Abstract
OBJECTIVE: To determine what organizational level indicators exist that could be used by local Ontario public health agencies to monitor and guide their progress in addressing health equity.
METHOD: This scoping review employed Arksey and O’Malley’s (2005) six-stage framework. Multiple online databases and grey literature sources were searched using a comprehensive strategy. Studies were included if they described or used indicators to assess an organization’s health equity activity. Abstracted indicator descriptions were classified using the roles for public health action identified by the Canadian National Collaborating Centre for Determinants of Health (NCCDH). Health equity experts participated in a consultation phase to examine items extracted from the literature.
SYNTHESIS: Eighteen peer-reviewed studies and 30 grey literature reports were included. Abstracted indicators were considered for 1) relevance for organizational assessment, 2) ability to highlight equity-seeking populations, and 3) potential feasibilityforapplication. Twenty-eight items formed the basis for consultation with 13 selected health equity experts. Items considered for retention were all noted to require significant clarification, definition and development. Those eliminated were often redundant or not an organizational level indicator.
CONCLUSION: Few evidence-based, validated indicators to monitor and guide progress to address health inequities at the level of the local public health organization were identified. There is a need for continued development of identified indicator items, including careful operationalization of concepts and establishing clear definitions for key terms.
Key Words: Health equity, public health, organization, evaluation, review
Résumé
OBJECTIF: Déterminer s’il existe des indicateurs organisationnels dont peuvent se servir les organismes de santé publique locaux de l’Ontario pour surveiller et guider les progrès qu’ils accomplissent vers l’équité en santé.
MÉTHODE: Pour cette étude de champ, nous avons employé le cadre en six étapes d’Arksey et O’Malley (2005). Nous avons interrogé de nombreuses bases de données en ligne, ainsi que la littérature grise, à l’aide d’une stratégie globale. Ont été incluses les études qui décrivaient ou qui utilisaient des indicateurs pour évaluer les efforts d’organismes sur le plan de l’équité en santé. Des descriptions abrégées de ces indicateurs ont été classifiées selon les rôles d’action en santé publique répertoriés par le Centre de collaboration nationale des déterminants de la santé (CCNDS). Des spécialistes de l’équité en santé ont participé à une phase de consultation visant à examiner les articles tirés de la revue de la littérature.
SYNTHÈSE: Dix-huit études évaluées par des pairs et 30 rapports tirés de la littérature grise ont été inclus. Les indicateurs abrégés ont été examinés en fonction: 1) de leur pertinence pour l’évaluation organisationnelle, 2) de leur capacité à faire ressortir les populations en quête d’équité et 3) de leur potentiel d’application. Vingt-huit articles ont servi à la consultation avec les 1 3 spécialistes de l’équité en santé sélectionnés. Nous avons noté que tous les articles respectant les critères de sélection avaient besoin d’être en grande partie éclaircis, définis et développés. Les articles éliminés étaient souvent redondants ou ne portaient pas sur un indicateur organisationnel.
CONCLUSION: Nous avons trouvé peu d’indicateurs validés et fondés sur des données probantes pour surveiller et guider les progrès accomplis vers l’équité en santé à l’échelle des organismes de santé publique locaux. Il est nécessaire de poursuivre l’élaboration des indicateurs recensés, notamment par une opérationnalisation soigneuse des concepts et en définissant clairement les termes clés.
Mots Clés: Équité en santé, santé publique, organisation, évaluation, revue de la littérature
Footnotes
Conflict of Interest: None to declare.
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