Theory of change for addressing sex and gender bias, invisibility and exclusion in Australian health and medical research, policy and practice

• Published in: Health research policy and systems Vol. 22; no. 1; pp. 86 - 10
• Main Authors: Gadsden, Thomas, Hallam, Laura, Carcel, Cheryl, Norton, Robyn, Woodward, Mark, Chappell, Louise, Downey, Laura E.
• Format: Journal Article
• Language: English
• Published: London BioMed Central 15.07.2024; BioMed Central Ltd; BMC
• Subjects: Analysis; Australia; Bias; Biomedical Research; Community; Data quality; Discrimination; Evidence-based medicine; Evidence-based practice; Female; Gender; Gender equity; Health; Health Administration; Health disparities; Health Policy; Health Services Research; Healthcare Disparities; Human bias; Humans; Inclusion; Interviews; Invisibility; Male; Marginalized groups; Medical policy; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Policy research; Public Health; Qualitative research; R & D/Technology Policy; Research Design; Research Subjects; Sex; Sex and gender; Sex discrimination; Sex Factors; Sexism; Stakeholder Participation; Stakeholders; Theory of change; Women; Australia; Sex and gender; Medical research; Health policy; Theory of change; Evidence-based practice
• ISSN: 1478-4505; 1478-4505
• DOI: 10.1186/s12961-024-01173-z

Sex and gender are inadequately considered in health and medical research, policy and practice, leading to preventable disparities in health and wellbeing. Several global institutions, journals, and funding bodies have developed policies and guidelines to improve the inclusion of diverse participants and consideration of sex and gender in research design and reporting and the delivery of clinical care. However, according to recent evaluations, these policies have had limited impact on the inclusion of diverse research participants, adequate reporting of sex and gender data and reducing preventable inequities in access to, and quality provision of, healthcare. In Australia, the Sex and Gender Policies in Medical Research (SGPMR) project aims to address sex and gender bias in health and medical research by (i) examining how sex and gender are currently considered in Australian research policy and practice; (ii) working with stakeholders to develop policy interventions; and (iii) understanding the wider impacts, including economic, of improved sex and gender consideration in Australian health and medical research. In this paper we describe the development of a theory of change (ToC) for the SGPMR project. The ToC evolved from a two-stage process consisting of key stakeholder interviews and a consultation event. The ToC aims to identify the pathways to impact from improved consideration of sex and gender in health and medical research, policy and practice, and highlight how key activities and policy levers can lead to improvements in clinical practice and health outcomes. In describing the development of the ToC, we present an entirely novel framework for outlining how sex and gender can be appropriately considered within the confines of health and medical research, policy and practice.