PROGRESS framework: Applying an equity lens to interventions

A Summary of

O'Neill, J., Tabish, H., Welch, V., Petticrew, M., Pottie, K., & Clarke, M. (2014). Applying an equity lens to interventions: Using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health. Journal of Clinical Epidemiology, 67, 56-64.

Description

The PROGRESS acronym is intended to ensure that there is explicit consideration for health equity, the unfair difference in disease burden, when conducting research and adapting research evidence to inform the design of new interventions. The PROGRESS acronym was created by Evans and Brown (2003) to describe factors that contribute to health inequity. PROGRESS stands for:

  • Place of residence
  • Race/ethnicity/culture/language
  • Occupation
  • Gender/sex
  • Religion
  • Education
  • Socioeconomic status
  • Social capital

PROGRESS serves as a reminder to consider the intersecting determinants of health when designing research or an implementation plan. The acronym is not meant to encompass all the factors involved with the distribution of health. Rather, it emphasizes that multiple factors affect health inequity. This acronym encourages public health researchers, program planners and managers to think about these intersecting determinants of health, and their consequences on equity. Explicit identification of these factors can create opportunities to redistribute resources to address health inequities.

In some contexts, additional factors may affect the impact an intervention can have on equity. PROGRESS has been expanded into PROGRESS-Plus (Oliver et al., 2008) to include other context-specific factors that facilitate disadvantage. These factors include: personal characteristics that are associated with discrimination (e.g., age, disability), features of a relationship (e.g., smoking parents, excluded from school), time-dependant relationships (e.g., leaving the hospital, respite care) and other circumstances that may indicate disadvantage.

Access the Method

Format of the Method


Language(s)

English

Format(s)

Periodical

Cost

None

Using the Method


Time for Participation/Completion

30 to 60 minutes

Additional Resources and/or Skills Needed for Implementation

None

Steps for Using Method/Tool

The PROGRESS acronym helps you to remember to consider the social determinants of health when adapting an evidence-informed recommendation to a community. PROGRESS stands for:

  • Place of residence
  • Race/ethnicity/culture/language
  • Occupation
  • Gender/sex
  • Religion
  • Education
  • Socioeconomic status
  • Social capital

You can use the PROGRESS factors after you have searched, appraised and synthesized the research evidence. To use PROGRESS:

  1. Compile the recommendation(s) for the interventions(s) you have formed with the research evidence.
  2. Independently or with stakeholders, consider the impact each potential recommendation can have on the PROGRESS factors.
  3. Consider the effect PROGRESS factors have on access and acceptability of each recommendation.
  4. Choose the most appropriate intervention for your community.
  5. Create an implementation plan for the intervention that addresses the relevant PROGRESS factors.

Who is involved

Program planners or managers will lead the administration of this method. If equity is not a priority, they may need to champion the use of the PROGRESS factors during planning and implementation. Representatives from your community can engage with this method, so they can share their experience with each PROGRESS factor.

Conditions for Use

© 2014 Elsevier Inc.

Evaluation of the Method


Evaluation

Information not available

Validity

Validity not tested

Reliability

Reliability not tested

Methodological Rating

Not applicable

Development of the Method


Developer(s)

Jennifer O’Neill
Hilary Tabish
Vivian Welch
Mark Petticrew
Kevin Pottie
Mike Clarke
Tim Evans
Jordi Pardo Pardo
Elizabeth Waters
Howard White
Peter Tugwell

Method of Development

The acronym PROGRESS was developed by Evans and Browns (2003). This acronym was adopted by the Campbell and Cochrane Equity Methods Group to guide the analysis and reporting of equity focused research. The use of PROGRESS to apply an equity lens to interventions was developed through consultation with experts on the PROGRESS factors.

Release Date

2014

Contact Person/Source

Jennifer O'Neill
Institute of Population Health
University of Ottawa
Ottawa, ON K1N 6N5
Phone: (613) 562-5800

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.

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