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Addressing Equity, Diversity and Inclusion in JBI Qualitative Systematic Reviews: A Methodological Scoping Review

Evans, Catrin; Hassanein, Zeinab M; Bains, Manpreet; Bennett, Clare; Bjerrum, Merete; Edgley, Alison; Edwards, Deborah; Porritt, Kylie; Salmond, Susan


Professor of Evidence Based Healthcare

Zeinab M Hassanein

Clare Bennett

Merete Bjerrum

Deborah Edwards

Kylie Porritt

Susan Salmond


Objective: To investigate ways in which qualitative review teams are addressing equity, diversity and inclusion (EDI) in the process of conducting and reporting qualitative systematic reviews which utilize JBI guidelines.

Introduction: In order to promote health equity, there is a need for evidence synthesis processes and practices to develop approaches that incorporate EDI. Some guidance is available to guide equity-focused review methods and reporting, but this is primarily oriented to quantitative systematic reviews. There is currently limited knowledge about how review teams are addressing EDI within qualitative evidence syntheses.

Inclusion criteria: English language qualitative systematic reviews, published in 2022, that had utilized all the steps outlined in JBI guidance for qualitative reviews.

Methods: A one year sample of published reviews was identified from a search (undertaken on 17/03/23) of two major healthcare databases - Medline (Ovid) and CINAHL (EBSCOhost). Data extraction followed a framework approach, utilizing an adapted pre-existing equity template. This included attention to: (i) the reporting of a range of characteristics associated with EDI, (ii) search approaches, and (iii) analytical approaches (including reflexivity, intersectionality and knowledge user engagement). Data were analyzed using descriptive statistics and narrative summary.

Results: Forty three reviews met the inclusion criteria. The majority of reviews (n=30) framed their questions and aims in a generic/universal (rather than EDI-focused) way. Six reviews justified their population focus in terms of an EDI-related issue. Only one review included a knowledge user. The socio-demographic and other key characteristics of the samples in underpinning studies were poorly reported making it hard to discern EDI-related issues or to undertake EDI-related analyses. One third (n=13) of the reviews had included non-English language evidence sources and two thirds (n=31) had included grey literature sources. Ten reviews demonstrated an element of intersectional or otherwise ‘critical’ approaches within their analyses of categories and synthesized findings (whereby issues of power and/or representation were explicitly considered). Only eight of the reviews included discussions of review team composition and reflexivity within the review process.

Conclusions: This study suggests a need for qualitative review authors to pay greater attention to EDI. Further methodological work is needed in 6 areas: (i) when framing the question; (ii) considering grey literature sources and inclusion of studies in languages other than English; (iii) describing the population, geographical and other EDI characteristics of the underpinning studies in detail and highlighting where there may be potential gaps in representation; (iv) considering whether and how to address EDI and intersectionality within analytical processes; (v) considering the nature of reflexivity in the underpinning evidence (and its potential impact on an understanding of EDI in relation to their phenomenon of interest); and, (vi) critically reflecting on the potential transferability of their findings in relation to groups or contexts that were not represented in the underpinning evidence for the review. Additional guidance may be needed to support knowledge user involvement and greater reflexivity (or reporting thereof) within the review process.

Journal Article Type Article
Acceptance Date Jun 13, 2024
Deposit Date Jun 14, 2024
Journal JBI Evidence Synthesis
Electronic ISSN 2689-8381
Publisher Wolters Kluwer
Peer Reviewed Peer Reviewed
Keywords Qualitative evidence synthesis; qualitative systematic review; equity; diversity; inclusion
Public URL