Time to upgrade inequality from "control variable" to central theoretical concern.
Thanks to everyone involved in this epic review adventure - Lisa, Doro, Núria, Mark and @psychjones.bsky.social!

🔬 What now? Our review reveals major gaps:
Health behavior theories need explicit integration of social inequality mechanisms, and environmental & situational factors deserve more attention than stable cognitions.
The heterogeneity in our findings shows we need MORE systematic research, not less.

So... under not yet fully understood circumstances, interventions targeting motivation or intentions may help the privileged more than the disadvantaged - and knowledge (risk) or social influence (P&P) the other way round. But: We don't really know what these circumstances are...

⚠️ Finding #2: Are determinant effects similar for everyone? Well... it's complicated. We found that IF determinants (e.g., intentions, beliefs, emotions) had differential effects, they were mostly stronger in less disadvantaged groups. BUT: We don't really know WHEN effects differ (and when not).

This suggests current theories may miss key mechanisms of how inequality "gets under the skin" through behaviour - the large nonsig chunks of the bar and sankey plots. We need to look beyond social cognitions to understand health inequalities, and environmental aspects of opportunity seem promising.

🔍 Finding #1: Do health behavior theories explain social inequalities?
We found COM-B factors motivation and opportunity to be the strongest mediators linking inequality to both preventative and health risk behaviours. BUT: 58% of tests showed NO significant mediation.