SUPPORT Tool for considering equity in decision making

A summary of

Oxman, A. D., Lavis, J. N., Lewin, S. & Fretheim, A. (2009). SUPPORT Tools for evidence-informed health Policymaking (STP) 10: Taking equity into consideration when assessing the findings of a systematic review. Health Research Policy and Systems, 7, (S1): S10. doi: 10.1186/1478-4505-7-S1-S10

How to cite this NCCMT summary:

National Collaborating Centre for Methods and Tools (2012). SUPPORT Tool for considering equity in decision making. Hamilton, ON: McMaster University. (Updated 15 March, 2012) Retrieved from http://www.nccmt.ca/resources/search/120.

Categories: Tool, Synthesize, Adapt, Implement, Policy development, Situational assessment

These summaries are written by the NCCMT to condense and to provide an overview of the resources listed in the Registry of Methods and Tools and to give suggestions for their use in a public health context. For more information on individual methods and tools included in the review, please consult the authors/developers of the original resources.

Relevance for Public Health
Equity considerations are increasingly relevant in planning public health policies and programs. This tool could be used to determine the impact of an initiative on disadvantaged groups to ensure that health inequities are not increased, and if possible, are reduced.
Description
Developed by the SUPporting POlicy relevant Reviews and Trials (SUPPORT) Project, this tool provides four questions to help policy-makers determine the impact of policies and programs on disadvantaged groups. With scenarios, case examples and resources, this tool offers a structured approach to assessing research evidence with an equity lens during decision making.

Inequity has been defined as "differences in health which are not only unnecessary and avoidable, but in addition, are considered unfair and unjust" (Whitehead, 2002; cited in Oxman, Lavis, Lewin & Fretheim, 2009). There is very little evidence of the impact of policies or programs on inequities. Systematic reviews typically do not assess the effectiveness of policies or programs across different groups. Often there is a lack of evidence related to disadvantaged groups since they may not have been included in studies. For more equity resources, see NCCDH's Resource Library.

This tool is part of a series to support the use of research evidence in policy making. The SUPPORT series includes 18 tools that address four broad areas:

  • developing organizational support for evidence-informed policy making
  • identifying needs for research evidence for policy making
  • finding and assessing research
  • moving from research to action

To access the full suite of tools, which are available through the Health Research Policy and Systems journal, click here. To access the tools in a book format, available from the Norwegian Knowledge Centre for the Health Services, click here.

Implementing the Method/Tool
Steps for Using Method/Tool

The SUPPORT Tool consists of four questions:

  • Which group or settings are likely to be disadvantaged relative to the policy option being considered?
  • Are there reasons for differences in the relative effectiveness of the option for disadvantaged groups or settings?
  • Are there likely to be baseline differences across groups or settings that could influence the effectiveness of the option? Would these baseline differences mean the problem is more or less important for disadvantaged groups or settings?
  • What should be considered when implementing the proposed option to ensure that inequities are reduced and/or not increased?

The authors provide concrete examples and explanations for each of these questions and discuss their overall relevance to the concept of equity in health programs.

Who is involved
This tool could be used by any individual or organization considering equity when assessing research evidence, systematic reviews in particular. The SUPPORT tools are targeted to policy-makers and those who support policy-makers in assesing evidence for decision making.
Conditions for Use
Not specified
Evaluation and Measurement Characteristics
Evaluation
Information not available
Validity
Not applicable
Reliability
Not applicable
Methodological Rating
Unknown/No evidence
Method/Tool Development
Developer(s)

Andrew D. Oxman
Norwegian Knowledge Centre for the Health Services

John N. Lavis
Centre for Health Economics and Policy Analysis, McMaster University

Simon Lewin
Norwegian Knowledge Centre for the Health Services
Health Systems Research Unit, Medical Research Council of South Africa

Atle Fretheim
Norwegian Knowledge Centre for the Health Services
Section for International Health, University of Oslo

SUPPORT Project (SUPporting POlicy relevant Reviews and Trials)
website: http://www.support-collaboration.org

Method of Development

The SUPPORT Tools have been designed to help people use the best available research evidence in their decision making. The SUPporting POlicy relevant Reviews and Trials (SUPPORT) Project is an international collaboration funded by the European Commission's 6th Framework. There are 18 tools in total, including tools that address:

  • using research to clarify a problem;
  • using research to frame options for a policy issue;
  • preparing policy briefs; and
  • using policy dialogues in decision making.

The tools are freely available through the Health Research Policy and Systems journal (click here).

Release Date
2009
Contact Person/Source
Andrew D. Oxman
Norwegian Knowledge Centre for the Health Services
PO Box 7004
St. Olavs plass
N-0130
Oslo, Norway
email: oxman@online.no

Resources

Title of Primary Resource
SUPPORT Tools for evidence-informed health Policymaking (STP) 10: Taking equity into consideration when assessing the findings of a systematic review.
File Attachment
None
Web-link
Reference

Oxman, A. D., Lavis, J. N., Lewin, S. & Fretheim, A. (2009). SUPPORT Tools for evidence-informed health Policymaking (STP) 10: Taking equity into consideration when assessing the findings of a systematic review. Health Research Policy and Systems, 7, (S1): S10. doi: 10.1186/1478-4505-7-S1-S10

Type of Material
Journal article
Format
Periodical
Cost to Access
None.
Language
English
Conditions for Use
Copyright © 2009 Oxman et al; licensee BioMed Central Ltd.

Title of Supplementary Resource
SUPPORT Tools for evidence-informed health Policymaking (STP)
File Attachment
None
Web-link
Reference
Lavis, J. N., Oxman, A. D., Lewin, S. & Fretheim, A. (2009). SUPPORT Tools for evidence-informed health Policymaking (STP). Health Research Policy and Systems, 7 (Suppl 1): 11. doi: 10.1186/1478-4505-7-S1-11.
Type of Material
Journal article
Format
Periodical
Cost to Access
None.
Language
English
Conditions for Use
Copyright © 2009 Lavis et al; licensee BioMed Central Ltd.

Title of Supplementary Resource
SUPPORT Tools for evidence-informed health Policymaking (STP)
File Attachment
None
Web-link
Reference
Oxman, A. D., Lavis, J. N. Lewin, S., & Fretheim, A. (2010) SUPPORT Tools for evidence-informed health Policymaking (STP). Report no 4-2010. Oslo: Norwegian Knowledge Centre for the Health Services.
Type of Material
Report
Format
On-line Access
Cost to Access
None.
Language
Links to Chinese, French, Portuguese and Spanish translations are available from http://www.support-collaboration.org
Conditions for Use
Not specified

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