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Rehfuess E, Burns J, Ludolph R, Movsisyan A, Pfadenhauer L, Strahwald B. Public health and social measures during health emergencies such as the COVID-19 pandemic: an initial logic model to conceptualise and classify measures. Eur J Public Health 2022. [PMCID: PMC9594301 DOI: 10.1093/eurpub/ckac129.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Issue/problem In the context of the COVID-19 pandemic, public health and social measures (PHSM) are being implemented worldwide, but in very different ways. This is also due to a lacking common understanding of PHSM so far. As a result, there are limited insights regarding their components, implementation and effectiveness as well as impacts beyond health of PHSM. Description of the problem The project contributes to the WHO PHSM initiative. A logic model is being developed that offers a shared language and understanding of how PHSM are intended to achieve transmission-related outcomes, but also that non-intended consequences need to be considered. The overall approach is informed by a system-based logic model template and a staged approach to logic modeling. The development process is making use of (i) existing COVID PHSM taxonomies and related literature, (ii) existing theoretical frameworks related to complex interventions in complex systems, (iii) consultations with WHO staff and the according PHSM steering group, and (v) iterative brainstorming within the working group. Results The initial logic model is rooted in a complexity perspective which recognises that (i) all measures have both intended and unintended consequences for health and society and (ii) all elements within the logic model are interconnected and interact with each other. All PHSM operate through two basic mechanisms: reducing contacts and making contacts safer. Taken together, these two mechanisms work to reduce transmission-relevant contacts. Any specific PHSM is defined by a combination of the measure itself, the population and/or setting targeted and the mode of enactment. The central hub of the logic model connects and integrates all elements. The initial logic model was applied to school and travel measures as examples. Main messages The PHSM logic model is a conceptual basis to facilitate research on PHSM, monitoring and evaluation of PHSM, and evidence-informed decision-making.
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Affiliation(s)
- E Rehfuess
- Institute for Medical Information Processing, University of Munich , Munich, Germany
| | - J Burns
- Institute for Medical Information Processing, University of Munich , Munich, Germany
| | - R Ludolph
- High Impact Events Preparedness Unit, WHO , Geneva, Switzerland
| | - A Movsisyan
- Institute for Medical Information Processing, University of Munich , Munich, Germany
| | - L Pfadenhauer
- Institute for Medical Information Processing, University of Munich , Munich, Germany
| | - B Strahwald
- Institute for Medical Information Processing, University of Munich , Munich, Germany
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Geffert K, Rehfuess E, Rechel B. The role of public health services in implementing heat health action plans in Germany. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The rise in extreme heat periods is a major public health challenge of climate change and the World Health Organization therefore recommends the implementation of heat health action plans (HHAPs). In Germany, HHAPs are not implemented in a comprehensive manner nor nationwide. Public health authorities have been identified as key actors with regards to heat and health. This study aims at assessing the role of public health services in the implementation of HHAPs in Germany.
Methods
First, a review of the scientific and grey literature on the role of public health services in heat adaptation in Europe was conducted. Second, a policy document analysis of the legislation of Germany's federal states for public health services and their potential role in the implementation of HHAPs was carried out. Finally, semi-structured interviews with selected experts from multiple sectors at the local, federal and national level on their perception of the role of public health services in the implementation of HHAPs in Germany were undertaken.
Results
Preliminary findings show that the legal framework for public health services in the different federal states addresses environmental health and civil protection to varying extents, but that climate change-specific health risks are barely mentioned. The expert interviews revealed perceived barriers for the public health services to implement HHAPs, notably with regards to personnel (e.g. competencies, time), organizational structures (e.g. financial resources, administrative structures, legal mandates) and competing other tasks (e.g. COVID-19 response). Facilitators included motivated individuals, funding opportunities for cross-sectoral collaboration and political support.
Conclusions
The role of public health services in HHAP implementation in Germany varies widely between the different geographic settings and is influenced by several factors at the individual, organizational and political level.
Key messages
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Affiliation(s)
- K Geffert
- Public Health and Health Services Research, Ludwig-Maximilians-Universität , Munich, Germany
- Pettenkofer School of Public Health, Ludwig-Maximilians-Universität , Munich, Germany
- European Observatory, LSHTM , London, UK
| | - E Rehfuess
- Public Health and Health Services Research, Ludwig-Maximilians-Universität , Munich, Germany
- Pettenkofer School of Public Health, Ludwig-Maximilians-Universität , Munich, Germany
| | - B Rechel
- European Observatory, LSHTM , London, UK
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Hummel J, Voigt-Blaurock V, Coenen M, Klein C, Rehfuess E, Zu Rhein V, Jung-Sievers C. Einflussfaktoren der Implementierung eines Child Life
Specialist-Programms in der pädiatrischen Versorgung eines
Münchener Universitätsklinikums – eine qualitative
Interviewstudie im Rahmen der Prozessevaluation. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- J Hummel
- Klinikum der Universität München, Kinderklinik und
Kinderpoliklinik im Dr. von Haunerschen Kinderspital, München,
Deutschland
- Ludwig-Maximilians-Universität München, Lehrstuhl
für Public Health und Versorgungsforschung, Institut für
Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE),
München, Deutschland
- Pettenkofer School of Public Health, München,
Deutschland
| | - V Voigt-Blaurock
- Klinikum der Universität München, Kinderklinik und
Kinderpoliklinik im Dr. von Haunerschen Kinderspital, München,
Deutschland
| | - M Coenen
- Ludwig-Maximilians-Universität München, Lehrstuhl
für Public Health und Versorgungsforschung, Institut für
Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE),
München, Deutschland
- Pettenkofer School of Public Health, München,
Deutschland
| | - C Klein
- Klinikum der Universität München, Kinderklinik und
Kinderpoliklinik im Dr. von Haunerschen Kinderspital, München,
Deutschland
| | - E Rehfuess
- Ludwig-Maximilians-Universität München, Lehrstuhl
für Public Health und Versorgungsforschung, Institut für
Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE),
München, Deutschland
- Pettenkofer School of Public Health, München,
Deutschland
| | - V Zu Rhein
- Ludwig-Maximilians-Universität München, Lehrstuhl
für Public Health und Versorgungsforschung, Institut für
Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE),
München, Deutschland
- Pettenkofer School of Public Health, München,
Deutschland
| | - C Jung-Sievers
- Ludwig-Maximilians-Universität München, Lehrstuhl
für Public Health und Versorgungsforschung, Institut für
Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE),
München, Deutschland
- Pettenkofer School of Public Health, München,
Deutschland
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Voss S, Jung-Sievers C, Pfadenhauer LM, Rehfuess E, Selmani A, Coenen M. Entwicklung eines logischen Modells zu kommunalen Strategien der Gesundheitsförderung und Prävention am Beispiel der Präventionskette „Gut und gesund aufwachsen in Freiham“. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- S Voss
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie - IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München
- Pettenkofer School of Public Health
| | - C Jung-Sievers
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie - IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München
- Pettenkofer School of Public Health
| | - LM Pfadenhauer
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie - IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München
- Pettenkofer School of Public Health
| | - E Rehfuess
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie - IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München
- Pettenkofer School of Public Health
| | - A Selmani
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie - IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München
- Pettenkofer School of Public Health
| | - M Coenen
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie - IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München
- Pettenkofer School of Public Health
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Selmani A, Coenen M, Rehfuess E, Voss S, Jung-Sievers C, Robert M. EVIDENZBASIERTE GESUNDHEITSINDIZES UND -INDIKATOREN BEI KINDERN UND JUGENDLICHEN FÜR DIE EVALUATION VON GESUNDHEITSFÖRDERUNGSPROJEKTEN. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A Selmani
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie – IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München
- Pettenkofer School of Public Health
| | - M Coenen
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie – IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München
- Pettenkofer School of Public Health
| | - E Rehfuess
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie – IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München
- Pettenkofer School of Public Health
| | - S Voss
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie – IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München
- Pettenkofer School of Public Health
| | - C Jung-Sievers
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie – IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München
- Pettenkofer School of Public Health
| | - M Robert
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie – IBE, Lehrstuhl für Public Health und Versorgungsforschung, Ludwig-Maximilians-Universität München
- Pettenkofer School of Public Health
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Movsisyan A, Arnold L, Copeland L, Evans R, Littlecott H, Moore G, O’Cathain A, Pfadenhauer L, Segrott J, Rehfuess E. Adapting evidence-informed population health interventions for new contexts: a scoping review of current practice. Health Res Policy Syst 2021; 19:13. [PMID: 33546707 PMCID: PMC7863549 DOI: 10.1186/s12961-020-00668-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 12/06/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Implementing evidence-informed population health interventions in new contexts often requires adaptations. While the need to adapt interventions to better fit new contexts is recognised, uncertainties remain regarding why and when to adapt (or not), and how to assess the benefits (or not) of adaptation. The ADAPT Study aims to develop comprehensive guidance on adaptation. This scoping review informs guidance development by mapping and exploring how adaptation has been undertaken in practice, in public health and health services research. METHODS We searched seven databases from January 2000 and October 2018 to identify eligible studies for this scoping review and a related systematic review of adaptation guidance. We mapped the studies of adaptation by coding data from all eligible studies describing the methods, contexts, and interventions considered for adaptation. From this map, we selected a sample of studies for in-depth examination. Two reviewers extracted data independently into seven categories: description, key concepts, types, rationale, processes, evaluation methods, evaluation justification, and accounts of failures and successes. RESULTS We retrieved 6694 unique records. From 429 records screened at full text, we identified 298 eligible studies for mapping and selected 28 studies for in-depth examination. The majority of studies in our map focused on micro- (i.e., individual-) level interventions (84%), related to transferring an intervention to a new population group within the same country (62%) and did not report using guidance (73%). Studies covered a range of topic areas, including health behaviour (24%), mental health (19%), sexual health (16%), and parenting and family-centred interventions (15%). Our in-depth analysis showed that adaptation is seen to save costs and time relative to developing a new intervention, and to enhance contextual relevance and cultural compatibility. It commonly follows a structured process and involves stakeholders to help with decisions on what to adapt, when, and how. CONCLUSIONS Adaptation has been undertaken on a range of health topics and largely in line with existing guidance. Significant gaps relate to adaptation of macro- (e.g., national-) level interventions, consideration of programme theories, mechanisms and contexts (i.e., a functional view of interventions), nuances around stakeholder involvement, and evaluation of the adapted interventions. Registration Open Science Framework, 2019, osf.io/udzma.
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Affiliation(s)
- A. Movsisyan
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - L. Arnold
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - L. Copeland
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD Wales UK
| | - R. Evans
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD Wales UK
| | - H. Littlecott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD Wales UK
| | - G. Moore
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD Wales UK
| | - A. O’Cathain
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - L. Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - J. Segrott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD Wales UK
- Centre for Trials Research, Cardiff University, 4th floor Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS Wales UK
| | - E. Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
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Movsisyan A, Rehfuess E, Norris SL. When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions. BMC Med Res Methodol 2020; 20:245. [PMID: 33008285 PMCID: PMC7532611 DOI: 10.1186/s12874-020-01132-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/23/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Guidelines on public health and health system interventions often involve considerations beyond effectiveness and safety to account for the impact that these interventions have on the wider systems in which they are implemented. This paper describes how a complexity perspective may be adopted in guideline development to facilitate a more nuanced consideration of a range of factors pertinent to decisions regarding public health and health system interventions. These factors include acceptability and feasibility, and societal, economic, and equity and equality implications of interventions. MAIN MESSAGE A 5-step process describes how to incorporate a complexity perspective in guideline development with examples to illustrate each step. The steps include: (i) guideline scoping, (ii) formulating questions, (iii) retrieving and synthesising evidence, (iv) assessing the evidence, and (v) developing recommendations. Guideline scoping using stakeholder consultations, complexity features, evidence mapping, logic modelling, and explicit decision criteria is emphasised as a key step that informs all subsequent steps. CONCLUSIONS Through explicit consideration of a range of factors and enhanced understanding of the specific circumstances in which interventions work, a complexity perspective can yield guidelines with better informed recommendations and facilitate local adaptation and implementation. Further work will need to look into the methods of collecting and assessing different types of evidence beyond effectiveness and develop procedural guidance for prioritising across a range of decision criteria.
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Affiliation(s)
- A Movsisyan
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Marchioninistrasse 17, 81377, Munich, Germany. .,Pettenkofer School of Public Health, LMU Munich, Marchioninistrasse 17, 81377, Munich, Germany.
| | - E Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Marchioninistrasse 17, 81377, Munich, Germany.,Pettenkofer School of Public Health, LMU Munich, Marchioninistrasse 17, 81377, Munich, Germany
| | - S L Norris
- Science Division, Department of Quality Assurance of Norms and Standards, World Health Organization, 20 Avenue Appia, 1211, 27, Geneva, Switzerland
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Movsisyan A, Arnold L, Evans R, Hallingberg B, Moore G, O’Cathain A, Pfadenhauer LM, Segrott J, Rehfuess E. Adapting evidence-informed complex population health interventions for new contexts: a systematic review of guidance. Implement Sci 2019; 14:105. [PMID: 31847920 PMCID: PMC6918624 DOI: 10.1186/s13012-019-0956-5] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 11/28/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Adapting interventions that have worked elsewhere can save resources associated with developing new interventions for each specific context. While a developing body of evidence shows benefits of adapted interventions compared with interventions transported without adaptation, there are also examples of interventions which have been extensively adapted, yet have not worked in the new context. Decisions on when, to what extent, and how to adapt interventions therefore are not straightforward, particularly when conceptualising intervention effects as contingent upon contextual interactions in complex systems. No guidance currently addresses these questions comprehensively. To inform development of an overarching guidance on adaptation of complex population health interventions, this systematic review synthesises the content of the existing guidance papers. METHODS We searched for papers published between January 2000 and October 2018 in 7 bibliographic databases. We used citation tracking and contacted authors and experts to locate further papers. We double screened all the identified records. We extracted data into the following categories: descriptive information, key concepts and definitions, rationale for adaptation, aspects of adaptation, process of adaptation, evaluating and reporting adapted interventions. Data extraction was conducted independently by two reviewers, and retrieved data were synthesised thematically within pre-specified and emergent categories. RESULTS We retrieved 6694 unique records. Thirty-eight papers were included in the review representing 35 sources of guidance. Most papers were developed in the USA in the context of implementing evidence-informed interventions among different population groups within the country, such as minority populations. We found much agreement on how the papers defined key concepts, aims, and procedures of adaptation, including involvement of key stakeholders, but also identified gaps in scope, conceptualisation, and operationalisation in several categories. CONCLUSIONS Our review found limitations that should be addressed in future guidance on adaptation. Specifically, future guidance needs to be reflective of adaptations in the context of transferring interventions across countries, including macro- (e.g. national-) level interventions, better theorise the role of intervention mechanisms and contextual interactions in the replicability of effects and accordingly conceptualise key concepts, such as fidelity to intervention functions, and finally, suggest evidence-informed strategies for adaptation re-evaluation and reporting. TRIAL REGISTRATION PROSPERO 2018, CRD42018112714.
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Affiliation(s)
- A. Movsisyan
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
- Pettenkofer School of Public Health, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
| | - L. Arnold
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
- Pettenkofer School of Public Health, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
| | - R. Evans
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, CF10 3BD Cardiff, Wales UK
| | - B. Hallingberg
- Cardiff School of Sport & Health Sciences, Llandaff Campus, Cardiff Metropolitan University, Western Avenue, Cardiff, CF5 2YB Wales UK
| | - G. Moore
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, CF10 3BD Cardiff, Wales UK
| | - A. O’Cathain
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 20 Regent Street, S1 4DA Sheffield, UK
| | - L. M. Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
- Pettenkofer School of Public Health, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
| | - J. Segrott
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, CF10 3BD Cardiff, Wales UK
| | - E. Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
- Pettenkofer School of Public Health, LMU Munich, Marchioninistrasse 17, 81377 Munich, Germany
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Burford BJ, Rehfuess E, Schunemann HJ, Akl EA, Waters E, Armstrong R, Thomson H, Doyle J, Pettman T. Assessing evidence in public health: the added value of GRADE. J Public Health (Oxf) 2012; 34:631-5. [DOI: 10.1093/pubmed/fds092] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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