title: Non-pharmacological cancer pain interventions in populations with social disparities: a systematic review and meta-analysis.
abstract: BACKGROUND
  Global advances in pain relief have improved the quality of life of cancer populations. Yet, variation in cancer pain outcomes has been found in populations with social disparities compared to mainstream groups. Populations with social disparities bear an inequitable distribution of resources such as ethnic minorities, low income individuals, and women in vulnerable circumstances.
  
  
  OBJECTIVE
  A systematic review and meta-analysis of the effect of non-pharmacological cancer pain interventions in cancer populations with social disparities of income, ethnicity, or gender.
  
  
  METHODS
  Randomized controlled trials, controlled trials, and before and after studies were targeted through comprehensive multidatabase searches. Two reviewers independently screened titles/abstracts for potentially relevant studies and reviewed the full text of relevant articles for inclusion. Data were extracted from included studies by one reviewer and verified by another reviewer. Four reviewers independently completed quality assessment. Studies were grouped by intervention. Effects were evaluated for heterogeneity and pooled.
  
  
  RESULTS
  The search found 5219 potential records. Full text of 26 reports was evaluated. Three randomized controlled trials (RCTs) met inclusion criteria, targeting ethnic minorities and underserved populations and/or women. Interventions included education, coaching, and online support groups. Studies found no significant differences in pain reduction between intervention and control groups or between ethnic minorities and their counterparts. A high risk of bias was found in all studies. Meta-analysis found no statistically significant difference on pain intensity among underserved groups, ethnic minorities, or between ethnic minorities and white counterparts.
  
  
  CONCLUSIONS
  Results show the need to examine supportive care interventions particularly in populations with social disparities.
authors.affiliation: Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada. avs@ualberta.ca.
authors.forename: Anna
authors.initials: A
authors.lastname: Santos Salas
authors.affiliation: Department of Physiotherapy, Faculty of Health Sciences, Universidad Católica del Maule, Avda. San Miguel 3605, Talca, Chile.
authors.forename: Jorge
authors.initials: J
authors.lastname: Fuentes Contreras
authors.affiliation: Research Centre Faculty of Rehabilitation Medicine, 3-62 Corbett Hall, University of Alberta, 8205 114 Street, Edmonton, AB, T6G 2G4, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Armijo-Olivo
authors.affiliation: School of Dentistry, University of Alberta, 5-476 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
authors.forename: Humam
authors.initials: H
authors.lastname: Saltaji
authors.affiliation: Department of Symptom Control and Palliative Care, Cross Cancer Institute and Division of Palliative Care Medicine, Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Room 2001, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada.
authors.forename: Sharon
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: John W. Scott Health Sciences Library, University of Alberta Libraries, Edmonton, AB, T6G 2R7, Canada.
authors.forename: Thane
authors.initials: T
authors.lastname: Chambers
authors.affiliation: UBC Okanagan Library, The University of British Columbia, Okanagan Campus, 3333 University Way, Kelowna, BC, V1V 1V7, Canada.
authors.forename: Lori
authors.initials: L
authors.lastname: Walter
authors.affiliation: Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
authors.forename: Greta G
authors.initials: GG
authors.lastname: Cummings
mesh_terms: D000328:Adult; D005006:Ethnicity; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008913:Minority Groups; D009369:Neoplasms / Q000473:pathology; D010146:Pain / Q000473:pathology*; D059408:Pain Management / Q000379:methods*; D011788:Quality of Life
keywords: Healthcare disparities; Minority groups; Pain management; Review; Social determinants of health; Supportive care