Promoting equitable access to infection prevention for people with different vulnerabilities: a scoping review

Abstract

Background: Educational health interventions play a crucial role in the prevention of respiratory infections, particularly among people with vulnerabilities, who bear a disproportionate burden, which can lead to severe complications such as increased morbidity and mortality. Tailored educational approaches, including digital interventions, are essential to engage and empower these groups, promote self-care behaviors, and reduce health inequities. Despite their significance, evidence on educational interventions, particularly those leveraging digital platforms, has yet to be systematically mapped. To identify and analyze existing educational interventions designed to foster self-care behaviors and prevent respiratory infections among people with vulnerabilities in community settings was the intent of this study. Methods: The PRISMA-ScR checklist was followed to conduct this scoping review. Systematic searches were performed in PubMed, CINAHL, Cochrane, and Scopus, supplemented by grey literature and reference screening. Studies involving educational interventions for people with vulnerabilities in community settings were included, with no publication date restrictions. The review protocol was registered in the Open Science Framework on February 21, 2024. Data extracted were narratively synthesized, focusing on interventions characteristics, different populations included, and outcomes. Results: Twelve studies were included, reporting in-person education, tailored materials, e-health, telehealth, digital and computer-based educational interventions. Older adults, children, individuals with chronic conditions, and groups with socioeconomic vulnerabilities were involved. Interventions have triggered significant improvements in knowledge, attitudes, and preventive behaviors. Digital approaches enhanced outreach and engagement but revealed barriers such as technological disparities due to limited digital literacy among people with vulnerabilities. In-person and culturally tailored interventions proved effective in promoting behavior change, particularly when aligned with community needs. Conclusions: Tailored, community-based and hybrid approaches that combine face-to-face and digital components are recommended to close knowledge and behavioral gaps regarding preventive measures against respiratory infections in people with different vulnerabilities. However, there are challenges such as inequality in digital access and variability in intervention outcomes that suggest hybrid models and culturally sensitive approaches. Further research is needed to assess the long-term impact of these strategies on reducing respiratory infections and improving health equity.