Abstract

Background: It has been suggested that interventions focusing on individual behaviour change, such as behavioural weight management interventions, may exacerbate health inequalities. These intervention-generated inequalities may occur at different stages, including intervention uptake, adherence and effectiveness. We conducted a systematic review to synthesise evidence on how different measures of inequality moderate the uptake of, adherence to and effectiveness of behavioural weight management interventions in adults. Methods: We updated a previous systematic literature review from the US Preventive Services Taskforce to identify trials of behavioural weight management interventions in adults that could be conducted in or recruited from primary care. Medline, Cochrane database (CENTRAL) and PsycINFO were searched. Only randomised controlled trials and cluster-randomised controlled trials were included. Two investigators independently screened articles for eligibility and conducted risk of bias assessment. We curated publication families for eligible trials. The PROGRESS-Plus acronym (place of residence, race/ethnicity, occupation, gender, religion, education, socioeconomic status, social capital, plus other discriminating factors) was used to consider a comprehensive range of health inequalities. Data on trial uptake, intervention adherence, weight change, and PROGRESS-Plus related-data were extracted. Results: Data extraction in currently underway. A total of 108 studies are included in the review. Data will be synthesised narratively and through the use of Harvest Plots. A Harvest plot for each PROGRESS-Plus criterion will be presented, showing whether each trial found a negative, positive or no health inequality gradient. We will also identify potential sources of unpublished original research data on these factors which can be synthesised through a future individual participant data meta- analysis. Conclusions and implications: The review findings will contribute towards the consideration of intervention-generated inequalities by researchers, policy makers and healthcare and public health practitioners. Authors of trials included in the completed systematic review may be invited to collaborate on a future IPD meta-analysis. PROSPERO registration number: CRD42020173242

Highlights

  • It has been suggested that interventions focusing on individual behaviour change, such as behavioural weight management interventions, may exacerbate health inequalities

  • Health inequalities occur by Place of residence, Race/ethnicity, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital plus factors such as age and sexual orientation (PROGRESS-Plus). [1]

  • Previous systematic reviews have focused on mean weight loss [5] and have not considered whether uptake, adherence or effectiveness differs by PROGRESS-Plus criteria

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Summary

Background

The HIV-1 envelope glycoprotein (Env) is the target of antigen design for antibodybased vaccination. In 2019, four trimeric Env vaccines entered an experimental trial: ConM, ConS, and their cross-linked counterparts. The trimers were formulated with MPLA adjuvant. Studies have demonstrated that adjuvants trigger neutrophil infiltration. Neutrophils activate and degranulate releasing proteases, namely elastase and cathepsinG. Aims: To assess the stability and immunogenicity of these vaccines in the presence of adjuvantrecruited neutrophils and their proteolytic enzymes

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Teesside University
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University of Cambridge
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