[Adaptation and conditions of use of a health equity tool: The Reflex-ISS tool]

Engaging patients and citizens in digital health technology development through the virtual space

Digital technologies are increasingly empowering individuals to take charge of their health and improve their well-being. However, there are disparities in access related to demographic, economic, and sociocultural factors that result in exclusion from the use of digital technologies for different groups of the population. The development of digital technology in health is a powerful lever for improving care and services, but also brings risks for certain users in vulnerable situations. Increased digital health inequalities are associated with limited digital literacy, lack of interest, and low levels of self-efficacy in using technology. In the context of the COVID-19 pandemic and post-pandemic healthcare systems, the leap to digital is essential. To foster responsible innovation and optimal use of digital health by all, including vulnerable groups, we propose that patient and citizen engagement must be an essential component of the research strategy. Patient partners will define expectations and establish research priorities using their experiential knowledge, while benefiting from rich exposure to the research process to increase their self-efficacy and digital literacy. We will support this proposition with an operationalised example aiming to implement a Virtual Community of Patients and Citizens Partners (COMVIP), a digital tool co-created with patients and public experts, as active team members in research. Founded on the principles of equity, diversity and inclusion, this base of citizen expertise will assemble individuals from different backgrounds and literacy levels living in vulnerable situations to acquire knowledge, and share their experiences, while contributing actively in the co-development of innovative strategies and health technology assessment.

Findings from a scoping review

OBJECTIVE

This scoping review aimed to identify how equity has been considered in large-scale infectious disease testing initiatives.

STUDY DESIGN AND SETTING

Large-scale testing interventions are instrumental for infectious disease control and a central tool for the coronavirus 19 (COVID-19) pandemic. We searched Web of Science: core collection, Embase and Medline in June 2021 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations for scoping reviews. We critically analyzed the content of all included articles.

RESULTS

Our search resulted in 2448 studies of which 86 were included for data extraction after screening. Of the included articles, 80% reported on COVID-19 -related screening programs. None of the studies presented a formal definition of (in)equity in testing, however, 71 articles did indirectly include elements of equity through the justification of their target population. Of these 71 studies, 58% articles indirectly alluded to health equity according to the PROGRESS-Plus framework, an acronym used to identify a list of socially stratifying characteristics driving inequity in health outcomes.

CONCLUSION

The studies included in our scoping review did not explicitly consider equity in their design or evaluation which is imperative for the success of infectious disease testing programs.

Towards a better integration of social sciences in arbovirus research and decision-making: an experience from scientific collaboration between Cuban and Quebec institutions

In 2017, the Institute of Tropical Medicine Pedro Kourí, University of Montreal Public Health Research Institute, and McGill University joined efforts to provide scenarios for scientific exchange and knowledge dissemination about the social science contribution on arboviral research. This commentary describes the scientific collaboration between Cuban and Canadian (Quebec) institutions, illustrating the need and opportunities to facilitate research and effective decision-making processes for arboviral prevention and control, going beyond traditional biomedical aspects. We organized a set of scientific activities within three international events conducted in Cuba between 2017 and 2018. Given the collaborating institutions' expertise and the knowledge gaps in arboviral research, we selected three main thematic areas: social determinants and equity, community-based interventions and use of evidence for decision-making. The partnership shows that interdisciplinary collaboration and the use and integration of quantitative and qualitative methods from the social sciences is essential to face the current challenges in arbovirus research.

Equity at all cost-and any price-for research funding in Canada?

This commentary is in response to the May 2018 announcement by the Canadian Institutes of Health Research (CIHR) of a new procedure to ensure fairer access to health research funding for participants. As such, all applicants to CIHR's funding programs will now be required to complete a five-question questionnaire covering the dimensions of gender, age, Indigenous origin, visible minorities, and disability. On this basis, CIHR intends to gain a better understanding of the performance of its funding programs in terms of equity. In this commentary, we wish to question the theoretical and conceptual assumptions of a vision of equity framed principally in terms of diversity upstream from the research process as a founding principle of more equitable health research in Canada. We draw attention to the fact that diversity policies do not necessarily challenge inequity in research funding or in research projects. Having established the urgent need for action on equity to improve the health of populations, we recall the ethical responsibility of research and researchers to better take the various facets of equity in research into account. We recommend expanding efforts to understand and reflexively address both equity and diversity when considering the performance of population health research programs.