Societal-level Factors Research Articles

Sexual healthcare to meet the needs of sexuality and gender diverse aboriginal young people: imagined possibilities

In Australia, Aboriginal young people who are lesbian, gay, bisexual, trans, queer or otherwise sexuality and gender diverse (LGBTQ+) are recognised within several overlapping priority populations in state and federal sexually transmissible infection and HIV strategies. However, limited research has documented their unique sexual health experiences, needs and preferences. In this qualitative study, semi-structured interviews were conducted with 10 LGBTQ+ Aboriginal young people aged 16–24 years in New South Wales. Interviews incorporated questions about service access, positive and negative experiences and self-determined healthcare priorities. We conducted a strengths-based thematic analysis to understand the issues of greatest importance in sexual healthcare for participants. Using the framework of ‘imaginaries’, we explored how participants imagined sexual healthcare that would meet their individual and cultural needs. The dominant imaginary centred on respect, representation and the as-yet-unrealised possibility of sexual healthcare designed by and for people who shared the intersection of Aboriginal and LGBTQ+ experience. We identified individual-level, service-level and societal-level factors influencing this imaginary, including relationships, accessibility and experiences of racism. Analysing the imaginaries constructed by LGBTQ+ Aboriginal young people of empowering, culturally safe sexual healthcare that is ‘for them’ provides insight into potential service design to improve sexual health outcomes for this population.

Using the Socio-Ecological Model to Understand Increased Risk of Gun Violence in the African American Community.

Gun violence is a major public health issue of growing concern in the United States (U.S.) with 48,830 lives lost to gun related violence in 2021, documenting the highest number of gun related homicides and suicides ever recorded. The African American community is disproportionately impacted by gun violence and members of this community are almost 14x more likely to die by gun homicide than their white counterparts. The Centers for Disease Control and Prevention (CDC) has identified a socio-ecological framework as a lens through which to better understand violence and inform potential prevention strategies to address it. This model identifies four levels (individual, relationship, community, societal) which help to enhance our understanding of the complex interplay between individuals and their environments. Here, we use this model to understand why the African American community experiences elevated risk of gun violence in the U.S. and propose strategies for prevention. Understanding the issue of gun violence beyond individual level risk, this analysis highlights the interplay between multiple levels including the ways in which societal level factors influence violence. While this paper provides a lens through which to understand the multi-leveled factors that contribute to gun violence in the African American community, it also serves as a call to action for policymakers, scholars, and agencies to develop culturally informed policy and programming efforts specific to those who are most impacted.

Integrating family caregivers in older adults' hospital stays: a needed cultural shift.

This study aimed to examine perceived barriers and facilitators to caregiver inclusion in the hospital care of older adult family members or friends through the perspectives of (1) hospitalized older adults, (2) caregivers of a hospitalized older adult, (3) healthcare clinicians, and (4) policymakers. This qualitative descriptive exploratory study utilized semi-structured interviews with N = 24 participants and was analyzed using a framework method. Eight codes arose that were categorized into four domains guided by the Social Ecological Model. Individual-level factors were determined both for the caregiver and for the clinician. Relationship-level factors were revealed pertaining to communication style and method. Hospital-level factors included hospital environment and resources. Societal-level factors included healthcare climate and policies. Findings indicated that hospital workflows and policies inadequately support family caregivers. This study highlights potential solutions to caregivers' integration into hospital workflows.

Impact of Perceived and Collective Norms on COVID-19 Preventive Behaviors in 23 Countries: A Multi-Level Approach

ABSTRACT Social norms can be studied at both the individual and societal levels. While the influence of individual perceived norms on health behaviors has been well-documented, the role of societal-level factors in social normative influence remains unclear. We adopted a multilevel approach to investigate the impact of individual-level perceived norms, country-level collective norms, and individualistic culture on mask-wearing behavior during the COVID-19 pandemic. A secondary analysis of cross-sectional data collected from 23 countries (N = 450,223) was conducted. The findings reveal that perceived descriptive norms, perceived injunctive norms, and collective norms conjointly influenced mask-wearing behavior. Positive relationships between perceived descriptive and injunctive norms and mask wearing were stronger in countries with a higher collective norm. Furthermore, positive relationships between norms (i.e., perceived descriptive norms, perceived injunctive norms, and collective norms) and mask wearing were stronger in countries with a more individualistic culture. The study provides evidence for theorizing social normative influence beyond the individual level and underscores the importance of incorporating multilevel factors in social norm research.

Perspectives of community-based organizations on digital health equity interventions: a key informant interview study.

Health and healthcare are increasingly dependent on internet and digital solutions. Medically underserved communities that experience health disparities are often those who are burdened by digital disparities. While digital equity and digital health equity are national priorities, there is limited evidence about how community-based organizations (CBOs) consider and develop interventions. We conducted key informant interviews in 2022 purposively recruiting from health and welfare organizations engaged in digital equity work. Nineteen individuals from 13 organizations serving rural and/or urban communities from the local to national level participated in semi-structured interviews via Zoom regarding their perspectives on digital health equity interventions. Directed content analysis of verbatim interview transcripts was conducted to identify themes. Themes emerged at individual, organizational, and societal levels. Individual level themes included potential benefits from digital health equity, internet access challenges, and the need for access to devices and digital literacy. Organizational level themes included leveraging community assets, promising organizational practices and challenges. For the societal level, the shifting complexity of the digital equity ecosystem, policy issues, and data for needs assessment and evaluation were described. Several example case studies describing these themes were provided. Digital health equity interventions are complex, multi-level endeavors. Clear elucidation of the individual, organizational, and societal level factors that may impact digital health equity interventions are necessary to understanding if and how CBOs participate in such initiatives. This study presents unique perspectives directly from CBOs driving programs in this new arena of digital health equity.

The association of adverse family experiences, physical activity,and depression in a national sample of US adolescents.

Sufficient engagement in physical activity could foster resilience in adolescents and help alleviate the impact of adverse family experiences (AFEs), such as depression. However, the association between cumulative AFEs exposure, physical activity, and depression remains unclear. The aims of this study are to determine the relationship between AFEs and adolescent depression and whether physical activity moderates this relationship. Secondary analyses were conducted on 29,617 adolescents aged 12-17 years from the 2016-2017 National Survey of Children's Health. Binomial logistic regression was used to examine the relationship among AFEs, child depression, and physical activity. Covariates include individual-level, social-level, and societal-level factors. This study reveals that 7.3% of US adolescents had a depression diagnosis. The odds of having a depression diagnosis among US children were 1.6 times (adjusted OR: 1.6, 95%CI: 1.37-1.86) greater for adolescents with one type of AFEs, and 3.4 times greater (adjusted OR: 3.39, 95%CI: 2.78-4.13) for adolescents with three or more AFEs, compared with children living without AFEs. Physical activity for 1-3 days per week remained a significant, substantial protector of childhood depression among children with at least one type of AFEs (adjusted OR: 0.73, 95%CI: 0.62-0.87). These results suggest a clinical concern for adolescents with more AFEs. Trauma-informed care to address multiple types of trauma and physical activity interventions to reduce depression symptoms may be particularly important.

Establishing the health and wellbeing needs of mining host community in Brazil, Chile and Peru: a mixed-method approach to identify priority areas for action to help communities meet their SDG3 targets

BackgroundThe global mining industry is an important partner in advancing the 2030 Agenda for Sustainable Development. In 2018, Anglo American plc published their Sustainable Mining Plan, containing a goal for improving health and wellbeing aligned with the Sustainable Development Goal 3 (SDG3) targets. Having formed an independent multidisciplinary research consortium, we designed and implemented a mixed-methods approach to attain a deeper understanding of SDG3 priorities within the local context of communities hosting Anglo American mining operations located in Latin America.MethodsIn 2019, within the host communities of three mining operations in Chile, three in Brazil, and one in Peru, we conducted a qualitative study which included stakeholder workshops and key informant interviews. We also quantitatively appraised existing health data. Findings emerging from the qualitative and quantitative assessments were compared to identify health and wellbeing priority areas for action relevant to each community.ResultsAcross the three countries, 120 people took part in workshops and 35 in interviews. In these workshops and interviews, non-communicable diseases (SDG3.4), harmful alcohol consumption (SDG3.5), and pollution, particularly air pollution (SDG3.9), were consistently identified as areas for priority action. There were similarities in the reporting of individual, interpersonal, community, societal, and structural factors underlying these priority areas across the different communities. The availability of quantitative data was generally good at the state level, becoming increasing sparse as we focused on smaller geographies. The priorities identified in the quantitative assessments generally aligned with those highlighted in the qualitative data.ConclusionsWe highlight the importance of engaging with local populations to understand and address health needs. To address the priorities identified, intervention packages tailored to the specific needs of host communities, that tackle associated upstream societal level factors, are required. To facilitate this, appropriate monitoring systems and epidemiological investigations should be implemented to better understand the local context and quantify health issues. In the host communities, it is essential for the mining sector to be a key health partner in promoting integrated programmes that contribute to achieving the priority objectives and targets aligned with the SDG3 agenda.

Social-ecological factors influencing loneliness and social isolation in older people: a scoping review

There are growing calls from researchers and policy makers to redefine loneliness and social isolation (SI) as public health issues, and to move towards a transdisciplinary, systems-based approach, due to their association with significant health risks, particularly in older people. Research about loneliness and SI in older people has typically adopted a narrow focus, evaluating effects of individual and inter-personal factors on these experiences. Less is known about the community and societal influences that may be used to inform public health interventions. We conducted a scoping review applying Joanna Briggs Institute methodology and the social-ecological model framework in order to: i) identify the available evidence for the influence of the community and societal factors on loneliness and SI as experienced by older people; ii) examine how quantitative research about community- and societal-level factors of loneliness and SI in the older population is conducted; and iii) identify current knowledge gaps in relation to the use of the social-ecological model in this area. A total of 52 articles from 30 countries met the inclusion criteria, including 33 observational studies, primarily cross-sectional (88%), and 19 interventions, mostly (89%) pre-post evaluations. The majority of included articles measured loneliness only (n = 34, 65%), while 11 measured both loneliness and SI (21%). To measure these outcomes validated scales were frequently used. Eighteen community/societal factors were investigated in relation to loneliness and/or SI, most commonly neighbourhood safety, access to public third-places and cultural practices. Three societal-level interventions were found: two campaigns to reduce ageism and one which explored the impact of free public transport. Community-based interventions were either educational or enlisted volunteers to foster connections. There is a need for longitudinal studies to better understand the mechanisms through which community- and societal- level factors affect loneliness and SI, which in turn will guide interventions that utilise the social-ecological framework for these issues.

Abstract 13094: Eliciting Home Health Aides Perspectives Towards Achieving Cardiovascular Health

Introduction: Home Health Aides (HHAs) provide essential care to adults with cardiovascular (CV) disease in the home. Yet, HHAs themselves are a vulnerable workforce with a high burden of cardiovascular (CV) disease risk factors, which poses challenges to their own health, and potentially their patients’. We elicited the perspectives of HHAs towards achieving CV health within the context of their job. Methods: We conducted focus groups and interviews with HHAs from January to May 2023 in partnership with the 1199SEIU Training and Employment Fund, a benefit fund of the 1199SEIU United Healthcare Workers East, the largest US healthcare union. We included English and Spanish speaking HHAs with poor CV health, defined as having: 1) hypertension, 2) obesity, and 3) ≥1 other CV disease risk factor (self-reported hyperlipidemia, diabetes, smoking, and physical inactivity). Interviews were audio-recorded, professionally transcribed, and translated. Data were analyzed thematically using the Social-Ecological Model. Results: Nineteen HHAs from 12 home care agencies participated. They had a mean age of 57 years (SD 9.3), 18 (94.7 %) were female, 9 (47.4 %) were Black, and 7 (36.8 %) were of Hispanic ethnicity. In line with the Social-Ecological Model, 5 themes emerged. At the individual level, despite having several CV disease risk factors, HHAs’ perceptions of their health ranged from poor to excellent. Many were motivated to eat healthier and be more active but faced challenges including insufficient time and their own physical limitations. At the interpersonal level, the HHA-patient relationship influenced both aides’ and patients’ health (e.g., food in patients’ home). At the community level, HHAs wanted to connect with peers to improve their CV health together. At the organizational level, shift work, long commutes, and agency culture influenced their CV health. At the policy level, structural inequities (e.g., access to health insurance, citizenship) were barriers to CV health. Conclusion: HHAs’ ability to achieve CV health was influenced by personal, interpersonal, organizational, and societal-level factors. The findings can inform future, multi-level interventions, aiming to improve the CV health of HHAs and potentially their patients.

Societal gender role beliefs moderate the pattern of gender differences in public- and private-sphere pro-environmental behaviors

Although societies have widely recognized the gender differences of women participating more than men do in private-sphere pro-environmental behavior, how the relationship between gender and public-sphere pro-environmental behavior varies across societies is less clear. To fill this gap, we examined the moderating effect of societal gender role beliefs in how gender predicts public-sphere pro-environmental behavior across societies using large-scale surveys. In Study 1, using the data from the World Values Survey (N = 85,484 from 57 countries), we found that gender differences (i.e., men do more than women) in the number of participations in different types of public-sphere pro-environmental behavior were greater among societies with stronger gender role beliefs. In Study 2, using the data from the International Social Survey Programme (N = 46,705 from 34 countries), we replicated the findings in Study 1 for public-sphere pro-environmental behavior. Additionally, we found that gender differences (i.e., women do more than men) in the number of participations in different types of private-sphere pro-environmental behavior were greater among societies with weaker gender role beliefs. However, these results diminished with the moderating effect of other societal-level factors controlled. These findings provide a better understanding of the relationship between gender and pro-environmental behaviors and reveal the importance of social contexts in moderating the magnitude of gender identity maintenance across domains.

The Search for Some General Psychological Principles for Improving Intercultural Living in Plural Societies

The dramatic increase of intercultural encounters that have resulted from international migration and globalisation has presented challenges for societies, their institutions and their residents. The assumption is usually made that most culturally plural societies and their members seek to engage in positive encounters, rather than having conflictual ones. There are many factors (political, economic and historical) that can promote or limit the attainment of this goal of positive intercultural relations. Beyond these societal-level factors, another set of factors are psychological; these are based on the presence of some shared underlying psychological processes that enable mutual understanding and acceptance. For over 50 years, I have searched for some of these shared psychological principles, guided by some assertions contained in the Canadian policy of multiculturalism. These assertions are the promotion of: feelings of security in a group’s and a person’s place in the society; the presence of social contacts that are mutually respectful; and the existence of multiple identities and ways of living in the diverse population. This article reviews the evidence for these principles, using data from Canadian and international studies. I conclude that this psychological research has provided support for these general principles that are derived from public policy. As a result, they are ripe for possible use in many plural societies now seeking ways to manage and improve their intercultural relations. The journey has been from policy to research, and back to policy formulation and implementation.

Long-term care planning and the influencing factors among sexual minority older women: A qualitative study.

The aim of the study was to explore plans, considerations and factors influencing long-term care among older sexual minority (SM) women. Qualitative interview study. Semi-structured in-depth interviews were conducted with 37 older Taiwanese SM women between May and September 2019. This study analysed interview data using a socio-ecological model and constant comparative analysis. The most frequently reported long-term care plans were housing and institutions, private medical or long-term care insurance, financial planning and medical decisions. Factors associated with women's long-term care plans were categorized using the socio-ecological model level: (1) intrapersonal factors: current physical and mental health status, ageing signs and women's attitudes towards ageing; (2) interpersonal-level factors: receiving support from partners, child(ren), siblings or significant others, concerns about being a caregiver for parents and worries regarding social isolation; (3) community-level factors: receiving support from lesbian, gay, bisexual and transgender (LGBT) organizations; private lesbian online groups; or religious groups; (4) societal-level factors: concerns about negative social environments, concerns about the healthcare system and healthcare providers, inappropriate policies and insufficient resources. This study identified multi-level factors related to long-term care plans and concerns among older Taiwanese SM women. Recommendations for nurses, managers of long-term care and healthcare settings, policymakers, and governments have been provided to diminish health disparities and reduce anxiety among older SM women. This study assists nurses in understanding older SM women's long-term care concerns and worries when accessing long-term care and healthcare services and helps nurses provide SM-sensitive services and care for women. SM older women were recruited from LGBT organizations, LGBT-friendly bookstores, restaurants, coffee shops and LGBT online chatrooms using purposive and snowball sampling.

Socio-cultural factors perceived to influence sexual behaviours of adolescents in Ethiopia.

Adolescence is a period of transition from childhood to adulthood. It is the age of experimentation. They are vulnerable to the undesirable effect of sexual and reproductive health (SRH) problems such as human immunodeficiency virus, sexually transmitted infections and unsafe abortion and childbirth-related risks. To explore and describe perceived organisational, community and societal level factors that influence sexual behaviours among adolescents in Ethiopia. The study was conducted by public health care organisations, youth centres and non-governmental organisations in Addis Ababa, Ethiopia. A qualitative descriptive study design was conducted with purposively selected health professionals and adolescents in Addis Ababa from June 2019 to February 2020. The data were collected using in-depth interviews, key informant interviews and focus group discussions. Transcribed interviews were imported to ATLAS. ti 7 for coding, categorising and creating themes using thematic analysis. Lincoln and Guba's model was used to ensure trustworthiness and ethical standards were applied. Poor school involvement, social norms on sexual behaviour and lack of condom acceptability by the general population, financial problems and the gap in law enforcement were found perceived factors influencing sexual behaviour of adolescents. Adolescents are engaging in various risky sexual behaviours because of various organisational, community level and societal level factors, which emphasises the need to introduce social and culturally acceptable age-appropriate comprehensive sexuality education for adolescents and other multilevel interventions.Contribution: Provide an in-depth understanding of the influence of sociocultural issues related to adolescent sexual behaviour for health system stakeholders.

Political and Social Drivers of COVID-19 Prevention and Climate Change Behaviors and Attitudes

Attitudes and behaviors related to the COVID-19 pandemic and the climate change crisis might be driven by similar political beliefs and attitudes. The current study used a neo-Gramsci perspective to examine how political attitudes may be linked to COVID-19 prevention and climate change attitudes and behaviors. A longitudinal online survey in the US assessed climate change and COVID-19 attitudes and behaviors, and wave 7 (2021) data were used to predict outcomes at wave 8 (2022) among 572 respondents. There were significant correlations among the variables of political ideology, climate change concerns, COVID-19 vaccine hesitancy, COVID-19 skepticism, COVID-19 vaccine as a personal choice, COVID-19 conspiracy, political correctness, percent of Republican friends, and dislike of the Democratic Party. In the multivariate models, COVID-19 vaccination as a personal choice was significantly associated with the four outcomes: vaccination status, climate change actions, vaccine hesitancy, and climate change concerns. COVID-19 skepticism was significantly associated with vaccination status, vaccine hesitancy, and climate change concerns. These findings suggest that there are similar drivers of COVID-19 prevention and climate change attitudes and behaviors, and interventions need to be tailored to target individual-level and societal-level factors.

Anti-human Trafficking Service Professionals in India: Challenges and Barriers to Service Provision

ABSTRACT Sex trafficking (ST) interventions in India typically follow the “three R’s” – rescue, rehabilitation, and reintegration. Anti-human trafficking service organizations (AHTSOs) play an essential role in implementing the “three Rs,” influencing India’s anti-trafficking policy and aid for trafficking survivors. However, few investigations have explored AHTSOs professionals’ perceptions of their roles and the multilevel factors that influence their ability to address the needs of ST survivors in India. Thirteen Indian professionals participated in this study. Through the use of in-depth individual interviews, professionals discussed the challenges and barriers to their work. The findings of the study reflect that number of challenges and barriers faced by professionals when working with ST survivors included societal level factors such as ST stigma, apathy toward learning about ST, issues within the government and justice systems as well as distrust of AHTSOs and mistreatment of ST survivors. The results point to important areas of intervention to prevent the trafficking of girls and women in India, and further highlight the need for additional support for Indian professionals working with these survivors.

Hospital Physicians' Perspectives on Occupational Stress During COVID-19: a Qualitative Analysis from Two US Cities.

US physicians are at risk for high rates of occupational stress and burnout, which the COVID-19 pandemic has intensified. As approaches targeting physicians' individual resilience have fallen short, researchers are increasingly calling for studies that investigate organizational drivers of stress and burnout. To understand the multi-dimensional systems factors shaping hospital physicians' occupational stress during the pandemic. Qualitative, semi-structured interviews conducted in February-October 2021. Hospitals in New York City and New Orleans. A purposive snowball sample of attending physicians and fellows in hospital medicine, emergency medicine, pulmonary critical care, and palliative care who spent at least 4 weeks providing inpatient COVID-19 care beginning in March 2020 was selected. The sample included 40 physicians from 14 hospitals in New York City and 39 physicians from nine hospitals in New Orleans. Descriptive analysis of participants' self-reported perceptions of occupational stress. Participants identified multiple factors shaping their occupational stress including individual-level factors such as age, work experience, and life stage; institutional-level factors such as resource disparities, institutional type and size, and policies; professional-level factors such as informal rationing and medical uncertainty; and societal-level factors such as the federal response, COVID politics, and social inequalities. Stressors within and across these four levels worked in combination to shape physicians' perceptions of occupational stress at the individual level. This article contributes to an emergent literature on systems-based approaches to occupational stress and burnout among physicians by demonstrating the intersections among societal conditions, professional cultures, institutional work environments, and individual stress. Findings from semi-structured interviews suggest that interventions to reduce physician stress and burnout may be more effective if they target systems factors and stressors at multiple levels.

Black American Muslims: a study of religious identity and mental health

ABSTRACT Racism is a salient societal-level factor that adversely impacts the mental health of Black Americans. Although religiosity and racial identity have been studied in this population as protective factors, few studies have specifically considered Black American Muslims. We assessed the relationship between religious and racial identity on mental health-related factors among 499 Black American Muslims, utilising data from a cross-sectional study of Muslims in America conducted by the Yaqeen Institute for Islamic Research. Cluster analysis results indicated a five-cluster solution. Differential associations were identified between cluster membership and psychological health outcomes. Participants in profiles characterised by a belief in the low societal regard for Muslims and Blacks had significantly worse mental health than did those in other profiles. The analysis further identified religiosity, gratitude, and private regard as buffering mental health agents, with uncertainty intolerance and John Henryism being related risk factors. Implications for future research are discussed.

Using a Socio-Ecological Framework to Understand Romantic Relationship Satisfaction Among Emerging Adults During the COVID-19 Pandemic.

The formation and maintenance of satisfying romantic relationships, a developmental milestone for many emerging adults, has been challenged by the negative impact of the COVID-19 pandemic. Yet, the impact of COVID-19 stress on relationship satisfaction has not been explored within the context of individual and relationship factors. Guided by a socio-ecological framework, this study used a longitudinal design to investigate the impact of individual-level (i.e., growth beliefs, destiny beliefs), couple-level (i.e., daily criticism), and societal-level (i.e., COVID-19 stress) factors on relationship satisfaction during Fall 2021. We also explored the moderating effects of destiny beliefs and growth beliefs. Results revealed relationship satisfaction was negatively associated with daily criticism, but not directly associated with destiny beliefs, growth beliefs, or COVID-19 stress. However, growth beliefs buffered against the negative impact of criticism on relationship satisfaction. These findings are consistent with the notion that growth beliefs may play a protective role in relationship processes.

A randomized trial of probiotic supplementation in nurses to reduce stress and viral illness

Animal studies demonstrate how the gut microbiota influence psychological health and immunity to viral infections through their actions along multiple dynamic pathways in the body. Considerable interest exists in probiotics to reduce stress and illness symptoms through beneficial effects in the gut, but translating pre-clinical evidence from animal models into humans remains challenging. We conducted a large trial in nurses working during the 2020 COVID19 pandemic year to establish whether daily ingestion of the probiotic Lactobacillus rhamnosus HN001 reduced perceived stress and the number of days participants reported symptoms of a viral illness. Our results showed no significant difference in perceived stress or the average number of illness days between probiotic supplemented nurses and the placebo group. Stress and viral illness symptoms reduced during the study for all participants, a trajectory likely influenced by societal-level factors. The powerful effect of a well-managed public health response to the COVID19 pandemic and the elimination of COVID19 from the community in 2020 may have altered the trajectory of stress levels and reduced circulating viral infections making it difficult to detect any effect of probiotic supplementation. Our study highlights the challenge in controlling environmental factors in human trials.

Domestic/Family Homicide: A Systematic Review of Empirical Evidence

Background: Domestic/family homicide (D/FH) is a global social, economic and public health problem. To date, the research studies into risk factors associated with D/FH has largely focused on intimate partner homicide (IPH). A more contemporary approach recognizes that D/FH extends beyond the intimate partner relationship. This systematic review sought to identify and quantify the individual, relationship, community and societal factors in the empirical evidence literature on D/FH. Methods: Eight electronic databases were searched from January 1999 to December 2020. Published journal articles on studies of D/FH were included if the study included victims and/or perpetrator of D/FH, reported risk and/or protective factors associated with D/FH, reported primary data and was published in English. Factors were descriptively synthesized by the categories of the social ecological model and D/FH sub-type. Results: Three hundred and forty published articles met the inclusion criteria. From 1999 to 2020 the number of articles on D/FH increased globally from 10 to 40 respectively, declining to 23 in 2020. Almost half of the articles examined populations located in the Americas (160, 47.1%), predominately the United States and the majority of articles used quantitative designs (277, 81.5%). The forms of homicide more commonly studied were intimate partner (171, 50.3%), and filicide (98, 28.8%). Approximately 90% of articles reported individual victim and perpetrator factors, 64.7% examined relationship factors, 17.9% examined community factors and 15.6% examined societal factors. Conclusion: To inform universal and targeted D/FH elimination and prevention strategies, more research across different regions and a greater emphasis on community and societal-level factors is needed.