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Antonelli M, Donelli D, Carlone L, Maggini V, Firenzuoli F, Bedeschi E. Effects of forest bathing (shinrin-yoku) on individual well-being: an umbrella review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:1842-1867. [PMID: 33910423 DOI: 10.1080/09603123.2021.1919293] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/15/2021] [Indexed: 06/12/2023]
Abstract
The aim of this review was to outline the most relevant benefits of forest bathing for well-being promotion. This study was designed as an umbrella literature review. Medline (via PubMed), EMBASE, Web of Science, Cochrane Library, Google Scholar, Scopus, PsycINFO, CINAHL and the DOAJ were systematically searched for relevant reviews up to February 2021. After article selection, 16 systematic reviews met inclusion criteria. Overall, the best available evidence supports the use of forest bathing as a complementary practice for the promotion of psychophysical well-being, whereas evidence for its use as a therapeutic practice for the improvement of organic diseases needs to grow before clear and specific clinical indications can be formulated. The positive impact of forest bathing on individual quality of life, along with its favorable cost-effectiveness profile, may justify its possible adoption for public health strategies of well-being promotion. Further investigations on the topic are advised.
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Affiliation(s)
| | - Davide Donelli
- Local Public Health Authority, AUSL-IRCCS, Reggio Emilia, Italy
| | - Lucrezia Carlone
- Department of Medicine and Surgery, University of Parma , Parma, Italy
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Movsisyan A, Dennis J, Rehfuess E, Grant S, Montgomery P. Rating the quality of a body of evidence on the effectiveness of health and social interventions: A systematic review and mapping of evidence domains. Res Synth Methods 2018; 9:224-242. [PMID: 29346709 PMCID: PMC6001464 DOI: 10.1002/jrsm.1290] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 12/11/2017] [Accepted: 01/07/2018] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Rating the quality of a body of evidence is an increasingly common component of research syntheses on intervention effectiveness. This study sought to identify and examine existing systems for rating the quality of a body of evidence on the effectiveness of health and social interventions. METHODS We used a multicomponent search strategy to search for full-length reports of systems for rating the quality of a body of evidence on the effectiveness of health and social interventions published in English from 1995 onward. Two independent reviewers extracted data from each eligible system on the evidence domains included, as well as the development and dissemination processes for each system. RESULTS Seventeen systems met our eligibility criteria. Across systems, we identified 13 discrete evidence domains: study design, study execution, consistency, measures of precision, directness, publication bias, magnitude of effect, dose-response, plausible confounding, analogy, robustness, applicability, and coherence. We found little reporting of rigorous procedures in the development and dissemination of evidence rating systems. CONCLUSION We identified 17 systems for rating the quality of a body of evidence on intervention effectiveness across health and social policy. Existing systems vary greatly in the domains they include and how they operationalize domains, and most have important limitations in their development and dissemination. The construct of the quality of the body of evidence was defined in a few systems largely extending the Grading of Recommendations Assessment, Development, and Evaluation approach. Grading of Recommendations Assessment, Development, and Evaluation was found to be unique in its comprehensive guidance, rigorous development, and dissemination strategy.
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Affiliation(s)
- Ani Movsisyan
- Department of Social Policy and InterventionUniversity of OxfordOxfordOX1 2ERUK
| | - Jane Dennis
- London School of Hygiene and Tropical MedicineLondonWC1E 7HTUK
| | - Eva Rehfuess
- Institute for Medical Informatics, Biometry and EpidemiologyLudwig‐Maximilians‐UniversityMunich81377Germany
| | - Sean Grant
- RAND CorporationSanta MonicaCA90407‐2138USA
| | - Paul Montgomery
- Department of Social Policy, Sociology and CriminologyUniversity of BirminghamEdgbastonBirminghamB15 2TTUK
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Liabsuetrakul T, Suntharasaj T, Sangsupawanich P, Kongkamol C, Pornsawat P. Implementation of evidence-based medicine in a health promotion teaching block for Thai medical students. Glob Health Promot 2016; 24:62-68. [PMID: 27154911 DOI: 10.1177/1757975915626871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Evidence-based medicine (EBM) is well known in medical practice. Although health promotion (HP) is promoted worldwide, there is still some debate as to whether EBM is needed or useful in the teaching of health promotion. OBJECTIVE To assess the perceived usefulness of EBM in the teaching of HP among medical students and faculty members. METHODS A comparative study was conducted between two groups of fourth-year medical students in the academic year 2012 during the five-week Health Promotion Teaching Block at Prince of Songkla University, southern Thailand. A one-week EBM course was conducted with half the students in the first week of the block and the other half of the students in the last week of the block. All activities in the HP block were similar except for the different periods of the one-week of EBM teaching. The effect on knowledge, ability and perceived application of EBM in future practice was assessed by student self-evaluations before versus after taking the EBM course, and by faculty member evaluation of the students' end-of-block presentations. All evaluation items were rated from 1 (lowest) to 5 (highest). Data were analyzed using a t-test or Wilcoxon test, as appropriate. RESULTS The students' self-evaluations of knowledge and ability on EBM between the two groups were similar. The perception that teaching EBM is beneficial in health promotion and future practice increased significantly ( p<0.001) in both groups. Faculty members rated higher scores for the first group than the second group, although the rating differences were not at the level of significance. Ninety percent of the students believed that EBM was a useful addition to the teaching of HP. CONCLUSIONS Medical students and faculty members perceived that EBM is useful in the HP context. Future studies to evaluate the effect of using evidence-based teaching for health promotion are needed.
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Affiliation(s)
- Tippawan Liabsuetrakul
- 1. Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Thitima Suntharasaj
- 2. Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Pasuree Sangsupawanich
- 3. Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Chanon Kongkamol
- 4. Department of Community Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Panumad Pornsawat
- 5. Division of Medical Education, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Abstract
Over the last decade, there has been a marked increase in studies about built environments and physical activity. As the number of publications is growing rapidly, literature reviews play an important role in identifying primary studies and in synthesizing their findings. However, many of the reviews of effectiveness in this field demonstrate methodological limitations that might lead to inaccurate portrayals of the evidence. Some literature reviews a priori excluded intervention studies even though they provide the strongest level of evidence. The label 'systematic review' has mostly been used inappropriately. One of the major criteria of a systematic review that is hardly ever met is that the quality of the primary studies needs to be assessed and this should be reflected in the synthesis, presentation and interpretation of results. With few exceptions, 'systematic' reviews about environments and physical activity did not refer to or follow the QUORUM or PRISMA statements. This commentary points out the usefulness of the PRISMA statement to standardize the reporting of methodology of reviews and provides additional guidance to limit sources of bias in them. The findings and recommendations from this article can help in moving forward the synthesis of evidence of effectiveness not only in built environments and physical activity, but also more broadly in exercise science and public health.
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Attena F. Complexity and indeterminism of evidence-based public health: an analytical framework. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2014; 17:459-465. [PMID: 24634100 DOI: 10.1007/s11019-014-9554-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Improving the evidence in public health is an important goal for the health promotion community. With better evidence, health professionals can make better decisions to achieve effectiveness in their interventions. The relative failure of such evidence in public health is well-known, and it is due to several factors. Briefly, from an epistemological point of view, it is not easy to develop evidence-based public health because public health interventions are highly complex and indeterminate. This paper proposes an analytical explanation of the complexity and indeterminacy of public health interventions in terms of 12 points. Public health interventions are considered as a causal chain constituted by three elements (intervention, risk factor, and disease) and two levels of evaluation (risk factor and disease). Public health interventions thus differ from clinical interventions, which comprise two causal elements and one level of evaluation. From the two levels of evaluation, we suggest a classification of evidence into four typologies: evidence of both relations; evidence of the second (disease) but not of the first (risk factor) relation; evidence of the first but not of the second relation; and no evidence of either relation. In addition, a grading of indeterminacy of public health interventions is introduced. This theoretical point of view could be useful for public health professionals to better define and classify the public health interventions before acting.
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Combes M, Price K. Hip protectors: are they beneficial in protecting older people from fall-related injuries? J Clin Nurs 2013; 23:13-23. [PMID: 23551704 DOI: 10.1111/jocn.12193] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2012] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To report findings of an investigation into the methodological quality of research informing the use of hip protectors for those clients in residential aged care considered to be at high risk of falls and to contribute to the translation of research evidence into practice by identifying issues surrounding the use of hip protectors in practice. BACKGROUND Falls risk is a predominant concern when nursing older people, especially those in residential aged care. Fall-related injuries, specifically pertaining to the hip, yield a high cost to the individual both physically and psychologically. Accordingly, hip protectors are argued in related literature as a form of protection against such injuries. DESIGN A database search as per a specified search strategy was conducted for quantitative research publications and randomised control trials. METHODS English language publications were sought from the year 2000-2011. Searches were made, using specific combinations of keywords, in the following databases: MEDLINE via OvidSP, CINAHL via EBSCOHost, Ageline via OvidSP, Cochrane Library, The Joanna Briggs Institute and Google Scholar. RESULTS Six articles were selected for review. Methodological quality of the research publications collated varied, and the use of hip protectors was deemed inconclusive. Compliance was raised as a prevailing issue. CONCLUSION The problem of fall-related injuries is significant. Whilst some evidence is inconclusive, the use of hip protectors is recommended as best practice. RELEVANCE TO CLINICAL PRACTICE The issue of compliance, however, was identified to affect the use of appliances in residential aged care. Addressing compliance issues must be tackled if hip protectors are to be part of a resident-centred approach.
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Affiliation(s)
- Margot Combes
- Southern Cross Care (Tas) Inc., Moonah, Hobart, Tas, Australia
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Baral SD, Wirtz A, Sifakis F, Johns B, Walker D, Beyrer C. The highest attainable standard of evidence (HASTE) for HIV/AIDS interventions: toward a public health approach to defining evidence. Public Health Rep 2013; 127:572-84. [PMID: 23115382 DOI: 10.1177/003335491212700607] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Evidence-driven decisions have become a standard for health interventions, policy, and programs. While randomized controlled trials (RCTs) are encouraged for public health interventions, there are limitations with RCTs as the gold standard of evidence for HIV interventions. We developed a novel system of evaluating evidence for assessing HIV preventive interventions termed the Highest Attainable Standard of Evidence (HASTE). METHODS The HASTE system focuses on triangulation of three distinct categories of evidence: efficacy data, implementation data, and plausibility. We conducted systematic reviews, including experimental and observational data, to assess all available interventions for men who have sex with men (MSM). We collected implementation and programmatic data using a global electronic consultation, Internet searches, and in-person consultations. We assessed plausibility with expert analyses of both biological and public health evidence. RESULTS HASTE includes four grades of evidence: Strong (Grade 1), Conditional (Grade 2), Insufficient (Grade 3), and Inappropriate (Grade 4). We used the HASTE system to evaluate the evidence for HIV interventions for MSM in low- and middle-income countries. Several differences emerged in the strength of recommendation with the use of the HASTE system, including strong recommendations for voluntary counseling and testing and for structural interventions. CONCLUSIONS The HASTE system addresses a need for an evidence evaluation tool that is specific for HIV interventions and facilitates an evaluation of biomedical, behavioral, and structural approaches using the highest standard of attainable evidence. HASTE represents a tool that balances scientific integrity and practicality in assessing the quality of evidence of preventive interventions targeting the most-at-risk populations for HIV.
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Affiliation(s)
- Stefan D Baral
- Johns Hopkins School of Public Health, Department of Epidemiology, Center for Public Health and Human Rights, Baltimore, MD 21205, USA.
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Luoto J, Maglione MA, Johnsen B, Chang C, S Higgs E, Perry T, Shekelle PG. A comparison of frameworks evaluating evidence for global health interventions. PLoS Med 2013; 10:e1001469. [PMID: 23874159 PMCID: PMC3706307 DOI: 10.1371/journal.pmed.1001469] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Jill Luoto and colleagues apply different frameworks to the same body of evidence for three advocated global health interventions and compare the ratings and policy recommendations resulting from each. Please see later in the article for the Editors' Summary
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Affiliation(s)
- Jill Luoto
- Southern California Evidence Based Practice Center, Rand Health, Santa Monica, California, United States of America.
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Higgs ES, Zlidar VM, Balster RL. Evidence acquisition and evaluation for a U.S. Government Evidence Summit on Protecting Children Outside Family Care. CHILD ABUSE & NEGLECT 2012; 36:689-700. [PMID: 23083899 DOI: 10.1016/j.chiabu.2012.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 09/07/2012] [Indexed: 05/27/2023]
Abstract
Recognizing the need for evidence to inform policies, strategies, and programs to care for vulnerable children, the U.S. Government convened an Evidence Summit on Protecting Children Outside of Family Care on December 12-13, 2011, in Washington, DC, USA. This paper summarizes the background and methods for the acquisition and evaluation of the evidence used to achieve the goals of the Summit. A multistep process was undertaken to identify the appropriate evidence for review. It began by identifying crucial focal questions intended to inform low and middle income governments and the U.S. Government about effective systems for protecting children outside family care. This was followed by a systematic attempt to gather relevant peer reviewed and gray literature that would inform these focal questions. The search processes, methods used for screening and quality reviews are described. In addition, members of the Evidence Review Teams were invited to add relevant papers not identified in the initial literature review to complete the bibliographies. These teams were asked to comply with a specific evaluation framework for recommendations on practice and policy based on both expert opinion and the quality of the data. This was the first U.S. Government Evidence Summit originating in the U.S. Agency for International Development Global Health Bureau and valuable lessons were learned on the identification and assessment of evidence informing complex development challenges.
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Affiliation(s)
- Elizabeth S Higgs
- Global Health Bureau, U.S. Agency for International Development, Washington, DC, USA.
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Akl EA, Kennedy C, Konda K, Caceres CF, Horvath T, Ayala G, Doupe A, Gerbase A, Wiysonge CS, Segura ER, Schünemann HJ, Lo YR. Using GRADE methodology for the development of public health guidelines for the prevention and treatment of HIV and other STIs among men who have sex with men and transgender people. BMC Public Health 2012; 12:386. [PMID: 22640260 PMCID: PMC3490932 DOI: 10.1186/1471-2458-12-386] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2011] [Accepted: 03/21/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) Department of HIV/AIDS led the development of public health guidelines for delivering an evidence-based, essential package of interventions for the prevention and treatment of HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM) and transgender people in the health sector in low- and middle-income countries. The objective of this paper is to review the methodological challenges faced and solutions applied during the development of the guidelines. METHODS The development of the guidelines followed the WHO guideline development process, which utilizes the GRADE approach. We identified, categorized and labeled the challenges identified in the guidelines development process and described the solutions through an interactive process of in-person and electronic communication. RESULTS We describe how we dealt with the following challenges: (1) heterogeneous and complex interventions; (2) paucity of trial data; (3) selecting outcomes of interest; (4) using indirect evidence; (5) integrating values and preferences; (6) considering resource use; (7) addressing social and legal barriers; (8) wording of recommendations; and (9) developing global guidelines. CONCLUSION We were able to successfully apply the GRADE approach for developing recommendations for public health interventions. Applying the general principles of the approach while carefully considering specific challenges can enhance both the process and the outcome of guideline development.
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Affiliation(s)
- Elie A Akl
- Department of Medicine, State University of New York at Buffalo, NY, USA.
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Disseminating evidence from research and practice: a model for selecting evidence to guide obesity prevention. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2012; 17:133-40. [PMID: 21297408 DOI: 10.1097/phh.0b013e3181e39eaa] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Carter SM, Rychetnik L, Lloyd B, Kerridge IH, Baur L, Bauman A, Hooker C, Zask A. Evidence, ethics, and values: a framework for health promotion. Am J Public Health 2011; 101:465-72. [PMID: 21233436 PMCID: PMC3036693 DOI: 10.2105/ajph.2010.195545] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2010] [Indexed: 11/04/2022]
Abstract
We propose a new approach to guide health promotion practice. Health promotion should draw on 2 related systems of reasoning: an evidential system and an ethical system. Further, there are concepts, values, and procedures inherent in both health promotion evidence and ethics, and these should be made explicit. We illustrate our approach with the exemplar of intervention in weight, and use a specific mass-media campaign to show the real-world dangers of intervening with insufficient attention to ethics and evidence. Both researchers and health promotion practitioners should work to build the capacities required for evidential and ethical deliberation in the health promotion profession.
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Affiliation(s)
- Stacy M Carter
- Centre for Values, Ethics and the Law in Medicine and Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
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