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Table 3 Summary of included reviews reporting studies of education policy interventions

From: The effects of public health policies on health inequalities in high-income countries: an umbrella review

Study No. of relevant studies Context (setting, country, search timeframe) Intervention(s) Summary of results AMSTAR quality appraisal (derived from R-AMSTAR)
Brown et al. 2014 [20] 5 (117) Studies based in a country at stage 4 of the tobacco epidemic or in the WHO European Region, 1995–2013 Mass media campaigns. Mixed and inconclusive evidence of health equity effects of mass media campaigns to reduce smoking rates/tobacco use. 28 (medium)
Thomas et al. 2008 [30] 1 (84) Variety of settings; OECD countries; start date to January 2006 Health warnings on cigarettes. No evidence of differential effects for the use of health warnings on cigarettes. 25 (medium)
Niederdeppe et al. 2008 [41] 2 (50) State anti-smoking campaign, USA, 1990 onwards Anti-smoking campaign run in two USA states. Unclear effects on smoking behaviour amongst SES groups. 18 (low)
Beauchamp et al. 2014 [42] 2 (14) National intervention in Frances among children and adults, start date to 2012 Nutrition guidelines for the general population, mass media campaign and obesity screening tools for healthcare professionals. No effect among low SEP groups and a beneficial effect among high SEP groups in adults, no effect in any SEP group in children. 30 (medium)
Sumar and McLaren 2011 [31] 4 (10) Women, no country restrictions, 1990-time of study Information campaigns to increase folate intake.
Includes 2 studies also identified in Stockley and Lund (2008).
Information campaigns lead to worsening inequalities in health by socioeconomic status or race/ethnicity. 26 (medium)
Stockley and Lund 2008 [43] 3 (90) Netherlands, 1989–2006 State initiated national campaign encompassing advertisements in newspapers and national magazines, commercials on television, and radio and posters in healthcare settings. An additional local campaign targeting women in lower socioeconomic groups was also used.
Includes 2 studies also identified in Sumar and McLaren (2011).
Socioeconomic differences in pre-conception folic acid use widened in the national campaign, but remained similar where the additional local campaign was implemented. 17 (low)
McGill et al. 2015 [32] 1 (36) Any age or gender from any country, from 1980 onwards Education campaign to promote healthy eating. Study based on an education campaign found an overall widening impact. 27 (medium)
Olsted et al. 2016 [25] 1 (36) Healthy adults or children in any setting or country, January 2004–August 2015 Public information campaign (five a day). The information campaign (‘5 a day’, UK) had a positive effect on inequalities. 29 (medium)
McLaren et al. 2016 [28] 2 (25) Males and females, of any age, living, in any geographic region worldwide; database start date to 5 January 2015 Population-level interventions in government jurisdictions for dietary sodium reduction. Overall, interventions, both education only and education combined with regulation, had little effect on health inequalities with SES inequalities in salt intake persisting over time. 37 (high)
de Silva et al. 2016 [27] 1 (38) Nurseries, Scotland, 1996-April 2014 Daily supervised toothbrushing in nurseries of 5 year olds. Distribution of fluoridate toothpaste through nurseries to encourage home toothbrushing. Dental caries dramatically declined during the duration of the national nursery toothbrushing programme. Absolute inequality between dental caries rates in the most deprived areas and those in the least deprived areas was also observed. 34 (high)
Ciliska et al. 2000 [33] 1 (60) Community, USA, searches from start to August 1998. Evaluation of the Expanded Food and Nutrition Education Program (EFNEP) comprising education in homes/communities on topics such as nutrition, selecting, buying, cooking and preserving food and safety. Increase in fruit and vegetable consumption. 22 (low)
Black et al. 2000 [45] 2 (19) Deprived communities, no restrictions on country, although the majority of the included studies were from the USA, 1989 to 1999. Health promotion and education interventions to promote the update of cervical screening. Improved rates of cervical screening amongst deprived communities; cancer incidence was not reported. 28 (medium)