Table 5 Effects on socioeconomic disparities: Studies examining participation and attrition, stratified by quality
Study | Study question | Outcome | Intervention Description | SES adaptions made (if any) | SES status of population | Results (in terms of SES) | Impact on disparity |
|---|---|---|---|---|---|---|---|
Poduval 2018 | Can a DSME internet intervention engage people of differing demographics without increasing health inequity? | Use (more than 2 log-ins post registration) | Internet SM programme + email/text support and assistance to register and access site | Low literacy, developed with input from target population | Age: 58y mean Sex: 55.5%M Race: 55%EM Edu: 30% < 12 yr | No difference in use according to education. Users were reflective of the target population (inner London). | No change |
Thorn 2011 | Is pain SMS (CBT or education) effective in low SES groups and what are the predictors of engagement? | Initial participation and dropout | SMS groups CBT and education for 10 × 1.5 h over 10/52 | Literacy adaptations and teaching | Age: 53y mean Sex: 20%M Race: 79%EM Income:86% < $30,000 Literacy score: mean 21% (50% is population mean) | Non-attendance associated with low education, literacy and income; dropout associated with low income. | Increased |
Dattalo 2012 | Which subgroups of multimorbid older adults are most likely to attend CDSMPs? | Completion (attend 5 or more sessions) | Stanford CDSMP 6 × 2.5 h | None | Age: 67-95 yr Sex: 43%M Race: 51.8%EM Edu: 24% < 12 yr Other SES: 42% ‘financial strain’ | No effect of SES variables on course completion | No change. |
Cauch-Dudek 2014 | Are there disparities in utilisation of DSME soon after diagnosis? | Initial participation | Certified public health DSME programmes | Unspecified (multiple programmes) | All diabetics in Ontario, Canada diagnosed from Jan-June 2006 and followed up for 8/12. | Low SES area associated with increase in non-attendance, p < 0.001. | Increased |
Adjei Boakye 2018 | Are there are subgroups who do not participate in diabetes SM education (DSME)? | Initial participation | Diabetes SM education (DSME) - unspecified | Unspecified (multiple programmes) | Cross section of US population with diabetes | Non-participation associated with low education and low income; association stronger as education/income reduced. | Increased |
Glasgow 2018 | How representative of the diabetes population are those who participate or volunteer for an internet DSME study? | Initial participation | Internet DSME programme +/− support (phone calls and groups) | Available in 2 languages, no specific SES adaption | Age: 58y mean Sex: 50%M Race: 31%EM Edu: 34% ≤ 12 yrs. Income: 29% < $30,000 | Higher income and education increased chance of participation, especially for self-selected people | Increased |
Horrell 2017 | Do those in low income areas attend CDSMPs and how can we promote higher enrolment? | Initial participation and completion | Stanford CDSMP 6 × 2.5 h | None | USA attendees of CDSMP courses Age: 58y mean 83.6% of attendees lived in the least impoverished areas. | Lowest SE area was associated with low participation (0.3% of participants) but not with low completion. | Increased (participation) No change (completion) |
Hardman 2018 | Do the social determinants of health affect engagement with pain SMS programmes? | Dropout (attend 3 or less sessions) | CBT-informed tailored SMS, individual or group | Programme tailored to preference/need | Age: 55y mean Sex: 42%M Income: 82% on welfare benefit Other SES: 27% ‘social stressor’ | Income not significant post-regression but social stressors (substance abuse history, victim of abuse/assault) significantly associated with dropout. | Increased |
Kure-Beigel 2016 | Is there a social difference between those who do and don’t complete SMS programmes? | Course completion | Tailored SMS individual or group over 6–12 weeks | Programme tailored to preference/need | Age: 78% > 60 yrs. Sex: 50%M Edu: 57% < high school graduate | Education not significant post-regression but qualitative interviews suggested social factors (job/carer demands) were important. | No change - suggestive of increase |
Santorelli 2017 | What determines DSME participation and is it affected by the availability of DSME services? | Initial participation | DSME – unspecified type. | Unspecified (multiple programmes) | Survey sample of people living in New Jersey with diabetes | Lack of participation correlated with low education and ethnicity (p < 0.001) but not with income. | Increased |