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A scoping review of unintended harm associated with public health interventions: towards a typology and an understanding of underlying factors

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  • Published:
International Journal of Public Health

Abstract

Objectives

Unintended harm theory as related to public health interventions (PHI) is under developed, with harm evaluation and reporting often absent or incomplete. This review presents a typology for, and underlying factors linked to, PHI-associated unintended harm.

Methods

This scoping review was conducted electronically and includes articles from 1992 to June of 2013. Out of 2,490 originally identified titles, 26 full-text articles were included that discussed unintended harm associated with PHI. An iterative data analysis process was utilized to identify both a typology and underlying factors associated with unintended harm.

Results

A typology of PHI-associated unintended harm was identified: (1) physical; (2) psychosocial; (3) economic; (4) cultural and (5) environmental. Five underlying factors associated with PHI unintended harm emerged: (1) limited and/or poor quality evidence; (2) prevention of one extreme leads to another (boomerang effects); (3) lack of community engagement; (4) ignoring root causes; and (5) higher-income country PHI implementation in a lower- or middle-income country.

Conclusions

PHI planning and evaluation frameworks may benefit from the consideration and potential incorporation of the unintended harm typology and underlying factors.

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Acknowledgments

L.K. Allen-Scott is funded by the Vanier Canada Graduate Scholarships for her PhD dissertation. L. McIntyre holds a Canadian Institutes for Health Research Chair in Gender and Health.

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  1. Department of Community Health Sciences, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada

    L. K. Allen-Scott, J. M. Hatfield & L. McIntyre

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  1. L. K. Allen-Scott
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  2. J. M. Hatfield
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  3. L. McIntyre
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Correspondence to L. K. Allen-Scott.

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Allen-Scott, L.K., Hatfield, J.M. & McIntyre, L. A scoping review of unintended harm associated with public health interventions: towards a typology and an understanding of underlying factors. Int J Public Health 59, 3–14 (2014). https://doi.org/10.1007/s00038-013-0526-6

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