Examining subgroup effects by socioeconomic status of public health interventions targeting multiple risk behaviour in adolescence

BMC Public Health

Denise Gottfredson¹  D Paul Moberg²  Alberto Lana Perez³  David Wolfe⁴  Deborah Caldwell⁵  Matthew Hickman⁵  Laura Tinner⁵  Georgina J MacArthur⁵  Rona Campbell⁵ 

[1] Department of Criminology and Criminal Justice, University of Maryland;Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health;Department of Preventive Medicine and Public Health, School of Medicine and Health Sciences, University of Oviedo;Faculty of Education, Western University;Population Health Sciences, Bristol Medical School, University of Bristol;

关键词: Interventions;    Inequalities;    Socioeconomic status;    SES;    Multiple risk behaviour;    Adolescence;   

DOI  :  10.1186/s12889-018-6042-0

来源: DOAJ

【 摘 要 】

Abstract Background Multiple risk behaviour (MRB) refers to two or more risk behaviours such as smoking, drinking alcohol, poor diet and unsafe sex. Such behaviours are known to co-occur in adolescence. It is unknown whether MRB interventions are equally effective for young people of low and high socioeconomic status (SES). There is a need to examine these effects to determine whether MRB interventions have the potential to narrow or widen inequalities. Methods Two Cochrane systematic reviews that examined interventions to reduce adolescent MRB were screened to identify universal interventions that reported SES. Study authors were contacted, and outcome data stratified by SES and intervention status were requested. Risk behaviour outcomes alcohol use, smoking, drug use, unsafe sex, overweight/obesity, sedentarism, peer violence and dating violence were examined in random effects meta-analyses and subgroup analyses conducted to explore differences between high SES and low SES adolescents. Results Of 49 studies reporting universal interventions, only 16 also reported having measured SES. Of these 16 studies, four study authors provided data sufficient for subgroup analysis. There was no evidence of subgroup differences for any of the outcomes. For alcohol use, the direction of effect was the same for both the high SES group (RR 1.26, 95% CI: 0.96, 1.65, p = 0.09) and low SES group (RR 1.14, 95% CI: 0.98, 1.32, p = 0.08). The direction of effect was different for smoking behaviour in favour of the low SES group (RR 0.83, 95% CI: 0.66, 1.03, p = 0.09) versus the high SES group (RR 1.16, 95% CI: 0.82, 1.63, p = 0.39). For drug use, the direction of effect was the same for both the high SES group (RR 1.29, 95% CI: 0.97, 1.73, p = 0.08) and the low SES group (RR 1.28, 95% CI: 0.84, 1.96, p = 0.25). Conclusions The majority of studies identified did not report having measured SES. There was no evidence of subgroup difference for all outcomes analysed among the four included studies. There is a need for routine reporting of demographic information within studies so that stronger evidence of effect by SES can be demonstrated and that interventions can be evaluated for their impact on health inequalities.

【 授权许可】

Unknown