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Table 2 Characteristics of studies not included in Meta-analyses

From: Do health education initiatives assist socioeconomically disadvantaged populations? A systematic review and meta-analyses

1st Author (year), country

Study design

No at baseline (No analysed)

Country (Income level)

Population and setting

Focus of educational intervention

Comparison group

Relevant

Outcome(s)

Abiyu (2020) [58]

Cluster RCT

612 mother-infant pairs (554)

Ethiopia (LIC)

Mothers with infants < 6 months old residing in rural communities in Ethiopia

Feeding behaviour change intervention to improve infants’ feeding practices, health and growth

Usual care (routine health and nutrition services)

WHO dietary adequacy indicators (3), dietary intake (8)

Acharya

(2015) [59]

Cluster RCT

12,368 (11,885)

India (LMIC)

Community-dwelling pregnant women in Uttar Pradesh districts (high socioeconomic needs and low institutional delivery)

Pregnancy and Newborn Health – High intensity intervention

Low intensity intervention

Healthy delivery (5); breast feeding(4)

Almabadi

(2021) [60]

RCT

579 (295)

Australia (HIC)

Adults on a waiting list at an Oral Health Care Clinic in a low socio-economic community

Promoting improved oral health care via education about oral hygiene procedures, smoking and alcohol cessation, healthy diet

Routine oral health care

Smoking, alcohol, diet, BMI, blood makers (6), plaque index

Alegria

(2014) [61]

RCT

724 (647)

USA (HIC)

Low-income Latino and/or other minority patients of community mental health clinics; English and Spanish speaking

Teaching activation, self-management, engagement & retention in mental healthcare

Minimal intervention (received brochure)

Patient activation, self-management, service use, retention

Alias

(2021) [62]

Quasi-experimental

390 (358)

Spain (HIC)

Community dwelling older adults (≥ 60 years) living in urban disadvantaged areas who perceived their health as fair or poor

Aimed at promoting social support and participation, self-management and health literacy

Delayed intervention

Social participation; use of anxiolytics/antidepressants; use of health resources

Alvarenga

(2020) [63]

RCT

56 (44)

Brazil (UMIC)

Mother-infant dyads recruited from 2 health centres in 2 low-income communities

Infant development

Control intervention (monthly mailouts showing main developmental milestones)

Mother behaviours related to maternal sensitivity (6)

Andrews

(2016) [64]

RCT

409 (373)

USA (HIC)

Female smokers residing in government subsidized neighbourhoods in South Carolina

Smoking cessation intervention

Delayed intervention group

Smoking cessation (2)

Annan

(2017) [65]

RCT

479 (479)

Thailand (LMIC)

Burmese migrant parents or primary caregivers and their children residing in rural, peri-urban, or urban communities in Thailand

Parenting and family skills training program

Waiting list control condition

Child behaviour (3)

Avila

(1994) [37]

RCT

44 (39)

USA (HIC)

Obese, low-income Latina from a community medical clinic

Weight reduction program including exercise, nutrition education, behavioural modification strategies, and a buddy system

Control intervention—weekly cancer screening education sessions

Exercise frequency, BMI, cholesterol, blood glucose, BP, VO2 max

Bagner (2016) [66]

RCT

60 families (46)

USA (HIC)

Racial minority mothers and their 12–15-month-old infants living below the poverty line

Parenting intervention involving an Infant Behaviour Program

Standard paediatric care

Parent child interaction (2)

Baranowski (1990) [67]

RCT

94 families (94)

USA (HIC)

Black American families with children in 5th, 6th and 7th grade in community-based public or private school systems

Centre-based program to improve diet and increase aerobic activity

No intervention control group (no contact during the program)

Exercise (2), resting pulse rate, BP

Barry

(2022) [68]

RCT

574 (364)

USA (HIC)

English-speaking mother-infant dyads living in poverty in one of two major US cities

Positive parenting and healthy child development

Usual care

Child behaviour (4), continuous performance task

Befort

(2016) [69]

RCT

172 (168)

USA (HIC)

Postmenopausal female breast cancer survivors residing in rural areas through rural community cancer clinics

Diet and physical activity intervention (Phase 2—weight maintenance intervention)

Minimal intervention – mailout and phone calls covering the same educational content

Weight (4)

Berman

(1995) [70]

Quasi-experimental

446 (118)

USA (HIC)

Adult smokers who were parents of students or adult students from low to middle income, multi-ethnic, inner-city public-schools

Smoking cessation program

Control group—received health education material without smoking cessation information

Smoking cessation (4)

Bray

(2013) [71]

Quasi-experimental

727 (727)

USA (HIC)

Rural, low income, diabetic African Americans in rural, fee for service primary care practices

Diabetes self-management program involving education, self-management coaching and medication adjustment

Usual care—standard assessment and treatment, educational handouts offered

Haemoglobin, BP, lipid levels

Brooks

(2018) [72]

Cluster RCT

331 (250)

USA (HIC)

Smokers interested in quitting smoking from Boston public housing developments

Smoking cessation intervention

Standard care—smoking cessation materials and one visit from a Tobacco Treatment Advocate

Service use; smoking cessation (2)

Brown

(2013) [73]

RCT

252 (109)

USA (HIC)

Impoverished Mexican Americans with type 2 diabetes in the community

Culturally tailored diabetes self-management education intervention

Waiting list control

Leptin, A1C, BMI

Cahill

(2018) [74]

RCT

267 (240)

USA (HIC)

Socioeconomically disadvantaged pregnant African American women, overweight/obese before pregnancy

Homebased lifestyle weight management intervention to reduce gestational weight gain

Control group – parenting skills program

Weight (2), body composition, plasma glucose (2), insulin (2), lipids,

Calderon-Mora

(2020) [44]

Cluster RCT

300 (257)

USA (HIC)

Underserved Hispanic women—uninsured or underinsured/low income/low educational attainment

Group cervical cancer screening education program

Individual counselling with identical education content

Cervical cancer screening (1)

Childs

(1997) [75]

RCT

1000 (455)

England (HIC)

Children recorded on a child health register from households in inner city areas of high socioeconomic deprivation

Dietary health education program. Families received specific health education information at key child ages

Standard care

Haemoglobin; diet (2); breast feeding (3); intro-duction of pasteurised milk

Cibulka

(2011) [76]

RCT

170 (146)

USA (HIC)

Low-income pregnant women in an inner-city hospital based prenatal clinic

Oral care education program and provision of dental supplies

Control group – education without dental supplies

Brushing & flossing, sugary drink intake, dental check up

Curry

(2003) [77]

RCT

303 (ITT: 303)

USA (HIC)

Ethnically diverse, low-income female smokers whose children received care in a paediatric clinic

Smoking cessation intervention

Usual care with no education related to smoking cessation

Smoking cessation (4)

Damush

(2003) [78]

RCT

211 (139)

USA (HIC)

Low income, inner city primary care patients with acute low back pain in an inner-city neighbourhood health centre

Acute low back pain self-management program

Usual care—referrals and analgesics as indicated, and back exercise sheets

Physical activity (4)

Dawson-McClure

(2014) [79]

RCT

1050 (1050)

USA (HIC)

Low-income families with a non-Latino Black child in a pre-k program in disadvantaged urban neighbourhoods in New York City

ParentCorps Intervention aimed to increase parent involvement in early learning and behaviour management

ParentCorps intervention not provided in control schools

Parenting practices (4)

Dela Cruz

(2012) [80]

RCT

5,807 (5,807)

USA (HIC)

Low-income families with young children enrolled in Medicaid or Basic Health Plus in Yakima County, Washington State

Dental health care education

No postcard mailings

Service use

Doorenbos

(2011) [43]

RCT

5605 (5363)

USA (HIC)

Urban, low-income American Indians and Alaska native patients through mail to patients of an urban American Indian clinic

Mail-out intervention to increase cancer screening

Mailed calendar without cancer screening messages

Smoking cessation, cancer screening (3)

El-Mohandes

(2003) [81]

RCT

286 (167)

USA (HIC)

Lo- income minority mothers from a community-based hospital

Parenting skills education program

Standard social services care

Service use (2)

El-Mohandes

(2010) [82]

RCT

691 (691)

USA (HIC)

Pregnant African American women from 6 clinics in Washington, DC

Intervention aimed at reducing environmental tobacco smoke exposure

Routine prenatal care

Environmental tobacco smoke exposure (2)

Emmons

(2001) [83]

RCT

291 (279)

USA (HIC)

Low-income smokers or recent quitters through community-based health centres

Intervention for smoking parents of young children aimed at reducing household passive smoke exposure

Self-help smoking cessation resources

Household nicotine levels

Falbe

(2015) [84]

RCT

55 parent–child dyads (41)

USA (HIC)

Overweight or obese Latino parent and child dyads using federally funded care

Obesity intervention (Active and Healthy Families Intervention)

Usual care wait list control condition

BMI (2), BP, lipids, blood glucose, insulin (2), haemoglobin A1C

Fernandez-Jimenez

(2020) [85]

Cluster RCT

635 parent–child dyads (446)

USA (HIC)

Low-income and minority parents or caregivers and their children from 15 Head Start preschools in Harlem, New York

Health promotion intervention (2 arms) to improve cardiovascular risk factor profiles (Peer-to-Peer Program)

Control group received education unrelated to cardiovascular health

Composite health score, FBS

Fiks

(2017) [86]

RCT

87 (71)

USA (HIC)

Low-income, Medicaid insured new mothers of infants at high risk of obesity

Intervention to address parenting, maternal wellbeing, feeding and infant sleep

No education—text message appointment reminders only

Infant feeding, sleep, activity; maternal well being

Fitzgibbon

(1996) [87]

RCT

38 families (36)

USA (HIC)

Low-income inner city Hispanic American families living in the community in Chicago

Dietary intervention to reduce cancer risk

Control received health related pamphlets

Parent support, diet intake (2), BP

Fitzgibbon

(2004) [41]

RCT

256 (195)

USA (HIC)

Latino women from the Erie Family Health Centre

Combined dietary and breast health intervention

Control group received health information unrelated to breast health

Breast self-examination (2)

Fox

(1999) [88]

RCT

646 (566)

USA (HIC)

Residents in 9 rural counties with a minimum of 15% of their population below the poverty line and 10% minority population

‘In-home’ mental health screening and educational intervention

Control group—received list of local resources for health/mental health care

Rates of help seeking behaviour

Gielen

(1997) [89]

RCT

467 (391)

USA (HIC)

Low income, minority pregnant women smokers from an urban prenatal clinic

Smoking cessation and relapse prevention program (Smoke-Free Moms Project)

Usual care – routine clinic and inpatient smoking cessation education

Smoking cessation

Hayashi

(2010) [40]

RCT

1093 (869)

USA (HIC)

Low-income, uninsured/underinsured Hispanic women at risk for cardiovascular disease

Lifestyle intervention to improve health behaviours and reduce cardiovascular disease risk factors

Usual in-clinic care only with no lifestyle intervention

Eating habits (3); physical activity (3); BP; BMI; CHD risk; cholesterol; smoking

Hesselink

(2012) [90]

Quasi-experimental

239 (183)

Nether-lands (HIC)

1st and 2nd generation Turkish women living in the Netherlands through parent–child centres providing integrated maternity and infant care

Antenatal education program

Usual care

Smoking during pregnancy, parenting behaviours (2)

Hillemeier

(2008) [39]

RCT

692 (362)

USA (HIC)

Low socioeconomic status women, pregnant or able to become pregnant in low income urban, rural and semirural locations

Health education intervention to improve health behaviours and health status of pre-conceptional and inter-conceptional women

Control group

Physical activity, reading food labels, multivitamin use, BMI, weight, BP, blood glucose, cholesterol

Hoodbhoy

(2021)

Cluster RCT

32,595

Pakistan (LMIC)

Pregnant women and their families residing in a rural low-resource setting

Maternal and perinatal health program aimed at reducing all-cause maternal and perinatal morbidity and mortality

Routine antenatal

Birth preparedness (composite score & individual items (6))

Hooper

(2017) [91]

RCT

342 (282)

USA (HIC)

Low-income African American smokers through a university

Smoking cessation intervention

Standard CBT intervention—not culturally based

Smoking cessation

Hunt

(1976) [92]

RCT

344 (200)

USA (HIC)

Low-income pregnant women of Mexican descent from Los Angeles County prenatal clinics

Nutrition education intervention

Control group given vitamin and mineral capsules but no education

Dietary nutrients from blood samples (12)

Jacobson

(1999) [93]

RCT

433 (318)

USA (HIC)

Inner city minority patients 65 + years, presenting for routine primary care at an inner-city public hospital

One-page, low literacy patient education tool encouraging patients to ask their doctor about pneumococcal vaccination

Control group—one-page handout about nutrition

Vaccination rates, vaccination discussions with clinician

Janicke

(2008) [94]

RCT

93 (71)

USA (HIC)

Families with overweight children in underserved rural settings through Cooperative Extension Service offices

Diet and exercise intervention (two arms)

Waiting list control

Child’s BMI

Jensen

(2021) [95]

Cluster RCT

149814981498149814981498149814981498149814981498(1354)

Rwanda (LIC)

Families belonging to the most extreme level of poverty with one or more children aged 6–36 months

Early childhood development and non-violence

Usual care including social protection public works program and government support services

Violence and safety, harsh discipline

Kalichman

(2000) [42]

RCT

105 (53)

USA (HIC)

Inner city, low-income African American women who were patients of a community-based health clinic

Breast self-examination skills building workshop

Control group—sexually transmitted diseases prevention workshop

Breast self-examination skills and rate

Kasari

(2014) [96]

RCT

147 (95)

USA (HIC)

Families low income or with mothers with low educational attainment, or a primary carer who is unemployed, in low resource communities

Caregiver-mediated intervention for pre-schoolers with Autism

Two active interventions compared: individual and group

Parent–child interaction (4)

Kelly

(1994) [97]

RCT

197 (93)

USA (HIC)

Low-income, minority women in neighbour-hoods with high rates of sexually transmitted diseases, drug abuse & teenage pregnancy

HIV and AIDS risk reduction group education

Control group received sessions on health topics unrelated to AIDS

Safe sex practices (9)

Kim

(2021) [98]

RCT

63 (56)

South Korea (HIC)

Low-income women (40–60 years) residing in J Provence, South Korea

Healthy lifestyle intervention addressing nutrition, exercise, stress, psychological distress and dementia prevention

Minimal intervention (booklet with diet and exercise advice)

Health promoting behaviour, BMI, % body fat, waist-hip ratio

King

(2013) [38]

RCT

40 (39)

USA (HIC)

Low-income, inactive older adults through community centres serving primarily Latino population in San Jose, California

Physical activity intervention

Control group—received information about non-physical activity topics

Physical activity

Kreuter

(2010) [45]

RCT

489 (429)

USA (HIC)

Low-income African American women through low-income community neighbourhoods

Breast cancer screening intervention

Content equivalent video using a more explanatory and didactic approach

Mammogram

Krieger

(2005) [99]

RCT

274 (214)

USA (HIC)

Low-income, ethnically diverse urban households in their homes

High intensity intervention to decrease exposure to indoor asthma triggers

Low intensity intervention group

Asthma trigger reduction behaviour

Kulathinal

(2019) [100]

Quasi-experimental

405 (380)

India (LMIC)

Married men and women from primary health centres in rural Western India

Sexual and reproductive health intervention

Control areas received no mobile helpline

Contraceptive use (2)

Lutenbacher

(2018) [101]

RCT

188 (178)

USA (HIC)

Low-income pregnant Hispanic women in isolated community in a large metropolitan area

Home visiting program using peer mentors to improve maternal and child health outcomes

Minimal education intervention group received printed educational materials only

Breast feeding (3), prenatal care visits, reading stories, infant sleeping (2)

Maldonado (2020) [102]

Quasi-experimental

379 (326)

Kenya (LMIC)

Pregnant women attending their first antenatal care visits at a public health facility in a rural sub-county in Kenya

Education addressed antenatal care, family planning, intimate partner violence and microfinance literacy

Standard care (no structured education)

Facility-based delivery, healthy parenting practices (4), financial planning

Manandhar

(2004) [103]

Cluster RCT

24 clusters (24)

Nepal (LMIC)

Poor married women of reproductive age in a community based rural district

Childbirth and care behaviours intervention

Health service strengthening activities only

Antenatal care (10)

Martin

(2011) [104]

RCT

434 (338)

USA (HIC)

Low income, rural adults receiving medication at no charge from a public health department or a federally funded rural health centre

Adherence to hypertensive medications intervention

Control group – received cancer information

Medication adherence

McClure

(2020) [105]

RCT

718 (526)

USA (HIC)

Socioeconomically disadvantaged English- speaking adults who smoked > 5 cigarettes/day and were ready to quit smoking

A novel oral health and smoking cessation program

Standard smoking cessation program

Smoking cessation, oral health behaviours (4)

McConnell

(2016) [106]

RCT

104 (59)

Kenya (LMIC)

New mothers from a peri-urban community

Postnatal care intervention (2 arms)

Standard care group

Vaccination, family planning, breast feeding (2), index of health practices

McGilloway

(2014) [107]

RCT

149 (137)

Ireland (HIC)

Families in an urban disadvantaged area defined by their demographic profile, social class composition, and labour market situation

Parenting intervention aimed at fostering positive parent child relationships

Waiting list control

Child conduct (2), service use (2), social competence

Miller

(2013) [108]

RCT

210 (82)

USA (HIC)

Inner city, low income, minority women who had an abnormal pap smear

Colposcopy appointment adherence intervention (2 arms)

Enhanced standard care—included appointment reminders

Colposcopy (2)

Murthy

(2019) [109]

Quasi-experimental

2016 (1417)

India (LMIC)

Low-income pregnant women in urban slums (selected based on being in slums that are high proportion low income)

Healthy infant intervention

Control group

Child immunization, healthy infant nutrition (7)

Pandey

(2007) [110]

Cluster RCT

1045 households (1025)

India (LMIC)

Low socioeconomic status, resource poor, rural village clusters in Uttar Pradesh through the community

Pre-natal and infant health care utilisation

Control village clusters receiving no intervention

Prenatal care (3), tetanus injection, infant received vaccination

Phillips

(2014) [111]

RCT

53 (53)

Australia (HIC)

Australian Aboriginal children with tympanic membrane perforation through remote communities

Child ear health intervention

Usual care – received information sheet, treat-ment guidelines, advice to attend weekly clinic

Service use

Pitchik

(2021) [112]

Cluster RCT

621 (568)

Bangla-desh (LMIC)

Pregnant women or primary caregivers of a child < 15 months residing in rural villages

Child development intervention including caregiver behaviours, nutrition, caregiver mental health and lead exposure prevention

No intervention

Stimulation in the home

Polomoff

(2022) [113]

RCT

188 (180)

USA (HIC)

Cambodian Americans aged 35–75 years at high risk of developing diabetes and meeting the criteria for likely depression

A bilingual, trauma-informed, cardio-metabolic education intervention to decrease diabetes risk

Control intervention (needs assessment and support)

Medication forgetting

Reijneveld

(2003) [114]

RCT

126 (92)

Nether-lands (HIC)

Turkish immigrants aged 40 + years old recruited via welfare services

Health education and physical exercise program

Control group received the ‘Ageing in the Netherlands’ program

Physical activity

Reisine

(2012) [115]

RCT

120 (93)

USA (HIC)

Low-income pregnant women attending a community health centre

Dental caries prevention and nutrition education

Control group – received dental caries prevention education only

Mutans levels, Service use, teeth brushing

Ridgeway

(2022) [116]

RCT

1377 (943)

USA (HIC)

Women 40–74 years presenting for a screening mammogram at a health clinic serving a primarily Latina/Latino population

Education to explain the meaning and implications of mammographic breast density

Usual care (mailed mammogram results only)

Provider conversations relating to breast density

Robinson

(2002) [117]

RCT

218 (122)

USA (HIC)

Low-income African American women

HIV and sexually transmitted diseases prevention intervention combined with comprehensive sexuality education

Control group—received an HIV pamphlet and a gift card to a local beauty school

Sexual communication (3)

Ryser

(2004) [118]

RCT

54 (54)

USA (HIC)

Low-income pregnant women

Breast feeding education program

Control group—no exposure to Best Start program

Breast feeding

Saleh

(2018) [119]

RCT

Data from 2359 patient records

Lebanon (UMIC)

Individuals with noncommunicable diseases in rural areas and refugee camps

Hypertension and diabetes self-management education

Control group—no intervention

BP (2), diabetes markers (3)

SantaMaria

(2021) [120]

RCT

519 (397)

USA (HIC)

Parents of caregivers of youth 11–14 years of age living in medically underserved communities

Sexual health intervention including adolescent vaccinations and HPV

Control intervention – received nutrition and exercise information

Vaccination initiation and completion

Segal-Isaacson

(2006) [121]

RCT

466 (230)

USA (HIC)

Women with HIV/AIDS

High intensity coping skills, stress management and nutrition education intervention

Low intensity intervention—education with no individualization

CD4 and CD8 cell count, viral load, lipids

Seguin-Fowler

(2020) [122]

Cluster RCT

182 (182)

USA (HIC)

Women aged ≥ 40 years who were overweight or obese and sedentary; lived rurally in medically underserved towns

Healthy lifestyle intervention to reduce risk for cardiovascular disease

Delayed intervention

smoking cessation, diet, physical activity, weight, blood pressure, cholesterol, blood glucose

Simmons

(2022) [123]

RCT

1467 (1417)

USA (HIC)

Hispanic and Latino smoking adults

Smoking cessation program

Usual care (mailed Spanish language quit smoking booklet)

Smoking cessation

Smith

(2021) [124]

RCT

240 (240)

USA (HIC)

Racially and ethnically diverse low-income families with an overweight child attending paediatric primary care

Parenting skill development, connection with community-based services, telephone/face-to-face coaching

Usual care (information about services)

Child physical activity, diet, BMI, mealtime/media/sleep routines

Steptoe

(2003) [125]

RCT

271 (218)

USA (HIC)

Low-income, minority patients in a deprived ethnically diverse inner-city area

Individualised behavioural dietary counselling intervention targeted increasing intake of fruit and vegetables

Low intensity intervention—brief nutrition counselling

Dietary intake (2), nutrition blood levels (5), body weight, BMI, BP, cholesterol

Wiggins

(2005) [126]

RCT

731 (601)

England (HIC)

Low-income, inner city, culturally diverse minority women with infants in two disadvantaged inner-city boroughs of London

New mothers support interventions (2 arms)

Low intensity intervention—routine health visiting services

Smoking, infant feeding

Xu

(2019) [127]

RCT

278 (278)

Indonesia (LMIC)

Resource poor villagers diagnosed with schizophrenia in 9 rural townships

Schizophrenia support intervention (Lay health supporters, E-platform, Aware and iNtegration (LEAN))

Usual care – included a public health program for people with psychosis

Medication adherence