Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health

Abstract

Objectives: To assess the utility of an acronym, place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, and social capital ("PROGRESS"), in identifying factors that stratify health opportunities and outcomes. We explored the value of PROGRESS as an equity lens to assess effects of interventions on health equity.

Study design and setting: We assessed the utility of PROGRESS by using it in 11 systematic reviews and methodological studies published between 2008 and 2013. To develop the justification for each of the PROGRESS elements, we consulted experts to identify examples of unfair differences in disease burden and an intervention that can effectively address these health inequities.

Results: Each PROGRESS factor can be justified on the basis of unfair differences in disease burden and the potential for interventions to reduce these differential effects. We have not provided a rationale for why the difference exists but have attempted to explain why these differences may contribute to disadvantage and argue for their consideration in new evaluations, systematic reviews, and intervention implementation.

Conclusion: The acronym PROGRESS is a framework and aide-memoire that is useful in ensuring that an equity lens is applied in the conduct, reporting, and use of research.

Keywords: Health equity; Inequity; Interventions; Minorities; Social determinants of health; Subgroups; Vulnerable populations.