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Publications

Journal Article Ahead of print

PubMed: 42174617 DOI: 10.1186/s12939-026-02876-1

Exploring perspectives of knowledge users about reporting on health equity in observational studies: a qualitative study informing the development of the STROBE-Equity reporting guideline.

Int J Equity Health

Authors: Dana Simpson, Omar Dewidar, Elizabeth Ghogomu, Khadija Aliyeva, Zulfiqar Bhutta, Lucy C Barker, Luis Gabriel Cuervo, Holly N Ellingwood, Sonya Faber, Cindy Feng, Sarah Funnell, Billie-Jo Hardy, Janet Hatcher Roberts, Tanya Horsley, Alison Krentel, Julian Little, Michelle Kennedy, Tamara Kredo, Elizabeth Kristjansson, Daeria O Lawson, Michael Johnson Mahande, Zack Marshall, G J Melendez-Torres, Lawrence Mbuagbaw, Miriam Nkangu Nguilefem, Ekwaro A Obuku, Ebenezer Owusu-Addo, Tomas Pantoja, Kevin Pottie, Anita Rizvi, Larissa Shamseer, Peter Tugwell, Janice Tufte, Xiaoqin Wang, Charles S Wiysonge, Taryn Young, Vivian Welch, Janet Jull

Affiliations

  • Carleton University, Ottawa, Canada.
  • Bruyère Health Research Institute, Ottawa, Canada.
  • University of Ottawa, Ottawa, Canada.
  • Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada.
  • Women's College Hospital, Toronto, Canada.
  • University of Toronto, Toronto, Canada.
  • Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine and Public Health of the Autonomous University of Barcelona, Barcelona, Spain.
  • National Academy of Medicine of Colombia, Bogotá, Colombia.
  • Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada.
  • Faculty of Health Sciences, Queen's University, Kingston, Canada.
  • Department of Family Medicine, Queen's University, Kingston, Canada.
  • Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
  • WHO Collaborating Centre Knowledge Translation, Technology Assessment for Health Equity, Ottawa, Canada.
  • Research and Evaluation, Royal College of Physicians and Surgeons of Canada, Ottawa, Canada.
  • School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
  • School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
  • College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia.
  • Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.
  • School of Psychology, University of Ottawa, Ottawa, Canada.
  • Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
  • Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University, Moshi, Tanzania.
  • Management and Development for Health, Dar es Salaam, Tanzania.
  • Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
  • Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
  • Africa Centre for Systematic Reviews and Knowledge Translation, College of Health Sciences, Makerere University, Kampala, Uganda.
  • Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK.
  • Institute for Rural Development and Innovation Studies (IRDIS), College of Agriculture and Natural Resources, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
  • Department of Family Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
  • Department of Family Medicine, Dalhousie University, Halifax, Canada.
  • Unity Health Toronto, Toronto, Canada.
  • Cochrane Consumer Network, Seattle, USA.
  • Patient-Centered Outcomes Research Institute, Seattle, USA.
  • Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
  • Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
  • Stellenbosch University, Stellenbosch, South Africa.
  • Carleton University, Ottawa, Canada.
  • Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada.

Abstract

BACKGROUND

Health inequities arising from systemic factors and contextual conditions result in avoidable and unjust differences in health outcomes, with profound social and economic implications. Health inequities can frequently go unreported in observational studies. Observational studies can uniquely inform how we understand and address persisting health inequities through collecting, reporting and analyzing health equity factors using 'inclusive' methodological considerations. While the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) reporting guideline aims to improve observational study reporting quality, existing extensions lacked a specific focus on health equity. Engaging those who will use or be impacted by research ("knowledge users"), including participant-research collaborators, is central to bridging the gap between knowledge production and real-world application. Therefore, the purpose of this study was to gather a range of perspectives from these knowledge users as part of, and to inform, the development of the STROBE-Equity guideline extension, which aims to improve the reporting of equity-relevant considerations in observational studies.

METHODS

This study used a qualitative description approach, employing semi-structured key informant interviews and framework analysis to collect and analyze the views of researchers, policymakers, decision-makers, funders, journal editors, ethicists, and participant-research collaborators. Participants were purposefully sampled to reflect diverse perspectives from knowledge users with relevant experience on health equity reporting.

RESULTS

Eleven key informants participated in the interviews. Information from interviews was categorized into seven themes: "Clarifying equity", "Equity is dynamic", "The challenges of making equity claims", "Making reporting on equity feasible", "Using reporting guidelines to manage tension", "Potential for better outcomes", and "Nobody's perspective is neutral". Participants emphasized the need for standardized equity-relevant reporting practices and offered insight into challenges, opportunities, and strategies for integrating equity-relevant considerations into observational study reporting.

CONCLUSIONS

Findings show that participants viewed equity as a complex concept and stressed the need for practical guidance to support equity reporting in observational studies. They highlighted barriers such as limited time, resources, and publication word limits, and perceived the STROBE-Equity extension as a valuable tool for structuring reporting, raising awareness, and encouraging reflection, with the potential to improve the quality and impact of equity-relevant research.

MeSH

Research