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Applying a health equity tool to assess a public health nursing guideline for practice in sexually transmitted infection assessment in British Columbia

Abstract

Setting

There is a multitude of health equity tools but little guidance on how to effectively use these tools in public health nursing practice. In BC, public health nurses who are certified in sexually transmitted infection care utilize guidelines authorized by the nursing regulatory body.

Intervention

As part of the Equity Lens in Public Health (ELPH) research project, an assessment of the nursing guideline, Sexually Transmitted Infection (STI) Assessment Decision Support Tool, was undertaken using the Assessing Equity in Clinical Practice Guidelines health equity assessment tool. The chosen tool is intended for use by health care providers, is broadly applicable to clinical practice guidelines, can be used retrospectively, and falls within the category of equity checklists and audits.

Outcomes

Overall, the tool was useful in assessing the inclusion and omission of an equity focus in the guideline. However, there were several challenges: the identification of an appropriate health equity tool; the absence of an evaluation of the chosen tool; the tool’s focus on chronic disease versus communicable disease; and the difficulty of obtaining client perspectives.

Implications

For an improved equity lens in the STI Assessment Decision Support Tool, future revisions should be equity focused and include perspectives from affected populations, an emphasis on the determinants of health that perpetuate inequities for populations who experience a disproportionate burden of STI, information on provincially available resources, and service delivery models that improve timely and equitable access to treatment and care.

Résumé

Contexte

Il existe une multitude d’outils d’équité en santé, mais peu de conseils sur la manière de les utiliser efficacement dans la pratique des soins infirmiers en santé publique. En Colombie-Britannique, les infirmières de la santé publique certifiées en matière de traitement des infections sexuellement transmissibles utilisent les directives autorisées par l’organisme de réglementation des soins infirmiers.

Intervention

Dans le cadre du projet de recherche Equity Lens in Public Health (ELPH), une évaluation de la ligne directrice en matière de soins infirmiers Sexually Transmitted Infections (STI) Assessment Decision Support Tool a été mis au point à l’aide de l’outil d’évaluation de l’équité en pratique clinique Assessing Equity in Clinical Practice Guidelines. L’outil choisi est destiné aux fournisseurs de soins de santé, s’applique largement aux directives de pratique clinique, peut être utilisé rétrospectivement et relève de la catégorie des listes de vérification et d’audit en matière d’équité.

Résultats

Dans l’ensemble, l’outil s’est avéré utile pour évaluer l’inclusion et l’omission d’une focalisation sur l’équité dans la ligne directrice. Cependant, il y avait plusieurs défis, dont : l’identification d’un outil approprié d’équité en santé; l’absence d’évaluation de l’outil choisi; l’outil met l’accent sur les maladies chroniques par rapport aux maladies transmissibles; et la difficulté d’obtenir les points de vue des clients.

Implications

Pour améliorer l’optique du STI Assessment Decision Support Tool en matière d’équité, les révisions futures devraient être axées sur l’équité et tenir compte des points de vue des populations touchées, l’accent étant mis sur les déterminants de la santé qui perpétuent les inégalités pour les populations qui subissent un fardeau disproportionné, informations disponibles à l’échelle provinciale, et les ressources et les modèles de prestation de services qui améliorent l’accès rapide et équitable aux traitements et aux soins.

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Funding

This work and the preparation of this manuscript were supported by the Equity Lens in Public Health CIHR Research Project (Funding Number: 116688).

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Correspondence to Sana Z. Shahram.

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Prescott, C., Shahram, S.Z., Ogilvie, G. et al. Applying a health equity tool to assess a public health nursing guideline for practice in sexually transmitted infection assessment in British Columbia. Can J Public Health 111, 610–616 (2020). https://doi.org/10.17269/s41997-019-00285-2

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Keywords

  • Health equity assessment
  • Health equity tool
  • Sexually transmitted infections
  • Clinical practice guideline
  • Decision Support Tool (DST)
  • STI Assessment DST
  • Public health nursing

Mots-clés

  • Évaluation d’équité en matière de santé
  • Outil d’équité en matière de santé
  • Infections sexuellement transmissibles
  • Guide de pratique clinique
  • Outil d’aide à la décision (DST)
  • Évaluation des IST DST
  • Soins infirmiers en santé publique