{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T04:15:09Z","timestamp":1783138509332,"version":"3.54.6"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n One potential approach to eliminating or reducing health inequities for health systems is audit and feedback (A&F). A&F involves providing measurements of quality indicators to health professionals to support continuous quality improvement, and to increase clinicians\u2019 adherence to clinical practice guidelines. In theory, A&F could help direct efforts toward equity deserving sub-groups (e.g., gender-diverse individuals or those living with low-income) by highlighting factors that may place such sub-groups at higher risk of poor health outcomes. In cases where healthcare professionals can make adjustments to their practice or advocate for mitigating supports or services, A&F \u2013 when applied broadly \u2013 could help to address some health inequities. However, it is unknown whether and how A&F interventions are currently being used to support equity-oriented quality improvement. In this study, we sought to examine the extent to which trials evaluating A&F interventions address health equity.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a secondary analysis of randomized controlled trials included in the latest Cochrane systematic review on the effects of A&F on professional practice, which included articles published up to 2020. We used the PROGRESS-Plus framework to consider the extent to which variables related to equity were examined in the trials. Based on extracted data, studies were categorized as not equity-oriented, equity-informed, or equity-focused.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the 271 articles included within this analysis, 44% of trials were classified as not equity-oriented (n\u2009=\u2009120), 35% as equity-informed (n\u2009=\u200995), and 21% as equity-focused (n\u2009=\u200956). The proportion of equity-focused and informed trials increased over the timeline assessed. Only two articles described an equity-oriented framework approach. Only three articles explicitly reported how equity was embedded in their A&F process by highlighting factors including age, gender\/sex, and substance use as part of the patient data presented in their feedback. The PROGRESS-Plus factors most commonly considered in the methods or analysis of the trials were age, insurance status, place of residence, and gender\/sex.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A&F trials rarely examine or report the extent to which equity issues inform trial design, A&F processes, analyses, and\/or interpretations. Our findings suggest a need for future A&F trials that test explicit approaches to incorporating equity-related interventions to address health equity by helping healthcare professionals, teams, and organizations to be more aware of inappropriate discrepancies in care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0339361","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T17:32:12Z","timestamp":1773077532000},"page":"e0339361","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring equity in audit and feedback trials: Secondary analysis of a systematic review"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8904-3186","authenticated-orcid":true,"given":"Zeenat","family":"Ladak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3230-583X","authenticated-orcid":true,"given":"Tolulope","family":"Ojo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Renee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aranee","family":"Senthilmurugan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0252-9923","authenticated-orcid":true,"given":"Thomas 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