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The effectiveness of community engagement in public health interventions for disadvantaged groups: a meta-analysis.

O'Mara-Eves A, Brunton G, Oliver S, Kavanagh J, Jamal F, Thomas J - BMC Public Health (2015)

Bottom Line: The overall effect size for health behaviour outcomes is d = .33 (95% CI .26, .40).Although the type of community engagement was not a significant moderator of effect, we identified some trends across studies.There is insufficient evidence to determine whether one particular model of community engagement is more effective than any other.

View Article: PubMed Central - PubMed

Affiliation: Social Science Research Unit, UCL Institute of Education, London, UK. a.omara-eves@ioe.ac.uk.

ABSTRACT

Background: Inequalities in health are acknowledged in many developed countries, whereby disadvantaged groups systematically suffer from worse health outcomes such as lower life expectancy than non-disadvantaged groups. Engaging members of disadvantaged communities in public health initiatives has been suggested as a way to reduce health inequities. This systematic review was conducted to evaluate the effectiveness of public health interventions that engage the community on a range of health outcomes across diverse health issues.

Methods: We searched the following sources for systematic reviews of public health interventions: Cochrane CDSR and CENTRAL, Campbell Library, DARE, NIHR HTA programme website, HTA database, and DoPHER. Through the identified reviews, we collated a database of primary studies that appeared to be relevant, and screened the full-text documents of those primary studies against our inclusion criteria. In parallel, we searched the NHS EED and TRoPHI databases for additional primary studies. For the purposes of these analyses, study design was limited to randomised and non-randomised controlled trials. Only interventions conducted in OECD countries and published since 1990 were included. We conducted a random effects meta-analysis of health behaviour, health consequences, self-efficacy, and social support outcomes, and a narrative summary of community outcomes. We tested a range of moderator variables, with a particular emphasis on the model of community engagement used as a potential moderator of intervention effectiveness.

Results: Of the 9,467 primary studies scanned, we identified 131 for inclusion in the meta-analysis. The overall effect size for health behaviour outcomes is d = .33 (95% CI .26, .40). The interventions were also effective in increasing health consequences (d = .16, 95% CI .06, .27); health behaviour self-efficacy (d = .41, 95% CI .16, .65) and perceived social support (d = .41, 95% CI .23, .65). Although the type of community engagement was not a significant moderator of effect, we identified some trends across studies.

Conclusions: There is solid evidence that community engagement interventions have a positive impact on a range of health outcomes across various conditions. There is insufficient evidence to determine whether one particular model of community engagement is more effective than any other.

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Prioritisation and selection of studies for the meta-analysis.
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Fig2: Prioritisation and selection of studies for the meta-analysis.

Mentions: In total, this gave us 1,151 primary study reports to screen on full text, from which a total of 361 reports of 319 studies met our inclusion criteria. After mapping the characteristics of the 319 studies we had identified, we consulted our advisory group and narrowed the focus of the meta-analysis to those studies of high priority areas for the UK, as identified in the Marmot review (8). This is summarised in Figure 2.Figure 2


The effectiveness of community engagement in public health interventions for disadvantaged groups: a meta-analysis.

O'Mara-Eves A, Brunton G, Oliver S, Kavanagh J, Jamal F, Thomas J - BMC Public Health (2015)

Prioritisation and selection of studies for the meta-analysis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4374501&req=5

Fig2: Prioritisation and selection of studies for the meta-analysis.
Mentions: In total, this gave us 1,151 primary study reports to screen on full text, from which a total of 361 reports of 319 studies met our inclusion criteria. After mapping the characteristics of the 319 studies we had identified, we consulted our advisory group and narrowed the focus of the meta-analysis to those studies of high priority areas for the UK, as identified in the Marmot review (8). This is summarised in Figure 2.Figure 2

Bottom Line: The overall effect size for health behaviour outcomes is d = .33 (95% CI .26, .40).Although the type of community engagement was not a significant moderator of effect, we identified some trends across studies.There is insufficient evidence to determine whether one particular model of community engagement is more effective than any other.

View Article: PubMed Central - PubMed

Affiliation: Social Science Research Unit, UCL Institute of Education, London, UK. a.omara-eves@ioe.ac.uk.

ABSTRACT

Background: Inequalities in health are acknowledged in many developed countries, whereby disadvantaged groups systematically suffer from worse health outcomes such as lower life expectancy than non-disadvantaged groups. Engaging members of disadvantaged communities in public health initiatives has been suggested as a way to reduce health inequities. This systematic review was conducted to evaluate the effectiveness of public health interventions that engage the community on a range of health outcomes across diverse health issues.

Methods: We searched the following sources for systematic reviews of public health interventions: Cochrane CDSR and CENTRAL, Campbell Library, DARE, NIHR HTA programme website, HTA database, and DoPHER. Through the identified reviews, we collated a database of primary studies that appeared to be relevant, and screened the full-text documents of those primary studies against our inclusion criteria. In parallel, we searched the NHS EED and TRoPHI databases for additional primary studies. For the purposes of these analyses, study design was limited to randomised and non-randomised controlled trials. Only interventions conducted in OECD countries and published since 1990 were included. We conducted a random effects meta-analysis of health behaviour, health consequences, self-efficacy, and social support outcomes, and a narrative summary of community outcomes. We tested a range of moderator variables, with a particular emphasis on the model of community engagement used as a potential moderator of intervention effectiveness.

Results: Of the 9,467 primary studies scanned, we identified 131 for inclusion in the meta-analysis. The overall effect size for health behaviour outcomes is d = .33 (95% CI .26, .40). The interventions were also effective in increasing health consequences (d = .16, 95% CI .06, .27); health behaviour self-efficacy (d = .41, 95% CI .16, .65) and perceived social support (d = .41, 95% CI .23, .65). Although the type of community engagement was not a significant moderator of effect, we identified some trends across studies.

Conclusions: There is solid evidence that community engagement interventions have a positive impact on a range of health outcomes across various conditions. There is insufficient evidence to determine whether one particular model of community engagement is more effective than any other.

Show MeSH