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OBJECTIVE: The objective of this review was to map the available global evidence on strategies that nurses can use to facilitate genomics-informed health care to address health disparities to inform the development of a research and action agenda. INTRODUCTION: The integration of genomics into health care is improving patient outcomes through better prevention, diagnostics, and treatment; however, scholars have noted concerns with widening health disparities. Nurses work across the health system and can address health disparities from a clinical, research, education, policy, and leadership perspective. To do this, a comprehensive understanding of existing genomics-informed strategies is required. INCLUSION CRITERIA: Published (qualitative, quantitative, mixed methods studies, systematic and literature reviews and text and opinion papers) and unpublished (gray) literature that focuses on genomics-informed nursing strategies to address health disparities over the last 10 years were included. No limitations were placed on language. METHODS: The review was conducted in accordance with the JBI methodology for scoping reviews. A search was undertaken on May 25, 2023, across 5 databases: MEDLINE (Ovid), Embase, Cochrane Library (Ovid), APA PsycINFO (EBSCOhost), and CINAHL (EBSCOhost). Gray literature was searched through websites, including the International Society of Nurses in Genetics and the Global Genomics Nursing Alliance. Abstracts, titles, and full texts were screened by 2 or more independent reviewers. Data were extracted using a data extraction tool. The coded data were analyzed by 2 or more independent reviewers using conventional content analysis and the summarized results are presented using descriptive statistics and evidence tables. RESULTS: In total, we screened 818 records and 31 were included in the review. The majority of papers were published in either 2019 (n=5, 16%), 2020 (n=5, 16%), or 2021 (n=5, 16%). Most papers came from the United States (n=25, 81%) followed by the Netherlands (n=3, 10%), United Kingdom (n=1, 3%), Tanzania (n=1, 3%) and written from a global perspective (n=1, 3%). Nearly half the papers discussed cancer-related conditions (n=14, 45%) and most of the others did not specify a disease or condition (n=12, 30%). In terms of population, nurse clinicians were mentioned the most frequently (n=16, 52%) followed by nurse researchers, scholars, or scientists (n=8, 26%). The patient population varied, with African American patients or communities (n=7, 23%) and racial or ethnic minorities (n=6, 19%) discussed most frequently. The majority of equity issues focused on inequitable access to genetic and genomics health services amongst ethnic and racial groups (n=14, 45%), individuals with lower educational attainment or health literacy (n=6, 19%), individuals with lower socioeconomic status (n=3, 10%), migrants (n=3, 10%), individuals with lack of insurance coverage (n=2, 6%), individuals living in rural or remote areas (n=1, 3%) individuals of older age (n=1, 3%). Root causes contributing to health disparity issues varied at the patient, provider, and system levels. Strategies were grouped into 2 categories: those to prepare the nursing workforce and those nurses can implement in practice. We further categorized the strategies by domains of practice, including clinical practice, education, research, policy advocacy, and leadership. Papers that mentioned strategies focused on preparing the nursing workforce were largely related to the education domain (n=16, 52%), while papers that mentioned strategies that nurses can implement were mostly related to clinical practice (n=19, 61%). CONCLUSIONS: Nurses in all domains of practice can draw on the identified strategies to address health disparities related to genomics in health care. We found a notable lack of intervention and evaluation studies exploring the impact on health and equity outcomes. Additional research informed by implementation science and that measures health outcomes is needed to identify best practices. SUPPLEMENTAL DIGITAL CONTENT: A French-language version of the abstract of this review is available as Supplemental Digital Content [ http://links.lww.com/SRX/A65 ].
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OBJECTIVE: The objective of this review is to better understand how allyship is defined in the literature from 1970 to the present with regard to lesbian, gay, bisexual, transgender, queer, two-spirit, and other (LGBTQ2S+) groups within health settings where English is the primary spoken language. INTRODUCTION: LGBTQ2S+ individuals experience health inequities rooted in discrimination. Activism to redress this discrimination in health settings is frequently termed allyship. Definitions of allyship, however, remain ambiguous. A clearer understanding of how allyship is defined and operationalized within health settings is integral to supporting the health of LGBTQ2S+ groups. INCLUSION CRITERIA: Literature in English from 1970 to the present that utilizes the concept of allyship within health care and/or health settings in relation to LGBTQ2S+ groups in Canada and the United States, Australia, New Zealand, and the United Kingdom will be included. METHODS: This scoping review will be conducted in accordance with the JBI methodology for scoping reviews. Databases to be searched will include MEDLINE (OVID), CINAHL (EBSCOhost), APA PsycINFO (EBSCOhost), LGBTQ+ Source (EBSCOhost), Scopus, and Web of Science, along with ProQuest Dissertations and Theses for gray literature. Two independent reviewers will screen titles, abstracts, and full-text articles; discrepancies will be resolved by consensus or with a third reviewer. Data will be extracted using an extraction tool developed by the research team. Findings will be presented in tabular/diagram format along with a narrative summary to highlight key themes that relate to contemporary conceptualizations of allyship with LGBTQ2S+ individuals/groups within health care settings and the implications for health professional practice and health outcomes. REVIEW REGISTRATION: Open Science Framework osf.io/2rek9.