A scoping review establishes need for consensus guidance on reporting health equity in observational studies.

To evaluate the support from the available guidance on reporting of health equity in research for our candidate items and to identify additional items for the Strengthening Reporting of Observational studies in Epidemiology-Equity extension. We conducted a scoping review by searching Embase, MEDLINE, CINAHL, Cochrane Methodology Register, LILACS, and Caribbean Center on Health Sciences Information up to January 2022. We also searched reference lists and gray literature for additional resources. We included guidance and assessments (hereafter termed "resources") related to conduct and/or reporting for any type of health research with or about people experiencing health inequity. We included 34 resources, which supported one or more candidate items or contributed to new items about health equity reporting in observational research. Each candidate item was supported by a median of six (range: 1-15) resources. In addition, 12 resources suggested 13 new items, such as "report the background of investigators". Existing resources for reporting health equity in observational studies aligned with our interim checklist of candidate items. We also identified additional items that will be considered in the development of a consensus-based and evidence-based guideline for reporting health equity in observational studies

Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimientos de atención de la salud Recomendaciones basadas en consenso de expertos e informadas en la evidencia

The “Asociación Colombiana de Infectología” (ACIN) and the “Instituto de Evaluación de Nuevas Tecnologías de la Salud” (IETS) created a task force to develop recommendations for Covid 19 health care diagnosis, management and treatment informed, and based, on evidence. Theses reccomendations are addressed to the health personnel on the Colombian context of health services. © 2020 Asociacion Colombiana de Infectologia. All rights reserved

Dynamic measurements of geographical accessibility considering traffic congestion using open data : a cross-sectional assessment for haemodialysis services in Cali, Colombia

Background: Many cities with traffic congestion lack accessibility assessments accounting for traffic congestion and equity considerations but have disaggregated georeferenced municipal-level open data on health services, populations, and travel times big data. We convened a multistakeholder intersectoral collaborative group that developed a digital, web-based platform integrating open and big data to derive dynamic spatial-temporal accessibility measurements (DSTAM) for haemodialysis services. We worked with stakeholders and data scientists and considered people's places of residence, service locations, and travel time to the service with the shortest travel time. Additionally, we predicted the impacts of strategically introducing haemodialysis services where they optimise accessibility. Methods: Cross-sectional analyses of DSTAM, accounting for traffic congestion, were conducted using a web-based platform. This platform integrated traffic analysis zones, public census and health services datasets, and Google Distance Matrix API travel-time data. Predictive and prescriptive analytics identified optimal locations for new haemodialysis services and estimated improvements. Primary outcomes included the percentage of residents within a 20-min car drive of a haemodialysis service during peak and free-flow traffic congestion. Secondary outcomes focused on optimal locations to maximise accessibility with new services and potential improvements. Findings were disaggregated by sociodemographic characteristics, providing an equity perspective. The study in Cali, Colombia, used geographic and disaggregated sociodemographic data from the adjusted 2018 Colombian census. Predicted travel times were obtained for two weeks in 2020. Findings: There were substantial traffic variations. Congestion reduced accessibility, especially among marginalised groups. For 6-12 July, free-flow and peak-traffic accessibility rates were 95.2% and 45.0%, respectively. For 23-29 November, free-flow and peak traffic accessibility rates were 89.1% and 69.7%. The locations where new services would optimise accessibility had slight variation and would notably enhance accessibility and health equity. Interpretation: Establishing haemodialysis services in targeted areas has significant potential benefits. By increasing accessibility, it would enhance urban health and equity

Assessing equity in accessibility to haemodialysis services by automobile in Cali, Colombia : Cross-sectional analyses using publicly available data

Objectives: To obtain dynamic spatial-temporal measurements of driving times to haemodialysis services and estimate the benefits of adding new services. Design: Cross-sectional analyses of dynamic spatial-temporal accessibility, considering traffic congestion. A web-based platform integrated traffic analysis zones, public census and health services datasets, with Google Distance Matrix API big travel-time big data. Predictive and prescriptive analytics identified optimal locations for new haemodialysis services and estimated accessibility improvements. Setting and participants: Cali, Colombia (2020 population: 2.258 million) using geographic and disaggregated sociodemographic data from the adjusted 2018 Colombian census. Predicted travel times were obtained for 6-12 July and 23-29 November 2020. This study is part of a project measuring accessibility to health services. Primary and secondary outcomes: Percentage of residents within 20 minutes by car of a haemodialysis service at peak- and free-flow traffic congestion. Locations where new services maximise accessibility and estimated improvements. Findings were disaggregated by sociodemographic characteristics, providing an equity perspective. Results: Accessibility was lower in July, without COVID-19 traffic restrictions. Traffic congestion reduces accessibility to haemodialysis, hurting more less-educated people, residents of low-income housing and outlying neighbourhoods, and specific ethnic groups. For 6-12 July, free-flow and peak-traffic accessibility were 95.2% and 45.0%, respectively; 19.9% at peak traffic for the lowest-income stratum. Adding services in the Agua Blanca district and southern Cali would increase peak traffic accessibility to 70.2% and 62.4% for the lowest-income stratum. Accessibility for 23-29 November was better. Conclusions: New haemodialysis services in eastern Cali would improve accessibility and reduce inequities. Dynamic accessibility measures improve health services and land-use planning

Dynamic measurements of geographical accessibility considering traffic congestion using open data: a cross-sectional assessment for haemodialysis services in Cali, Colombia

Background: Many cities with traffic congestion lack accessibility assessments accounting for traffic congestion and equity considerations but have disaggregated georeferenced municipal-level open data on health services, populations, and travel times big data. We convened a multistakeholder intersectoral collaborative group that developed a digital, web-based platform integrating open and big data to derive dynamic spatial–temporal accessibility measurements (DSTAM) for haemodialysis services. We worked with stakeholders and data scientists and considered people's places of residence, service locations, and travel time to the service with the shortest travel time. Additionally, we predicted the impacts of strategically introducing haemodialysis services where they optimise accessibility. Methods: Cross-sectional analyses of DSTAM, accounting for traffic congestion, were conducted using a web-based platform. This platform integrated traffic analysis zones, public census and health services datasets, and Google Distance Matrix API travel-time data. Predictive and prescriptive analytics identified optimal locations for new haemodialysis services and estimated improvements. Primary outcomes included the percentage of residents within a 20-min car drive of a haemodialysis service during peak and free-flow traffic congestion. Secondary outcomes focused on optimal locations to maximise accessibility with new services and potential improvements. Findings were disaggregated by sociodemographic characteristics, providing an equity perspective. The study in Cali, Colombia, used geographic and disaggregated sociodemographic data from the adjusted 2018 Colombian census. Predicted travel times were obtained for two weeks in 2020. Findings: There were substantial traffic variations. Congestion reduced accessibility, especially among marginalised groups. For 6–12 July, free-flow and peak-traffic accessibility rates were 95.2% and 45.0%, respectively. For 23–29 November, free-flow and peak traffic accessibility rates were 89.1% and 69.7%. The locations where new services would optimise accessibility had slight variation and would notably enhance accessibility and health equity. Interpretation: Establishing haemodialysis services in targeted areas has significant potential benefits. By increasing accessibility, it would enhance urban health and equity. Funding: No external or institutional funding was received. © 2024 The Author

Improving the reporting of public health intervention research: advancing TREND and CONSORT

Background: Evidence-based public health decision-making depends on high quality and transparent accounts of what interventions are effective, for whom, how and at what cost. Improving the quality of reporting of randomized and non-randomized study designs through the CONSORT and TREND statements has had a marked impact on the quality of study designs. However, public health users of systematic reviews have been concerned with the paucity of synthesized information on context, development and rationale, implementation processes and sustainability factors.<p></p> Methods: This paper examines the existing reporting frameworks for research against information sought by users of systematic reviews of public health interventions and suggests additional items that should be considered in future recommendations on the reporting of public health interventions.<p></p> Results: Intervention model, theoretical and ethical considerations, study design choice, integrity of intervention/process evaluation, context, differential effects and inequalities and sustainability are often overlooked in reports of public health interventions.<p></p> Conclusion: Population health policy makers need synthesized, detailed and high quality a priori accounts of effective interventions in order to make better progress in tackling population morbidities and inequalities. Adding simple criteria to reporting standards will significantly improve the quality and usefulness of published evidence and increase its impact on public health program planning

Improving Accessibility to Radiotherapy Services in Cali, Colombia : Cross-Sectional Equity Analyses Using Open Data and Big Data Travel Times from 2020

In this study, we employed a methodology to evaluate and forecast the cumulative opportunities for residents to access radiotherapy services in Cali, Colombia, while accounting for traffic congestion from an equity perspective. Furthermore, we identified 1-2 optimal locations where new services would maximise accessibility. We utilised open data and publicly available big data. Methodology: Using a people-centred approach, we tested a web-based digital platform developed through design thinking. The platform integrates open data, including the location of radiotherapy services, the disaggregated sociodemographic microdata for the population and places of residence, and big data for travel times from Google Distance Matrix API. We used genetic algorithms to search heuristics to identify optimal locations for new services. We predicted accessibility cumulative opportunities (ACO) for traffic ranging from peak congestion to free-flow conditions at hourly assessments for 6-12 July 2020 and 23-29 November 2020. The interactive digital platform is openly available. Primary and Secondary Outcomes: We present descriptive statistics and population distribution heatmaps based on 20-minute Accessible Catchment Area (ACO) isochrones for car journeys. These isochrones connect the population-weighed centroid of the traffic analysis zone at the place of residence to the corresponding zone of the radiotherapy service with the shortest travel time under varying traffic conditions, ranging from free-flow to peak-traffic congestion levels. Additionally, we conducted a time-series bivariate analysis to assess geographical accessibility based on economic stratum. We identify 1-2 optimal locations where new services would maximise the 20-minute ACO during peak-traffic congestion. Results: Traffic congestion significantly diminished accessibility to radiotherapy services, particularly affecting vulnerable populations. For instance, urban 20-minute ACO by car dropped from 91% during free-flow traffic to 31% during peak traffic for the week of 6-12 July 2020. Specific ethnic groups, individuals with lower educational attainment, and residents in the outskirts of Cali experienced disproportionate effects, with accessibility decreasing to 11% during peak traffic compared to 81% during free-flow traffic for low-income households. We predict that strategically adding sufficient services in 1-2 locations in eastern Cali would notably enhance accessibility and reduce inequities. The recommended locations for new services remained consistent in both of our measurements. These findings underscore the significance of prioritising equity and comprehensive care in healthcare accessibility. They also offer a practical approach to optimising service locations to mitigate disparities. Expanding this approach to encompass other transportation modes, services, and cities, or updating measurements, is feasible and affordable. The new approach and data are particularly relevant for planning authorities and urban development actors

Advancing pediatric palliative care in a low-middle income country: an implementation study, a challenging but not impossible task

Background: The disparities in access to pediatric palliative care and pain management in Latin America remains an unaddressed global health issue. Efforts to improve the development of Palliative Care (PC) provision have traditionally targeted services for adults, leaving the pediatric population unaddressed. Examples of such services are scarce and should be portrayed in scientific literature to inform decision-makers and service providers on models of care available to tackle the burden of Pediatric Palliative Care (PPC) in Low-and middle-income countries (LMIC). The purpose of this study is to describe the implementation of a pediatric palliative care program, “Taking Care of You” (TCY), in a tertiary care, university hospital in Cali, Colombia. Methods: A program’s database was built with children between 0 to 18 years old and their families, from year 2017 to 2019. Descriptive analysis was carried out to evaluate the impact of the program and service delivery. A theory-based method was directed to describe the PPC program, according to the implementation of self-designed taxonomy, mapping theoretical levels and domains. Clinical outcomes in patients were included in the analysis. Results: Since 2017 the program has provided PPC services to 1.965 children. Most of them had an oncologic diagnosis and were referred from hospitalization services (53%). The number of ambulatory patients increased by 80% every trimester between 2017 and 2018. A 50% increase was reported in hospitalization, emergency, and intensive care units during the same time period. Conclusions: The program addressed a gap in the provision of PPC to children in Cali. It shows effective strategies used to implement a PPC program and how the referral times, coordination of care, communication with other hospital services were improved while providing compassionate/holistic care to children with life-limiting and threatening diseases and in end-of-life. The implementation of this program has required the onset of specific strategies and arrangements to promote awareness and education proving it a hard task, yet not impossible

Advancing pediatric palliative care in a low-middle income country: an implementation study, a challenging but not impossible task

Background: The disparities in access to pediatric palliative care and pain management in Latin America remains an unaddressed global health issue. Efforts to improve the development of Palliative Care (PC) provision have traditionally targeted services for adults, leaving the pediatric population unaddressed. Examples of such services are scarce and should be portrayed in scientific literature to inform decision-makers and service providers on models of care available to tackle the burden of Pediatric Palliative Care (PPC) in Low-and middle-income countries (LMIC). The purpose of this study is to describe the implementation of a pediatric palliative care program, “Taking Care of You” (TCY), in a tertiary care, university hospital in Cali, Colombia. Methods: A program’s database was built with children between 0 to 18 years old and their families, from year 2017 to 2019. Descriptive analysis was carried out to evaluate the impact of the program and service delivery. A theory-based method was directed to describe the PPC program, according to the implementation of self-designed taxonomy, mapping theoretical levels and domains. Clinical outcomes in patients were included in the analysis. Results: Since 2017 the program has provided PPC services to 1.965 children. Most of them had an oncologic diagnosis and were referred from hospitalization services (53%). The number of ambulatory patients increased by 80% every trimester between 2017 and 2018. A 50% increase was reported in hospitalization, emergency, and intensive care units during the same time period. Conclusions: The program addressed a gap in the provision of PPC to children in Cali. It shows effective strategies used to implement a PPC program and how the referral times, coordination of care, communication with other hospital services were improved while providing compassionate/holistic care to children with life-limiting and threatening diseases and in end-of-life. The implementation of this program has required the onset of specific strategies and arrangements to promote awareness and education proving it a hard task, yet not impossible