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Exploring perspectives of knowledge users about reporting on health equity in observational studies: a qualitative study informing the development of the STROBE-Equity reporting guideline.

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Title: Exploring perspectives of knowledge users about reporting on health equity in observational studies: a qualitative study informing the development of the STROBE-Equity reporting guideline.
Authors: Simpson D; Carleton University, Ottawa, Canada., Dewidar O; Bruyère Health Research Institute, Ottawa, Canada., Ghogomu E; Bruyère Health Research Institute, Ottawa, Canada., Aliyeva K; University of Ottawa, Ottawa, Canada., Bhutta Z; Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada., Barker LC; Women's College Hospital, Toronto, Canada.; University of Toronto, Toronto, Canada., Cuervo LG; Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine and Public Health of the Autonomous University of Barcelona, Barcelona, Spain.; National Academy of Medicine of Colombia, Bogotá, Colombia., Ellingwood HN; Carleton University, Ottawa, Canada., Faber S; University of Ottawa, Ottawa, Canada., Feng C; Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada., Funnell S; Faculty of Health Sciences, Queen's University, Kingston, Canada.; Department of Family Medicine, Queen's University, Kingston, Canada., Hardy BJ; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada., Roberts JH; Bruyère Health Research Institute, Ottawa, Canada.; WHO Collaborating Centre Knowledge Translation, Technology Assessment for Health Equity, Ottawa, Canada., Horsley T; Research and Evaluation, Royal College of Physicians and Surgeons of Canada, Ottawa, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada., Krentel A; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada., Little J; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada., Kennedy M; College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia., Kredo T; Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa., Kristjansson E; School of Psychology, University of Ottawa, Ottawa, Canada., Lawson DO; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada., Mahande MJ; Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University, Moshi, Tanzania.; Management and Development for Health, Dar es Salaam, Tanzania., Marshall Z; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada., Melendez-Torres GJ; Faculty of Health and Life Sciences, University of Exeter, Exeter, UK., Mbuagbaw L; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada., Nguilefem MN; University of Ottawa, Ottawa, Canada., Obuku EA; Africa Centre for Systematic Reviews and Knowledge Translation, College of Health Sciences, Makerere University, Kampala, Uganda.; Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK., Owusu-Addo E; Institute for Rural Development and Innovation Studies (IRDIS), College of Agriculture and Natural Resources, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana., Pantoja T; Department of Family Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile., Pottie K; Department of Family Medicine, Dalhousie University, Halifax, Canada., Rizvi A; School of Psychology, University of Ottawa, Ottawa, Canada., Shamseer L; Unity Health Toronto, Toronto, Canada., Tugwell P; University of Ottawa, Ottawa, Canada., Tufte J; Cochrane Consumer Network, Seattle, USA.; Patient-Centered Outcomes Research Institute, Seattle, USA., Wang X; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore., Wiysonge CS; Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa., Young T; Stellenbosch University, Stellenbosch, South Africa., Welch V; Bruyère Health Research Institute, Ottawa, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada., Jull J; Carleton University, Ottawa, Canada. JanetJull@cunet.carleton.ca.; Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada. JanetJull@cunet.carleton.ca.
Source: International journal for equity in health [Int J Equity Health] 2026 May 22; Vol. 25 (1). Date of Electronic Publication: 2026 May 22.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: BioMed Central Country of Publication: England NLM ID: 101147692 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-9276 (Electronic) Linking ISSN: 14759276 NLM ISO Abbreviation: Int J Equity Health Subsets: MEDLINE
Imprint Name(s): Original Publication: [London] : BioMed Central, 2002-
MeSH Terms: Health Equity*/standards , Observational Studies as Topic*/standards , Research Design*/standards , Guidelines as Topic*, Humans ; Qualitative Research
Abstract: Background: Health inequities arising from systemic factors and contextual conditions result in avoidable and unjust differences in health outcomes, with profound social and economic implications. Health inequities can frequently go unreported in observational studies. Observational studies can uniquely inform how we understand and address persisting health inequities through collecting, reporting and analyzing health equity factors using 'inclusive' methodological considerations. While the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) reporting guideline aims to improve observational study reporting quality, existing extensions lacked a specific focus on health equity. Engaging those who will use or be impacted by research ("knowledge users"), including participant-research collaborators, is central to bridging the gap between knowledge production and real-world application. Therefore, the purpose of this study was to gather a range of perspectives from these knowledge users as part of, and to inform, the development of the STROBE-Equity guideline extension, which aims to improve the reporting of equity-relevant considerations in observational studies.
Methods: This study used a qualitative description approach, employing semi-structured key informant interviews and framework analysis to collect and analyze the views of researchers, policymakers, decision-makers, funders, journal editors, ethicists, and participant-research collaborators. Participants were purposefully sampled to reflect diverse perspectives from knowledge users with relevant experience on health equity reporting.
Results: Eleven key informants participated in the interviews. Information from interviews was categorized into seven themes: "Clarifying equity", "Equity is dynamic", "The challenges of making equity claims", "Making reporting on equity feasible", "Using reporting guidelines to manage tension", "Potential for better outcomes", and "Nobody's perspective is neutral". Participants emphasized the need for standardized equity-relevant reporting practices and offered insight into challenges, opportunities, and strategies for integrating equity-relevant considerations into observational study reporting.
Conclusions: Findings show that participants viewed equity as a complex concept and stressed the need for practical guidance to support equity reporting in observational studies. They highlighted barriers such as limited time, resources, and publication word limits, and perceived the STROBE-Equity extension as a valuable tool for structuring reporting, raising awareness, and encouraging reflection, with the potential to improve the quality and impact of equity-relevant research.
(© 2026. The Author(s).)
Competing Interests: Declarations. Ethics approval and consent to participate: This study received ethics approval from the Bruyère Health Research Institute Research Ethics Board (Protocol # M16-21-025). Consent for publication: Not applicable. Competing interests: LCG contributed as a doctoral student and during his study time. While he is employed by the Pan American Health Organization (PAHO/WHO), the ideas expressed in this manuscript are the authors’ own and do not necessarily reflect the decisions and policies of PAHO/WHO. No other authors declare competing interests.
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Grant Information: 438315 Canada CAPMC CIHR
Contributed Indexing: Keywords: Equity-relevant data; Framework analysis; Health equity; Key informant interviews; Knowledge translation; Knowledge users; Observational studies; Qualitative research; Reporting guidelines; STROBE-Equity
Entry Date(s): Date Created: 20260523 Date Completed: 20260726 Latest Revision: 20260729
Update Code: 20260729
PubMed Central ID: PMC13404581
DOI: 10.1186/s12939-026-02876-1
PMID: 42174617
Database: MEDLINE
Description
ISSN:1475-9276
DOI:10.1186/s12939-026-02876-1