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Kennedy CE, Yeh PT, Fonner VA, Armstrong KA, Denison JA, O'Reilly KR, Sweat MD. The Evidence Project: Protocol for Systematic Reviews of Behavioral Interventions and Behavioral Aspects of Biomedical Interventions for HIV Prevention, Treatment, and Health Service Delivery in Low- and Middle-Income Countries. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2024; 36:87-102. [PMID: 38648175 DOI: 10.1521/aeap.2024.36.2.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
The Evidence Project conducts systematic reviews and meta-analyses of HIV behavioral interventions, behavioral aspects of biomedical interventions, combination prevention strategies, modes of service delivery, and integrated programs in low- and middle-income countries. Here, we present the overall protocol for our reviews. For each topic, we conduct a comprehensive search of five online databases, complemented by secondary reference searching. Articles are included if they are published in peer-reviewed journals and present pre/post or multi-arm data on outcomes of interest. Data are extracted from each included article by two trained coders working independently using standardized coding forms, with differences resolved by consensus. Risk of bias is assessed with the Evidence Project tool. Data are synthesized descriptively, and meta-analysis is conducted when there are similarly measured outcomes across studies. For over 20 years, this approach has allowed us to synthesize literature on the effectiveness of interventions and contribute to the global HIV response.
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Affiliation(s)
- Caitlin E Kennedy
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ping Teresa Yeh
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Virginia A Fonner
- Global Health and Population Research, FHI360, Durham, North Carolina
| | | | - Julie A Denison
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kevin R O'Reilly
- Medical University of South Carolina, Charleston, South Carolina
| | - Michael D Sweat
- Global Health and Population Research, FHI360, Durham, North Carolina
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Kamitani E, Peng Y, Hopkins D, Higa DH, Mullins MM. A Community Guide Systematic Review: Digital HIV Pre-Exposure Prophylaxis Interventions. Am J Prev Med 2024:S0749-3797(24)00063-1. [PMID: 38367928 DOI: 10.1016/j.amepre.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/09/2024] [Accepted: 02/09/2024] [Indexed: 02/19/2024]
Abstract
INTRODUCTION HIV preexposure prophylaxis (PrEP) is highly effective when taken as prescribed. Digital health adherence interventions have been identified as effective for improving antiretroviral therapy adherence among people with HIV, but limited evidence exists for PrEP adherence interventions among people without HIV. The purpose of this Community Guide systematic review was to present the characteristics and effectiveness of digital PrEP adherence interventions. METHODS The author searched the CDC HIV Prevention Research Synthesis cumulative database for digital health interventions with PrEP adherence outcomes published in peer-reviewed journals from 2000 to 2022. Studies with comparison arms or pre-post data evaluating interventions in high-income countries were included. Two reviewers independently screened citations, extracted data, conducted risk of bias assessment, and resolved discrepancies through discussion. Summary effect estimates were calculated using median and interquartile interval. RESULTS Nine studies were included and all focused on gay, bisexual, and other men who have sex with men. Eight studies were U.S.-based while the other was conducted in the Netherlands. Five were randomized control trials and four were pre-/post studies. All studies showed improved adherence in the intervention arms compared with comparison groups or preintervention data. One study also reported improvement in PrEP care retention. DISCUSSION Digital health adherence interventions with different strategies to improve PrEP and HIV-related outcomes were identified. The small number of studies identified is a limitation. Findings from this review served as the basis for the Community Preventive Services Task Force recommendation to use these interventions to increase PrEP adherence to prevent HIV infection.
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Affiliation(s)
- Emiko Kamitani
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, & TB Prevention, the Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329-4027.
| | - Yinan Peng
- Community Guide Program, Office of Science, CDC, Atlanta, GA 30329-4027
| | - David Hopkins
- Community Guide Program, Office of Science, CDC, Atlanta, GA 30329-4027
| | - Darrel H Higa
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, & TB Prevention, the Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329-4027
| | - Mary M Mullins
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, & TB Prevention, the Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329-4027
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Gaertner K, von Ammon K, Fibert P, Frass M, Frei-Erb M, Klein-Laansma C, Ulbrich-Zuerni S, Weiermayer P. Recommendations in the design and conduction of randomised controlled trials in human and veterinary homeopathic medicine. Complement Ther Med 2023; 76:102961. [PMID: 37393961 DOI: 10.1016/j.ctim.2023.102961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/30/2023] [Accepted: 06/28/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Randomised controlled trials (RCTs) are an established research method to investigate the effects of an intervention. Several recent systematic reviews and meta-analyses of RCTs with homeopathic interventions have identified shortcomings in design, conduct, analysis, and reporting of trials. Guidelines for RCTs in homeopathic medicine are lacking. OBJECTIVES This paper aims to fill this gap in order to enhance the quality of RCTs in the field of homeopathy. METHODS Identification of the homeopathy-specific requirements for RCTs by reviewing literature and experts' communications. Systematization of the findings using a suitable checklist for planning, conducting, and reporting RCTs, namely the SPIRIT statement, and high-quality homeopathy RCTs as examples. Cross-checking of the created checklist with the RedHot-criteria, the PRECIS criteria, and a qualitative evaluation checklist. Consideration of the REFLECT statement and the ARRIVE Guidelines 2.0 for veterinary homeopathy. RESULTS Recommendations for future implementation of RCTs in homeopathy are summarized in a checklist. Alongside, identified useful solutions to the issues encountered when designing and conducting homeopathy RCTs are presented. CONCLUSIONS The formulated recommendations present guidelines additional to those in the SPIRIT checklist, on how to better plan, design, conduct, and report RCTs in homeopathy.
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Affiliation(s)
- Katharina Gaertner
- Institute of Complementary and Integrative Medicine IKIM, University of Bern, Freiburgstr. 46, CH-3010 Bern, Switzerland; Institute of Integrative Medicine, University of Witten/Herdecke, Gerhard-Kienle-Weg 4, DE-58313 Herdecke, Germany
| | - Klaus von Ammon
- Institute of Complementary and Integrative Medicine IKIM, University of Bern, Freiburgstr. 46, CH-3010 Bern, Switzerland
| | - Philippa Fibert
- Department of Psychology and Pedagogic Science, St Mary's University, Twickenham, UK
| | - Michael Frass
- em. Medical University of Vienna, Department of Medicine I, A-1090 Vienna, Austria; Institute for Homeopathic Research, Columbusgasse 20, A-1100 Vienna, Austria
| | - Martin Frei-Erb
- Institute of Complementary and Integrative Medicine IKIM, University of Bern, Freiburgstr. 46, CH-3010 Bern, Switzerland
| | - Christien Klein-Laansma
- Louis Bolk Institute, Health and Nutrition, Kosterijland 3-5, NL-3981 AJ Bunnik, the Netherlands
| | | | - Petra Weiermayer
- WissHom: Scientific Society for Homeopathy, Wallstraße 48, DE-06366 Koethen, Germany.
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Okasako-Schmucker DL, Peng Y, Cobb J, Buchanan LR, Xiong KZ, Mercer SL, Sabatino SA, Melillo S, Remington PL, Kumanyika SK, Glenn B, Breslau ES, Escoffery C, Fernandez ME, Coronado GD, Glanz K, Mullen PD, Vernon SW. Community Health Workers to Increase Cancer Screening: 3 Community Guide Systematic Reviews. Am J Prev Med 2023; 64:579-594. [PMID: 36543699 PMCID: PMC10033345 DOI: 10.1016/j.amepre.2022.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Many in the U.S. are not up to date with cancer screening. This systematic review examined the effectiveness of interventions engaging community health workers to increase breast, cervical, and colorectal cancer screening. METHODS Authors identified relevant publications from previous Community Guide systematic reviews of interventions to increase cancer screening (1966 through 2013) and from an update search (January 2014-November 2021). Studies written in English and published in peer-reviewed journals were included if they assessed interventions implemented in high-income countries; reported screening for breast, cervical, or colorectal cancer; and engaged community health workers to implement part or all of the interventions. Community health workers needed to come from or have close knowledge of the intervention community. RESULTS The review included 76 studies. Interventions engaging community health workers increased screening use for breast (median increase=11.5 percentage points, interquartile interval=5.5‒23.5), cervical (median increase=12.8 percentage points, interquartile interval=6.4‒21.0), and colorectal cancers (median increase=10.5 percentage points, interquartile interval=4.5‒17.5). Interventions were effective whether community health workers worked alone or as part of a team. Interventions increased cancer screening independent of race or ethnicity, income, or insurance status. DISCUSSION Interventions engaging community health workers are recommended by the Community Preventive Services Task Force to increase cancer screening. These interventions are typically implemented in communities where people are underserved to improve health and can enhance health equity. Further training and financial support for community health workers should be considered to increase cancer screening uptake.
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Affiliation(s)
- Devon L Okasako-Schmucker
- Community Guide Office, Office of the Associate Director for Policy and Strategy (OADPS), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yinan Peng
- Community Guide Office, Office of the Associate Director for Policy and Strategy (OADPS), Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Jamaicia Cobb
- Community Guide Office, Office of the Associate Director for Policy and Strategy (OADPS), Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Ka Zang Xiong
- Community Guide Office, Office of the Associate Director for Policy and Strategy (OADPS), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shawna L Mercer
- Community Guide Office, Office of the Associate Director for Policy and Strategy (OADPS), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan A Sabatino
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention, Atlanta Georgia
| | - Stephanie Melillo
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention, Atlanta Georgia
| | - Patrick L Remington
- Department of Population Health Sciences, Madison School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Shiriki K Kumanyika
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Beth Glenn
- Department of Health Policy & Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Erica S Breslau
- Healthcare Delivery Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Cam Escoffery
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Maria E Fernandez
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | | | - Karen Glanz
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Patricia D Mullen
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - Sally W Vernon
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
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Chattopadhyay SK, Jacob V, Hopkins DP, Lansky A, Elder R, Cuellar AE, Calonge N, Clymer JM. Community Guide Methods for Systematic Reviews of Economic Evidence. Am J Prev Med 2023; 64:569-578. [PMID: 36529574 DOI: 10.1016/j.amepre.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/10/2022] [Accepted: 10/24/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Community Guide systematic economic reviews provide information on the cost, economic benefit, cost-benefit, and cost-effectiveness of public health interventions recommended by the Community Preventive Services Task Force on the basis of evidence of effectiveness. The number and variety of economic evaluation studies in public health have grown substantially over time, contributing to methodologic challenges that required updates to the methods for Community Guide systematic economic reviews. This paper describes these updated methods. METHODS The 9-step Community Guide economic review process includes prioritization of topic, creation of a coordination team, conceptualization of review, literature search, screening studies for inclusion, abstraction of studies, analysis of results, translation of evidence to Community Preventive Services Task Force economic findings, and dissemination of findings and evidence gaps. The methods applied in each of these steps are reported in this paper. RESULTS Two published Community Guide reviews, tailored pharmacy-based interventions to improve adherence to medications for cardiovascular disease and permanent supportive housing with housing first to prevent homelessness, are used to illustrate the application of the updated methods. The Community Preventive Services Task Force reached a finding of cost-effectiveness for the first intervention and a finding of favorable cost-benefit for the second on the basis of results from the economic reviews. CONCLUSIONS The updated Community Guide economic systematic review methods provide transparency and improve the reliability of estimates that are used to derive a Community Preventive Services Task Force economic finding. This may in turn augment the utility of Community Guide economic reviews for communities making decisions about allocating limited resources to effective programs.
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Affiliation(s)
- Sajal K Chattopadhyay
- The Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Verughese Jacob
- The Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David P Hopkins
- The Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amy Lansky
- The Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Randy Elder
- Office of Science, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alison E Cuellar
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, Virginia
| | - Ned Calonge
- Department of Family Medicine, University of Colorado, Aurora, Colorado
| | - John M Clymer
- National Forum for Heart Disease and Stroke Prevention, Washington, District of Columbia
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Buchanan LR, Wethington HR, Finnie RKC, Mercer SL, Merlo C, Michael S, Sliwa S, Pratt CA, Ochiai E. A Community Guide Systematic Review: School Dietary and Physical Activity Interventions. Am J Prev Med 2023; 64:441-451. [PMID: 36496280 PMCID: PMC9974744 DOI: 10.1016/j.amepre.2022.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 12/13/2022]
Abstract
CONTEXT Schools can play an important role in supporting a healthy lifestyle by offering nutritious foods and beverages and providing opportunities for physical activity. A healthy diet and regular physical activity may reduce the risk of obesity. This manuscript reports on a Community Guide systematic review examining the effectiveness of interventions in schools combining school meal or fruit and vegetable snack programs and physical activity. EVIDENCE ACQUISITION Studies meeting the intervention definition were identified from a literature search (search period: January 1990-November 2019). Community Guide systematic review methods were used to assess effectiveness as measured by dietary behavior, physical activity, and weight changes; analyses were conducted in 2020. EVIDENCE SYNTHESIS Interventions (n=24 studies) were considered effective for increasing physical activity (median increase=21.8 minutes/day; interquartile interval= -0.8 to 27.4 minutes/day), modestly increasing fruit and vegetable intake (median relative increase=12.1%; interquartile interval= -4.6%, 73.4%), and decreasing the prevalence of overweight and obesity (median decrease=2.5 percentage points; interquartile interval= -8.1, -1.6 percentage points) among elementary school students through sixth grade. There were not enough studies to determine the effectiveness of interventions for middle- and high-school students. CONCLUSIONS School meal or fruit and vegetable snack interventions combined with physical activity were effective in increasing physical activity, with modest effects for improving fruit and vegetable consumption and reducing the prevalence of overweight and obesity among elementary students. These results may inform researchers and school administrators about healthy eating and physical activity interventions.
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Affiliation(s)
| | - Holly R Wethington
- Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Ramona K C Finnie
- Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shawna L Mercer
- Office of the Director, Center for Surveillance, Epidemiology, and Laboratory Services (CSELS), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Caitlin Merlo
- School Health Branch, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shannon Michael
- School Health Branch, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah Sliwa
- School Health Branch, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Charlotte A Pratt
- Clinical Applications and Prevention Branch, Prevention and Population Sciences Program, Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Emmeline Ochiai
- Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Washington, District of Columbia
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Roczniewska M, Rogala A, Marszałek M, Hasson H, Bakker AB, von Thiele Schwarz U. Job crafting interventions: what works, for whom, why, and in which contexts? Research protocol for a systematic review with coincidence analysis. Syst Rev 2023; 12:10. [PMID: 36670492 PMCID: PMC9857908 DOI: 10.1186/s13643-023-02170-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 01/03/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Recent challenges in the working world that resulted from the pandemic and technological advances have underlined the importance of flexibility in how jobs are designed. Job crafting (JC) refers to self-initiated changes that employees introduce to their jobs to optimize their job design and increase the fit between the job and their needs and preferences. These behaviors can be stimulated by job crafting training interventions, which aim to change how individual employees design, organize, or manage their work. However, since the interventions are implemented in various ways, we do not know which context and intervention factors are necessary or sufficient to achieve desired outcomes. Without this knowledge, benefitting from the potential of job crafting interventions is limited. The overall aim of this project will be to investigate what combinations of context, intervention, and mechanism factors are linked with effective JC interventions. Specifically, we will detect what factors are minimally sufficient and/or necessary to produce a successful JC intervention, how they combine, as well as what are the multiple alternative paths to their success. METHODS We will perform a systematic review of the JC interventions literature combined with coincidence analysis (CNA). We will search electronic databases of journals and utilize Rayyan software to make decisions regarding inclusion. Data regarding context (e.g., fit), intervention (e.g., types of activities), mechanisms (e.g., intention implementation), and outcomes (e.g., employee well-being, job performance) will be extracted using a pre-piloted form and coded into a crisp-set (factor present vs. absent). Analyses will be carried out using the CNA package in R. DISCUSSION This review will address gaps in knowledge about the context, intervention, and mechanism-related factors that may impact the effects of JC interventions. Consequently, this review will help develop a program theory for JC interventions that explains what works, how and under which circumstances. Applying CNA to synthesize these complex solutions across multiple studies provides an innovative method that may be used in future review attempts evaluating the implementation of interventions. Finally, our synthesis will provide knowledge relevant to organizational practitioners and scholars who want to implement JC interventions. TRIAL REGISTRATION https://osf.io/2g6yx.
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Affiliation(s)
- Marta Roczniewska
- PROCOME Research Group, Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Faculty of Psychology in Sopot, SWPS University of Social Sciences and Humanities, Sopot, Poland
| | - Anna Rogala
- Faculty of Psychology in Warsaw, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Magdalena Marszałek
- Faculty of Psychology in Sopot, SWPS University of Social Sciences and Humanities, Sopot, Poland
| | - Henna Hasson
- PROCOME Research Group, Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm, Sweden
| | - Arnold B. Bakker
- Center of Excellence for Positive Organizational Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Industrial Psychology and People Management, University of Johannesburg, Johannesburg, South Africa
| | - Ulrica von Thiele Schwarz
- PROCOME Research Group, Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Calonge N, Shekelle PG, Owens DK, Teutsch S, Downey A, Brown L, Noyes J. A framework for synthesizing intervention evidence from multiple sources into a single certainty of evidence rating: Methodological developments from a US National Academies of Sciences, Engineering, and Medicine Committee. Res Synth Methods 2023; 14:36-51. [PMID: 35722864 PMCID: PMC10084284 DOI: 10.1002/jrsm.1582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/27/2022] [Accepted: 05/11/2022] [Indexed: 01/18/2023]
Abstract
Despite research investment and a growing body of diverse evidence there has been no comprehensive review and grading of evidence for public health emergency preparedness and response practices comparable to those in medicine and other public health fields. The National Academies of Sciences, Engineering, and Medicine convened an ad hoc committee to develop and use methods for grading and synthesizing diverse types of evidence to create a single certainty of intervention-related evidence to support recommendations for Public Health Emergency Preparedness and Response Research. A 13-step consensus building method was used. Experts were first canvassed in public meetings, and a comprehensive review of existing methods was undertaken. Although aspects of existing review methodologies and evidence grading systems were relevant, none adequately covered all requirements for this specific context. Starting with a desire to synthesize diverse sources of evidence not usually included in systematic reviews and using GRADE for assessing certainty and confidence in quantitative and qualitative evidence as the foundation, we developed a mixed-methods synthesis review and grading methodology that drew on (and in some cases adapted) those elements of existing frameworks and methods that were most applicable. Four topics were selected as test cases. The process was operationalized with a suite of method-specific reviews of diverse evidence types for each topic. Further consensus building was undertaken through stakeholder engagement and feedback The NASEM committee's GRADE adaption for mixed-methods reviews will further evolve over time and has yet to be endorsed by the GRADE working group.
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Affiliation(s)
- Ned Calonge
- Department of Family Medicine, University of Colorado School of Medicine, Colorado School of Public Health, Aurora, Colorado, USA.,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
| | - Paul G Shekelle
- General Internal Medicine Division, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, California, USA.,Department of Medicine, University of California, Los Angeles, California, USA
| | - Douglas K Owens
- Department of Health Policy, School of Medicine, Freeman-Spogli Institute for International Studies, Stanford University, Palo Alto, California, USA
| | - Steven Teutsch
- Department of Public Health, University of California, Los Angeles; and Senior Fellow, Leonard D. Schaeffer Center for Health, Policy and Economics, University of Southern California, California, Los Angeles, USA
| | - Autumn Downey
- National Academies for Science, Engineering and Medicine, Washington, Washington, District of Columbia, USA
| | - Lisa Brown
- National Academies for Science, Engineering and Medicine, Washington, Washington, District of Columbia, USA
| | - Jane Noyes
- Department of Health and Social Care Services Research and Child Health, School of Medical and Health Sciences, Bangor University, Bangor, Wales, UK
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Finnie RKC, Peng Y, Hahn RA, Schwartz A, Emmons K, Montgomery AE, Muntaner C, Garrison VH, Truman BI, Johnson RL, Fullilove MT, Cobb J, Williams SP, Jones C, Bravo P, Buchanan S. Tenant-Based Housing Voucher Programs: A Community Guide Systematic Review. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E795-E803. [PMID: 36194822 PMCID: PMC9555591 DOI: 10.1097/phh.0000000000001588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
CONTEXT Unaffordable or insecure housing is associated with poor health in children and adults. Tenant-based housing voucher programs (voucher programs) limit rent to 30% or less of household income to help households with low income obtain safe and affordable housing. OBJECTIVE To determine the effectiveness of voucher programs in improving housing, health, and other health-related outcomes for households with low income. DESIGN Community Guide systematic review methods were used to assess intervention effectiveness and threats to validity. An updated systematic search based on a previous Community Guide review was conducted for literature published from 1999 to July 2019 using electronic databases. Reference lists of included studies were also searched. ELIGIBILITY CRITERIA Studies were included if they assessed voucher programs in the United States, had concurrent comparison populations, assessed outcomes of interest, were written in English, and published in peer-reviewed journals or government reports. MAIN OUTCOME MEASURES Housing quality and stability, neighborhood opportunity (safety and poverty), education, income, employment, physical and mental health, health care use, and risky health behavior. RESULTS Seven studies met inclusion criteria. Compared with low-income households not offered vouchers, voucher-using households reported increased housing quality (7.9 percentage points [pct pts]), decreased housing insecurity or homelessness (-22.4 pct pts), and decreased neighborhood poverty (-5.2 pct pts).Adults in voucher-using households had improved health care access and physical and mental health. Female youth experienced better physical and mental health but not male youth. Children who entered the voucher programs under 13 years of age had improved educational attainment, employment, and income in their adulthood; children's gains in these outcomes were inversely related to their age at program entry. CONCLUSION Voucher programs improved health and several health-related outcomes for voucher-using households, particularly young children. Research is still needed to better understand household's experiences and contextual factors that influence achievement of desired outcomes.
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Affiliation(s)
- Ramona K. C. Finnie
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Yinan Peng
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Robert A. Hahn
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Alex Schwartz
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Karen Emmons
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Ann Elizabeth Montgomery
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Carles Muntaner
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Veronica Helms Garrison
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Benedict I. Truman
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Robert L. Johnson
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Mindy T. Fullilove
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Jamaicia Cobb
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Samantha P. Williams
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Camara Jones
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Pablo Bravo
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - Sharunda Buchanan
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
| | - The Community Preventive Services Task Force
- Community Guide Office, Office of the Associate Director for Policy and Strategy (Drs Finnie, Peng, and Hahn and Ms Cobb), Office of the Associate Director for Science (Dr Truman), National Center for HIV, Viral Hepatitis, STD, & TB Prevention (Dr Williams), and National Center for Environmental Health (Dr Buchanan), Centers for Disease Control and Prevention, Atlanta, Georgia; Milano School of Policy, Management, and Environment, Graduate Program in Public and Urban Policy, New School, New York City, New York (Drs Schwartz and Fullilove); Harvard T. H. Chan School of Public Health, Cambridge, Massachusetts (Dr Emmons); University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (Dr Montgomery); US Department of Veterans Affairs, Washington, District of Columbia (Dr Montgomery); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); US Department of Housing and Urban Development, Washington, District of Columbia (Ms Garrison); Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Dignity Health, San Francisco, California (Mr Bravo)
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Cuellar AE, Calonge BN. The Community Preventive Services Task Force: 25 Years of Effectiveness, Economics, and Equity. Am J Prev Med 2022; 62:e371-e373. [PMID: 35597572 DOI: 10.1016/j.amepre.2022.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Alison Evans Cuellar
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia; National Bureau of Economic Research, Cambridge, Massachusetts.
| | - B Ned Calonge
- Department of Family Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Editor's Choice - European Society for Vascular Surgery Clinical Practice Guideline Development Scheme: An Overview of Evidence Quality Assessment Methods, Evidence to Decision Frameworks, and Reporting Standards in Guideline Development. Eur J Vasc Endovasc Surg 2022; 63:791-799. [PMID: 35697645 DOI: 10.1016/j.ejvs.2022.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/17/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE A structured and transparent approach is instrumental in translating research evidence to health recommendations and evidence informed clinical decisions. The aim was to conduct an overview and analysis of principles and methodologies for health guideline development. METHODS A literature review on methodologies, strategies, and fundamental steps in the process of guideline development was performed. The clinical practice guideline development process and methodology adopted by the European Society for Vascular Surgery are also presented. RESULTS Sophisticated methodologies for health guideline development are being applied increasingly by national and international organisations. Their overarching principle is a systematic, structured, transparent, and iterative process that is aimed at making well informed healthcare choices. Critical steps in guideline development include the assessment of the certainty of the body of evidence; evidence to decision frameworks; and guideline reporting. The goal of strength of evidence assessments is to provide well reasoned judgements about the guideline developers' confidence in study findings, and several evidence hierarchy schemes and evidence rating systems have been described for this purpose. Evidence to decision frameworks help guideline developers and users conceptualise and interpret the construct of the quality of the body of evidence. The most widely used evidence to decision frameworks are those developed by the GRADE Working Group and the WHO-INTEGRATE, and are structured into three distinct components: background; assessment; and conclusions. Health guideline reporting tools are employed to ensure methodological rigour and transparency in guideline development. Such reporting instruments include the AGREE II and RIGHT, with the former being used for guideline development and appraisal, as well as reporting. CONCLUSION This guide will help guideline developers/expert panels enhance their methodology, and patients/clinicians/policymakers interpret guideline recommendations and put them in context. This document may be a useful methodological summary for health guideline development by other societies and organisations.
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Bennett N, Karkada M, Erdogan M, Green RS. The effect of legislation on firearm-related deaths in Canada: a systematic review. CMAJ Open 2022; 10:E500-E507. [PMID: 35672042 PMCID: PMC9177199 DOI: 10.9778/cmajo.20210192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Firearm misuse is common in cases of homicide, suicide and unintentional injury; this is a major public health issue, with societal and economic costs extending beyond the immediate injury or loss of life. We sought to review the evidence on the effectiveness of Canadian legislation in reducing deaths caused by firearms. METHODS Five databases (PubMed, Embase, CINAHL, Web of Science and Scopus) were searched from inception to May 2021 for studies evaluating the effect of Canadian gun control laws Bill C-51 (1977), Bill C-17 (1991) and Bill C-68 (1995) on rates of firearm-related death. Two reviewers performed article screening independently and in duplicate. We synthesized data using descriptive statistics. The primary outcome of interest was firearm-related mortality rates. Because of study heterogeneity, a meta-analysis was not performed. RESULTS Overall, 1479 articles were screened, and 18 studies were included. Ten studies examined the effect on homicides, of which 5 reported a reduction during the postlegislation period; 1 study reported evidence of substitution from firearms to other methods of homicide among people aged 15-24 years. Eleven studies evaluated the effect on suicides, with 9 finding a reduction in suicide rates. Eight of these studies reported evidence of substitution from firearms to other suicide methods. Two studies investigated accidental deaths; neither reported any benefit after legislation. INTERPRETATION Evidence supporting the effectiveness of Canadian firearms legislation in the reduction of homicide and accidental death rates is inconclusive; a decrease in firearm-related suicide rates was observed by most studies, but evidence of method substitution was also identified. Re-evaluation of existing laws may be beneficial to build an improved and effective evidence-based national framework for prevention of gun violence. PROSPERO REGISTRATION CRD42020192486.
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Affiliation(s)
- Nick Bennett
- Faculty of Medicine, Dalhousie University (Bennett, Karkada); Nova Scotia Health Trauma Program (Erdogan, Green), Nova Scotia Health; Departments of Emergency Medicine and Critical Care (Green), Dalhousie University, Halifax, NS
| | - Manolhas Karkada
- Faculty of Medicine, Dalhousie University (Bennett, Karkada); Nova Scotia Health Trauma Program (Erdogan, Green), Nova Scotia Health; Departments of Emergency Medicine and Critical Care (Green), Dalhousie University, Halifax, NS
| | - Mete Erdogan
- Faculty of Medicine, Dalhousie University (Bennett, Karkada); Nova Scotia Health Trauma Program (Erdogan, Green), Nova Scotia Health; Departments of Emergency Medicine and Critical Care (Green), Dalhousie University, Halifax, NS
| | - Robert S Green
- Faculty of Medicine, Dalhousie University (Bennett, Karkada); Nova Scotia Health Trauma Program (Erdogan, Green), Nova Scotia Health; Departments of Emergency Medicine and Critical Care (Green), Dalhousie University, Halifax, NS
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Shantharam SS, Mahalingam M, Rasool A, Reynolds JA, Bhuiya AR, Satchell TD, Chapel JM, Hawkins NA, Jones CD, Jacob V, Hopkins DP. Systematic Review of Self-Measured Blood Pressure Monitoring With Support: Intervention Effectiveness and Cost. Am J Prev Med 2022; 62:285-298. [PMID: 34686388 PMCID: PMC8748385 DOI: 10.1016/j.amepre.2021.06.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/14/2021] [Accepted: 06/17/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Self-measured blood pressure monitoring with support is an evidence-based intervention that helps patients control their blood pressure. This systematic economic review describes how certain intervention aspects contribute to effectiveness, intervention cost, and intervention cost per unit of the effectiveness of self-measured blood pressure monitoring with support. METHODS Papers published between data inception and March 2021 were identified from a database search and manual searches. Papers were included if they focused on self-measured blood pressure monitoring with support and reported blood pressure change and intervention cost. Papers focused on preeclampsia, kidney disease, or drug efficacy were excluded. Quality of estimates was assessed for effectiveness, cost, and cost per unit of effectiveness. Patient characteristics and intervention features were analyzed in 2021 to determine how they impacted effectiveness, intervention cost, and intervention cost per unit of effectiveness. RESULTS A total of 22 studies were included in this review from papers identified in the search. Type of support was not associated with differences in cost and cost per unit of effectiveness. Lower cost and cost per unit of effectiveness were achieved with simple technologies such as interactive phone systems, smartphones, and websites and where providers interacted with patients only as needed. DISCUSSION Some of the included studies provided only limited information on key outcomes of interest to this review. However, the strength of this review is the systematic collection and synthesis of evidence that revealed the associations between the characteristics of implemented interventions and their patients and the interventions' effectiveness and cost, a useful contribution to the fields of both research and implementation.
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Affiliation(s)
- Sharada S Shantharam
- IHRC, Inc., Atlanta, Georgia; Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Mallika Mahalingam
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Aysha Rasool
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Jeffrey A Reynolds
- Karna, LLC, Atlanta, Georgia; Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Aunima R Bhuiya
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Tyra D Satchell
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - John M Chapel
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Nikki A Hawkins
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher D Jones
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Verughese Jacob
- Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David P Hopkins
- Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia
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Revisiting evidence of primary prevention of suicide among adult populations: A systematic overview. J Affect Disord 2022; 297:641-656. [PMID: 34728288 DOI: 10.1016/j.jad.2021.10.076] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/24/2021] [Accepted: 10/23/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUNDS Primary prevention of suicidal behaviors in the general population is required to interrupt the trend of self-inflicted deaths worldwide. We reviewed the evidence of the efficacy of primary prevention of suicide among the adult population. METHODS This is an overview of systematic reviews. We searched PubMed, EMBASE, Scopus, PsycINFO, and Cochrane databases to identify articles on suicide prevention strategies in non-clinical populations. For the purpose of overview, only systematic reviews were eligible. Primary outcomes: The outcomes of the present study were changes in the number of suicide death or suicide behaviors. Two reviewers assessed the methodological quality and the risk of bias of included studies. RESULTS From the initial 2,315 records, 32 articles met inclusion criteria. Evidence of reduction of suicide-related outcomes was detected, but of small magnitude. Most multicomponent prevention programs were delivered to specific populations, comprising strategies such as restriction to lethal means, educational programs, and gatekeeper training. Means restriction was the single intervention that showed some evidence of individual efficacy in reducing suicide. There is evidence that poor quality of media reporting is related with increasing suicide and better-quality reports could help suicide prevention. Most of the included SRs were of critically-low methodological quality. LIMITATIONS Publication bias, reporting bias, study designs, outcome definition and article overlap across studies are the main concerns. CONCLUSIONS Multicomponent programs and means restriction have indicated a reduction of suicide rates, mainly in specific populations. There is insufficient evidence to recommend a widespread implementation of suicide primary prevention in the general population.
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Intimate Partner and Sexual Violence Prevention Among Youth: A Community Guide Systematic Review. Am J Prev Med 2022; 62:e45-e55. [PMID: 34772564 PMCID: PMC9125790 DOI: 10.1016/j.amepre.2021.06.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/29/2021] [Accepted: 06/29/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Intimate partner violence and sexual violence are widespread and often occur early in life. This systematic review examines the effectiveness of interventions for primary prevention of intimate partner violence and sexual violence among youth. METHODS Studies were identified from 2 previous systematic reviews and an updated search (January 2012-June 2016). Included studies were implemented among youth, conducted in high-income countries, and aimed to prevent or reduce the perpetration of intimate partner violence or sexual violence. In 2016-2017, Guide to Community Preventive Services (Community Guide) methods were used to assess effectiveness as determined by perpetration, victimization, or bystander action. When heterogeneity of outcomes prevented usual Community Guide methods, the team systematically applied criteria for favorability (statistically significant at p<0.05 or approaching significance at p<0.10) and consistency (75% of results in the same direction). RESULTS A total of 28 studies (32 arms) met inclusion and quality of execution criteria. Interventions used combinations of teaching healthy relationship skills, promoting social norms to protect against violence, or creating protective environments. Overall, 18 of 24 study arms reported favorable results on the basis of the direction of effect for decreasing perpetration; however, favorability for bystander action diminished with longer follow-up. Interventions did not demonstrate consistent results for decreasing victimization. A bridge search conducted during Fall 2020 confirmed these results. DISCUSSION Interventions for the primary prevention of intimate partner violence and sexual violence are effective in reducing perpetration. Increasing bystander action may require additional follow-up as effectiveness diminishes over time. Findings may inform researchers, school personnel, public health, and other decision makers about effective strategies to prevent intimate partner violence and sexual violence among youth.
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Norris SL, Aung MT, Chartres N, Woodruff TJ. Evidence-to-decision frameworks: a review and analysis to inform decision-making for environmental health interventions. Environ Health 2021; 20:124. [PMID: 34876125 PMCID: PMC8653547 DOI: 10.1186/s12940-021-00794-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence-to-decision (EtD) frameworks provide a structured and transparent approach for groups of experts to use when formulating recommendations or making decisions. While extensively used for clinical and public health recommendations, EtD frameworks are not in widespread use in environmental health. This review sought to identify, compare and contrast key EtD frameworks for decisions on interventions used in clinical medicine, public health or environmental health. This information can be used to develop an EtD framework suitable for formulating recommendations for interventions in environmental health. METHODS We identified a convenience sample of EtD frameworks used by a range of organizations. We searched Medline for systematic reviews of frameworks. We summarized the decision criteria in the selected frameworks and reviews in a qualitative manner. FINDINGS Fourteen organizations provided 18 EtD frameworks; most frameworks focused on clinical medicine or public health interventions; four focused on environmental health and three on economic considerations. Harms of interventions were examined in all frameworks and benefits in all but one. Other criteria included certainty of the body of evidence (15 frameworks), resource considerations (15), feasibility (13), equity (12), values (11), acceptability (11), and human rights (2). There was variation in how specific criteria were defined. The five identified systematic reviews reported a similar spectrum of EtD criteria. INTERPRETATION The EtD frameworks examined encompassed similar criteria, with tailoring to specific audience needs. Existing frameworks are a useful starting point for development of one tailored to decision-making in environmental health. FUNDER JPB Foundation.
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Affiliation(s)
- Susan L. Norris
- Department of Family Medicine, Oregon Health & Science University, Portland, OR 97239 USA
| | - Max T. Aung
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, California USA
| | - Nicholas Chartres
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, California USA
| | - Tracey J. Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, California USA
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Supervised Injection Facilities as Harm Reduction: A Systematic Review. Am J Prev Med 2021; 61:738-749. [PMID: 34218964 PMCID: PMC8541900 DOI: 10.1016/j.amepre.2021.04.017] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/29/2021] [Accepted: 04/19/2021] [Indexed: 11/22/2022]
Abstract
CONTEXT Supervised injection facilities are harm reduction interventions that allow people who inject drugs to use previously obtained substances under the supervision of health professionals. Although currently considered illegal under U.S. federal law, several U.S. cities are considering implementing supervised injection facilities anyway as a response to the escalating overdose crisis. The objective of this review is to determine the effectiveness of supervised injection facilities, compared with that of control conditions, for harm reduction and community outcomes. EVIDENCE ACQUISITION Studies were identified from 2 sources: a high-quality, broader review examining supervised injection facility-induced benefits and harms (from database inception to January 2014) and an updated search using the same search strategy (January 2014‒September 2019). Systematic review methods developed by the Guide to Community Preventive Services were used (screening and analysis, September 2019‒December 2020). EVIDENCE SYNTHESIS A total of 22 studies were included in this review: 16 focused on 1 supervised injection facility in Vancouver, Canada. Quantitative synthesis was not conducted given inconsistent outcome measurement across the studies. Supervised injection facilities in the included studies (n=number of studies per outcome category) were mostly associated with significant reductions in opioid overdose morbidity and mortality (n=5), significant improvements in injection behaviors and harm reduction (n=7), significant improvements in access to addiction treatment programs (n=7), and no increase or reductions in crime and public nuisance (n=7). CONCLUSIONS For people who inject drugs, supervised injection facilities may reduce the risk of overdose morbidity and mortality and improve access to care while not increasing crime or public nuisance to the surrounding community.
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Langmann C. Suicide, firearms, and legislation: A review of the Canadian evidence. Prev Med 2021; 152:106471. [PMID: 34538364 DOI: 10.1016/j.ypmed.2021.106471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/18/2021] [Accepted: 02/20/2021] [Indexed: 11/18/2022]
Abstract
Suicide accounts for approximately 4000 deaths a year in Canada, of which about 16% of those are suicide using a firearm. Canada has undertaken legislative efforts to regulate and control firearms, Bill C-51 in 1977 and Bills C-17 and C-68 in 1991 and 1995. Regulatory approaches that decrease the availability of firearms are hypothesized to reduce suicide by firearm however the substitution effect suggests it is possible that people may substitute other methods of suicide in place. Canadian studies on associations between legislation, regulation, and suicide rates have been published over the last three decades, and a search revealed thirteen that met the criteria. Seven studies examined the association between Bill C-51 and suicide rates and found that while rates of suicide by firearm appeared to have declined in association with regulations, there appears to be a substitution effect into other methods and no overall change in suicide rates. Six studies examining the effects of Bill C-17 and C-68 revealed a decrease in the rates of suicide by firearms, with a corresponding increase in non-firearms suicide rates and no decrease in overall suicide rates. One study even suggested no associated decrease in firearm suicide rates with an increasing rate of suicide by hanging possibly due to changes in preferences. These results suggest legislation has mixed effects on firearm suicide rates and may not alone reduce overall suicide in Canada.
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Affiliation(s)
- Caillin Langmann
- Department of Medicine, Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada.
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Home-Based Parent-Child Interaction Therapy to Prevent Child Maltreatment: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168244. [PMID: 34444004 PMCID: PMC8394039 DOI: 10.3390/ijerph18168244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/27/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
High treatment attrition and limited reach of mental health services for at-risk families remains an important problem in order to effectively address the global concern of child maltreatment and child disruptive behavior problems. This study evaluated the effectiveness of a home-based and time-limited adaptation of Parent-Child Interaction Therapy (PCIT). Twenty families with children (70% boys) aged between three and seven years were randomly assigned to an immediate treatment group (IT, n = 10) or a waitlist control group (WL, n = 10). After receiving treatment and compared to mothers in the WL group, mothers in the IT group reported fewer child behavior problems and more improved parenting skills. Although initial analyses revealed no significant differences, additional analyses showed a significant decrease in the primary outcome of the study, namely child abuse potential, between the baseline and follow-up assessment for the total treated sample. A low treatment attrition rate (15%) was found, indicating higher accessibility of treatment for families. Findings suggest that the brief home-based PCIT is a potentially effective intervention to prevent child maltreatment and disruptive behavior problems in at-risk families. Results also reinforce the importance of addressing the specific needs of these families to increase treatment effectiveness.
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20
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Vere J, Gibson B. Variation amongst hierarchies of evidence. J Eval Clin Pract 2021; 27:624-630. [PMID: 32364299 DOI: 10.1111/jep.13404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 01/25/2020] [Accepted: 04/02/2020] [Indexed: 12/11/2022]
Abstract
Evidence-based standards are fundamental to the practice, funding, and governance of modern medicine. These standards are developed using hierarchies of evidence yet it is often not appreciated that different hierarchies exist and there is a risk that inconsistent standards may be developed depending upon the hierarchy that is used. In this paper, we present four factors, independent of study design, that have led to differences amongst hierarchies. These factors are: establishment of professional jurisdiction, practical concerns, methodological quality, and the importance of different questions within medicine. We demonstrate that each of these factors has led to the upgrading of expert opinion and/or the downgrading of randomized controlled trials and meta-analyses within different hierarchies. Our aim is to raise awareness of factors that have influenced the development of hierarchies. This may make the reader more critical of the processes that are used to develop evidence based standards.
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Affiliation(s)
- Joseph Vere
- University Hospitals of Leicester NHS Trust, Department of Orthodontics and Restorative Dentistry, Glenfield Hospital, Leicester, UK
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21
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Hong K, Leidner AJ, Tsai Y, Tang Z, Cho BH, Stokley S. Costs of Interventions to Increase Vaccination Coverage Among Children in the United States: A Systematic Review. Acad Pediatr 2021; 21:S67-S77. [PMID: 33958096 PMCID: PMC9998236 DOI: 10.1016/j.acap.2020.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/15/2020] [Accepted: 11/08/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The Community Preventive Services Task Force (CPSTF) has recommended several interventions that have been demonstrated to be effective at increasing vaccination coverage. OBJECTIVE Conduct a systematic review to examine the costs of interventions designed to increase vaccination coverage among children and adolescents in the United States. DATA SOURCES PubMed, EconLit, Embase, and Cochrane. STUDY ELIGIBILITY, PARTICIPANTS, AND INTERVENTIONS Peer-reviewed articles from January 1, 2009 to August 31, 2019. APPRAISAL AND SYNTHESIS METHODS Studies were identified with systematic searches of the literature, reviewed for inclusion criteria, abstracted for data on intervention, target population, costs, and risk of bias. Cost measures were reported as costs per child in the target population, costs per vaccinated child, incremental costs per vaccinated child, and costs per vaccine dose administered. Results were stratified by intervention type, vaccine, and age group. RESULTS Thirty-seven studies were identified for full-text review. Across all interventions and age groups, the cost per child ranged from $0.10 to $537.38, and the incremental cost per vaccinated child ranged from $6.52 to $5,098.57. Provider assessment and feedback interventions had the lowest (median) cost per child ($0.17) and a healthcare system-based combined intervention with multiple components had the lowest (median) incremental cost per vaccinated child ($26.65). A community-based combined intervention with multiple components had the highest median cost per child ($537.38) and the highest median incremental cost per vaccinated child ($5,098.57). LIMITATIONS A small number of included intervention types and inconsistent cost definition. CONCLUSIONS There is substantial variability in the costs of CPSTF-recommended interventions.
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Affiliation(s)
- Kai Hong
- Immunization Service Division, National Center for Immunization and Respiratory Diseases (NCIRD) (K Hong, AJ Leidner, Y Tsai, B-H Cho, and S Stokley), Centers for Disease Control and Prevention (CDC), Atlanta, Ga.
| | - Andrew J Leidner
- Immunization Service Division, National Center for Immunization and Respiratory Diseases (NCIRD) (K Hong, AJ Leidner, Y Tsai, B-H Cho, and S Stokley), Centers for Disease Control and Prevention (CDC), Atlanta, Ga
| | - Yuping Tsai
- Immunization Service Division, National Center for Immunization and Respiratory Diseases (NCIRD) (K Hong, AJ Leidner, Y Tsai, B-H Cho, and S Stokley), Centers for Disease Control and Prevention (CDC), Atlanta, Ga
| | - Zhaoli Tang
- Berry Technology Solutions (Z Tang), Atlanta, Ga
| | - Bo-Hyun Cho
- Immunization Service Division, National Center for Immunization and Respiratory Diseases (NCIRD) (K Hong, AJ Leidner, Y Tsai, B-H Cho, and S Stokley), Centers for Disease Control and Prevention (CDC), Atlanta, Ga
| | - Shannon Stokley
- Immunization Service Division, National Center for Immunization and Respiratory Diseases (NCIRD) (K Hong, AJ Leidner, Y Tsai, B-H Cho, and S Stokley), Centers for Disease Control and Prevention (CDC), Atlanta, Ga
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Ciccarello C, Leber MB, Leonard MC, Nesbit T, Petrovskis MG, Pherson E, Pillen HA, Proctor C, Reddan J. ASHP Guidelines on the Pharmacy and Therapeutics Committee and the Formulary System. Am J Health Syst Pharm 2021; 78:907-918. [PMID: 33954417 DOI: 10.1093/ajhp/zxab080] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Christy Ciccarello
- Vice President, Clinical Pharmacy Services, Novant Health, Winston-Salem, NC, USA
| | - Molly Billstein Leber
- Associate Director, Drug Use Policy and Formulary Management, Yale New Haven Health System, New Haven, CT, USA
| | - Mandy C Leonard
- System Director, Drug Use Policy and Formulary Management, Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA
| | - Todd Nesbit
- Director of Pharmacy Patient Care Services, The Johns Hopkins Health System, Baltimore, MD, USA
| | - Mary G Petrovskis
- PGY2 Health-System Pharmacy Administration Resident, University of North Carolina Medical Center, Chapel Hill, NC, USA
| | - Emily Pherson
- Assistant Director, Medication Use Policy & Clinical Informatics, The Johns Hopkins Health System, Baltimore, MD, USA
| | - Heidi A Pillen
- Director of Pharmacy, Clinical Services & Medication Use Policy, Beaumont Health, Southfield, MI, USA
| | - Celia Proctor
- Assistant Director, System Formulary Management & Integration, The Johns Hopkins Health System, Baltimore, MD, USA
| | - Jennifer Reddan
- Pharmacy Executive Director, Excelerate, Vizient, Irving, TX, USA
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Evans MA, Buysse DJ, Marsland AL, Wright AGC, Foust J, Carroll LW, Kohli N, Mehra R, Jasper A, Srinivasan S, Hall MH. Meta-analysis of age and actigraphy assessed sleep characteristics across the lifespan. Sleep 2021; 44:6211192. [PMID: 33823052 DOI: 10.1093/sleep/zsab088] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/11/2021] [Indexed: 12/17/2022] Open
Abstract
STUDY OBJECTIVES Sleep quantity and continuity vary across the lifespan. Actigraphy is a reliable and widely-used behavioral measure of sleep in research and personal health monitoring. This meta-analysis provides a novel examination of whether age (in years) is associated with actigraphy-assessed sleep across the lifespan. METHODS A systematic search of PubMed, Embase.com, Cochrane CENTRAL, and PsycINFO using "actigraphy" and "sleep" terms provided 7,079 titles/abstracts; studies of individuals with known psychiatric or medical comorbidities were excluded. Ninety-one articles (N = 23,365) provided data for six meta-analyses examining sleep duration (k = 89), sleep efficiency (k = 58), bedtime (k = 19) and waketime (k = 9) for individuals ages 6-21, and bedtime (k = 7) and waketime (k = 7) for individuals ages 22 and older. RESULTS At older ages, sleep duration was shorter (r = -0.12) and sleep efficiency was lower (r = -0.05). Older age was associated with later bedtime (r = 0.37) and wake-up time (r = 0.24) from ages 6-21, whereas older age was associated with earlier bedtime (r = -0.66) and wake-up time (r = -0.59) for ages 22 and above. The strength of these associations was modified by study continent, but not by any other moderator. CONCLUSIONS Age was negatively associated with actigraphy-assessed sleep duration and efficiency, but the effects were small in magnitude. On the other hand, large associations were observed between age and sleep timing, despite a smaller literature and the absence of analyzable data for ages 30-60. Changes in sleep timing, rather than changes in sleep duration or continuity, may better characterize the effects of age on human sleep.
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Affiliation(s)
- Marissa A Evans
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anna L Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jill Foust
- Health Sciences Library System, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lucas W Carroll
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Naina Kohli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rishabh Mehra
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Adam Jasper
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Swathi Srinivasan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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Naicker A, Shrestha A, Joshi C, Willett W, Spiegelman D. Workplace cafeteria and other multicomponent interventions to promote healthy eating among adults: A systematic review. Prev Med Rep 2021; 22:101333. [PMID: 33732606 PMCID: PMC7937753 DOI: 10.1016/j.pmedr.2021.101333] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 01/28/2021] [Accepted: 02/09/2021] [Indexed: 12/18/2022] Open
Abstract
The objective of this review is to evaluate evidence for the effectiveness of workplace cafeteria and other supporting multicomponent interventions to promote healthy eating and reductions in health risks among adults. We conducted an electronic search in EMBASE, CINAHL, EconLit, Ovid, Cochrane, Web of Science and PubMed for English-language articles published from 1985 to July 2019. Studies were original articles reporting the results of workplace cafeteria interventions to promote healthy eating and reduction in health risks. Outcomes were classified as changes in fruit and vegetable intake, health risk indicators, dietary intake, and food sales. Interventions were categorized as interventions targeting food quality or quantity, targeting price, targeting food choice at point of purchase, targeting improved supply, targeting client's information, education or motivation and targeting organization policies. Behavioral change conditions used in interventions were identified using the COM-B system of behavioral change. Results were presented in a narrative summary. A total of 55 studies out of 6285 articles were identified for this review. Several studies used multicomponent interventions and the most featured interventions included interventions targeting food quality or quantity, targeting client's information, education or motivation and targeting food choice at point of purchase. There is evidence that workplace cafeteria and other supporting multicomponent interventions resulted in higher intake of fruit and vegetables, improved dietary intake, improved health outcomes and healthy food sales. The findings of this review have the potential to inform future cafeteria-based and other supporting multicomponent workplace health interventions. The review protocol was not registered in a repository.
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Affiliation(s)
- Ashika Naicker
- Department of Food and Nutrition, Durban University of Technology, Durban, South Africa.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - Archana Shrestha
- Center for Methods on Implementation and Prevention Science (CMIPS) Yale School of Public Health, New Haven, USA
| | | | - Walter Willett
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - Donna Spiegelman
- Center for Methods on Implementation and Prevention Science (CMIPS) Yale School of Public Health, New Haven, USA
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Foti K, Foraker RE, Martyn-Nemeth P, Anderson CAM, Cook NR, Lichtenstein AH, de Ferranti SD, Young DR, Hivert MF, Ross R, Deedwania P, Whitsel LP, Appel LJ. Evidence-Based Policy Making for Public Health Interventions in Cardiovascular Diseases: Formally Assessing the Feasibility of Clinical Trials. Circ Cardiovasc Qual Outcomes 2020; 13:e006378. [PMID: 32981337 PMCID: PMC7674216 DOI: 10.1161/circoutcomes.119.006378] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Implementation of prevention policies has often been impeded or delayed due to the lack of randomized controlled trials (RCTs) with hard clinical outcomes (eg, incident disease, mortality). Despite the prominent role of RCTs in health care, it may not always be feasible to conduct RCTs of public health interventions with hard outcomes due to logistical and ethical considerations. RCTs may also lack external validity and have limited generalizability. Currently, there is insufficient guidance for policymakers charged with establishing evidence-based policy to determine whether an RCT with hard outcomes is needed before policy recommendations. In this context, the purpose of this article is to assess, in a case study, the feasibility of conducting an RCT of the oft-cited issue of sodium reduction on cardiovascular outcomes and then propose a framework for decision-making, which includes an assessment of the feasibility of conducting an RCT with hard clinical outcomes when such trials are unavailable. We designed and assessed the feasibility of potential individual- and cluster-randomized trials of sodium reduction on cardiovascular outcomes. Based on our assumptions, a trial using any of the designs considered would require tens of thousands of participants and cost hundreds of millions of dollars, which is prohibitively expensive. Our estimates may be conservative given several key challenges, such as the unknown costs of sustaining a long-term difference in sodium intake, the effect of differential cotreatment with antihypertensive medications, and long lag time to clinical outcomes. Thus, it would be extraordinarily difficult to conduct such a trial, and despite the high costs, would still be at substantial risk for a spuriously null result. A robust framework, such as the one we developed, should be used to guide policymakers when establishing evidence-based public health interventions in the absence of trials with hard clinical outcomes.
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Affiliation(s)
- Kathryn Foti
- Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Randi E. Foraker
- Department of Internal Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO
| | | | - Cheryl A. M. Anderson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Family Medicine and Public Health, UC San Diego School of Medicine, La Jolla, CA
| | - Nancy R. Cook
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Alice H. Lichtenstein
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Sarah D. de Ferranti
- Department of Cardiology, Boston Children’s Hospital, Boston MA
- Harvard Medical School, Boston, MA
| | - Deborah Rohm Young
- Director, Division of Behavioral Research; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena CA
| | - Marie-France Hivert
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA
| | - Robert Ross
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada
| | - Prakash Deedwania
- School of Medicine, University of California at San Francisco, Fresno CA1
| | - Laurie P. Whitsel
- Department of Policy Research and Translation, American Heart Association, Washington, DC
| | - Lawrence J. Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD
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Can We Change Health Care Costs in Patients With Complex Back Pain?: Results From a 5-year Before and After Study. Spine (Phila Pa 1976) 2020; 45:1443-1450. [PMID: 32502071 PMCID: PMC7515478 DOI: 10.1097/brs.0000000000003550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A before and after study cohort study. OBJECTIVES The aim of this study was to examine changes in health care costs after multidisciplinary spine care in patients with complex chronic back pain (CBP), to analyze the predictive value of patient and disease characteristics on health care costs, and to study the potential impact of biases concerning the use of real world data. SUMMARY OF BACKGROUND DATA Due to high direct and indirect societal costs of back pain there is a need for interventions that can assist in reducing the economic burden on patients and society. METHODS All patients referred to a university-based spine center insured at a major health care insurer in the Netherlands were invited. Personal and disease-related data were collected at baseline. Health care costs were retrieved from the health care insurer from 2 years before to 2 years after intervention. Repeated measures analysis of variances were calculated to study changes in health care costs after intervention. Multivariable regression analyses and cluster robust fixed effect models were applied to predict characteristics on health care costs. To study regression to the mean, a fixed effect model was calculated comparing 2 years before and 2 years post-intervention. RESULTS In total 428,158 declarations during 4.6 years were filed by 997 participants (128,666 considered CBP-related). CBP-related costs significantly increased during the intervention period and reduced 2 years after the intervention. Total health care costs kept rising. The intervention was associated with a 21% to 34% (P < 0.01) reduction in costs depending on the model used. Reduction in costs was related to being male and lower body mass index. CONCLUSION This study suggests that reduction in CBP-related health care utilization in patients with complex CBP can be achieved after a multidisciplinary spine intervention. The results are robust to controlling for background characteristics and are unlikely to be fully driven by regression to the mean. LEVEL OF EVIDENCE 4.
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Omura JD, Carlson SA, Brown DR, Hopkins DP, Kraus WE, Staffileno BA, Thomas RJ, Lobelo F, Fulton JE. Built Environment Approaches to Increase Physical Activity: A Science Advisory From the American Heart Association. Circulation 2020; 142:e160-e166. [PMID: 32787451 PMCID: PMC10959241 DOI: 10.1161/cir.0000000000000884] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Engaging in regular physical activity is one of the most important things people can do to improve their cardiovascular health; however, population levels of physical activity remain low in the United States. Effective population-based approaches implemented in communities can help increase physical activity among all Americans. Evidence suggests that built environment interventions offer one such approach. These interventions aim to create or modify community environmental characteristics to make physical activity easier or more accessible for all people in the places where they live. In 2016, the Community Preventive Services Task Force released a recommendation for built environment approaches to increase physical activity. This recommendation is based on a systematic review of 90 studies (search period, 1980-June 2014) conducted using methods outlined by the Guide to Community Preventive Services. The Community Preventive Services Task Force found sufficient evidence of effectiveness to recommend combined built environment strategies. Specifically, these strategies combine interventions to improve pedestrian or bicycle transportation systems with interventions to improve land use and environmental design. Components of transportation systems can include street pattern design and connectivity, pedestrian infrastructure, bicycle infrastructure, and public transit infrastructure and access. Components of land use and environmental design can include mixed land use, increased residential density, proximity to community or neighborhood destinations, and parks and recreational facility access. Implementing this Community Preventive Services Task Force recommendation in communities across the United States can help promote healthy and active living, increase physical activity, and ultimately improve cardiovascular health.
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The viewpoint by White and colleagues critiquing the evaluation of the safety and efficacy of mass chemotherapy for Taenia solium taeniasis is unsubstantiated. PLoS Negl Trop Dis 2020; 14:e0008592. [PMID: 32881869 PMCID: PMC7470277 DOI: 10.1371/journal.pntd.0008592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 11/19/2022] Open
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Nittas V, Ameli V, Little M, Humphreys DK. Exploring the equity impact of mobile health-based human immunodeficiency virus interventions: A systematic review of reviews and evidence synthesis. Digit Health 2020; 6:2055207620942360. [PMID: 32742717 PMCID: PMC7375713 DOI: 10.1177/2055207620942360] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 06/23/2020] [Indexed: 11/15/2022] Open
Abstract
Objective While mobile health-based human immunodeficiency virus (HIV) interventions are often designed to promote health equity, systematic differences in the use of and access to mobile technologies may counteract that and widen treatment gaps. This systematic review applies an equity lens to investigate whether existing research provides adequate evidence on the ethical implications of mHealth technologies in HIV treatment and prevention. Methods This study included a two-stage methodology, consisting of (a) a systematic review of systematic reviews and (b) an evidence synthesis of primary studies. For the review of reviews we searched eight electronic databases, eight electronic journals and Google Scholar. We also screened reference lists and consulted authors of included studies. Primary studies were extracted from eligible reviews. We based our data extraction and analysis on the Place of residence, Race, Occupation, Gender/Sex, Religion, Education, Socioeconomic status, Social capital and other disadvantage related characteristics (PROGRESS-Plus) framework and the use of harvest plots, focusing on the socio-demographic distribution of mHealth effects. Results A total of 8786 citations resulted in 19 eligible reviews and 39 eligible primary studies. Existing reviews did not provide any analyses of the equity impacts of mobile health-based HIV initiatives. Information availability was higher in primary studies, predominantly suggesting no social gradient of mobile health-based HIV interventions. Overall, evidence remains weak and not sufficient to allow for confident equity statements. Conclusions Despite the negative force of socio-demographic inequities and the emerging nature of mobile health technologies, evidence on the equity implications of mobile health interventions for HIV care remains scarce. Not knowing how the effects of mobile health technologies differ across population subgroups inevitably limits our capacities to equitably adopt, adjust and integrate mobile health interventions towards reaching those disproportionally affected by the epidemic.
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Affiliation(s)
- Vasileios Nittas
- Department of Social Policy and Intervention, University of Oxford, UK.,Green Templeton College, University of Oxford, UK
| | - Vira Ameli
- Department of Social Policy and Intervention, University of Oxford, UK.,Green Templeton College, University of Oxford, UK
| | - Madison Little
- Department of Social Policy and Intervention, University of Oxford, UK.,Green Templeton College, University of Oxford, UK
| | - David K Humphreys
- Department of Social Policy and Intervention, University of Oxford, UK.,Green Templeton College, University of Oxford, UK
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Permanent Supportive Housing With Housing First to Reduce Homelessness and Promote Health Among Homeless Populations With Disability: A Community Guide Systematic Review. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 26:404-411. [PMID: 32732712 DOI: 10.1097/phh.0000000000001219] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Poor physical and mental health and substance use disorder can be causes and consequences of homelessness. Approximately 2.1 million persons per year in the United States experience homelessness. People experiencing homelessness have high rates of emergency department use, hospitalization, substance use treatment, social services use, arrest, and incarceration. OBJECTIVES A standard approach to treating homeless persons with a disability is called Treatment First, requiring clients be "housing ready"-that is, in psychiatric treatment and substance-free-before and while receiving permanent housing. A more recent approach, Housing First, provides permanent housing and health, mental health, and other supportive services without requiring clients to be housing ready. To determine the relative effectiveness of these approaches, this systematic review compared the effects of both approaches on housing stability, health outcomes, and health care utilization among persons with disabilities experiencing homelessness. DESIGN A systematic search (database inception to February 2018) was conducted using 8 databases with terms such as "housing first," "treatment first," and "supportive housing." Reference lists of included studies were also searched. Study design and threats to validity were assessed using Community Guide methods. Medians were calculated when appropriate. ELIGIBILITY CRITERIA Studies were included if they assessed Housing First programs in high-income nations, had concurrent comparison populations, assessed outcomes of interest, and were written in English and published in peer-reviewed journals or government reports. MAIN OUTCOME MEASURES Housing stability, physical and mental health outcomes, and health care utilization. RESULTS Twenty-six studies in the United States and Canada met inclusion criteria. Compared with Treatment First, Housing First programs decreased homelessness by 88% and improved housing stability by 41%. For clients living with HIV infection, Housing First programs reduced homelessness by 37%, viral load by 22%, depression by 13%, emergency departments use by 41%, hospitalization by 36%, and mortality by 37%. CONCLUSIONS Housing First programs improved housing stability and reduced homelessness more effectively than Treatment First programs. In addition, Housing First programs showed health benefits and reduced health services use. Health care systems that serve homeless patients may promote their health and well-being by linking them with effective housing services.
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Healthier Food and Beverage Interventions in Schools: Four Community Guide Systematic Reviews. Am J Prev Med 2020; 59:e15-e26. [PMID: 32564807 PMCID: PMC9366443 DOI: 10.1016/j.amepre.2020.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 11/23/2022]
Abstract
CONTEXT Healthy eating during childhood is important for optimal growth and helps reduce the risk of obesity, which has potentially serious health consequences. Changing the school food environment may offer one way to improve students' dietary intake. This manuscript reports 4 Community Guide systematic reviews examining the effectiveness of interventions in schools promoting healthy eating and weight. EVIDENCE ACQUISITION School obesity prevention programs aiming to improve diet were identified from a 2013 Agency for Health Care Research and Quality systematic review and an updated search (August 2012-January 4, 2017). In 2017-2018, Community Guide systematic review methods were used to assess effectiveness as determined by dietary behavior and weight changes. EVIDENCE SYNTHESIS Interventions improving school meals or offering fruits and vegetables (n=27 studies) are considered effective. Evidence is insufficient to determine the effectiveness of interventions supporting healthier snack foods and beverages outside of school meal programs given inconsistent findings (n=13 studies). Multicomponent interventions to increase availability of healthier foods and beverages are considered effective. These interventions must include 1 component from school meals or fruit and vegetable programs and interventions supporting healthier snack foods and beverages (n=12 studies). There is insufficient evidence to determine the effectiveness of interventions to increase water access because only 2 studies met inclusion criteria. CONCLUSIONS A total of 2 school-based dietary interventions have favorable effects for improving dietary habits and modest effects for improving or maintaining weight. More evidence is needed regarding interventions with insufficient findings. These reviews may inform researchers and school administrators about healthy eating and obesity prevention interventions.
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Peng Y, Finnie RKC, Hahn RA, Truman BI, Johnson RL, Fielding JE, Muntaner C, Fullilove MT, Zhang X. Expanded In-School Instructional Time and the Advancement of Health Equity: A Community Guide Systematic Review. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25:584-589. [PMID: 30204626 PMCID: PMC7359915 DOI: 10.1097/phh.0000000000000834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Expanded in-school instructional time (EISIT) may reduce racial/ethnic educational achievement gaps, leading to improved employment, and decreased social and health risks. When targeted to low-income and racial/ethnic minority populations, EISIT may thus promote health equity. Community Guide systematic review methods were used to search for qualified studies (through February 2015, 11 included studies) and summarize evidence of the effectiveness of EISIT on educational outcomes. Compared with schools with no time change, schools with expanded days improved students' test scores by a median of 0.05 standard deviation units (range, 0.0-0.25). Two studies found that schools with expanded day and year improved students' standardized test scores (0.04 and 0.15 standard deviation units). Remaining studies were inconclusive. Given the small effect sizes and a lack of information about the use of added time, there is insufficient evidence to determine the effectiveness of EISIT on academic achievement and thus health equity.
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Affiliation(s)
- Yinan Peng
- Community Guide Branch, Division of Public Health Information Dissemination (Drs Peng, Finnie, and Hahn), and Office of the Associate Director for Science, National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention (Dr Truman), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; Rutgers New Jersey Medical School, Newark, New Jersey (Dr Johnson); UCLA Fielding School of Public Health, Los Angeles, California (Dr Fielding); University of Toronto, Toronto, Canada (Dr Muntaner); Columbia University, New York, New York (Dr Fullilove); and National Institute on Minority Health and Health Disparities, National Institutes of Health, Washington, District of Columbia (Dr Zhang). Names and affiliations of the Community Preventive Services Task Force members can be found at www.thecommunityguide.org/about/task-force-members.html
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Bowen DJ, Hyams T, Laurino M, Woolley T, Cohen S, Leppig KA, Jarvik G. Development of FamilyTalk: an Intervention to Support Communication and Educate Families About Colorectal Cancer Risk. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:470-478. [PMID: 30737640 PMCID: PMC6688969 DOI: 10.1007/s13187-019-1484-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
IFamily members of individuals with colorectal cancer (CRC) may be at increased risk of developing the disease. However, the majority of CRC can be prevented through colonoscopy screening and family members may not be aware if they are recommended to pursue earlier screening because of their family history of CRC. As such, tools must be developed to effectively communicate potential changes to the recommended age for colonoscopy screening and other important CRC-related information to family members. We modified and adapted a successful intervention for families with melanoma to be appropriate for families with CRC to increase communication and screening in family members. The multistep process included the following: (1) developing a paper version of the intervention, (2) piloting the paper version among families with CRC, (3) developing the web-based version, and (4) testing the intervention for usability. Qualitative data was collected and analyzed for pilot testing. Usability testing utilized both qualitative and quantitative data. Patients with CRC liked the paper version and had multiple suggestions, including adding a better introduction, sections on genetics and family history, and clearer communication assistance. The web-based tool was well received and improved upon the linear book format with links, better section instructions, and more proactive communication tools for families. These processes produced materials that satisfied individuals from various families with assistance and support for communicating about CRC. Evaluating the effects of the tools in rigorous research projects is the next step.
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Affiliation(s)
- Deborah J Bowen
- Department of Bioethics and Humanities, University of Washington, Box 357120, Seattle, WA, 98195, USA.
| | - Travis Hyams
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Mercy Laurino
- Genetics and Cancer Prevention Programs, Seattle Cancer Care Alliance, Seattle, WA, USA
| | | | - Stacey Cohen
- Division of Oncology, University of Washington, Seattle, WA, USA
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Gail Jarvik
- Department of Medicine, Division of Medical Genetics, University of Washington, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
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Sacks G, Kwon J, Ananthapavan J. The Application of an Evidence Framework for Obesity Prevention at the Population-Level. Curr Obes Rep 2020; 9:150-158. [PMID: 32266649 DOI: 10.1007/s13679-020-00376-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW To review existing frameworks for assessing the evidence of effectiveness of obesity prevention interventions, and discuss the application of a custom-developed evidence framework to inform an obesity prevention priority-setting study in Australia. RECENT FINDINGS There are a wide range of frameworks for grading evidence. However, most frameworks are not well suited to assess the effectiveness of obesity prevention interventions because they do not include processes to synthesise evidence from multiple study designs and outcome measures. The key features of the Obesity Prevention Evidence Assessment (OPEA) Framework are: [1] separately assessed weight-, diet- and physical activity-related outcomes; [2] consideration of the balance of evidence from multiple study types; and [3] a summary indication of the degree of certainty of intervention effectiveness. Evidence frameworks that recognise the complexities of obesity prevention research can support decision-makers in prioritising actions to address obesity alongside broader priority-setting considerations.
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Affiliation(s)
- Gary Sacks
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Janelle Kwon
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Jaithri Ananthapavan
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia
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Shoemaker ES, Kendall CE, Mathew C, Crispo S, Welch V, Andermann A, Mott S, Lalonde C, Bloch G, Mayhew A, Aubry T, Tugwell P, Stergiopoulos V, Pottie K. Establishing need and population priorities to improve the health of homeless and vulnerably housed women, youth, and men: A Delphi consensus study. PLoS One 2020; 15:e0231758. [PMID: 32298388 PMCID: PMC7162520 DOI: 10.1371/journal.pone.0231758] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 04/01/2020] [Indexed: 11/25/2022] Open
Abstract
Background Homelessness is one of the most disabling and precarious living conditions. The objective of this Delphi consensus study was to identify priority needs and at-risk population subgroups among homeless and vulnerably housed people to guide the development of a more responsive and person-centred clinical practice guideline. Methods We used a literature review and expert working group to produce an initial list of needs and at-risk subgroups of homeless and vulnerably housed populations. We then followed a modified Delphi consensus method, asking expert health professionals, using electronic surveys, and persons with lived experience of homelessness, using oral surveys, to prioritize needs and at-risk sub-populations across Canada. Criteria for ranking included potential for impact, extent of inequities and burden of illness. We set ratings of ≥ 60% to determine consensus over three rounds of surveys. Findings Eighty four health professionals and 76 persons with lived experience of homelessness participated from across Canada, achieving an overall 73% response rate. The participants identified priority needs including mental health and addiction care, facilitating access to permanent housing, facilitating access to income support and case management/care coordination. Participants also ranked specific homeless sub-populations in need of additional research including: Indigenous Peoples (First Nations, Métis, and Inuit); youth, women and families; people with acquired brain injury, intellectual or physical disabilities; and refugees and other migrants. Interpretation The inclusion of the perspectives of both expert health professionals and people with lived experience of homelessness provided validity in identifying real-world needs to guide systematic reviews in four key areas according to priority needs, as well as launch a number of working groups to explore how to adapt interventions for specific at-risk populations, to create evidence-based guidelines.
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Affiliation(s)
- Esther S. Shoemaker
- Bruyère Research Institute, Ottawa, ON, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
- Institute of Clinical and Evaluative Sciences, Toronto, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Claire E. Kendall
- Bruyère Research Institute, Ottawa, ON, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
- Institute of Clinical and Evaluative Sciences, Toronto, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Institute du Savoir Montfort, Ottawa, ON, Canada
| | | | | | - Vivian Welch
- Bruyère Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Anne Andermann
- Department of Family Medicine, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- St Mary’s Research Centre, St Mary’s Hospital, Montreal, QC, Canada
| | - Sebastian Mott
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | | | - Gary Bloch
- Department of Family and Community Medicine, St. Michael’s Hospital, Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Inner City Health Associates, Toronto, ON, Canada
| | | | - Tim Aubry
- School of Psychology and Centre for Research on Educational and Community Services, University of Ottawa, Ottawa, ON, Canada
| | - Peter Tugwell
- Bruyère Research Institute, Ottawa, ON, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Vicky Stergiopoulos
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addictions and Mental Health, Toronto, ON, Canada
| | - Kevin Pottie
- Bruyère Research Institute, Ottawa, ON, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
- * E-mail:
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Saginur M, Fergusson D, Zhang T, Yeates K, Ramsay T, Wells G, Moher D. Journal impact factor, trial effect size, and methodological quality appear scantly related: a systematic review and meta-analysis. Syst Rev 2020; 9:53. [PMID: 32164791 PMCID: PMC7069162 DOI: 10.1186/s13643-020-01305-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 02/20/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND As systematic reviews' limited coverage of the medical literature necessitates decision-making based on unsystematic review, we investigated a possible advantage of systematic review (aside from dataset size and systematic analysis): does systematic review avoid potential bias in sampling primary studies from high impact factor journals? If randomized controlled trials (RCTs) reported in higher-impact journals present different treatment benefits than RCTs reported in lower-impact journals, readers who focus on higher-impact journals for their rapid literature reviews may introduce bias which could be mitigated by complete, systematic sampling. METHODS We randomly sampled Cochrane Library (20 July 2005) treatment reviews that measured mortality as a binary outcome, published in English or French, with at least five RCTs with one or more deaths. Our domain-based assessment of risk of bias included funding source, randomness of allocation sequence, blinding, and allocation concealment. The primary analysis employed logistic regression by a generalized linear model with a generalized estimating equation to estimate the association between various factors and publication in a journal with a high journal impact factor (JIF). RESULTS From the 29 included systematic reviews, 189 RCTs contributed data. However, in the primary analyses comparing RCT results within meta-analyses, there was no statistically significant association: unadjusted odds of greater than 50% mortality protection in high-JIF (> 5) journals were 1.4 (95% CI 0.42, 4.4) and adjusted, 2.5 (95% CI 0.6, 10). Elements of study quality were weakly, inconsistently, and not statistically significantly correlated with journal impact factor. CONCLUSIONS Journal impact factor may have little to no association with study results, or methodological quality, but the evidence is very uncertain.
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Affiliation(s)
- Michael Saginur
- Montfort Research Institute, 713 Montreal Road, Ottawa, Canada.
| | - Dean Fergusson
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
| | - Tinghua Zhang
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
| | - Karen Yeates
- Department of Medicine, Queen's University, 76 Stuart Street, Kingston, K7L 2V7, Canada
| | - Tim Ramsay
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
| | - George Wells
- University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON, K1Y 4W7, Canada
| | - David Moher
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
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The Community Guide: A Living Resource for Nursing Practice. Am J Nurs 2020; 120:55-57. [PMID: 32079800 DOI: 10.1097/01.naj.0000656352.36531.5d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Evidence-based recommendations for preventive health.
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Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch SM, Atkins D. REPRINT OF: Current Methods of the U.S. Preventive Services Task Force: A Review of the Process. Am J Prev Med 2020; 58:316-331. [PMID: 32087860 DOI: 10.1016/j.amepre.2020.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Editor's Note: This article is a reprint of a previously published article. For citation purposes, please use the original publication details: Harris RP, Helfand M, Woolf SH, et al. Current methods of the U.S. Preventive Services Task Force: a review of the process. Am J Prev Med. 2001;20(3S):21-35. The U.S. Preventive Services Task Force (USPSTF/Task Force) represents one of several efforts to take a more evidence-based approach to the development of clinical practice guidelines. As methods have matured for assembling and reviewing evidence and for translating evidence into guidelines, so too have the methods of the USPSTF. This paper summarizes the current methods of the third USPSTF, supported by the Agency for Healthcare Research and Quality (AHRQ) and two of the AHRQ Evidence-based Practice Centers (EPCs). The Task Force limits the topics it reviews to those conditions that cause a large burden of suffering to society and that also have available a potentially effective preventive service. It focuses its reviews on the questions and evidence most critical to making a recommendation. It uses analytic frameworks to specify the linkages and key questions connecting the preventive service with health outcomes. These linkages, together with explicit inclusion criteria, guide the literature searches for admissible evidence. Once assembled, admissible evidence is reviewed at three strata: (1) the individual study, (2) the body of evidence concerning a single linkage in the analytic framework, and (3) the body of evidence concerning the entire preventive service. For each stratum, the Task Force uses explicit criteria as general guidelines to assign one of three grades of evidence: good, fair, or poor. Good or fair quality evidence for the entire preventive service must include studies of sufficient design and quality to provide an unbroken chain of evidence-supported linkages, generalizable to the general primary care population, that connect the preventive service with health outcomes. Poor evidence contains a formidable break in the evidence chain such that the connection between the preventive service and health outcomes is uncertain. For services supported by overall good or fair evidence, the Task Force uses outcomes tables to help categorize the magnitude of benefits, harms, and net benefit from implementation of the preventive service into one of four categories: substantial, moderate, small, or zero/negative. The Task Force uses its assessment of the evidence and magnitude of net benefit to make a recommendation, coded as a letter: from A (strongly recommended) to D (recommend against). It gives an I recommendation in situations in which the evidence is insufficient to determine net benefit. The third Task Force and the EPCs will continue to examine a variety of methodologic issues and document work group progress in future communications.
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Affiliation(s)
- Russell P Harris
- School of Medicine and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Mark Helfand
- Division of Medical Informatics and Outcomes Research, and Evidence-based Practice Center, Oregon Health Sciences University, Portland, Oregon; Portland Veterans Affairs Medical Center, Portland, Oregon
| | - Steven H Woolf
- Department of Family Practice, Medical College of Virginia, Virginia Commonwealth University, Fairfax, Virginia
| | - Kathleen N Lohr
- Research Triangle Institute, Research Triangle Park, North Carolina; Program on Health Outcomes, and School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Cynthia D Mulrow
- Department of Medicine, University of Texas Health Science Center, San Antonio, Texas
| | - Steven M Teutsch
- Outcomes Research and Management, Merck & Co., Inc., West Point, Pennsylvania
| | - David Atkins
- Center for Practice and Technology Assessment, Agency for Healthcare Research and Quality, Rockville, Maryland
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Clinical Decision Support Systems in Breast Cancer: A Systematic Review. Cancers (Basel) 2020; 12:cancers12020369. [PMID: 32041094 PMCID: PMC7072392 DOI: 10.3390/cancers12020369] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 12/12/2022] Open
Abstract
Breast cancer is the most frequently diagnosed cancer in women, with more than 2.1 million new diagnoses worldwide every year. Personalised treatment is critical to optimising outcomes for patients with breast cancer. A major advance in medical practice is the incorporation of Clinical Decision Support Systems (CDSSs) to assist and support healthcare staff in clinical decision-making, thus improving the quality of decisions and overall patient care whilst minimising costs. The usage and availability of CDSSs in breast cancer care in healthcare settings is increasing. However, there may be differences in how particular CDSSs are developed, the information they include, the decisions they recommend, and how they are used in practice. This systematic review examines various CDSSs to determine their availability, intended use, medical characteristics, and expected outputs concerning breast cancer therapeutic decisions, an area that is known to have varying degrees of subjectivity in clinical practice. Utilising the methodology of Kitchenham and Charter, a systematic search of the literature was performed in Springer, Science Direct, Google Scholar, PubMed, ACM, IEEE, and Scopus. An overview of CDSS which supports decision-making in breast cancer treatment is provided along with a critical appraisal of their benefits, limitations, and opportunities for improvement.
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Zanobini P, Lorini C, Baldasseroni A, Dellisanti C, Bonaccorsi G. A Scoping Review on How to Make Hospitals health Literate Healthcare Organizations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031036. [PMID: 32041282 PMCID: PMC7037285 DOI: 10.3390/ijerph17031036] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/27/2020] [Accepted: 02/04/2020] [Indexed: 12/13/2022]
Abstract
The concept of health literacy is increasingly being recognised as not just an individual trait, but also as a characteristic related to families, communities, and organisations providing health and social services. The aim of this study is to identify and describe, through a scoping review approach, the characteristics and the interventions that make a hospital a health literate health care organisation (HLHO), in order to develop an integrated conceptual model. We followed Arksey and O’Malley’s five-stage scoping review framework, refined with the Joanna Briggs Institute methodology, to identify the research questions, identify relevant studies, select studies, chart the data, and collate and summarize the data. Of the 1532 titles and abstracts screened, 106 were included. Few studies have explored the effect of environmental support on health professionals, and few outcomes related to staff satisfaction/perception of helpfulness have been reported. The most common types of interventions and outcomes were related to the patients. The logical framework developed can be an effective tool to define and understand priorities and related consequences, thereby helping researchers and policymakers to have a wider vision and a more homogeneous approach to health literacy and its use and promotion in healthcare organizations.
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Affiliation(s)
- Patrizio Zanobini
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (G.B.)
- Correspondence: ; Tel.: +39-3663435179
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (G.B.)
| | - Alberto Baldasseroni
- Tuscany Regional Centre for Occupational Injuries and Diseases (CeRIMP), Central Tuscany LHU, Via di San Salvi, 12, 50135 Florence, Italy;
| | - Claudia Dellisanti
- Department of Epidemiology, Regional Health Agency of Tuscany, Via Pietro Dazzi, 1, 50141 Florence, Italy;
| | - Guglielmo Bonaccorsi
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (G.B.)
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Bach AT, Kang AY, Lewis J, Xavioer S, Portillo I, Goad JA. Addressing common barriers in adult immunizations: a review of interventions. Expert Rev Vaccines 2019; 18:1167-1185. [PMID: 31791159 DOI: 10.1080/14760584.2019.1698955] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Introduction: Low levels of adult vaccination have been documented in the United States and globally. Research has been conducted to identify reasons for low immunization rates; however, the most useful studies are those that implemented interventions for identified barriers to evaluate their impact on rates of immunization. Identifying successful interventions provides immunization providers with evidence-based methods that can be utilized to increase the uptake of recommended vaccines.Areas covered: This review focuses on known barriers to adult immunizations and the interventions available in the literature to overcome these barriers. It outlines interventions that may increase vaccine uptake in the adult population through addressing barriers related to lack of vaccine knowledge, cost, access, provider and practice-based challenges, and racial and ethnic disparities.Expert opinion: Improving adult immunization rates is critical to protecting a population against vaccine-preventable diseases. Those interventions that appeared to increase immunization rates in the adult population included education and reminders about vaccination using text and telephone calls, low-cost or subsidized vaccines, easy access to immunization services, and understanding the cultural and social needs of different racial and ethnic populations. It is likely that an evidence-based multimodal approach using different categories of interventions is necessary to significantly improve adult immunization rates.
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Affiliation(s)
- Albert T Bach
- Assistant Professor of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
| | - Amy Y Kang
- Assistant Professor of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
| | - Jelena Lewis
- Assistant Professor of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
| | - Sharon Xavioer
- Assistant Professor of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
| | - Ivan Portillo
- AHIP Health Sciences Librarian, Leathery Libraries, Chapman University, Irvine, CA, USA
| | - Jeffery A Goad
- Chair of the Department of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
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Kim D. Bridging the epidemiology-policy divide: A consequential and evidence-based framework to optimize population health. Prev Med 2019; 129:105781. [PMID: 31330155 DOI: 10.1016/j.ypmed.2019.105781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 05/21/2019] [Accepted: 07/17/2019] [Indexed: 11/27/2022]
Abstract
Epidemiology is the scientific cornerstone of public health. Its traditional role has been to test scientific hypotheses on causal relationships of exposures with health outcomes, the results of which should in turn be synthesized and lead to evidence-based recommendations and the formation of policy. However, the messy truth is that the path from epidemiology to policy is frequently not a perfectly rational, linear one, and the choices of which scientific hypotheses are pursued and the ways in which they are tested, evaluated, and translated into policies do not occur systematically. One avenue for bridging this divide is widespread adoption and implementation of a consequential, evidence-based framework-whereby we can systematically facilitate the translation of epidemiology into policies and interventions to optimize population health. This paper describes the roadmap for a seven-step, outcomes-based consequential approach, that includes priority-setting of problems at both the federal and regional/state levels, and that proposes to strengthen alignment of public and private research funding and journals with these priorities. Over the long term, implementing this framework should help to bridge the divide between epidemiology and policy and optimize the use of increasingly constrained resources to reduce disease burden and promote the nation's health.
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Affiliation(s)
- Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, MA, United States of America.
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Benzon HT, Joshi GP, Gan TJ, Vetter TR. Development, Reporting, and Evaluation of Clinical Practice Guidelines. Anesth Analg 2019; 129:1771-1777. [PMID: 31743200 DOI: 10.1213/ane.0000000000004441] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Clinical practice parameters have been published with greater frequency by professional societies and groups of experts. These publications run the gamut of practice standards, practice guidelines, consensus statements or practice advisories, position statements, and practice alerts. The definitions of these terms have been clarified in an accompanying article. In this article, we present the criteria for high-quality clinical practice parameters and outline a process for developing them, specifically the Delphi method, which is increasingly being used to build consensus among content experts and stakeholders. Several tools for grading the level of evidence and strength of recommendation are offered and compared. The speciousness of categorizing guidelines as evidence-based or consensus-based will be explained. We examine the recommended checklist for reporting and appraise the tools for evaluating a practice guideline. This article is geared toward developers and reviewers of clinical practice guidelines and consensus statements.
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Affiliation(s)
- Honorio T Benzon
- From the Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Girish P Joshi
- Department of Anesthesiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Tong J Gan
- Department of Anesthesiology, Stony Brook University, Stony Brook, New York
| | - Thomas R Vetter
- Department of Surgery and Perioperative Care, University of Texas, Austin, Texas
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Mölenberg FJM, Panter J, Burdorf A, van Lenthe FJ. A systematic review of the effect of infrastructural interventions to promote cycling: strengthening causal inference from observational data. Int J Behav Nutr Phys Act 2019. [DOI: 10.1186/s12966-019-0850-1#:~:text=most%20of%20the%20evaluations%20found,baseline%3a%2022%25%3b%20range%3a%20%e2%88%92] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Previous reviews have suggested that infrastructural interventions can be effective in promoting cycling. Given inherent methodological complexities in the evaluation of such changes, it is important to understand whether study results obtained depend on the study design and methods used, and to describe the implications of the methods used for causality. The aims of this systematic review were to summarize the effects obtained in studies that used a wide range of study designs to assess the effects of infrastructural interventions on cycling and physical activity, and whether the effects varied by study design, data collection methods, or statistical approaches.
Methods
Six databases were searched for studies that evaluated infrastructural interventions to promote cycling in adult populations, such as the opening of cycling lanes, or the expansion of a city-wide cycling network. Controlled and uncontrolled studies that presented data before and after the intervention were included. No language or date restrictions were applied. Data was extracted for any outcome presented (e.g. bikes counted on the new infrastructure, making a bike trip, cycling frequency, cycling duration), and for any purpose of cycling (e.g. total cycling, recreational cycling, cycling for commuting). Data for physical activity outcomes and equity effects was extracted, and quality assessment was conducted following previous methodologies and the UK Medical Research Council guidance on natural experiments. The PROGRESS-Plus framework was used to describe the impact on subgroups of the population.
Studies were categorized by outcome, i.e. changes in cycling behavior, or usage of the cycling infrastructure. The relative change was calculated to derive a common outcome across various metrics and cycling purposes. The median relative change was presented to evaluate whether effects differed by methodological aspects.
Results
The review included 31 studies and all were conducted within urban areas in high-income countries. Most of the evaluations found changes in favor of the intervention, showing that the number of cyclists using the facilities increased (median relative change compared to baseline: 62%; range: 4 to 438%), and to a lesser extent that cycling behavior increased (median relative change compared to baseline: 22%; range: − 21 to 262%). Studies that tested for statistical significance and studies that used subjective measurement methods (such as surveys and direct observations of cyclists) found larger changes than those that did not perform statistical tests, and those that used objective measurement methods (such as GPS and accelerometers, and automatic counting stations). Seven studies provided information on changes of physical activity behaviors, and findings were mixed. Three studies tested for equity effects following the opening of cycling infrastructure.
Conclusions
Study findings of natural experiments evaluating infrastructural interventions to promote cycling depended on the methods used and the approach to analysis. Studies measuring cycling behavior were more likely to assess actual behavioral change that is most relevant for population health, as compared to studies that measured the use of cycling infrastructure. Triangulation of methods is warranted to overcome potential issues that one may encounter when evaluating environmental changes within the built environment.
Trial registration
The protocol of this study was registered at PROSPERO (CRD42018091079).
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Mölenberg FJM, Panter J, Burdorf A, van Lenthe FJ. A systematic review of the effect of infrastructural interventions to promote cycling: strengthening causal inference from observational data. Int J Behav Nutr Phys Act 2019; 16:93. [PMID: 31655609 PMCID: PMC6815350 DOI: 10.1186/s12966-019-0850-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 09/20/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Previous reviews have suggested that infrastructural interventions can be effective in promoting cycling. Given inherent methodological complexities in the evaluation of such changes, it is important to understand whether study results obtained depend on the study design and methods used, and to describe the implications of the methods used for causality. The aims of this systematic review were to summarize the effects obtained in studies that used a wide range of study designs to assess the effects of infrastructural interventions on cycling and physical activity, and whether the effects varied by study design, data collection methods, or statistical approaches. METHODS Six databases were searched for studies that evaluated infrastructural interventions to promote cycling in adult populations, such as the opening of cycling lanes, or the expansion of a city-wide cycling network. Controlled and uncontrolled studies that presented data before and after the intervention were included. No language or date restrictions were applied. Data was extracted for any outcome presented (e.g. bikes counted on the new infrastructure, making a bike trip, cycling frequency, cycling duration), and for any purpose of cycling (e.g. total cycling, recreational cycling, cycling for commuting). Data for physical activity outcomes and equity effects was extracted, and quality assessment was conducted following previous methodologies and the UK Medical Research Council guidance on natural experiments. The PROGRESS-Plus framework was used to describe the impact on subgroups of the population. Studies were categorized by outcome, i.e. changes in cycling behavior, or usage of the cycling infrastructure. The relative change was calculated to derive a common outcome across various metrics and cycling purposes. The median relative change was presented to evaluate whether effects differed by methodological aspects. RESULTS The review included 31 studies and all were conducted within urban areas in high-income countries. Most of the evaluations found changes in favor of the intervention, showing that the number of cyclists using the facilities increased (median relative change compared to baseline: 62%; range: 4 to 438%), and to a lesser extent that cycling behavior increased (median relative change compared to baseline: 22%; range: - 21 to 262%). Studies that tested for statistical significance and studies that used subjective measurement methods (such as surveys and direct observations of cyclists) found larger changes than those that did not perform statistical tests, and those that used objective measurement methods (such as GPS and accelerometers, and automatic counting stations). Seven studies provided information on changes of physical activity behaviors, and findings were mixed. Three studies tested for equity effects following the opening of cycling infrastructure. CONCLUSIONS Study findings of natural experiments evaluating infrastructural interventions to promote cycling depended on the methods used and the approach to analysis. Studies measuring cycling behavior were more likely to assess actual behavioral change that is most relevant for population health, as compared to studies that measured the use of cycling infrastructure. Triangulation of methods is warranted to overcome potential issues that one may encounter when evaluating environmental changes within the built environment. TRIAL REGISTRATION The protocol of this study was registered at PROSPERO (CRD42018091079).
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Affiliation(s)
- Famke J. M. Mölenberg
- 000000040459992Xgrid.5645.2Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Jenna Panter
- 0000000121885934grid.5335.0MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - Alex Burdorf
- 000000040459992Xgrid.5645.2Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Frank J. van Lenthe
- 000000040459992Xgrid.5645.2Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands ,0000000120346234grid.5477.1Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands
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Okasako-Schmucker DL, Cole KH, Finnie RKC, Basile KC, DeGue S, Niolon PH, Swider SM, Remington PL. Using a Community Preventive Services Task Force Recommendation to Prevent and Reduce Intimate Partner Violence and Sexual Violence. J Womens Health (Larchmt) 2019; 28:1335-1337. [PMID: 31622189 DOI: 10.1089/jwh.2019.8104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Intimate partner violence (IPV) and sexual violence (SV) are preventable public health problems affecting millions in the United States. The Community Preventive Services Task Force (CPSTF), an independent panel of experts that develops evidence-based recommendations based on rigorous systematic reviews, recommends interventions that aim to prevent or reduce IPV and SV among youth aged 12-24 years. Decision makers can use these findings to select interventions appropriate for their populations, identify additional areas for research, and justify funding requests.
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Affiliation(s)
- Devon L Okasako-Schmucker
- Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | | | - Ramona K C Finnie
- Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Kathleen C Basile
- Division of Violence Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Sarah DeGue
- Division of Violence Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Phyllis Holditch Niolon
- Division of Violence Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Susan M Swider
- Department of Community, Systems and Mental Health Nursing, Rush University, Chicago, Illinois
| | - Patrick L Remington
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
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Bergum A, Grigg L, Givens ML, Booske Catlin B, Willems Van Dijk J. How to Be an Informed Consumer of Evidence Ratings: It's in the Details. Prev Chronic Dis 2019; 16:E121. [PMID: 31489836 PMCID: PMC6745893 DOI: 10.5888/pcd16.190067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
What are evidence-based strategies and how can public health practitioners find evidence without conducting extensive literature reviews? We developed an inventory of clearinghouses and other resources that disseminate research on evidence of effectiveness. We examined differences in evidence classification among 6 evidence clearinghouses that rate the effectiveness of community-level strategies to address determinants of health. Most evidence clearinghouses clearly defined their scope, but only a few clearinghouses explicitly defined the types of strategies they assess (eg, programs, policies, practices). The term “evidence-based” was widely used, but definitions and standards were inconsistent across organizations and disciplines. Evidence clearinghouses varied in the way they used evidence rating classifications and criteria for assigning ratings. Attention to detail is important. The criteria for the top rating of some evidence clearinghouses, for example, require a more thorough literature review with more robust results than the criteria for the top rating of others. In addition, some clearinghouses report only on strategies considered to be evidence-based, whereas others also report on strategies that have no effect, mixed evidence, or no qualifying studies, demonstrating that a listing of a strategy by an evidence clearinghouse does not necessarily mean that it is effective. We conclude by providing guidance for users of evidence clearinghouses about how to interpret and effectively apply rating criteria across platforms: look closely at the details of how clearinghouses assign their ratings and be aware of similarities and differences when you are aligning potential strategies with your local priorities. We encourage communities to balance evidence with local needs, resources, and culture in strategy selection and funding decisions.
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Affiliation(s)
- Alison Bergum
- Population Health Institute, University of Wisconsin-Madison, Madison, Wisconsin.,University of Wisconsin Population Health Institute, 610 Walnut St, WARF 524, Madison, WI 53726.
| | - Lael Grigg
- Population Health Institute, University of Wisconsin-Madison, Madison, Wisconsin
| | - Marjory L Givens
- Population Health Institute, University of Wisconsin-Madison, Madison, Wisconsin
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Pharmacists’ Utilization of Information Sources Related to Community and Population Needs in the Upper Midwest and Associations with Continuing Professional Education. PHARMACY 2019; 7:pharmacy7030125. [PMID: 31470542 PMCID: PMC6789527 DOI: 10.3390/pharmacy7030125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/25/2019] [Accepted: 08/26/2019] [Indexed: 11/24/2022] Open
Abstract
Background: To investigate information sources utilized in pharmacists’ assessment of population-based health needs and/or community changes; and the association between information sources utilized and reported completion of continuing professional education topics. Methods: In 2017; licensed pharmacists (n = 1124) in North Dakota; South Dakota; Minnesota; Iowa; and Nebraska completed a questionnaire on continuing professional education and information sources on population-based health needs and community changes. Data were entered; cleaned and imported into Stata 11.1. Census Bureau county-level population density data were used to classify local area characteristics. Descriptive statistics and multivariate logistic regression analyses were performed. Results: Most sources of primary; county-level data on population-based health needs or community changes were minimally utilized. Pharmacists in more rural areas were statistically more likely to use local health professionals; local non-health professionals; and/or the state health department compared to pharmacists in less rural areas. Pharmacists reporting higher use of population-based information sources were more likely to have completed continuing education in the past 12 months for all 21 surveyed topics; 13 significantly so. Conclusions: There is a reliance of pharmacists on information from local health and non-health professionals for information on population-based health needs and/or community changes. Utilization of health departments and other primary information sources was associated with increased rates of completion of an array of continuing professional education topics. Expanding utilization of evidence-driven information sources would improve pharmacists’ ability to better identify and respond to population-based health needs and/or community changes through programs and services offered; and tailor continuing professional education to population-based health needs.
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Katz DL, Karlsen MC, Chung M, Shams-White MM, Green LW, Fielding J, Saito A, Willett W. Hierarchies of evidence applied to lifestyle Medicine (HEALM): introduction of a strength-of-evidence approach based on a methodological systematic review. BMC Med Res Methodol 2019; 19:178. [PMID: 31429718 PMCID: PMC6701153 DOI: 10.1186/s12874-019-0811-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 07/25/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Current methods for assessing strength of evidence prioritize the contributions of randomized controlled trials (RCTs). The objective of this study was to characterize strength of evidence (SOE) tools in recent use, identify their application to lifestyle interventions for improved longevity, vitality, or successful aging, and to assess implications of the findings. METHODS The search strategy was created in PubMed and modified as needed for four additional databases: Embase, AnthropologyPlus, PsycINFO, and Ageline, supplemented by manual searching. Systematic reviews and meta-analyses of intervention trials or observational studies relevant to lifestyle intervention were included if they used a specified SOE tool. Data was collected for each SOE tool. Conditions necessary for assigning the highest SOE grading and treatment of prospective cohort studies within each SOE rating framework were summarized. The expert panel convened to discuss the implications of findings for assessing evidence in the domain of lifestyle medicine. RESULTS AND CONCLUSIONS A total of 15 unique tools were identified. Ten were tools developed and used by governmental agencies or other equivalent professional bodies and were applicable in a variety of settings. Of these 10, four require consistent results from RCTs of high quality to award the highest rating of evidence. Most SOE tools include prospective cohort studies only to note their secondary contribution to overall SOE as compared to RCTs. We developed a new construct, Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM), to illustrate the feasibility of a tool based on the specific contributions of diverse research methods to understanding lifetime effects of health behaviors. Assessment of evidence relevant to lifestyle medicine requires a potential adaptation of SOE approaches when outcomes and/or exposures obviate exclusive or preferential reliance on RCTs. This systematic review was registered with the International Prospective Register of Systematic Reviews, PROSPERO [CRD42018082148].
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Affiliation(s)
- D. L. Katz
- American College of Lifestyle Medicine, PO Box 6432, Chesterfield, MO 63006 USA
- The True Health Initiative, Derby, CT USA
- Yale Griffith Prevention Research Center, 130 Division St, Derby, CT 06418 USA
| | - M. C. Karlsen
- American College of Lifestyle Medicine, PO Box 6432, Chesterfield, MO 63006 USA
- Applied Clinical Nutrition and Global Public Health Programs, University of New England, 11 Hills Beach Rd, Biddeford, ME 04005 USA
| | - M. Chung
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111 USA
| | - M. M. Shams-White
- Risk Factor Assessment Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, 4E204, Bethesda, MD 20850 USA
| | - L. W. Green
- Department of Epidemiology and Biostatistics, University of California at San Francisco School of Medicine, 550 16th Street, Second Floor, San Francisco, CA 94158 USA
| | - J. Fielding
- University of California Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA 90095 USA
| | - A. Saito
- Brown University School of Public Health, 121 S Main St, Providence, RI 02903 USA
| | - W. Willett
- Harvard University T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115 USA
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115 USA
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Zeoli AM, Goldstick J, Mauri A, Wallin M, Goyal M, Cunningham R. The association of firearm laws with firearm outcomes among children and adolescents: a scoping review. J Behav Med 2019; 42:741-762. [PMID: 31367938 PMCID: PMC7780485 DOI: 10.1007/s10865-019-00063-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 05/21/2019] [Indexed: 10/26/2022]
Abstract
We conducted a scoping review to determine the current state of knowledge and areas for advancements in research on the association of firearm laws with child and adolescent firearm-related outcomes. We queried Scopus, EMBASE, Pubmed, and CJ Abstracts for English language original empirical research articles on policies affecting child and adolescent firearm-related outcomes published between January 1, 1985 and July 1, 2018. Data were abstracted, and methodologic quality assessed. Twenty articles met inclusion criteria. Among the policies studied were child access prevention laws (12 studies) and minimum age restrictions for firearm purchase and possession (4 studies). Outside of child access prevention laws, which are associated with reductions in child and adolescent unintentional and firearm suicide deaths, there is, at best, equivocal evidence of policy effects. This area is understudied, particularly in regard to nonfatal firearm injuries, for which the lack of a national surveillance system hampers research efforts. Further rigorous firearm policy evaluations are needed.
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Affiliation(s)
- April M Zeoli
- School of Criminal Justice, Michigan State University, 655 Auditorium Road, East Lansing, MI, 48824, USA.
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA.
| | - Jason Goldstick
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
- Department of Emergency Medicine, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Amanda Mauri
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Mikaela Wallin
- School of Criminal Justice, Michigan State University, 655 Auditorium Road, East Lansing, MI, 48824, USA
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Monika Goyal
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
- Children's National Medical Center, The George Washington University, Washington, DC, USA
| | - Rebecca Cunningham
- Firearm Safety Among Children and Teens Consortium, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
- Department of Emergency Medicine, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA
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