Kurzfassung: Addressing persistent and pervasive health inequities is a global moral imperative, which has been highlighted and magnified by the societal and health impacts of the COVID-19 pandemic. Observational studies can aid our understanding of the impact of health and structural oppression based on the intersection of gender, race, ethnicity, age and other factors, as they frequently collect this data. However, the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline, does not provide guidance related to reporting of health equity. The goal of this project is to develop a STROBE-Equity reporting guideline extension. Methods We assembled a diverse team across multiple domains, including gender, age, ethnicity, Indigenous background, disciplines, geographies, lived experience of health inequity and decision-making organizations. Using an inclusive, integrated knowledge translation approach, we will implement a five-phase plan which will include: (1) assessing the reporting of health equity in published observational studies, (2) seeking wide international feedback on items to improve reporting of health equity, (3) establishing consensus amongst knowledge users and researchers, (4) evaluating in partnership with Indigenous contributors the relevance to Indigenous peoples who have globally experienced the oppressive legacy of colonization, and (5) widely disseminating and seeking endorsement from relevant knowledge users. We will seek input from external collaborators using social media, mailing lists and other communication channels. Discussion Achieving global imperatives such as the Sustainable Development Goals (e.g., SDG 10 Reduced inequalities, SDG 3 Good health and wellbeing) requires advancing health equity in research. The implementation of the STROBE-Equity guidelines will enable a better awareness and understanding of health inequities through better reporting. We will broadly disseminate the reporting guideline with tools to enable adoption and use by journal editors, authors, and funding agencies, using diverse strategies tailored to specific audiences.

Kurzfassung: This review evaluates the effects of mass deworming for soil‐transmitted helminths on growth, educational achievement, cognition, school attendance, quality of life and adverse effects in children in endemic helminth areas. Mass deworming for soil‐transmitted helminths probably has little to no effect on weight, height, school attendance, cognition measured by short‐term attention, or mortality. There are no data on short‐term quality of life and little evidence of adverse effects. Mass deworming for schistosomiasis alone may slightly increase weight but probably has little to no effect on height and cognition. The evidence does not support indirect benefits for untreated children from being exposed to treated children. One moderate quality long term study showed an increase in economic productivity (hours worked) and increase in educational enrollment 10 years later of mass deworming and hygiene promotion. But, it is uncertain whether these effects are due to the deworming or the combined hygiene intervention. Findings are consistent for various groups of the population by age, gender, worm prevalence, baseline nutritional status, compliance, impact on worms, infection intensity, types of worms, risk of bias, and study characteristics. Deworming for children who screened positive for schistosomiasis or soil‐transmitted helminths results in larger gains in weight but no difference in effect on height, cognition or school attendance. Also, one low to moderate quality study showed long‐term benefit on school enrolment of sanitation improvement combined with screening and treating people for hookworm infection. Abstract Background Soil‐transmitted helminthiasis and schistosomiasis, considered among the neglected tropical diseases by the World Health Organization (WHO), affect more than a third of the world's population, with varying intensity of infection. There is debate about the effectiveness and cost‐effectiveness of mass deworming of children as a strategy to improve child health in endemic areas. Objectives The objective of this review was to evaluate the effects of mass deworming for soil‐transmitted helminths with or without deworming for schistosomiasis or co‐interventions on growth, educational achievement, cognition, school attendance, quality of life and adverse effects in children inendemic helminth areas. We also aimed to assess possible effect modifiers using pre‐planned subgroup analysis of age, sex, prevalence of worms and baseline nutritional status. Search strategy Our librarian scientist designed a search strategy that was reviewed by the Campbell Collaboration librarian for the following 11 electronic databases: MEDLINE, CINAHL, LILACS, EMBASE, the Cochrane Library, Econlit, Internet Documents in Economics Access Service (IDEAS), Public Affairs Information Service (PAIS), Social Services Abstracts, Global Health CABI and CAB Abstracts, up to May 13, 2015. We also searched websites and clinical trial registers, other systematic reviews, and contacted authors and experts in the field. Study selection criteria We included studies if they included children aged six months to 16 years, carried out mass deworming for soil‐transmitted helminths (alone or in combination with other drugs or child health interventions), reported one of our primary outcomes of growth, school attendance, school performance, cognitive processing or development, well‐being, or adverse events, and included a comparator to a control or active comparator. We included randomized trials, quasi‐randomized trials, controlled before after studies, interrupted time series and quasi‐experimental studies that used statistical methods of analysis to match participants with non‐participants, or statistical methods to account for confounding and sample selection bias. Data collection and analysis We screened titles and abstracts in duplicate, as well as the full texts of those considered eligible at level 1. We used a pre‐tested data extraction form to collect details on participants, interventions, outcomes, study methods and setting, and extracted data in duplicate. We conducted random effects pairwise meta‐analysis for all primary outcomes. If heterogeneity was acceptable (I 2 〈 75%), we conducted random effects, Bayesian network meta‐analysis to compare different drugs and combinations of interventions, using WinBugs. We assessed risk of bias with the Cochrane risk of bias tool or the Campbell International Development review group tool, as appropriate. We assessed GRADE certainty of evidence for each outcome using the GRADE Working Group methods. Results We analysed 65 studies with a duration from four months to five years (median 12 months) with 1,092,120 children and five long‐term studies eight to 10 years after mass deworming programmes with 〉 90,000 children. These studies were conducted in 23 low and middle income countries (L & MICs), in areas where prevalence of worms ranged from 0.5 per cent to 99 per cent infected. Most of the studies consisted of deworming twice per year or more frequently, with only two studies deworming once per year. Overall risk of bias was moderate. Mass deworming for soil‐transmitted helminths compared to controls probably has little to no improvement in weight (0.09 kg, 95%CI: ‐0·04 to 0·2; 35,430 participants, 11 trials), height (0.07 cm, 95% CI:‐0.1 cm to 0.24 cm); 6,839 participants, nine trials) or attendance (1% higher, 95% CI: ‐1% to 3%; 〉 30,000 participants, seven trials) (moderate certainty evidence). Mass deworming for soil transmitted helminths leads to little to no difference in proportion stunted (eight per 1000 fewer‐from 48 fewer to 32 more; 4,286 participants, four trials), cognition measured by short‐term attention (‐0·23 points on 100 point scale, 95%CI ‐0·6, 0·14; 4,078 participants, three trials), or mortality (1 per 1000 fewer, 95%CI: ‐3 to 1 per 1000; 〉 1 million participants, six trials) (high certainty evidence). We found no data on short‐term quality of life and little evidence of adverse effects. Mass deworming for schistosomiasis alone may slightly increase weight (0·4 kg, 95%CI: ‐0·2, 1·0) and has little to no effect on height (low certainty evidence) and cognition (moderate certainty evidence). Our analyses do not support indirect benefits for untreated children, from being exposed to treated children in the community (low certainty evidence). There may be increase in long‐term economic productivity (1.58 hours more per week, 95%CI: ‐0.46 to 3.62) and school enrolment (0.29 years, 95%CI 0.01 to 0.58), little to no effect on height (‐0.11 cm, 95%CI: ‐0.64 to 0.42) and self‐reported health (0.04 units, 95%CI: 0.0 to 0.08) of mass deworming when combined with hygiene education, however, it is uncertain whether these effects are due to deworming alone or hygiene or the combination (very low certainty). We are uncertain about long‐term effects on math or English at school and cognitive development due to very low certainty evidence.. Results were congruentacross sensitivity and subgroup analyses by age, sex, worm prevalence, baseline nutritional status, impact on worms, infection intensity, types of worms (ascaris, hookworm or trichuris), risk of bias, cluster vs. individual trials, high compliance and low attrition bias. Deworming for children who screened positive for schistosomiasis or soil‐transmitted helminths resulted in larger gains in weight and no difference in effect on height, cognition or school attendance. Implications for policy and programmes This independent analysis reinforces the case against mass deworming. These findings suggest that in addition to a reconsideration of mass deworming programmes in their current form, additional policy options need to be explored to improve child health and nutrition in worm‐endemic areas. These include the needs for investing in interventions to address basic determinants of worm infestations such as poverty, living conditions, sanitation and inequities. Decisions on public health approaches in such settings need to be taken on the basis of human rights, ethics and evidence‐based, sustainable cost‐effective approaches. For schistosomiasis, the policy implication is that mass deworming may be effective at improving weight. Implications for research Since all analyses of effect modification are limited by aggregate level data which may hide individual level differences, we propose that future research should assess which subset of children does benefit from mass deworming, if any, using individual patient data meta‐analysis. This analysis and other work could focus on whether it is feasible to develop a case‐finding tool with clinical data that could identify children and settings that would benefit from treatment. Plain Language Summary Mass deworming programmes have little or no effect on most welfare outcomes. The Campbell review in brief The effectiveness and cost‐effectiveness of mass deworming of children to improve child health and other outcomes is debated. This independent analysis reinforces the case against mass deworming, finding little or no effect on most welfare outcomes. What is this review about? Soil‐transmitted helminthiasis and schistosomiasis affect more than a third of the world's population. There is debate about the effectiveness and cost‐effectiveness of mass deworming of children to improve child health and other outcomes in endemic areas. This review evaluates the effects of mass deworming for soil‐transmitted helminths on growth, educational achievement, cognition, school attendance, quality of life and adverse effects in children in endemic helminth areas. What studies were included? Included studies examine out mass deworming for soil‐transmitted helminths (alone or in combination with other drugs or child health interventions) for children aged 6 months to 16 years, and report at least one of the following outcomes: growth, school attendance, school performance, cognitive processing or development, well‐being, or adverse events. Included study designs are randomized trials, interrupted time series and non‐experimental studies that used statistical methods of analysis to match participants with non‐participants, or statistical methods to account for confounding and sample selection bias. Sixty‐five studies are analyzed in the review, with a treatment duration from 4 months to 5 years, covering 1,092,120 children, including five long‐term studies 8‐10 years after mass deworming programs with over 90,000 children. These studies were conducted in 23 low and middle income countries. Most programmes studied conduct deworming twice per year or more frequently, with only two studies of programmes deworming just once per year. Does deworming improve child health and other welfare outcomes? Mass deworming for soil‐transmitted helminths probably has little to no effect on weight, height, school attendance, cognition measured by short‐term attention, or mortality. There are no data on short‐term quality of life and little evidence of adverse effects. Mass deworming for schistosomiasis alone may slightly increase weight but probably has little to no effect on height and cognition. The evidence does not support indirect benefits for untreated children from being exposed to treated children. One moderate quality long term study showed an increase in economic productivity (hours worked) and increase in educational enrollment 10 years later of mass deworming and hygiene promotion. But, it is uncertain whether these effects are due to the deworming or the combined hygiene intervention. Findings are consistent for various groups of the population by age, gender, worm prevalence, baseline nutritional status, compliance, impact on worms, infection intensity, types of worms, risk of bias, and study characteristics. Deworming for children who screened positive for schistosomiasis or soil‐transmitted helminths results in larger gains in weight but no difference in effect on height, cognition or school attendance. Also, one low to moderate quality study showed long‐term benefit on school enrolment of sanitation improvement combined with screening and treating people for hookworm infection. What are the implications of this review for policy makers and decision makers? This independent analysis reinforces the case against mass deworming. In addition to a reconsideration of mass deworming programs in their current form, additional policy options need to be explored to improve child health and nutrition in worm‐endemic areas. For schistosomiasis, policy implications are that mass deworming may be effective at improving weight. What are the research implications of this review? Future research should assess which subset of children benefit from mass deworming using individual‐level meta‐analysis. This analysis could explore whether it is feasible to develop a case‐finding tool to identify children and settings which will benefit from treatment.

Kurzfassung: By 2030, the global population of people older than 60 years is expected to be higher than the number of children under 10 years, resulting in major health and social care system implications worldwide. Without a supportive environment, whether social or built, diminished functional ability may arise in older people. Functional ability comprises an individual's intrinsic capacity and people's interaction with their environment enabling them to be and do what they value. Objectives This evidence and gap map aims to identify primary studies and systematic reviews of health and social support services as well as assistive devices designed to support functional ability among older adults living at home or in other places of residence. Search Methods We systematically searched from inception to August 2018 in: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL, CINAHL, PsycINFO, AgeLine, Campbell Library, ASSIA, Social Science Citation Index and Social Policy & Practice. We conducted a focused search for grey literature and protocols of studies (e.g., ProQuest Theses and Dissertation Global, conference abstract databases, Help Age, PROSPERO, Cochrane and Campbell libraries and ClinicalTrials.gov ). Selection Criteria Screening and data extraction were performed independently in duplicate according to our intervention and outcome framework. We included completed and on‐going systematic reviews and randomized controlled trials of effectiveness on health and social support services provided at home, assistive products and technology for personal indoor and outdoor mobility and transportation as well as design, construction and building products and technology of buildings for private use such as wheelchairs, and ramps. Data Collection and Analysis We coded interventions and outcomes, and the number of studies that assessed health inequities across equity factors. We mapped outcomes based on the International Classification of Function, Disability and Health (ICF) adapted categories: intrinsic capacities (body function and structures) and functional abilities (activities). We assessed methodological quality of systematic reviews using the AMSTAR II checklist. Main Results After de‐duplication, 10,783 records were screened. The map includes 548 studies (120 systematic reviews and 428 randomized controlled trials). Interventions and outcomes were classified using domains from the International Classification of Function, Disability and Health (ICF) framework. Most systematic reviews ( n  = 71, 59%) were rated low or critically low for methodological quality. The most common interventions were home‐based rehabilitation for older adults ( n  = 276) and home‐based health services for disease prevention ( n  = 233), mostly delivered by visiting healthcare professionals ( n  = 474). There was a relative paucity of studies on personal mobility, building adaptations, family support, personal support and befriending or friendly visits. The most measured intrinsic capacity domains were mental function ( n  = 269) and neuromusculoskeletal function ( n  = 164). The most measured outcomes for functional ability were basic needs ( n  = 277) and mobility ( n  = 160). There were few studies which evaluated outcome domains of social participation, financial security, ability to maintain relationships and communication. There was a lack of studies in low‐ and middle‐income countries (LMICs) and a gap in the assessment of health equity issues. Authors' Conclusions There is substantial evidence for interventions to promote functional ability in older adults at home including mostly home‐based rehabilitation for older adults and home‐based health services for disease prevention. Remotely delivered home‐based services are of greater importance to policy‐makers and practitioners in the context of the COVID‐19 pandemic. This map of studies published prior to the pandemic provides an initial resource to identify relevant home‐based services which may be of interest for policy‐makers and practitioners, such as home‐based rehabilitation and social support, although these interventions would likely require further adaptation for online delivery during the COVID‐19 pandemic. There is a need to strengthen assessment of social support and mobility interventions and outcomes related to making decisions, building relationships, financial security, and communication in future studies. More studies are needed to assess LMIC contexts and health equity issues.

Kurzfassung: In 2019, the estimated prevalence of food insecurity for Black non-Hispanic households was higher than the national average due to health disparities exacerbated by forms of racial discrimination. During the COVID-19 pandemic, Black households have experienced higher rates of food insecurity when compared to other populations in the United States. The primary objectives of this review were to identify which risk factors have been investigated for an association with food insecurity, describe how food insecurity is measured across studies that have evaluated this outcome among African Americans, and determine which dimensions of food security (food accessibility, availability, and utilization) are captured by risk factors studied by authors. Food insecurity related studies were identified through a search of Google Scholar, PubMed, CINAHL Plus, MEDLINE ® , PsycINFO, Health Source: Nursing/Academic Edition, and Web of Science ™ (Clarivate), on May 20, 2021. Eligible studies were primary research studies, with a concurrent comparison group, published in English between 1995 and 2021. Ninety-eight relevant studies were included for data charting with 37 unique measurement tools, 115 risk factors, and 93 possible consequences of food insecurity identified. Few studies examined factors linked to racial discrimination, behaviour, or risk factors that mapped to the food availability dimension of food security. Infrequently studied factors, such as lifetime racial discrimination, socioeconomic status (SES), and income insecurity need further investigation while frequently studied factors such as age, education, race/ethnicity, and gender need to be summarized using a systematic review approach so that risk factor impact can be better assessed. Risk factors linked to racial discrimination and food insecurity need to be better understood in order to minimize health disparities among African American adults during the COVID-19 pandemic and beyond.