Age- and gender-based social inequalities in palliative care for cancer patients: a systematic literature review.

Objectives: Cancer is a major public health problem worldwide, given its magnitude and growing burden, in addition to the repercussions on health and quality of life. Palliative care can play an important role improving quality of life and it is cost-effective, but some population groups may not benefit from it or benefit less based on age and gender inequalities. The aim of this systematic review was to analyze the available evidence on age- and gender-based social inequalities in access to and use of palliative care in cancer patients. Methods: A systematic review was conducted following the PRISMA guidelines. An exhaustive literature research was performed in Pubmed, CINHAL and Embase until November 2022 and were not restricted by language or date of publication. Eligible studies were observational studies analyzing the access and use of palliative care in cancer patients. Results: Fifty-three studies were included in the review. Forty-five analyzed age and 44 analyzed gender inequalities in relation to use of and access to palliative care. Our results show that older people receive poorer quality of care, worst symptom control and less preferences for palliative care. In relation to gender, women have a greater preference for the use of palliative care and generally have more access to basic and specialized palliative care services and palliative care facilities. Conclusion: This review reveals difficulties for older persons and men for access to key elements of palliative care and highlights the need to tackle access barriers for the most vulnerable population groups. Innovative collaborative services based around patient, family and wider community are needed to ensure optimal care.

Characteristics and effectiveness of interventions to reduce cyberbullying: a systematic review.

Background: This paper presents the results from a systematic review on the effectiveness of interventions to reduce Cyberbullying (CB) as a function of their outcomes and main characteristics; and an analysis of the level of completeness to which the characteristics of these interventions are described. Methods: Systematic searches were conducted in PubMed, Scopus, ERIC and Psycinfo databases on February 14, 2022. In addition, relevant publications were hand searched for relevant studies. We considered interventions that provided data on CB prevalence changes in populations between primary school and college age. Results: In total, 111 studies were retained for further screening from 3,477 results. Following rigorous screening, 43 reports including 46 studies and information from 36 different interventions were included in our systematic review. Results shows that most of the interventions measuring reductions in global CB, cyberperpetration/victimization, cybervictimization and cyberperpetration were effective or partially effective. While the interventions measuring reductions in cyber-bystanding were not effective. Multicomponent interventions showed higher effectiveness than single-component interventions. After completion of the TIDieR check-list, included interventions were considered to offer an insufficient level of detail for a number of the analyzed items in relation to "how well planned," "intervention modifications" and "tailoring." Conclusion: Given the aforementioned, it is critical to increase the number of studies and the quality of interventions targeting CB and the level of detail of its description in order to obtain more robust outcomes about how to reduce its prevalence and facilitate the replication of the effective interventions. Systematic review registration: https://archive.org/details/osf-registrations-wn5u4-v1, Identifer DOI: 10.17605/OSF.IO/WN5U4.

Effectiveness of patient-targeted interventions to increase cancer screening participation in rural areas: A systematic review.

BACKGROUND: Cancer is a major public health problem worldwide. The GLOBOCAN estimated 18.1 million new cases of cancer and 9.6 million deaths from cancer in 2018. In some of the more frequent cancers, mortality can be significantly reduced through cancer screening programs. Nevertheless, socially disadvantaged groups have difficulties in benefitting from these screening programs, especially rural populations. OBJECTIVE: To identify, characterize and summarize patient-targeted interventions aimed at increasing cancer screening participation among rural populations. METHODS: An exhaustive literature search was performed in the most relevant bibliographic databases for biomedical research. The systematic review was reported according to the PRISMA guidelines. RESULTS: Twenty studies assessing 37 interventions were identified. Most of the studies were conducted in the United States and targeted women. Ninety-seven percent of the interventions were aimed at increasing community demand, 65% community access and 11% provider delivery. Our findings suggest that 21 of the 37 interventions using a multicomponent approach were effective in increasing breast, cervical and colorectal cancer screening in rural areas. CONCLUSIONS: Multicomponent interventions were effective in increasing breast, cervical and colorectal cancer screening among rural populations, and nurse-led interventions contributed to improving cancer screening participation. Moreover, the involvement of communities in the development of interventions can facilitate the participation in cancer screening programs among rural residents.

Effectiveness of interventions to improve cancer treatment and follow-up care in socially disadvantaged groups.

OBJECTIVE: To identify and characterize the interventions that aimed to improve cancer treatment and follow-up care in socially disadvantaged groups. To summarize the state of the art for clinicians and researchers. METHODS: We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were randomized controlled trials and quasi-experimental studies with a control group (usual care or enhanced usual care) conducted in Organization for Economic Co-operation and Development (OECD) member countries and published until 2016. RESULTS: Thirty-one interventions were identified, the majority of which were conducted in the United States in patients with breast cancer. Most interventions aimed to decrease social inequalities based on ethnicity/race and/or socioeconomic level, with fewer interventions targeting inequalities based on geographical area. The most frequently assessed outcomes were quality of life (n = 20) and psychosocial factors (n = 20), followed by treatment adherence or satisfaction (n = 12,), knowledge (n = 11), pain management (n = 10), and lifestyle habits (n = 3). CONCLUSIONS: The impact of interventions designed to improve cancer treatment and follow-up care in socially disadvantages groups is multifactorial. Multicomponent-intervention approaches and cultural adaptations are common, and their effectiveness should be evaluated in the populations of interest. More interventions are needed from outside the Unite States and in patients with cancers other than breast cancer, targeting gender or geographical inequalities and addressing key outcomes such as treatment adherence or symptom management.

Effectiveness of patient-targeted interventions to promote cancer screening among ethnic minorities: A systematic review.

BACKGROUND: Cancer is a major public health problem due to its incidence, morbidity and mortality. A large proportion of cancer cases and deaths could be prevented through the implementation of cancer screening programmes. However, there are social inequalities in patient access to these programmes, especially in underserved communities and minority populations. OBJECTIVE: To identify, characterise and analyse the effectiveness of patient-targeted healthcare interventions to promote cancer screening programmes in ethnic minorities. METHODS: A comprehensive search of bibliographic databases was conducted. The results of our systematic review were reported in accordance with the PRISMA guidelines. RESULTS: Seventeen articles were identified and included in the review. Sixteen of the seventeen studies were conducted in the United States and one was conducted in Israel. Fifteen of the seventeen interventions selected were effective in increasing cancer screening rates. Moreover, five of the seventeen studies found an improvement in cancer knowledge, awareness, self-efficacy, attitudes, intention and perceptions, and three studies found a positive change in health beliefs and barriers. The results show that culturally adapted interventions appear to increase the rate of participation in cancer screening. In addition, the effectiveness of the interventions seems to be related to the use of small media, one-on-one interactions, small group education sessions, reminder strategies, and strategies for reducing structural barriers and out-of-pocket costs. CONCLUSION: Culturally adapted patient-targeted healthcare interventions can help to reduce racial or ethnic inequalities in access to cancer screening programmes. Further research is needed to develop interventions to promote adherence to cancer screening programmes with repeat testing and vigorous economic evaluation methodologies.