Influence of sex and gender on depression-related healthcare utilisation following traumatic brain injury sustained during childhood and adolescence: protocol for a systematic review.

Abstract

Depression is a prevalent mental health condition often occurring after traumatic brain injury (TBI) in both children and adults. Sex, gender and other social determinants of health (SDoH) (e.g., race/ethnicity or socio-economic status) play an important role in depression-related and TBI-related healthcare utilisation (e.g., diagnosis, treatment and management of the conditions). Despite this, no reviews have examined how sex and gender, along with other SDoH, influence depression-related healthcare utilisation among individuals who sustained a TBI ≤19 years of age. The review's objective will be to synthesise evidence on sex-based and/or gender-based findings, along with other SDoH, in depression-related healthcare utilisation among individuals who sustained a TBI ≤19 years of age. Searches will be conducted on Ovid Medline, Embase, American Psychological Association PsycINFO and Cumulative Index of Nursing and Allied Health Literature from database inception to the search date. The review will follow the Joanna Briggs Institute evidence synthesis framework for knowledge synthesis and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA)-P, PRISMA-Equity guidelines and PROGRESS-Plus for reporting results. Included studies will be peer-reviewed articles published in any language that examined individuals who sustained a TBI at ≤19 years of age, reported depression-related healthcare services and provided sex-stratified and/or gender-stratified results. Studies will be excluded if they were grey literature, included individuals who sustained a TBI at >19 years without age-stratified results, reported healthcare services for conditions other than depression without depression-specific stratification or did not provide sex-stratified or gender-stratified results. A narrative synthesis will be conducted to identify themes and attributes describing how sex, gender and other SDoH influence depression-related healthcare utilisation. Methodological quality will be assessed using the National Heart, Lung and Blood Institute Quality Assessment Tool. No institutional ethics approval will be required as this study will not conduct primary data collection. The review will be disseminated as a peer-reviewed publication. CRD420261301669.