Addressing equity, diversity, and inclusion in JBI qualitative systematic reviews: a methodological scoping review

Objective: The objective of this methodological scoping review was 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 that use JBI guidelines. Introduction: 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: This review included English-language qualitative systematic reviews, published in 2022, that used all the steps outlined in the JBI guidance for qualitative reviews. Methods: A 1-year sample of published reviews was identified from a search undertaken on March 17, 2023, of 2 health care databases: MEDLINE (Ovid) and CINAHL (EBSCOhost). Data extraction followed a framework approach, using 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 the 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 1 review included a knowledge user. The sociodemographic 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. Thirteen of the reviews included non-English-language evidence sources, and 31 reviews included gray literature sources. Ten reviews demonstrated an element of intersectional or otherwise critical approach within their analyses of categories and synthesized findings (whereby issues of power and/or representation were explicitly considered). Only 8 reviews included discussions of review team composition and reflexivity within the review process. Conclusions: This EDI-focused methodological enquiry has highlighted some limitations within current qualitative evidence synthesis practice. Without closer attention to EDI, there is a danger that systematic reviews may simply serve to amplify, rather than illuminate, existing gaps, silences, and inequitable knowledge claims based on dominant representations. This review sets out a range of suggestions to help qualitative evidence synthesis teams to more systematically embed EDI within their methods and practices.