Evidence map›Paper›PMID 36890466›Full record

SynthesisBMC public health2023

Do health education initiatives assist socioeconomically disadvantaged populations? A systematic review and meta-analyses.

E L Karran, A R Grant, H Lee, S J Kamper, C M Williams, L K Wiles, R Shala, C V Poddar, T Astill, G L Moseley

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
14.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.

  1. Pooled it
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  5. Review
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  7. Laying the Foundations for Co-Design: A Micro-Community Engagement Approach to Patient and Public Involvement in Rural Health Research.Health expectations : an international journal of public participation in health care and health policy · 2026
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  8. Canadian journal of pain = Revue canadienne de la douleur · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 4 countries.

E L KarranIIMPACT in Health, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia. emma.karran@unisa.edu.au.
A R GrantIIMPACT in Health, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
H LeeCentre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal, Sciences, University of Oxford, Oxford, UK.
S J KamperSchool of Health Sciences, University of Sydney, Sydney, NSW, Australia.
C M WilliamsUniversity of Newcastle, Sydney, NSW, Australia.
L K WilesIIMPACT in Health, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
R ShalaIIMPACT in Health, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
C V PoddarSir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, India.
T AstillWestern Sydney University, Sydney, NSW, Australia.
G L MoseleyIIMPACT in Health, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
University of South Australia · AUNuffield Orthopaedic Centre · GBSir H.N. Reliance Foundation Hospital and Research Centre · INSouth Australian Health and Medical Research Institute · AUUniversity of Newcastle Australia · AUUniversity of Prishtina · XKUniversity of Sydney · AUWestern Sydney University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHealth education interventions are considered critical for the prevention and management of conditions of public health concern. Although the burden of these conditions is often greatest in socio-economically disadvantaged populations, the effectiveness of interventions that target these groups is unknown. We aimed to identify and synthesize evidence of the effectiveness of health-related educational interventions in adult disadvantaged populations.

methodsWe pre-registered the study on Open Science Framework https://osf.io/ek5yg/ . We searched Medline, Embase, Emcare, and the Cochrane Register from inception to 5/04/2022 to identify studies evaluating the effectiveness of health-related educational interventions delivered to adults in socio-economically disadvantaged populations. Our primary outcome was health related behaviour and our secondary outcome was a relevant biomarker. Two reviewers screened studies, extracted data and evaluated risk of bias. Our synthesis strategy involved random-effects meta-analyses and vote-counting.

resultsWe identified 8618 unique records, 96 met our criteria for inclusion - involving more than 57,000 participants from 22 countries. All studies had high or unclear risk of bias. For our primary outcome of behaviour, meta-analyses found a standardised mean effect of education on physical activity of 0.05 (95% confidence interval (CI) = -0.09-0.19), (5 studies, n = 1330) and on cancer screening of 0.29 (95% CI = 0.05-0.52), (5 studies, n = 2388). Considerable statistical heterogeneity was present. Sixty-seven of 81 studies with behavioural outcomes had point estimates favouring the intervention (83% (95% CI = 73%-90%), p < 0.001); 21 of 28 studies with biomarker outcomes showed benefit (75% (95%CI = 56%-88%), p = 0.002). When effectiveness was determined based on conclusions in the included studies, 47% of interventions were effective on behavioural outcomes, and 27% on biomarkers.

conclusionsEvidence does not demonstrate consistent, positive impacts of educational interventions on health behaviours or biomarkers in socio-economically disadvantaged populations. Continued investment in targeted approaches, coinciding with development of greater understanding of factors determining successful implementation and evaluation, are important to reduce inequalities in health.

Indexed as

Health EducationVulnerable PopulationsAdultBiasHealth BehaviorHealth PromotionHumansHealth educationHealth promotionSocial determinants of healthSocio-economic disadvantageSystematic review

Identifiers

PMID36890466
PMCPMC9996883
OpenAlexW4323544232

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.