reporting behavioural outcomes of interventions targeting smoking, excessive alcohol use, unhealthy diet or physical inactivity in low income or socio-economic status (SES), unemployed people, homeless people, care leavers, prisoners, refugees or asylum seekers, Travellers, Gypsies or Roma, people with learning disabilities or deprived areas or communities were eligible. Reviews of population-level policies reporting differential effects for disadvantaged groups and qualitative reviews exploring barriers or facilitators to behaviour change were also included. The literature was mapped based on the group and behaviour targeted.

Results In total 9,336 records were screened, 262 full texts retrieved and 92 systematic reviews included. The majority of reviews included studies of people with low income or SES (n=68), with diet and low income the most frequently addressed combination. There were fourteen reviews on prisoners, 12 on deprived areas, ten on homeless people and nine on people with learning disabilities. Only three reviews included unemployed people and two included refugees or asylum seekers (both focusing on barriers and facilitators to healthy eating). No reviews were identified on care leavers or Gypsies, Travellers and Roma. In total there were 11 reviews targeting alcohol use. Sixteen qualitative reviews explored participants’ perceptions of barriers and facilitators to changing their behaviour.

Conclusion A large number of systematic reviews were identified but we found some evidence gaps where new syntheses or primary studies may be needed to guide policy, for example on care leavers, Gypsies, Travellers and Roma and refugees and asylum seekers. Other useful contributions might include an overview bringing together different interventions in low-income populations and an overview of the perceptions of disadvantaged groups about behaviour change, allowing common barriers to be identified as well as factors that are unique to specific groups.

  • risk behaviours
  • disadvantage
  • inequalities

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