Background: Marginalized communities experience disproportionate health burdens due to complex intersections of social, economic, and environmental determinants. Traditional health promotion models inadequately address these multifaceted challenges, necessitating comprehensive approaches that target root causes of health inequities. Objective: To systematically evaluate the effectiveness of holistic health promotion interventions in addressing physical and mental health disparities among marginalized communities and identify critical success factors for intervention design and implementation. Methods: We conducted a mixed-methods systematic review and meta-analysis of peer-reviewed literature (2015-2024) using PRISMA guidelines. Comprehensive searches across seven databases identified studies of holistic health promotion interventions targeting marginalized populations. Random-effects meta-analysis quantified intervention effects, while reflexive thematic analysis explored implementation mechanisms. Quality assessment employed validated tools (MMAT, CASP). Results: Forty-seven studies (n=18,426 participants) met inclusion criteria, representing diverse marginalized populations across 23 countries. Meta-analysis revealed significant improvements in physical health (SMD=0.68, 95% CI: 0.45-0.91, p<0.001) and mental health outcomes (SMD=0.72, 95% CI: 0.52-0.92, p<0.001). Thematic analysis identified five critical success factors: authentic community engagement, cultural responsiveness, multi-level social determinants intervention, integrated service delivery, and sustainable capacity building. Interventions incorporating all five components demonstrated 43% greater effectiveness than partial implementations (p=0.02). Conclusions: Holistic health promotion approaches significantly outperform traditional interventions in addressing health disparities among marginalized communities. Success requires comprehensive strategies simultaneously targeting individual, interpersonal, organizational, community, and policy levels. Implementation demands authentic community partnerships, cultural adaptation, and systemic approaches to social determinants of health.
Dr Hardik Pipalia (Wed,) studied this question.
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