Background: Evaluations of public health interventions require an understanding of the contextual factors that shape their effectiveness. Context (including socioeconomic, cultural, and environmental factors) plays a critical role in establishing how interventions achieve impact, why outcomes can vary and whether the interventions of interest can be translated from one context to another. This overview explores the extent to which systematic reviews of public health interventions for low-income or low socioeconomic status (SES) populations report contextual factors influencing outcomes.

Methods: Systematic reviews were identified through a scoping review and updated searches in March 2023. Reviews focused on interventions targeting smoking, unhealthy diet, physical inactivity, and harmful alcohol use in disadvantaged groups. Reviews were screened for eligibility, and data were extracted on contextual factors related to intervention implementation and effectiveness. Data were synthesised using a framework approach, categorising findings by behaviour and level of intervention.

Results: Applying a very broad definition of context, 29 of 86 identified reviews provided some degree of contextual data which varied across interventions but was largely restricted to intervention implementation and delivery factors. For example, environmental characteristics, such as crime and perceived personal safety, affected the use of physical activity infrastructure in disadvantaged areas. Food voucher schemes had mixed results, with social and economic factors affecting their use and effectiveness. However, most reviews lacked sufficient reporting on contextual data, limiting conclusions on the role of context in intervention outcomes.

Conclusions: Contextual factors are often underreported in systematic reviews of public health interventions targeting disadvantaged populations. Such underreporting is likely to be similar in other areas of public health. This limits policymakers' ability to adapt interventions to specific settings. Improved reporting and consideration of context in systematic reviews are needed to ensure that interventions are appropriately tailored to the needs of low-income and low SES groups.

Keywords: Contextual factors; Disadvantaged populations; Public health interventions; Systematic reviews.

© 2025. The Author(s).

背景：

评估公共卫生干预措施需要理解影响其效果的环境因素。环境（包括社会经济、文化和环境因素）在确定干预措施如何实现影响、为何结果会有所不同，以及感兴趣的干预措施是否可以从一个环境转移到另一个环境中起着关键作用。本综述探讨了针对低收入或低社会经济地位人群的公共卫生干预措施系统评价中报告的影响结果的环境因素的程度。

方法：

通过一项回顾性审查和2023年3月的更新搜索确定了系统评价。这些评价关注于针对弱势群体的吸烟、不健康饮食、缺乏体育活动和有害饮酒等干预措施。筛选符合标准的评论，并提取与实施和效果相关的环境因素数据。使用框架方法对数据进行综合，按行为和干预级别分类。

结果：

应用非常宽泛的环境定义，86项中29项综述提供了一定程度的环境数据，这些数据在不同干预措施间有所差异，但主要局限于实施和交付因素。例如，犯罪和个人感知的安全等环境特征影响了弱势地区体育活动基础设施的使用。食品券计划效果不一，社会和经济因素对其使用和有效性产生了影响。然而，大多数综述对环境数据的报告不足，限制了对环境在干预结果中作用的结论。

结论：

在针对低收入或低社会经济地位人群的公共卫生干预措施系统评价中，环境因素往往被低估。这种低估很可能在公共健康的其他领域也存在。这限制了政策制定者根据具体情况进行调整的能力。为了确保干预措施能够适应低收入和低社会经济状况群体的需求，需要改进系统评价中的报告和对环境因素的考虑。

关键词：

环境因素；弱势人群；公共卫生干预；系统评价。