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Thapa S, Ogunleye TT, Shrestha R, Joshi R, Hannes K. Increased Stigma, and Physical and Sexual Violence Against Men Who Have Sex with Men and Transgender Women in Sub-Saharan Africa: A Qualitative Evidence Synthesis Analyzing Social and Structural Barriers to HIV Testing and Coping Behaviors. J Homosex 2024:1-27. [PMID: 38456684 DOI: 10.1080/00918369.2024.2320237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
In sub-Saharan Africa, accessing HIV testing services is a significant challenge for men who have sex with men (MSM) and transgender women (TGW). In this qualitative evidence synthesis, our aim is to understand social and structural barriers and how they hinder MSM's and TGW's access to HIV testing services in sub-Saharan African countries. We searched four selective databases (PubMed, Web of Science and CINAHL complemented with Google Scholar) for qualitative studies, published in English between January 2005 and December 2023, generated 1507 articles, of which 22 were included. Thematic synthesis was conducted for data synthesis. This led to five barriers that hinder HIV test uptake among MSM and TGW, which included: non-availability of tailored HIV testing services, stigma, lack of trust among service providers, sexual and physical violence, and criminalization of same sex relationship. To navigate these social and structural barriers and cope with fears of discrimination and criminalization, MSM and TGW engaged into riskier behaviors, including avoiding HIV testing, non-disclosure, or relying on informal or alternative sources of HIV testing. Decriminalization of same-sex relationship and peer-led HIV testing services were noted to address structural barriers, including stigma and poor access, and subsequently increase the participation in HIV testing services.
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Affiliation(s)
- Subash Thapa
- Rural Health Research Institute, Charles Sturt University, Orange, Australia
| | - Tadese Tewogbola Ogunleye
- Unit for Health Promotion, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Roman Shrestha
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ranjila Joshi
- Unit for Health Promotion, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Karin Hannes
- Research Group SoMeTHin'K (Social, Methodological and Theoretical Innovation/Kreative), Faculty of Social Sciences, Katholieke Universiteit, Leuven, Belgium
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Bekkering GE, Corremans M, Gemignani M, Gerber N, Godderis L, Kaewma S, Khammathit A, Steel J, Hannes K. Culture-based prescribing to improve mental health: a scoping review protocol. JBI Evid Synth 2023; 21:1679-1686. [PMID: 36999382 DOI: 10.11124/jbies-22-00211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
OBJECTIVE The objective of this review is to investigate what is known about culture-based prescribing to improve mental health and well-being. INTRODUCTION Culture-based prescribing, where a person is referred by a clinical professional to an arts or cultural activity aimed at improving mental health and well-being, is increasingly used as a community-based source of support. Although culture-based prescribing seems promising, the field is heterogeneous with respect to definition, underlying hypotheses, and cultural activity. This hampers its further development and implementation. INCLUSION CRITERIA We will consider publications that report on or explore culture-based prescribing to improve mental health and well-being for adults with symptoms related to mental health conditions who are seeking care from any clinical professional. METHODS We will search 8 electronic literature databases for published or unpublished reports on culture-based prescribing, without date limits. We will also search for gray literature and screen reference lists of relevant reviews. No language restrictions will be applied during the screening process, but for data extraction, we will only extract studies in languages our team has proficiency in. The screening and data extraction will be performed by 2 reviewers, independently. Data analysis will be descriptive, with results tabulated separately for each subquestion. The results will be complemented with a narrative summary. REVIEW REGISTRATION Open Science Framework https://osf.io/ndbqj.
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Affiliation(s)
- Geertruida E Bekkering
- JBI Belgium: A JBI Affiliated Group, Leuven, Belgium
- Department of Public Health and Primary Care, KU Leuven, Belgium
| | - Marleen Corremans
- JBI Belgium: A JBI Affiliated Group, Leuven, Belgium
- Karel de Grote University of Applied Sciences and Arts, Antwerp, Belgium
| | | | - Nancy Gerber
- Department of Art Education, Art Therapy Program, Florida State University, Tallahassee, Florida, USA
| | - Lode Godderis
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Group IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
| | - Sumuttana Kaewma
- The Centre for Nursing Education BCNU Thailand: A JBI Affiliated Group, Boromarajonani College of Nursing, Udon Thani, Thailand
| | - Adchara Khammathit
- The Centre for Nursing Education BCNU Thailand: A JBI Affiliated Group, Boromarajonani College of Nursing, Udon Thani, Thailand
| | - Jonas Steel
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Karin Hannes
- JBI Belgium: A JBI Affiliated Group, Leuven, Belgium
- Research Group SoMeTHin'K, Faculty of Social Science, KU Leuven, Leuven, Belgium
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Bengough T, Sommer I, Hannes K. The CONSENSYS approach: An instrument to support CONtextual SENsitivity in SYStematic reviews. Res Synth Methods 2023; 14:266-282. [PMID: 36513598 DOI: 10.1002/jrsm.1615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 11/14/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
Contextual factors such as cultural values and traditions impact on implementation processes of healthcare interventions. It is one of the reasons why local stakeholders may decide to role out a programme differently from how it has originally been developed or described in scientific literature. This can result in different but most likely more context-specific outcomes. Systematic reviews are considered important in answering what works, for whom and in which circumstances. They often include a section on implications for policymakers and practitioners, in which they discuss relevant options to engage with. Implementation sections are coloured by the cultural background, theoretical and disciplinary perspective of the reviewers formulating them. They do not necessarily consider local contexts in which the evidence needs to be applied, hence the recommendations may be too general to be useful. When policy makers and practitioners implement systematic review findings the evidence presented needs to be translated to their local context. We propose CONSENSYS, an instrument that facilitates the transfer from review evidence into practice. CONSENSYS contains 52 contextual factors categorised as either of ecological and socio-cultural relevance or pitched as influencing actor. CONSENSYS is relevant for reviewers because it supports them in structuring and formulating context-sensitive implications sections. It may also guide end-users of systematic reviews in translating review evidence for use in local policies and practices. CONSENSYS is the first rigorously developed instrument that focusses on implications for policy and practice sections in systematic reviews.
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Affiliation(s)
- Theresa Bengough
- Faculty of Social Sciences, KU Leuven, Research Group SoMeTHin'K (Social, Methodological and Theoretical Innovation/Kreative), Leuven, Belgium.,National Centre for Early Childhood Intervention, Austrian National Public Health Institute, Vienna, Austria
| | - Isolde Sommer
- Department for Evidence-based Medicine, University for Continuing Education Krems, Krems, Austria
| | - Karin Hannes
- Faculty of Social Sciences, KU Leuven, Research Group SoMeTHin'K (Social, Methodological and Theoretical Innovation/Kreative), Leuven, Belgium
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Macura B, Foggitt E, Liera C, Soto A, Orlando A, Del Duca L, Carrard N, Hannes K, Sommer M, Dickin S. Systematic mapping of gender equality and social inclusion in WASH interventions: knowledge clusters and gaps. BMJ Glob Health 2023; 8:bmjgh-2022-010850. [PMID: 36693669 PMCID: PMC9884933 DOI: 10.1136/bmjgh-2022-010850] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 10/03/2022] [Accepted: 12/29/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Poor access to water, sanitation and hygiene (WASH) services threatens population health and contributes to gender and social inequalities, especially in low-resource settings. Despite awareness in the WASH sector of the importance of promoting gender equality and social inclusion (GESI) to address these inequalities, evaluations of interventions focus largely on health outcomes, while gender equality and other social outcomes are rarely included. This review aimed to collate and describe available research evidence of GESI outcomes evaluated in WASH intervention studies. METHODS We applied a systematic mapping methodology and searched for both academic and grey literature published between 2010 and 2020 in 16 bibliographic databases and 53 specialist websites. Eligibility screening (with consistency checking) was conducted according to predetermined criteria, followed by metadata coding and narrative synthesis. RESULTS Our evidence base comprises 463 intervention studies. Only 42% of studies measured transformative GESI outcomes of WASH interventions, referring to those that seek to transform gender relations and power imbalances to promote equality. A majority of studies disaggregated outcome data by sex, but other forms of data disaggregation were limited. Most included studies (78%) lacked a specific GESI mainstreaming component in their intervention design. Of the interventions with GESI mainstreaming, the majority targeted women and girls, with very few focused on other social groups or intersectional considerations. CONCLUSION The review points to various areas for future primary and secondary research. Given the potential contribution of WASH to GESI, GESI considerations should be incorporated into the evaluation of WASH interventions. Regular collection of data and monitoring of GESI outcomes is needed as well as developing new and testing existing methods for monitoring and evaluation of such data.
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Affiliation(s)
| | - Ella Foggitt
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - Carla Liera
- Stockholm Environment Institute, Stockholm, Sweden
| | - Adriana Soto
- Stockholm Environment Institute, Stockholm, Sweden
| | - Arianna Orlando
- Department of Politics and Public Administration, University of Konstanz, Konstanz, Germany
| | | | - Naomi Carrard
- Institute for Sustainable Futures, University of Technology Sydney, Broadway, Sydney, Australia
| | - Karin Hannes
- Research Group SoMeTHin’K, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
| | - Marni Sommer
- Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Sarah Dickin
- Stockholm Environment Institute, Stockholm, Sweden,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Bengough T, Dawson S, Cheng H, McFadden A, Gavine A, Rees R, Sacks E, Hannes K. Factors that influence women's engagement with breastfeeding support: A qualitative evidence synthesis. Matern Child Nutr 2022; 18:e13405. [PMID: 36006012 PMCID: PMC9480951 DOI: 10.1111/mcn.13405] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/05/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022]
Abstract
Breastfeeding is an integral part of early childhood interventions as it can prevent serious childhood and maternal illnesses. For breastfeeding support programmes to be effective, a better understanding of contextual factors that influence women's engagement and satisfaction with these programmes is needed. The aim of this synthesis is to suggest strategies to increase the level of satisfaction with support programmes and to better match the expectations and needs of women. We systematically searched for studies that used qualitative methods for data collection and analysis and that focused on women's experiences and perceptions regarding breastfeeding support programmes. We applied a maximum variation purposive sampling strategy and used thematic analysis. We assessed the methodological quality of the studies using a modified version of the CASP tool and assessed our confidence in the findings using the GRADE-CERQual approach. We included 51 studies of which we sampled 22 for in-depth analysis. Our sampled studies described the experiences of women with formal breastfeeding support by health care professionals in a hospital setting and informal support as for instance from community support groups. Our findings illustrate that the current models of breastfeeding support are dependent on a variety of contextual factors encouraging and supporting women to initiate and continue breastfeeding. They further highlight the relevance of providing different forms of support based on socio-cultural norms and personal backgrounds of women, especially if the support is one-on-one. Feeding decisions of women are situated within a woman's personal situation and may require diverse forms of support.
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Affiliation(s)
- Theresa Bengough
- Research Group SoMeTHin'K (Social, Methodological and Theoretical Innovation/Kreative), Faculty of Social SciencesKU LeuvenLeuvenBelgium
- National Centre for Early Childhood InterventionThe Austrian Public Health InstituteViennaAustria
| | - Shoba Dawson
- Faculty of Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Hui‐Lin Cheng
- School of NursingThe Hong Kong Polytechnic UniversityKowloonHong Kong
| | - Alison McFadden
- School of Health SciencesUniversity of DundeeDundeeScotlandUK
| | - Anna Gavine
- School of Health SciencesUniversity of DundeeDundeeScotlandUK
| | - Rebecca Rees
- EPPI‐Centre, Social Science Research Unit, UCL Institute of EducationUniversity College LondonLondonUK
| | - Emma Sacks
- Department of International HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Karin Hannes
- Research Group SoMeTHin'K (Social, Methodological and Theoretical Innovation/Kreative), Faculty of Social SciencesKU LeuvenLeuvenBelgium
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Hendricks LA, Young T, Van Wyk SS, Matheï C, Hannes K. Storyboarding HIV Infected Young People's Adherence to Antiretroviral Therapy in Lower- to Upper Middle-Income Countries: A New-Materialist Qualitative Evidence Synthesis. Int J Environ Res Public Health 2022; 19:11317. [PMID: 36141589 PMCID: PMC9517626 DOI: 10.3390/ijerph191811317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/16/2023]
Abstract
Young people living with perinatal infections of Human Immunodeficiency Virus (YLPHIV) face a chronic disease, with treatment including adherence to lifelong antiretroviral treatment (ART). The aim of this QES was to explore adherence to ART for YLPHIV as an assemblage within the framework of the biopsychosocial model with a new materialist perspective. We searched up to November 2021 and followed the ENTREQ and Cochrane guidelines for QES. All screening, data extraction, and critical appraisal were done in duplicate. We analysed and interpreted the findings innovatively by creating images of meaning, a storyboard, and storylines. We then reported the findings in a first-person narrative story. We included 47 studies and identified 9 storylines. We found that treatment adherence has less to do with humans' preferences, motivations, needs, and dispositions and more to do with how bodies, viruses, things, ideas, institutions, environments, social processes, and social structures assemble. This QES highlights that adherence to ART for YLPHIV is a multisensorial experience in a multi-agentic world. Future research into rethinking the linear and casual inferences we are accustomed to in evidence-based health care is needed if we are to adopt multidisciplinary approaches to address pressing issues such as adherence to ART.
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Affiliation(s)
- Lynn A. Hendricks
- Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, Cape Town 3000, South Africa
- Research Group SoMeTHin’K (Social, Methodological and Theoretical Innovation/Kreative), Faculty of Social Sciences, Katholieke Universiteit, 3000 Leuven, Belgium
| | - Taryn Young
- Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, Cape Town 3000, South Africa
| | - Susanna S. Van Wyk
- Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, Cape Town 3000, South Africa
| | - Catharina Matheï
- Department of Public Health and Primary Care, Katholieke Universiteit, 3000 Leuven, Belgium
| | - Karin Hannes
- Research Group SoMeTHin’K (Social, Methodological and Theoretical Innovation/Kreative), Faculty of Social Sciences, Katholieke Universiteit, 3000 Leuven, Belgium
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Elfeky A, Treweek S, Hannes K, Bruhn H, Fraser C, Gillies K. Using qualitative methods in pilot and feasibility trials to inform recruitment and retention processes in full-scale randomised trials: a qualitative evidence synthesis. BMJ Open 2022; 12:e055521. [PMID: 35437247 PMCID: PMC9016401 DOI: 10.1136/bmjopen-2021-055521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 03/28/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To systematically review published pretrial qualitative research studies and explore how their findings were used to inform recruitment and retention processes in full-scale trials. DESIGN Qualitative evidence synthesis using thematic analysis. DATA SOURCES AND ELIGIBILITY CRITERIA We conducted a comprehensive search of databases; Dissertation Abstracts International, CINAHL, Embase, MEDLINE, Sociological Abstracts and PsycINFO. We included all reports of pretrial qualitative data on recruitment and retention in clinical trials up to March 2018. DATA EXTRACTION AND SYNTHESIS Two authors independently extracted data using a predefined data extraction form that captured study aims, design, methodological approach and main findings, including barriers and facilitators to recruitment and or retention. The synthesis was undertaken using Thomas and Harden's thematic synthesis method and reported following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines. Confidence was assessed using Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research approach. RESULTS Thirty-five papers (connected to 31 feasibility studies) from three different countries, published between 2010 and 2017 were included. All studies were embedded in pilot or feasibility studies to inform design aspects in preparation for a subsequent full-scale trial. Twelve themes were identified as recruitment barriers and three as recruitment facilitators. Two themes were identified as barriers for retention and none as retention facilitators. The findings from qualitative research in feasibility or pilot trials are often not explicitly linked to proposed changes to the recruitment and retention strategies to be used in the future or planned full-scale trial. CONCLUSIONS Many trial teams do pretrial qualitative work with the aim of improving recruitment and retention in future full-scale trials. Just over half of all reports of such work do not clearly show how their findings will change the recruitment and retention strategy of the future trial. The scope of pretrial work needs to expand beyond looking for problems and also look for what might help and spend more time on retention.
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Affiliation(s)
- Adel Elfeky
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Karin Hannes
- Research Group SoMeTHin'K, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
| | - Hanne Bruhn
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Cynthia Fraser
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Du KJ, Li GS, Zhang K, Lin Y, Yang F, Hannes K. Prof. Karin Hannes: COREQ (Consolidated Criteria for Reporting Qualitative Studies). Ann Transl Med 2022; 10:1073. [PMID: 36330400 PMCID: PMC9622469 DOI: 10.21037/atm-2022-23] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Kathy J. Du
- ATM Editorial Office, AME Publishing Company;
| | - Grace S. Li
- ATM Editorial Office, AME Publishing Company;
| | | | - Yao Lin
- ATM Editorial Office, AME Publishing Company;
| | | | - Karin Hannes
- Social Research Methodology Group, Faculty of Social Sciences, Leuven, Belgium
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Macura B, Del Duca L, Soto A, Carrard N, Gosling L, Hannes K, Thomas J, Sara L, Sommer M, Waddington HS, Dickin S. PROTOCOL: What is the impact of complex WASH interventions on gender and social equality outcomes in low- and middle-income countries? A mixed-method systematic review protocol. Campbell Syst Rev 2021; 17:e1164. [PMID: 37051177 PMCID: PMC8356345 DOI: 10.1002/cl2.1164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Affiliation(s)
| | - Laura Del Duca
- Stockholm Environment InstituteStockholmSweden
- Institute of Development StudiesUniversity of SussexBrightonUK
| | | | - Naomi Carrard
- Institute for Sustainable FuturesUniversity of TechnologySydneyAustralia
| | | | - Karin Hannes
- Research group SoMeTHin'K (Social, Methodological and Theoretical Innovation Kreative), CESO, Faculty of Social SciencesKU LeuvenLeuvenBelgium
| | - James Thomas
- Department of Social Science, EPPI‐CentreUCL Institute of EducationLondonUK
| | | | - Marni Sommer
- Department of Sociomedical Sciences, Mailman School of Public HealthColumbia UniversityNew York CityNew YorkUSA
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Dierckx C, Hendricks L, Coemans S, Hannes K. The third sphere: Reconceptualising allyship in community-based participatory research praxis. Qualitative Research in Psychology 2020. [DOI: 10.1080/14780887.2020.1854402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Lynn Hendricks
- Katholieke Universiteit Leuven, Belgium
- Centre for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Sara Coemans
- Laboratory for Education and Society, Faculty of Psychology and Educational Sciences, Katholieke Universiteit Leuven, Belgium
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Santens T, Hannes K, Levy S, Diamond G, Bosmans G. Barriers and Facilitators to Implementing Attachment-based Family Therapy into a Child Welfare Setting: A Qualitative Process Evaluation. Fam Process 2020; 59:1483-1497. [PMID: 31823356 DOI: 10.1111/famp.12504] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Child welfare systems (CWSs) worldwide show increased interest in adopting empirically informed clinical strategies to increase treatment effectiveness. Many empirically supported treatments (ESTs) exist, but little is known about EST implementation barriers and facilitators in CWS. This study explored CWS providers' experiences of implementing attachment-based family therapy (ABFT) in home-based services of the Flemish CWS (in Belgium). Sixteen CWS providers (twelve counselors and four supervisors) involved in three home-based services were interviewed. The Consolidated Framework for Implementation Research (CFIR) was used to guide collection, coding, and analysis of interview data. Findings revealed that implementation success was related to ABFT's fit with the CWS's mission, philosophy, and existing practices. CWS providers' belief in the compatibility between ABFT and CWS increased investment in implementation efforts and persistence to overcome challenges and setbacks. Some barriers pertained to the learning of ABFT and some barriers pertained to systems level challenges such as lack of leadership and support, poor coordination with referral sources and other youth care partners, and lack of policy support. For successful expansion of ESTs into CWS settings, various barriers at multiple systemic levels need to be addressed.
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Affiliation(s)
- Tara Santens
- Parenting and Special Education Research Unit, KU Leuven, Leuven, Belgium
| | - Karin Hannes
- Center for Sociological Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
| | - Suzanne Levy
- Center for Family Intervention Science, Drexel University, Philadelphia, PA
| | - Guy Diamond
- Center for Family Intervention Science, Drexel University, Philadelphia, PA
| | - Guy Bosmans
- Parenting and Special Education Research Unit, KU Leuven, Leuven, Belgium
- Clinical Psychology, KU Leuven, Leuven, Belgium
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Lockwood C, Stannard D, Bjerrum M, Carrier J, Evans C, Hannes K, Munn Z, Porritt K, Salmond SW. A situated philosophical perspective would make some of the paradigm wars in qualitative evidence synthesis redundant: A commentary on Bergdahl's critique of the meta-aggregative approach. Nurs Inq 2019; 26:e12317. [PMID: 31637806 DOI: 10.1111/nin.12317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 07/09/2019] [Accepted: 07/13/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Craig Lockwood
- Joanna Briggs Institute, The University of Adelaide, Adelaide, Australia
| | - Daphne Stannard
- School of Nursing, San Francisco State University, San Francisco, CA, USA
| | - Merete Bjerrum
- Department of Public Health, Aarhus University, Aarhus, Denmark.,Danish Center of Systematic Review, A JBI Center of Excellence, Danish Centre of Clinical Guidelines, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Judith Carrier
- Wales Centre for Evidence Based Care-a JBI Centre of Excellence, School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Catrin Evans
- School of Health Sciences, The Nottingham Centre for Evidence-Based Healthcare: A Joanna Briggs Centre of Excellence, University of Nottingham, Nottingham, UK
| | - Karin Hannes
- Social Research Methodology Group, Centre for Sociological Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
| | - Zachary Munn
- Joanna Briggs Institute, The University of Adelaide, Adelaide, Australia
| | - Kylie Porritt
- Joanna Briggs Institute, The University of Adelaide, Adelaide, Australia
| | - Susan W Salmond
- Northeast Institute Evidence Synthesis & Translation, Rutgers School of Nursing, New Brunswick, NJ, USA
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France EF, Cunningham M, Ring N, Uny I, Duncan EAS, Jepson RG, Maxwell M, Roberts RJ, Turley RL, Booth A, Britten N, Flemming K, Gallagher I, Garside R, Hannes K, Lewin S, Noblit GW, Pope C, Thomas J, Vanstone M, Higginbottom GMA, Noyes J. Improving reporting of meta-ethnography: The eMERGe reporting guidance. J Adv Nurs 2019; 75:1126-1139. [PMID: 30644123 PMCID: PMC7594209 DOI: 10.1111/jan.13809] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [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: 06/13/2017] [Revised: 06/22/2018] [Accepted: 07/03/2018] [Indexed: 01/26/2023]
Abstract
AIMS The aim of this study was to provide guidance to improve the completeness and clarity of meta-ethnography reporting. BACKGROUND Evidence-based policy and practice require robust evidence syntheses which can further understanding of people's experiences and associated social processes. Meta-ethnography is a rigorous seven-phase qualitative evidence synthesis methodology, developed by Noblit and Hare. Meta-ethnography is used widely in health research, but reporting is often poor quality and this discourages trust in and use of its findings. Meta-ethnography reporting guidance is needed to improve reporting quality. DESIGN The eMERGe study used a rigorous mixed-methods design and evidence-based methods to develop the novel reporting guidance and explanatory notes. METHODS The study, conducted from 2015 - 2017, comprised of: (1) a methodological systematic review of guidance for meta-ethnography conduct and reporting; (2) a review and audit of published meta-ethnographies to identify good practice principles; (3) international, multidisciplinary consensus-building processes to agree guidance content; (4) innovative development of the guidance and explanatory notes. FINDINGS Recommendations and good practice for all seven phases of meta-ethnography conduct and reporting were newly identified leading to 19 reporting criteria and accompanying detailed guidance. CONCLUSION The bespoke eMERGe Reporting Guidance, which incorporates new methodological developments and advances the methodology, can help researchers to report the important aspects of meta-ethnography. Use of the guidance should raise reporting quality. Better reporting could make assessments of confidence in the findings more robust and increase use of meta-ethnography outputs to improve practice, policy, and service user outcomes in health and other fields. This is the first tailored reporting guideline for meta-ethnography. This article is being simultaneously published in the following journals: Journal of Advanced Nursing, Psycho-oncology, Review of Education, and BMC Medical Research Methodology.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Kate Flemming
- Department of Health SciencesUniversity of YorkYorkUK
| | | | | | | | - Simon Lewin
- Global Health UnitNorwegian Institute of Public Health and Health Systems Research UnitOsloNorway,South African Medical Research CouncilCapetownSouth Africa
| | | | | | | | | | - Gina M. A. Higginbottom
- School of Health Sciences & Centre for Evidence Based Health CareThe University of NottinghamNottinghamUK
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France EF, Cunningham M, Ring N, Uny I, Duncan EAS, Jepson RG, Maxwell M, Roberts RJ, Turley RL, Booth A, Britten N, Flemming K, Gallagher I, Garside R, Hannes K, Lewin S, Noblit GW, Pope C, Thomas J, Vanstone M, Higginbottom GMA, Noyes J. Improving reporting of meta-ethnography: the eMERGe reporting guidance. BMC Med Res Methodol 2019; 19:25. [PMID: 30709371 PMCID: PMC6359764 DOI: 10.1186/s12874-018-0600-0] [Citation(s) in RCA: 212] [Impact Index Per Article: 42.4] [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] [Indexed: 01/08/2023] Open
Abstract
AIMS The aim of this study was to provide guidance to improve the completeness and clarity of meta-ethnography reporting. BACKGROUND Evidence-based policy and practice require robust evidence syntheses which can further understanding of people's experiences and associated social processes. Meta-ethnography is a rigorous seven-phase qualitative evidence synthesis methodology, developed by Noblit and Hare. Meta-ethnography is used widely in health research, but reporting is often poor quality and this discourages trust in and use of its findings. Meta-ethnography reporting guidance is needed to improve reporting quality. DESIGN The eMERGe study used a rigorous mixed-methods design and evidence-based methods to develop the novel reporting guidance and explanatory notes. METHODS The study, conducted from 2015 to 2017, comprised of: (1) a methodological systematic review of guidance for meta-ethnography conduct and reporting; (2) a review and audit of published meta-ethnographies to identify good practice principles; (3) international, multidisciplinary consensus-building processes to agree guidance content; (4) innovative development of the guidance and explanatory notes. FINDINGS Recommendations and good practice for all seven phases of meta-ethnography conduct and reporting were newly identified leading to 19 reporting criteria and accompanying detailed guidance. CONCLUSION The bespoke eMERGe Reporting Guidance, which incorporates new methodological developments and advances the methodology, can help researchers to report the important aspects of meta-ethnography. Use of the guidance should raise reporting quality. Better reporting could make assessments of confidence in the findings more robust and increase use of meta-ethnography outputs to improve practice, policy, and service user outcomes in health and other fields. This is the first tailored reporting guideline for meta-ethnography. This article is being simultaneously published in the following journals: Journal of Advanced Nursing, Psycho-oncology, Review of Education, and BMC Medical Research Methodology.
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Affiliation(s)
- Emma F France
- University of Stirling, Stirling, UK.
- NMAHP Research Unit, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, UK.
| | - Maggie Cunningham
- University of Stirling, Stirling, UK
- NMAHP Research Unit, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, UK
| | | | | | - Edward A S Duncan
- University of Stirling, Stirling, UK
- NMAHP Research Unit, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, UK
| | | | - Margaret Maxwell
- University of Stirling, Stirling, UK
- NMAHP Research Unit, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, UK
| | - Rachel J Roberts
- University of Stirling, Stirling, UK
- NMAHP Research Unit, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, UK
| | | | | | | | - Kate Flemming
- Department of Health Sciences, University of York, York, UK
| | | | | | | | - Simon Lewin
- Global Health Unit Norwegian Institute of Public Health and Health Systems Research Unit, Oslo, Norway
- South African Medical Research Council, Capetown, South Africa
| | - George W Noblit
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | | | | | | | - Gina M A Higginbottom
- School of Health Sciences & Centre for Evidence Based Health Care, The University of Nottingham, Nottingham, UK
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Abstract
INTRODUCTION There seems to be little information on interactional patterns of enabling and constraining factors contributing to HIV care engagement across systems and across time. Understanding these patterns from a (micro-meso-macro-exo) systems perspective can provide rich insights on relevant social networks affecting transgender populations. In this review, we will synthesise the wealth of literature on transgender persons' engagement in the HIV care continuum. METHODS AND ANALYSIS We will perform a networked systems approach to qualitative evidence synthesis of relevant qualitative research data generated from primary qualitative, mixed-method and evaluation studies exploring HIV care engagement among diverse transgender populations. Studies not using qualitative methods and studies not published in English will be excluded from this review. Empirical studies will be identified via a search in major databases such as PubMed, Scopus, ERIC, Embase, Web of Science, Sociological Abstracts, PsychInfo and Social Services Abstract in January 2019. Two reviewers will independently screen the studies for inclusion, assess their quality and extract data. In case some of the system levels in the network are ill-covered by empirical studies, non-empirical studies will be considered for inclusion. The qualitative evidence synthesis includes a summary of descriptive data (first order), an exploration of relationships between system levels or their components (second order) and a structured summary of research evidence through narrative synthesis. The narrative synthesis will be extended with an overall social network analysis that visualises important nodes and links cutting across ecological systems. ETHICS AND DISSEMINATION Ethical approval is not required to conduct this review. Review findings will be disseminated via peer-reviewed academic journals and a targeted information campaign towards organisations that work with our population of interest. PROSPERO REGISTRATION NUMBER CRD42018089956.
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Affiliation(s)
- Nico Canoy
- Department of Psychology, Ateneo de Manila University, Quezon City, Manila, Philippines
| | - Subash Thapa
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Karin Hannes
- Social Research Methodology Group, Faculty of Social Sciences, Leuven, Belgium
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France EF, Cunningham M, Ring N, Uny I, Duncan EA, Jepson RG, Maxwell M, Roberts RJ, Turley RL, Booth A, Britten N, Flemming K, Gallagher I, Garside R, Hannes K, Lewin S, Noblit GW, Pope C, Thomas J, Vanstone M, Higginbottom GMA, Noyes J. Improving reporting of meta-ethnography: The eMERGe reporting guidance. Psychooncology 2019; 28:447-458. [DOI: 10.1002/pon.4915] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 06/22/2018] [Accepted: 07/03/2018] [Indexed: 01/22/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Kate Flemming
- Department of Health Sciences; University of York; York UK
| | | | | | | | - Simon Lewin
- Global Health Unit Norwegian Institute of Public Health and Health Systems Research Unit; Oslo Norway
- South African Medical Research Council; Capetown South Africa
| | - George W. Noblit
- University of North Carolina at Chapel Hill; Chapel Hill North Carolina
| | | | | | | | - Gina M. A. Higginbottom
- School of Health Sciences & Centre for Evidence Based Health Care; The University of Nottingham; Nottingham UK
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17
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Thapa S, Hannes K, Cargo M, Buve A, Peters S, Dauphin S, Mathei C. Stigma reduction in relation to HIV test uptake in low- and middle-income countries: a realist review. BMC Public Health 2018; 18:1277. [PMID: 30453923 PMCID: PMC6245520 DOI: 10.1186/s12889-018-6156-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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: 01/10/2018] [Accepted: 10/26/2018] [Indexed: 11/20/2022] Open
Abstract
Background This realist review was conducted to understand how stigma is reduced in relation to HIV test uptake in low- and middle-income countries (LMICs). Methods A systematic search of eight databases resulted in 34 articles considered for synthesis. Data synthesis was guided by a preliminary programme theory and included coding the meaning units to develop themes or intervention pathways that corresponded to context-mechanism-outcome configurations. Results We found that the interventions produced an effect through two pathways: (a) knowledge leads to changes in stigmatizing attitudes and increases in HIV test uptake and (b) knowledge and attitudes lead to changes in stigmatizing behaviours and lead to HIV test uptake. We also found one competing pathway that illustrated the direct impact of knowledge on HIV test uptake without changing stigmatizing attitudes and behaviour. The identified pathways were found to be influenced by some structural factors (e.g., anti-homosexuality laws, country-specific HIV testing programmes and policies), community factors (e.g., traditional beliefs and practices, sexual taboos and prevalence of intimate partner violence) and target-population characteristics (e.g., age, income and urban-rural residence). Conclusions The pathways and underlying mechanisms support the adaptation of intervention strategies in terms of social context and the target population in LMICs.
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Affiliation(s)
- Subash Thapa
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, 5000, Denmark.
| | - Karin Hannes
- Social Research Methodology Group, Faculty of Social Sciences, KU Leuven, Parkstraat 45, 3000, Leuven, Belgium
| | - Margaret Cargo
- Health Research Institute, University of Canberra, University Drive, 22-B17, Bruce, ACT, 2601, Australia
| | - Anne Buve
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Sanne Peters
- Department of Public Health and Primary care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Stephanie Dauphin
- Department of Public Health and Primary care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Catharina Mathei
- Department of Public Health and Primary care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
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Bengough T, von Elm E, Heyvaert M, Hannes K. Factors that influence women’s engagement with breastfeeding support: a qualitative evidence synthesis. Hippokratia 2018. [DOI: 10.1002/14651858.cd013115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Theresa Bengough
- KU Leuven University; Social Research Methodology Group, Centre for Sociological Research, Faculty of Social Sciences; Parkstraat 45 Leuven Belgium BE 3000
- Austrian Public Health Institute; Department of Health and Society; Stubenring 6 Vienna Austria 1010
| | - Erik von Elm
- Lausanne University Hospital; Cochrane Switzerland, Institute of Social and Preventive Medicine; Route de la Corniche 10 Lausanne Switzerland CH-1010
| | - Mieke Heyvaert
- KU Leuven; Methodology of Educational Sciences Research Group; Andreas Vesaliusstraat 2 - box 3762 Leuven Belgium 3000
| | - Karin Hannes
- KU Leuven University; Social Research Methodology Group, Centre for Sociological Research, Faculty of Social Sciences; Parkstraat 45 Leuven Belgium BE 3000
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Noyes J, Booth A, Flemming K, Garside R, Harden A, Lewin S, Pantoja T, Hannes K, Cargo M, Thomas J. Cochrane Qualitative and Implementation Methods Group guidance series—paper 3: methods for assessing methodological limitations, data extraction and synthesis, and confidence in synthesized qualitative findings. J Clin Epidemiol 2018; 97:49-58. [DOI: 10.1016/j.jclinepi.2017.06.020] [Citation(s) in RCA: 149] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 05/19/2017] [Accepted: 06/05/2017] [Indexed: 12/18/2022]
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De Buck E, Hannes K, Cargo M, Van Remoortel H, Vande Veegaete A, Mosler HJ, Govender T, Vandekerckhove P, Young T. Engagement of stakeholders in the development of a Theory of Change for handwashing and sanitation behaviour change. Int J Environ Health Res 2018; 28:8-22. [PMID: 29260884 DOI: 10.1080/09603123.2017.1415306] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A Theory of Change (ToC) is an approach to map programmes aimed at inducing change in a specific context, with the goal of increasing their impact. We applied this approach to the specific case of handwashing and sanitation practices in low- and middle-income countries and developed a ToC as part of a systematic review exercise. Different existing sources of information were used to inform the initial draft of the ToC. In addition, stakeholder involvement occurred and peer review took place. Our stakeholders included methodological (ToC/quantitative and qualitative research) and content experts (WASH (Water, Sanitation, Hygiene)/behaviour change), as well as end-users/practitioners, policy-makers and donors. In conclusion, the development of a ToC, and the involvement of stakeholders in its development, was critical in terms of understanding the context in which the promotional programmes are being implemented. We recommend ToC developers to work with stakeholders to create a ToC relevant for practice.
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Affiliation(s)
- Emmy De Buck
- a Centre for Evidence-Based Practice , Belgian Red Cross-Flanders , Mechelen , Belgium
- b Department of Public Health and Primary Care, Faculty of Medicine , KU Leuven , Leuven , Belgium
| | - Karin Hannes
- c Faculty of Social Sciences , KU Leuven , Leuven , Belgium
| | - Margaret Cargo
- d Centre for Population Health Research , University of South Australia , Adelaide , Australia
| | - Hans Van Remoortel
- a Centre for Evidence-Based Practice , Belgian Red Cross-Flanders , Mechelen , Belgium
| | - Axel Vande Veegaete
- a Centre for Evidence-Based Practice , Belgian Red Cross-Flanders , Mechelen , Belgium
| | | | - Thashlin Govender
- f Division of Community Health, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa
| | - Philippe Vandekerckhove
- a Centre for Evidence-Based Practice , Belgian Red Cross-Flanders , Mechelen , Belgium
- b Department of Public Health and Primary Care, Faculty of Medicine , KU Leuven , Leuven , Belgium
- g Faculty of Medicine and Health Sciences , University of Ghent , Ghent , Belgium
| | - Taryn Young
- h Centre for Evidence-Based Health Care, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa
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Thapa S, Hannes K, Buve A, Bhattarai S, Mathei C. Theorizing the complexity of HIV disclosure in vulnerable populations: a grounded theory study. BMC Public Health 2018; 18:162. [PMID: 29351785 PMCID: PMC5775526 DOI: 10.1186/s12889-018-5073-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 05/23/2017] [Accepted: 01/11/2018] [Indexed: 12/04/2022] Open
Abstract
Background HIV disclosure is an important step in delivering the right care to people. However, many people with an HIV positive status choose not to disclose. This considerably complicates the delivery of adequate health care. Methods We conducted a grounded theory study to develop a theoretical model explaining how local contexts impact on HIV disclosure and what the mechanisms are that determine whether people choose to disclose or not. We conducted in-depth interviews among 23 people living with HIV, 8 health workers and 5 family and community members, and 1 community development worker in Achham, Nepal. Data were analysed using constant-comparative method, performing three levels of open, axial, and selective coding. Results Our theoretical model illustrates how two dominant systems to control HIV, namely a community self-coping and a public health system, independently or jointly, shape contexts, mechanisms and outcomes for HIV disclosure. Conclusion This theoretical model can be used in understanding processes of HIV disclosure in a community where HIV is concentrated in vulnerable populations and is highly stigmatized, and in determining how public health approaches would lead to reduced stigma levels and increased HIV disclosure rates.
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Affiliation(s)
- Subash Thapa
- Department of Public Health and Primary care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium. .,Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.
| | - Karin Hannes
- Centre for Sociological Research, Faculty of Social Sciences, KU Leuven, Parkstraat 45, 3000, Leuven, Belgium
| | - Anne Buve
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Shivani Bhattarai
- Department of Public Health, Nobel College Pokhara University, Kathmandu, 44601, Nepal
| | - Catharina Mathei
- Department of Public Health and Primary care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
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22
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Thapa S, Thapa DK, Buve A, Hannes K, Nepal C, Mathei C. HIV-Related Risk Behaviors Among Labor Migrants, Their Wives and the General Population in Nepal. J Community Health 2018; 42:260-268. [PMID: 27638032 DOI: 10.1007/s10900-016-0251-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Nepalese labor migrants and their wives are considered as at-risk populations for HIV infection. There may be a risk of HIV transmission from the labor migrant and their wives to the general population due to HIV-related risk behaviors, but so far empirical evidence to support this hypothesis is scarce. Therefore, this study was conducted to compare HIV-related risk behaviors between labor migrants, their wives, and males and females from the general population in the far-western region of Nepal. This was a cross-sectional study, in which structured face-to-face interviews were conducted with 261 male labor migrants, 262 wives of labor migrants, 123 males and 122 females from the general population. We found that the proportion of the labor migrants and their wives reporting having had extramarital sex in the previous year did not differ significantly with the males (11.9 vs. 13.4 %, p value 0.752) and females (2.0 vs. 1.7 %, p value 0.127) from the general population. However, the labor migrants compared with the males from the general population were 1.51 times and the wives of labor migrants compared with the females from the general population were 2.37 times more likely to have been tested for HIV. Both the males from the general population and the labor migrants are equally engaged in unprotected extramarital sex. Therefore, it is recommended that the prevention programs, including access to condoms and HIV testing, should be scaled up targeting a broader range of individuals in the far-western region of Nepal.
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Affiliation(s)
- Subash Thapa
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium. .,Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.
| | - Deependra Kaji Thapa
- United Nations Development Program/National Planning Commission, 44600, Kathmandu, Nepal
| | - Anne Buve
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Karin Hannes
- Centre for Sociological Research, Faculty of Social Sciences, KU Leuven, Parkstraat 45, 3000, Leuven, Belgium
| | | | - Catharina Mathei
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
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Harris JL, Booth A, Cargo M, Hannes K, Harden A, Flemming K, Garside R, Pantoja T, Thomas J, Noyes J. Cochrane Qualitative and Implementation Methods Group guidance series-paper 2: methods for question formulation, searching, and protocol development for qualitative evidence synthesis. J Clin Epidemiol 2017; 97:39-48. [PMID: 29248725 DOI: 10.1016/j.jclinepi.2017.10.023] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 09/26/2017] [Accepted: 10/17/2017] [Indexed: 11/17/2022]
Abstract
This paper updates previous Cochrane guidance on question formulation, searching, and protocol development, reflecting recent developments in methods for conducting qualitative evidence syntheses to inform Cochrane intervention reviews. Examples are used to illustrate how decisions about boundaries for a review are formed via an iterative process of constructing lines of inquiry and mapping the available information to ascertain whether evidence exists to answer questions related to effectiveness, implementation, feasibility, appropriateness, economic evidence, and equity. The process of question formulation allows reviewers to situate the topic in relation to how it informs and explains effectiveness, using the criterion of meaningfulness, appropriateness, feasibility, and implementation. Questions related to complex questions and interventions can be structured by drawing on an increasingly wide range of question frameworks. Logic models and theoretical frameworks are useful tools for conceptually mapping the literature to illustrate the complexity of the phenomenon of interest. Furthermore, protocol development may require iterative question formulation and searching. Consequently, the final protocol may function as a guide rather than a prescriptive route map, particularly in qualitative reviews that ask more exploratory and open-ended questions.
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Affiliation(s)
- Janet L Harris
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Margaret Cargo
- Spatial Epidemiology & Evaluation Research Group/Centre for Population Health Research, University of South Australia, 8th Floor Office 310, South Australia Health & Medical Research Institute, North Terrace, Adelaide SA 510, Australia
| | - Karin Hannes
- Social Research Methodology Group, Centre for Sociological Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
| | - Angela Harden
- The University of East London, Stratford Campus, Water Lane, London, UK
| | - Kate Flemming
- Department of Health Sciences, Faculty of Science, University of York, Seebohm Rowntree Building, Heslington, York YO10 5DD, UK
| | - Ruth Garside
- European Centre for Environment & Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, UK
| | - Tomas Pantoja
- Department of Family Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Lira 44. Edificio Decanato, Primer Piso, Santiago, Chile
| | - James Thomas
- UCL Institute of Education, University College London, 20 Bedford Way, London, UK
| | - Jane Noyes
- School of Social Sciences, Bangor University, Bangor, Gwynedd, LL57 2DG, UK
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Noyes J, Booth A, Cargo M, Flemming K, Garside R, Hannes K, Harden A, Harris J, Lewin S, Pantoja T, Thomas J. Cochrane Qualitative and Implementation Methods Group guidance series-paper 1: introduction. J Clin Epidemiol 2017; 97:35-38. [PMID: 29242094 DOI: 10.1016/j.jclinepi.2017.09.025] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 09/25/2017] [Accepted: 09/30/2017] [Indexed: 01/11/2023]
Affiliation(s)
- Jane Noyes
- School of Social Sciences, Bangor University, Bangor, Gwynedd, LL57 2DG, UK.
| | - Andrew Booth
- School of Health and Related Research (ScHARR), Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Margaret Cargo
- Spatial Epidemiology & Evaluation Research Group/Centre for Population Health Research, University of South Australia, South Australia Health & Medical Research Institute, 8th Floor Office 310, North Terrace, Adelaide SA 510 Australia
| | - Kate Flemming
- Department of Health Sciences, Faculty of Science, University of York, Seebohm Rowntree Building, Heslington York YO10 5DD, UK
| | - Ruth Garside
- European Centre for Environment & Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, UK
| | - Karin Hannes
- Methodology of Educational Sciences Research Group, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Angela Harden
- The University of East London, Stratford Campus, Water Lane, London, UK
| | - Janet Harris
- School of Health and Related Research (ScHARR), Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Simon Lewin
- Global Health Unit
- Norwegian Knowledge Centre for the Health Services at the Norwegian Institute of Public Health, and Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Tomas Pantoja
- Department of Family Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Lira 44. Edificio Decanato, Primer Piso, Santiago, Chile
| | - James Thomas
- UCL Institute of Education, University College London, 20 Bedford Way, London, UK
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Harden A, Thomas J, Cargo M, Harris J, Pantoja T, Flemming K, Booth A, Garside R, Hannes K, Noyes J. Cochrane Qualitative and Implementation Methods Group guidance series-paper 5: methods for integrating qualitative and implementation evidence within intervention effectiveness reviews. J Clin Epidemiol 2017; 97:70-78. [PMID: 29242095 DOI: 10.1016/j.jclinepi.2017.11.029] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 11/04/2017] [Accepted: 11/10/2017] [Indexed: 01/19/2023]
Abstract
The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method evidence from process evaluations. Despite a proliferation of methods for the synthesis of qualitative research, less attention has focused on how to integrate these syntheses within intervention effectiveness reviews. In this article, we report updated guidance from the group on approaches, methods, and tools, which can be used to integrate the findings from quantitative studies evaluating intervention effectiveness with those from qualitative studies and process evaluations. We draw on conceptual analyses of mixed methods systematic review designs and the range of methods and tools that have been used in published reviews that have successfully integrated different types of evidence. We outline five key methods and tools as devices for integration which vary in terms of the levels at which integration takes place; the specialist skills and expertise required within the review team; and their appropriateness in the context of limited evidence. In situations where the requirement is the integration of qualitative and process evidence within intervention effectiveness reviews, we recommend the use of a sequential approach. Here, evidence from each tradition is synthesized separately using methods consistent with each tradition before integration takes place using a common framework. Reviews which integrate qualitative and process evaluation evidence alongside quantitative evidence on intervention effectiveness in a systematic way are rare. This guidance aims to support review teams to achieve integration and we encourage further development through reflection and formal testing.
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Affiliation(s)
- Angela Harden
- Institute for Health and Human Development, The University of East London, Stratford Campus, Water Lane, London E15 4LZ, UK.
| | - James Thomas
- UCL Institute of Education, University College London, 20 Bedford Way, London, UK
| | - Margaret Cargo
- Spatial Epidemiology & Evaluation Research Group, Centre for Population Health University of South Australia, 8th Floor Office 310, SAHMRI Building (North Terrace), Adelaide, Australia
| | - Janet Harris
- School of Health and Related Research (ScHARR), University of Sheffield Regent Court, 30 Regent Street, Sheffield, UK
| | - Tomas Pantoja
- Department of Family Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Centro Médico San Joaquín, Av. Vicuna Mackenna, Macul, Santiago 4686, Chile
| | - Kate Flemming
- Department of Health Sciences, Faculty of Science, University of York, Seebohm Rowntree Building, Heslington, York, UK
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield Regent Court, 30 Regent Street, Sheffield, UK
| | - Ruth Garside
- European Centre for Environment & Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, UK
| | - Karin Hannes
- Social Research Methodology Group, Centre for Sociological Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
| | - Jane Noyes
- School of Social Sciences, Bangor University, Bangor, Gwynedd, UK
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Flemming K, Booth A, Hannes K, Cargo M, Noyes J. Cochrane Qualitative and Implementation Methods Group guidance series-paper 6: reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses. J Clin Epidemiol 2017; 97:79-85. [PMID: 29222060 DOI: 10.1016/j.jclinepi.2017.10.022] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 10/03/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To outline contemporary and novel developments for the presentation and reporting of syntheses of qualitative, implementation, and process evaluation evidence and provide recommendations for the use of reporting guidelines. STUDY DESIGN AND SETTING An overview of reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses drawing on current international literature and the collective expert knowledge of the Cochrane Qualitative and Implementation Methods Group. RESULTS Several reporting guidelines exist that can be used or adapted to report syntheses of qualitative, implementation, and process evaluation evidence. Methods to develop individual guidance varied. The use of a relevant reporting guideline can enhance the transparency, consistency, and quality of reporting. Guidelines that exist are generic, method specific, and for particular aspects of the reviewing process, searching. CONCLUSION Caution is expressed over the potential for reporting guidelines to produce a mechanistic approach moving the focus away from the content and toward the procedural aspects of the review. The use of a reporting guideline is recommended and a five-step decision flowchart to guide the choice of reporting guideline is provided. Gaps remain in method-specific reporting guidelines such as mixed-study, implementation, and process evaluation evidence syntheses.
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Affiliation(s)
- Kate Flemming
- Department of Health Sciences, Faculty of Science, University of York, Seebohm Rowntree Building, Heslington, York YO10 5DD, UK.
| | - Andrew Booth
- School of Health and Related Research (ScHARR), Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Karin Hannes
- Social Research Methodology Group, Centre for Sociological Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
| | - Margaret Cargo
- Spatial Epidemiology & Evaluation Research Group/Centre for Population Health Research, University of South Australia, 8th Floor Office 310, South Australia Health & Medical Research Insitute, North Terrace, Adelaide SA 510, Australia
| | - Jane Noyes
- School of Social Sciences, 2 Bangor University, Bangor, Gwynedd, LL57 2DG, UK
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Benoot C, Saelaert M, Hannes K, Bilsen J. The Sexual Adjustment Process of Cancer Patients and Their Partners: A Qualitative Evidence Synthesis. Arch Sex Behav 2017; 46:2059-2083. [PMID: 28039595 DOI: 10.1007/s10508-016-0868-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 09/08/2016] [Accepted: 09/16/2016] [Indexed: 06/06/2023]
Abstract
When confronted with cancer, a prominent challenge for patients and their partners is their changed sexual relationship. An empirically based theoretical model of the sexual adaptation process during cancer might be helpful in guiding the development of adequate interventions for couples who struggle with their sexual relationship. Therefore, the purpose of this study was to synthesize evidence from primary qualitative research studies and to arrive at a detailed description of the process of sexual adjustment during cancer. We conducted a qualitative evidence synthesis of a purposeful sample of 16 qualitative papers, using the meta-ethnography approach to synthesis. We found that the subsequent studies used different theoretical approaches to describe the sexual adaptation process. This led to three divergent sexual adaptation processes: (1) the pathway of grief and mourning, depicting sexual changes as a loss; (2) the pathway of restructuring, depicting the adjustment process toward sexual changes as a cognitive process with a strong focus on the social and cultural forces that shape the values and experiences of sexuality; and (3) the pathway of sexual rehabilitation, depicting sexual changes as a bodily dysfunction that needs treatment and specific behavioral strategies. All three pathways have their own opportunities and challenges. A greater awareness of these different pathways could help healthcare providers to better understand the ways a particular couple might cope with changed sexuality, offering them opportunities to discover alternative pathways for sexual adjustment.
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Affiliation(s)
- Charlotte Benoot
- Mental Health and Wellbeing Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Marlies Saelaert
- Mental Health and Wellbeing Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Karin Hannes
- Centre for Sociological Research, Catholic University of Leuven, Parkstraat 45, 3000, Louvain, Belgium
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
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Van Nuland M, Hannes K, Cools F, Goedhuys J. Educational interventions for improving the communication skills of general practice trainees in the clinical consultation. Hippokratia 2017. [DOI: 10.1002/14651858.cd005559.pub2] [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: 11/11/2022]
Affiliation(s)
- Marc Van Nuland
- Catholic University Leuven; Academic Centre for General Practice; Kapucijnenvoer 33 blok j - bus 7001 Leuven Belgium 3000
| | - Karin Hannes
- KU Leuven University; Social Research Methodology Group, Centre for Sociological Research, Faculty of Social Sciences; Parkstraat 45 Leuven Belgium BE 3000
| | - Filip Cools
- CEBAM, Belgian Centre for Evidence-Based Medicine; Kapucijnenvoer 33, blok J, bus 7001 Leuven Vlaams-Brabant Belgium 3000
| | - Jozef Goedhuys
- Catholic University Leuven; Academic Centre for General Practice; Kapucijnenvoer 33 blok j - bus 7001 Leuven Belgium 3000
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Lewin S, Hendry M, Chandler J, Oxman AD, Michie S, Shepperd S, Reeves BC, Tugwell P, Hannes K, Rehfuess EA, Welch V, Mckenzie JE, Burford B, Petkovic J, Anderson LM, Harris J, Noyes J. Assessing the complexity of interventions within systematic reviews: development, content and use of a new tool (iCAT_SR). BMC Med Res Methodol 2017; 17:76. [PMID: 28446138 PMCID: PMC5406941 DOI: 10.1186/s12874-017-0349-x] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 04/14/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Health interventions fall along a spectrum from simple to more complex. There is wide interest in methods for reviewing 'complex interventions', but few transparent approaches for assessing intervention complexity in systematic reviews. Such assessments may assist review authors in, for example, systematically describing interventions and developing logic models. This paper describes the development and application of the intervention Complexity Assessment Tool for Systematic Reviews (iCAT_SR), a new tool to assess and categorise levels of intervention complexity in systematic reviews. METHODS We developed the iCAT_SR by adapting and extending an existing complexity assessment tool for randomized trials. We undertook this adaptation using a consensus approach in which possible complexity dimensions were circulated for feedback to a panel of methodologists with expertise in complex interventions and systematic reviews. Based on these inputs, we developed a draft version of the tool. We then invited a second round of feedback from the panel and a wider group of systematic reviewers. This informed further refinement of the tool. RESULTS The tool comprises ten dimensions: (1) the number of active components in the intervention; (2) the number of behaviours of recipients to which the intervention is directed; (3) the range and number of organizational levels targeted by the intervention; (4) the degree of tailoring intended or flexibility permitted across sites or individuals in applying or implementing the intervention; (5) the level of skill required by those delivering the intervention; (6) the level of skill required by those receiving the intervention; (7) the degree of interaction between intervention components; (8) the degree to which the effects of the intervention are context dependent; (9) the degree to which the effects of the interventions are changed by recipient or provider factors; (10) and the nature of the causal pathway between intervention and outcome. Dimensions 1-6 are considered 'core' dimensions. Dimensions 7-10 are optional and may not be useful for all interventions. CONCLUSIONS The iCAT_SR tool facilitates more in-depth, systematic assessment of the complexity of interventions in systematic reviews and can assist in undertaking reviews and interpreting review findings. Further testing of the tool is now needed.
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Affiliation(s)
- Simon Lewin
- Norwegian Institute of Public Health, Oslo, Norway. .,Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.
| | - Maggie Hendry
- North Wales Centre for Primary Care Research, Bangor University, Bangor, UK
| | | | | | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| | - Sasha Shepperd
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Barnaby C Reeves
- Clinical Trials and Evaluation Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Peter Tugwell
- Institute of Population Health, University of Ottawa, Ottawa, Canada
| | - Karin Hannes
- Social Research Methodology Group, Centre for Sociological Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
| | - Eva A Rehfuess
- Institute for Medical Informatics, Biometry and Epidemiology, University of Munich, Munich, Germany
| | - Vivien Welch
- Bruyère Research Institute, Bruyère Continuing Care, Ottawa, Ontario, Canada.,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Joanne E Mckenzie
- School of Public Health and Preventive Medicine, The Alfred Centre, Monash University, Melbourne, Victoria, Australia
| | - Belinda Burford
- Cochrane Public Health Group and Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer Petkovic
- Campbell and Cochrane Equity Methods Group, Centre for Global Health, Institute of Population Health, University of Ottawa, Ottawa, Canada
| | - Laurie M Anderson
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - Janet Harris
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Jane Noyes
- School of Social Sciences, Bangor University, Bangor, UK
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Thapa S, Hannes K, Cargo M, Buve A, Aro AR, Mathei C. Building a Conceptual Framework to Study the Effect of HIV Stigma-Reduction Intervention Strategies on HIV Test Uptake: A Scoping Review. J Assoc Nurses AIDS Care 2017; 28:545-560. [PMID: 28473183 DOI: 10.1016/j.jana.2017.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 04/10/2017] [Indexed: 11/25/2022]
Abstract
A scoping review of grey and peer-reviewed literature was conducted to develop a conceptual framework to illustrate mechanisms involved in reducing HIV stigma and increasing HIV test uptake. We followed a three-step approach to exploring the literature: developing concepts, organizing and categorizing concepts, and synthesizing concepts into a framework. The framework contains four types of intervention strategies: awareness creation, influencing normative behavior, providing support, and developing regulatory laws. The awareness creation strategy generally improves knowledge and the influencing normative behavior strategy changes stigmatizing attitudes and behaviors, and subsequently, increases HIV test uptake. Providing support and development of regulatory law strategies changes actual stigmatizing behaviors of the people, and subsequently, increases HIV test uptake. The framework further outlines that the mechanisms described are influenced by the interaction of various social-contextual and individual factors. The framework sheds new light on the effects of HIV stigma-reduction intervention strategies and HIV test uptake.
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Bekkering GE, Mariën D, Parylo O, Hannes K. The Effectiveness of Self-Help Groups for Adolescent Substance Misuse: A Systematic Review. Journal of Child & Adolescent Substance Abuse 2016. [DOI: 10.1080/1067828x.2014.981772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Thapa S, Pathak S, Leppin A, Buve A, Hannes K, Kandel G, Mathei C. Factors Associated With Condom Use for HIV Prevention Among Nepalese Labor Migrant Couples. AIDS Educ Prev 2016; 28:180-190. [PMID: 27459168 DOI: 10.1521/aeap.2016.28.2.180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Information about factors associated with condom use among Nepalese labor migrant couples that are considered being at high risk of HIV infection is not clearly understood. Therefore, we carried out a cross-sectional study to identify the factors associated with condom use among Nepalese labor migrant couples. A total of 266 wives of Nepalese labor migrants were invited for an interview. Hierarchical logistic regression analysis was performed to analyze data. We found that almost 39% of the women reported having used a condom while having sex with their husbands. Age was the only husband-related factor independently associated with condom use. School education, knowledge about HIV/AIDS, discussion of HIV with peers and sexual negotiation with the husband were the wife-related factors independently associated with condom use. Our findings highlight a clear need to develop effective HIV prevention interventions targeting illiterate labor migrant couples, with a particular emphasis on increasing women's ability to negotiate condom use.
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Affiliation(s)
- Subash Thapa
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Srijana Pathak
- Unit of Health Promotion Research, Institute of Public Health, University of Southern Denmark, Denmark
| | - Anja Leppin
- Unit of Health Promotion Research, Institute of Public Health, University of Southern Denmark, Denmark
| | - Anne Buve
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Karin Hannes
- Centre for Sociological Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium
| | - Ghanshyam Kandel
- Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), Kathmandu, Nepal
| | - Catharina Mathei
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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Benoot C, Hannes K, Bilsen J. The use of purposeful sampling in a qualitative evidence synthesis: A worked example on sexual adjustment to a cancer trajectory. BMC Med Res Methodol 2016; 16:21. [PMID: 26891718 PMCID: PMC4757966 DOI: 10.1186/s12874-016-0114-6] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 01/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An increasing number of qualitative evidence syntheses papers are found in health care literature. Many of these syntheses use a strictly exhaustive search strategy to collect articles, mirroring the standard template developed by major review organizations such as the Cochrane and Campbell Collaboration. The hegemonic idea behind it is that non-comprehensive samples in systematic reviews may introduce selection bias. However, exhaustive sampling in a qualitative evidence synthesis has been questioned, and a more purposeful way of sampling papers has been proposed as an alternative, although there is a lack of transparency on how these purposeful sampling strategies might be applied to a qualitative evidence synthesis. We discuss in our paper why and how we used purposeful sampling in a qualitative evidence synthesis about 'sexual adjustment to a cancer trajectory', by giving a worked example. METHODS We have chosen a mixed purposeful sampling, combining three different strategies that we considered the most consistent with our research purpose: intensity sampling, maximum variation sampling and confirming/disconfirming case sampling. RESULTS The concept of purposeful sampling on the meta-level could not readily been borrowed from the logic applied in basic research projects. It also demands a considerable amount of flexibility, and is labour-intensive, which goes against the argument of many authors that using purposeful sampling provides a pragmatic solution or a short cut for researchers, compared with exhaustive sampling. Opportunities of purposeful sampling were the possible inclusion of new perspectives to the line-of-argument and the enhancement of the theoretical diversity of the papers being included, which could make the results more conceptually aligned with the synthesis purpose. CONCLUSIONS This paper helps researchers to make decisions related to purposeful sampling in a more systematic and transparent way. Future research could confirm or disconfirm the hypothesis of conceptual enhancement by comparing the findings of a purposefully sampled qualitative evidence synthesis with those drawing on an exhaustive sample of the literature.
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Affiliation(s)
- Charlotte Benoot
- Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, 1050, Belgium.
| | - Karin Hannes
- Centre for Sociological Research, Catholic University of Leuven, Parkstraat 45, Leuven, 3000, Belgium.
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, 1050, Belgium.
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Thapa S, Bista N, Hannes K, Buve A, Vermandere M, Mathei C. Vulnerability of wives of Nepalese labor migrants to HIV infection: Integrating quantitative and qualitative evidence. Women Health 2015; 56:745-66. [PMID: 26630366 DOI: 10.1080/03630242.2015.1118726] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
HIV risk is determined by the interaction between social and individual risk factors, but information about such factors among Nepalese women is not yet understood. Therefore, to assess the risk factors and vulnerability of the wives of Nepalese labor migrants to HIV infection, the authors conducted a mixed-methods study in which a descriptive qualitative study was embedded within a case-control study. Two hundred twenty-four wives of labor migrants were interviewed in the case-control study, and two focus group discussions (n = 8 and 9) were conducted in the qualitative study. The authors found that illiteracy, low socio-economic status, and gender inequality contributed to poor knowledge and poor sexual negotiation among the wives of labor migrants and increased their risk of HIV through unprotected sex. Among male labor migrants, illiteracy, low socio-economic status, migration to India before marriage, and alcohol consumption contributed to liaisons with female sex workers, increasing the risk of HIV to the men and their wives through unprotected sex. Both labor migrants and their wives feared disclosure of positive HIV status due to HIV stigma and thus were less likely to be tested for HIV. HIV prevention programs should consider the interaction among these risk factors when targeting labor migrants and their wives.
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Affiliation(s)
- Subash Thapa
- a Department of Public Health and Primary Care , Katholieke Universiteit Leuven , Leuven , Belgium.,b Department of Public Health , Institute of Tropical Medicine , Antwerp , Belgium
| | - Nirmala Bista
- c Department of Public Health , Nobel College Pokhara University , Kathmandu , Nepal.,d Faculty of Psychology and Educational Sciences, Katholieke Universiteit Leuven , Leuven , Belgium
| | - Karin Hannes
- e Centre for Sociology Research , Katholieke Universiteit Leuven , Leuven , Belgium
| | - Anne Buve
- b Department of Public Health , Institute of Tropical Medicine , Antwerp , Belgium
| | - Mieke Vermandere
- a Department of Public Health and Primary Care , Katholieke Universiteit Leuven , Leuven , Belgium
| | - Catharina Mathei
- a Department of Public Health and Primary Care , Katholieke Universiteit Leuven , Leuven , Belgium
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Thapa S, Hannes K, Cargo M, Buve A, Mathei C. Effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries: a realist review protocol. Syst Rev 2015; 4:142. [PMID: 26527403 PMCID: PMC4630912 DOI: 10.1186/s13643-015-0130-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 10/08/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several stigma reduction intervention strategies have been developed and tested for effectiveness in terms of increasing human immunodeficiency virus (HIV) test uptake. These strategies have been more effective in some contexts and less effective in others. Individual factors, such as lack of knowledge and fear of disclosure, and social-contextual factors, such as poverty and illiteracy, might influence the effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries. So far, it is not clearly known how the stigma reduction intervention strategies interact with these contextual factors to increase HIV test uptake. Therefore, we will conduct a review that will synthesize existing studies on stigma reduction intervention strategies to increase HIV test uptake to better understand the mechanisms underlying this process in low- and middle-income countries. METHODS A realist review will be conducted to unpack context-mechanism-outcome configurations of the effect of stigma reduction intervention strategies on HIV test uptake. Based on a scoping review, we developed a preliminary theoretical framework outlining a potential mechanism of how the intervention strategies influence HIV test uptake. Our realist synthesis will be used to refine the preliminary theoretical framework to better reflect mechanisms that are supported by existing evidence. Journal articles and grey literature will be searched following a purposeful sampling strategy. Data will be extracted and tested against the preliminary theoretical framework. Data synthesis and analysis will be performed in five steps: organizing extracted data into evidence tables, theming, formulating chains of inference from the identified themes, linking the chains of inference and developing generative mechanisms, and refining the framework. DISCUSSION This will be the first realist review that offers both a quantitative and a qualitative exploration of the available evidence to develop and propose a theoretical framework that explains why and how HIV stigma reduction intervention strategies influence HIV test uptake in low- and middle-income countries. Our theoretical framework is meant to provide guidance to program managers on identifying the most effective stigma reduction intervention strategies to increase HIV test uptake. We also include advice on how to effectively implement these strategies to reduce the rate of HIV transmission. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015023687.
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Affiliation(s)
- Subash Thapa
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium. .,Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.
| | - Karin Hannes
- Centre for Sociology Research, Faculty of Social Sciences, KU Leuven, 3000, Leuven, Belgium.
| | - Margaret Cargo
- School of Population Health, University of South Australia, Adelaide, SA, 5001, Australia.
| | - Anne Buve
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.
| | - Catharina Mathei
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
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Thapa S, Bista N, Hannes K, Buve A, Vermandere M, Mathei C. Vulnerability of wives of Nepalese labor migrants to HIV infection: a socio-epidemiological study. Arch Public Health 2015. [PMCID: PMC4582249 DOI: 10.1186/2049-3258-73-s1-p14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Cargo M, Stankov I, Thomas J, Saini M, Rogers P, Mayo-Wilson E, Hannes K. Development, inter-rater reliability and feasibility of a checklist to assess implementation (Ch-IMP) in systematic reviews: the case of provider-based prevention and treatment programs targeting children and youth. BMC Med Res Methodol 2015; 15:73. [PMID: 26346461 PMCID: PMC4562191 DOI: 10.1186/s12874-015-0037-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 05/20/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several papers report deficiencies in the reporting of information about the implementation of interventions in clinical trials. Information about implementation is also required in systematic reviews of complex interventions to facilitate the translation and uptake of evidence of provider-based prevention and treatment programs. To capture whether and how implementation is assessed within systematic effectiveness reviews, we developed a checklist for implementation (Ch-IMP) and piloted it in a cohort of reviews on provider-based prevention and treatment interventions for children and young people. This paper reports on the inter-rater reliability, feasibility and reasons for discrepant ratings. METHODS Checklist domains were informed by a framework for program theory; items within domains were generated from a literature review. The checklist was pilot-tested on a cohort of 27 effectiveness reviews targeting children and youth. Two raters independently extracted information on 47 items. Inter-rater reliability was evaluated using percentage agreement and unweighted kappa coefficients. Reasons for discrepant ratings were content analysed. RESULTS Kappa coefficients ranged from 0.37 to 1.00 and were not influenced by one-sided bias. Most kappa values were classified as excellent (n = 20) or good (n = 17) with a few items categorised as fair (n = 7) or poor (n = 1). Prevalence-adjusted kappa coefficients indicate good or excellent agreement for all but one item. Four areas contributed to scoring discrepancies: 1) clarity or sufficiency of information provided in the review; 2) information missed in the review; 3) issues encountered with the tool; and 4) issues encountered at the review level. Use of the tool demands time investment and it requires adjustment to improve its feasibility for wider use. CONCLUSIONS The case of provider-based prevention and treatment interventions showed relevancy in developing and piloting the Ch-IMP as a useful tool for assessing the extent to which systematic reviews assess the quality of implementation. The checklist could be used by authors and editors to improve the quality of systematic reviews, and shows promise as a pedagogical tool to facilitate the extraction and reporting of implementation characteristics.
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Affiliation(s)
- Margaret Cargo
- Spatial Epidemiology and Evaluation Research Group, School of Population Health, University of South Australia, Adelaide, Australia.
| | - Ivana Stankov
- Spatial Epidemiology and Evaluation Research Group, School of Population Health, University of South Australia, Adelaide, Australia.
| | - James Thomas
- Evidence for Policy and Practice Information and Co-ordinating (EPPI) Centre, Social Science Research Unit, UCL Institute of Education, University College London, London, UK.
| | - Michael Saini
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.
| | - Patricia Rogers
- Centre for Applied Social Research, RMIT University (Royal Melbourne Institute of Technology), Melbourne, Australia.
| | - Evan Mayo-Wilson
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Karin Hannes
- Methodology of Educational Sciences Research Group, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.
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Fiander M, McGowan J, Grad R, Pluye P, Hannes K, Labrecque M, Roberts NW, Salzwedel DM, Welch V, Tugwell P. Interventions to increase the use of electronic health information by healthcare practitioners to improve clinical practice and patient outcomes. Cochrane Database Syst Rev 2015; 2015:CD004749. [PMID: 25770311 PMCID: PMC7388512 DOI: 10.1002/14651858.cd004749.pub3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is a large volume of health information available, and, if applied in clinical practice, may contribute to effective patient care. Despite an abundance of information, sub-optimal care is common. Many factors influence practitioners' use of health information, and format (electronic or other) may be one such factor. OBJECTIVES To assess the effects of interventions aimed at improving or increasing healthcare practitioners' use of electronic health information (EHI) on professional practice and patient outcomes. SEARCH METHODS We searched The Cochrane Library (Wiley), MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), and LISA (EBSCO) up to November 2013. We contacted researchers in the field and scanned reference lists of relevant articles. SELECTION CRITERIA We included studies that evaluated the effects of interventions to improve or increase the use of EHI by healthcare practitioners on professional practice and patient outcomes. We defined EHI as information accessed on a computer. We defined 'use' as logging into EHI. We considered any healthcare practitioner involved in patient care. We included randomized, non-randomized, and cluster randomized controlled trials (RCTs, NRCTs, CRCTs), controlled clinical trials (CCTs), interrupted time series (ITS), and controlled before-and-after studies (CBAs).The comparisons were: electronic versus printed health information; EHI on different electronic devices (e.g. desktop, laptop or tablet computers, etc.; cell / mobile phones); EHI via different user interfaces; EHI provided with or without an educational or training component; and EHI compared to no other type or source of information. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risk of bias for each study. We used GRADE to assess the quality of the included studies. We reassessed previously excluded studies following our decision to define logins to EHI as a measure of professional behavior. We reported results in natural units. When possible, we calculated and reported median effect size (odds ratio (OR), interquartile ranges (IQR)). Due to high heterogeneity across studies, meta-analysis was not feasible. MAIN RESULTS We included two RCTs and four CRCTs involving 352 physicians, 48 residents, and 135 allied health practitioners. Overall risk of bias was low as was quality of the evidence. One comparison was supported by three studies and three comparisons were supported by single studies, but outcomes across the three studies were highly heterogeneous. We found no studies to support EHI versus no alternative. Given these factors, it was not possible to determine the relative effectiveness of interventions. All studies reported practitioner use of EHI, two reported on compliance with electronic practice guidelines, and none reported on patient outcomes.One trial (139 participants) measured guideline adherence for an electronic versus printed guideline, but reported no difference between groups (median OR 0.85, IQR 0.74 to 1.08). One small cross-over trial (10 participants) reported increased use of clinical guidelines when provided with a mobile versus stationary, desktop computer (mean use per shift: intervention group (IG) 3.6, standard deviation (SD) 1.7 vs. control group (CG) 2.0 (SD 1.9), P value = 0.033). One cross-over trial (203 participants) reported that using a customized versus a generic interface had little impact on practitioners' use of EHI (mean difference in adjusted end-of-study rate: 0.77 logins/month/user, 95% confidence interval (CI) CI 0.43 to 1.11). Three trials included education or training and reported increased use of EHI by practitioners following training. AUTHORS' CONCLUSIONS This review provided no evidence that the use of EHI translates into improved clinical practice or patient outcomes, though it does suggest that when practitioners are provided with EHI and education or training, the use of EHI increases. We have defined use as the activity of logging into an EHI resource, but based on our findings use does not automatically translate to the application of EHI in practice. While using EHI may be an important component of evidence-based medicine, alone it is insufficient to improve patient care or clinical practices. For EHI to be applied in patient care, it will be necessary to understand why practitioners' are reluctant to apply EHI when treating people, and to determine the most effective way(s) to reduce this reluctance.
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Affiliation(s)
| | - Jessie McGowan
- Faculty of Medicine, University of OttawaDepartment of MedicineOttawaONCanadaK1N 6N5
| | - Roland Grad
- McGill UniversityDepartment of Family Medicine3755 Cote Ste‐Catherine RoadMontrealQCCanadaH3T 1E2
| | - Pierre Pluye
- McGill UniversityDepartment of Family Medicine3755 Cote Ste‐Catherine RoadMontrealQCCanadaH3T 1E2
| | - Karin Hannes
- KU LeuvenMethodology of Educational Sciences Research GroupAndreas Vesaliusstraat 2LeuvenBelgium3000
| | - Michel Labrecque
- Centre hospitalier universitaire de Québec ‐ Hôpital St‐François d'AssiseDépartement de médecine familiale, Université Laval10, rue l"EspinayQuébecQCCanadaG1L 3L5
| | - Nia W Roberts
- University of OxfordBodleian Health Care LibrariesKnowledge Centre, ORC Research Building, Old Road CampusOxfordOxfordshireUKOX3 7DQ
| | - Douglas M Salzwedel
- University of British ColumbiaDepartment of Anesthesiology, Pharmacology and Therapeutics300C ‐ 2176 Health Sciences MallVancouverBCCanadaV6T 1Z3
| | - Vivian Welch
- University of OttawaBruyère Research Institute85 Primrose StreetOttawaONCanadaK1N 5C8
| | - Peter Tugwell
- Faculty of Medicine, University of OttawaDepartment of MedicineOttawaONCanadaK1N 6N5
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Hannes K, Aertgeerts B. Literature reviews should reveal the reviewers' rationale to opt for particular quality assessment criteria. Acad Med 2014; 89:370. [PMID: 24569656 DOI: 10.1097/acm.0000000000000128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Karin Hannes
- Assistant professor, Methodology of Educational Sciences Research Group, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; e-mail: . Professor, Academic Centre for General Practice, Faculty of Medicine, KU Leuven, Leuven, Belgium
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Bekkering GE, Aertgeerts B, Asueta-Lorente JF, Autrique M, Goossens M, Smets K, van Bussel JCH, Vanderplasschen W, Van Royen P, Hannes K. Practitioner review: evidence-based practice guidelines on alcohol and drug misuse among adolescents: a systematic review. J Child Psychol Psychiatry 2014; 55:3-21. [PMID: 24117606 DOI: 10.1111/jcpp.12145] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Context-specific evidence-based guidelines on how to prevent and treat substance misuse among adolescents are currently lacking in many countries. Due to the time consuming nature of de novo guideline development, the ADAPTE collaboration introduced a methodology to adapt existing guidelines to a local context. An important step in this method is a systematic review to identify relevant high-quality evidence-based guidelines. This study describes the results of this step for the development of guidelines on adolescent alcohol and drug misuse in Belgium. METHODS Rigorous systematic review methodology was used. This included searches of electronic databases (Medline, Embase, Cinahl, PsychInfo, and ERIC in June 2011), websites of relevant organizations, and reference lists of key publications. Experts in the field were also contacted. Included were Dutch, English, French, or German evidence-based practice guidelines from 2006 or later on the prevention, screening, assessment, or treatment of alcohol or illicit drug misuse in persons aged 12-18 years. Two independent reviewers assessed the quality of the guidelines using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument. SCOPE This overview provides a framework of current knowledge in adolescent alcohol and drug misuse prevention and treatment. RESULTS This systematic review identified 32 relevant evidence-based guidelines on substance misuse among adolescents. Nine guidelines were judged to be of high quality; of which four had recommendations specifically on adolescents: one on school-based prevention, one on substance misuse prevention in vulnerable young people and two on alcohol misuse with specific sections for the adolescent population. There were few commonalities as guidelines focused on different target groups, professional disciplines and type and level of substance misuse. Evidence to support the recommendations was sparse, and many recommendations were based on expert consensus or on studies among adults. Also, the link between evidence and recommendations was often unclear. CONCLUSIONS There are a substantial number of guidelines addressing substance misuse in adolescents. However, only four high-quality guidelines included recommendations specific for adolescents. The current level of evidence that underpins the recommendations in these high-quality guidelines is low.
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Affiliation(s)
- G E Bekkering
- Methodology of Educational Sciences Research Group, KU Leuven, Leuven, Belgium; CEBAM, Belgian Center for Evidence-Based Medicine, Leuven, Belgium
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Hannes K, Booth A, Harris J, Noyes J. Celebrating methodological challenges and changes: reflecting on the emergence and importance of the role of qualitative evidence in Cochrane reviews. Syst Rev 2013; 2:84. [PMID: 24135194 PMCID: PMC3853345 DOI: 10.1186/2046-4053-2-84] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 10/01/2013] [Indexed: 02/06/2023] Open
Abstract
Cochrane systematic reviews have proven to be beneficial for decision making processes, both on a practitioner and a policy level, and there are current initiatives to extend the types of evidence used by them, including qualitative research. In this article we outline the major achievements of the Cochrane Qualitative and Implementation Methods Group. Although the Group has encountered numerous challenges in dealing with the evolution of qualitative evidence synthesis, both outside and within the Cochrane Collaboration, it has successfully responded to the challenges posed in terms of incorporating qualitative evidence in systematic reviews. The Methods Group will continue to advocate for more flexible and inclusive approaches to evidence synthesis in order to meet the exciting challenges and opportunities presented by mixed methods systematic reviews and reviews of complex interventions.
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Affiliation(s)
- Karin Hannes
- Methodology of Educational Sciences research group, Faculty of Psychology and Educational Sciences, KU Leuven, Andreas Vesaliusstraat 2, Leuven, Belgium
| | - Andrew Booth
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, UK
| | - Janet Harris
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, UK
| | - Jane Noyes
- Centre for Health Related Research, School of Healthcare Sciences, Bangor University, Fron Heulog, FFriddoedd Road, Bangor, UK
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Hannes K, Goedhuys J, Aertgeerts B. Obstacles to implementing evidence-based practice in Belgium: a context-specific qualitative evidence synthesis including findings from different health care disciplines. Acta Clin Belg 2012; 67:99-107. [PMID: 22712165 DOI: 10.2143/acb.67.2.2062639] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A number of barriers to the implementation of evidence-based practice have already been inventoried. However, little attention has been given to their context-specific nature. This qualitative evidence synthesis examines commonalities in the obstacles perceived by different groups of health care practitioners working in the Belgian health care system and sets out to discuss potential strategies to bridge some of these barriers. We actively searched for primary studies addressing our topic of interest in international and national databases (1990 to May 2008), consulted experts and screened references of retrieved studies. We opted for the meta-aggregative approach, developed by the Joanna Briggs Institute, to analyse our findings. The findings indicate that (1) evidence might have a limited role in decision-making processes; (2) aspects other than quality of care steer the evidence-based practice agenda; (3) some health care providers benefit less from evidence-based practice than others and (4) there is a lack of competences to put the evidence-based principles in practice. Belgian policy makers might consider health care system characteristics from and strategies developed or suggested by others to respond to country-specific obstacles. Examples include but are not limited to; (a) providing incentives for patient-centred care coordination and patient communication, (b) supporting practitioners interested in applying research-related activities, (c) considering direct access systems and interprofessional learning to respond to the demand for autonomous decision-making from satellite professional groups, (d) systematically involving allied health professionals in important governmental advisory boards, (e) considering pharmaceutical companies perceived as 'the enemy' an ally in filling in research gaps, (f) embedding the evaluation of evidence-based knowledge and skills in examinations (g) moving from (in)formative learning to transformative learning and (h) organizing high quality catch-up programs for those who missed out on evidence-based medicine in their curriculum.
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Affiliation(s)
- K Hannes
- K U Leuven, Centre for Methodology of Educational Research, Leuven, Belgium.
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Hannes K, Harden A. Multi-context versus context-specific qualitative evidence syntheses: combining the best of both. Res Synth Methods 2012; 2:271-8. [PMID: 26061890 DOI: 10.1002/jrsm.55] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 01/02/2012] [Accepted: 01/17/2012] [Indexed: 11/08/2022]
Abstract
There is an increasing interest in the conduct of qualitative evidence syntheses (QES), particularly in the field of health care. Approaches to QES vary in the way they conduct a search, a critical appraisal or the data-analysis. To date, the use of multi-context versus context-specific QES has not yet been fully considered. In a multi-context, QES exhaustive searches are used that retrieve studies from a broad variety of geographical, socio-cultural, political, historical, economical, health care, linguistic, or other context relevant to the review. Authors of a context-specific QES would generally have a particular end user in mind, therefore, using a selective search strategy with a focus on one particular context in order to provide lines of actions or theories that are sensitive to a local setting. We used the insights from a recently conducted, context-specific QES to map out potential strengths and weaknesses of these two approaches and make recommendations regarding the future conduct of QES. We propose two ways of combining the best of both: the production of umbrella reviews of context-specific syntheses and/or the trans-cultural modification and trans-contextual adaptation of findings from multi-context syntheses. Copyright © 2012 John Wiley & Sons, Ltd.
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Hannes K, Lockwood C. Pragmatism as the philosophical foundation for the Joanna Briggs meta-aggregative approach to qualitative evidence synthesis. J Adv Nurs 2011; 67:1632-42. [DOI: 10.1111/j.1365-2648.2011.05636.x] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hannes K, Lockwood C, Pearson A. A comparative analysis of three online appraisal instruments' ability to assess validity in qualitative research. Qual Health Res 2010; 20:1736-1743. [PMID: 20671302 DOI: 10.1177/1049732310378656] [Citation(s) in RCA: 198] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The concept of validity has been a central component in critical appraisal exercises evaluating the methodological quality of quantitative studies. Reactions by qualitative researchers have been mixed in relation to whether or not validity should be applied to qualitative research and if so, what criteria should be used to distinguish high-quality articles from others. We compared three online critical appraisal instruments' ability to facilitate an assessment of validity. Many reviewers have used the critical appraisal skills program (CASP) tool to complete their critical appraisal exercise; however, CASP appears to be less sensitive to aspects of validity than the evaluation tool for qualitative studies (ETQS) and the Joanna Briggs Institute (JBI) tool. The ETQS provides detailed instructions on how to interpret criteria; however, it is the JBI tool, with its focus on congruity, that appears to be the most coherent.
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Affiliation(s)
- Karin Hannes
- Catholic University Leuven, Centre for Methodologyof Educational Research, Leuven, Belgium.
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Hannes K, Pieters G, Goedhuys J, Aertgeerts B. Exploring barriers to the implementation of evidence-based practice in psychiatry to inform health policy: a focus group based study. Community Ment Health J 2010; 46:423-32. [PMID: 19888653 DOI: 10.1007/s10597-009-9260-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Accepted: 10/20/2009] [Indexed: 11/28/2022]
Abstract
This study aims to explore the obstacles to Evidence-Based Practice (EBP) experienced by Belgian Dutch-speaking psychiatrists. We used an inductive, qualitative research strategy. Thirty-nine psychiatrists participated in five focus groups organised between September 2004 and September 2006. Data-analysis was guided by a 'grounded theory approach'. Three major themes emerged from the data: (1) Characteristics of evidence, including the lack of (use of) evidence and the applicability of evidence; (2) Characteristics of other partners in mental health care, including government, patients and drug companies and (3) Discipline-related barriers, including the complexity of diagnoses, the importance of the therapeutic relationship and personal experience, and the different schools of thoughts. A problem tree was developed, linking all obstacles. Although context-specific, the problem tree can assist policy makers working in health care systems with similar characteristics in formulating objectives and developing strategies that facilitate EBP in the field of psychiatric care.
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Affiliation(s)
- Karin Hannes
- Belgian Centre for Evidence-Based Medicine, Belgian Branch of the Cochrane Collaboration, Kapucijnenvoer 33 blok J, 3000, Leuven, Belgium.
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Hannes K, Staes F, Goedhuys J, Aertgeerts B. Obstacles to the implementation of evidence-based physiotherapy in practice: A focus group-based study in Belgium (Flanders). Physiother Theory Pract 2009; 25:476-88. [DOI: 10.3109/09593980802661949] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bruyninckx R, Van den Bruel A, Hannes K, Buntinx F, Aertgeerts B. GPs' reasons for referral of patients with chest pain: a qualitative study. BMC Fam Pract 2009; 10:55. [PMID: 19646225 PMCID: PMC2731044 DOI: 10.1186/1471-2296-10-55] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Accepted: 07/31/2009] [Indexed: 01/09/2023]
Abstract
Background Prompt diagnosis of an acute coronary syndrome is very important and urgent referral to a hospital is imperative because fast treatment can be life-saving and increase the patient's life expectancy and quality of life. The aim of our study was to identify GPs' reasons for referring or not referring patients presenting with chest pain. Methods In a semi-structured interview, 21 GPs were asked to describe why they do or do not refer a patient presenting with chest pain. Interviews were taped, transcribed and qualitatively analysed. Results Histories of 21 patients were studied. Six were not referred, seven were referred to a cardiologist and eight to the emergency department. GPs' reasons for referral were background knowledge about the patient, patient's age and cost-benefit estimation, the perception of a negative attitude from the medical rescue team, recent patient contact with a cardiologist without detection of a coronary disease and the actual presentation of signs and symptoms, gut feeling, clinical examination and ECG results. Conclusion This study suggests that GPs believe they do not exclusively use the 'classical' signs and symptoms in their decision-making process for patients presenting with chest pain. Background knowledge about the patient, GPs' personal ideas and gut feeling are also important.
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Affiliation(s)
- Rudi Bruyninckx
- Department of General Practice, Katholieke Universiteit Leuven, Leuven, Belgium.
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McGowan J, Grad R, Pluye P, Hannes K, Deane K, Labrecque M, Welch V, Tugwell P. Electronic retrieval of health information by healthcare providers to improve practice and patient care. Cochrane Database Syst Rev 2009:CD004749. [PMID: 19588361 PMCID: PMC4164913 DOI: 10.1002/14651858.cd004749.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The movement towards evidence-based practice makes explicit the need for access to current best evidence to improve health. Advances in electronic technologies have made health information more available, but does availability affect the rate of use of evidence in practice? OBJECTIVES To assess the effectiveness of interventions intended to provide electronic retrieval (access to information) to health information by healthcare providers to improve practice and patient care. SEARCH STRATEGY We obtained studies from computerized searches of multiple electronic bibliographic databases, supplemented by checking reference lists, and consultation with experts. SELECTION CRITERIA Randomized controlled trials (RCTs) including cluster randomized trials (CRCTs), controlled clinical trials (CCT), and interrupted time series analyses (ITS) of any language publication status examining interventions of effectiveness of electronic retrieval of health information by healthcare providers. DATA COLLECTION AND ANALYSIS Duplicate relevancy screening of searches, data abstraction and risk of bias assessment was undertaken. MAIN RESULTS We found two studies that examined this question. Neither study found any changes in professional behavior following an intervention that facilitated electronic retrieval of health information. There was some evidence of improvements in knowledge about the electronic sources of information reported in one study. Neither study assessed changes in patient outcomes or the costs of provision of the electronic resource and the implementation of the recommended evidence-based practices. AUTHORS' CONCLUSIONS Overall there was insufficient evidence to support or refute the use of electronic retrieval of healthcare information by healthcare providers to improve practice and patient care.
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Affiliation(s)
- Jessie McGowan
- Institute of Population Health/Ottawa Health Research Institute, University of Ottawa, Ottawa, Canada
| | - Roland Grad
- Family Medicine, McGill University, Montreal, Canada
| | - Pierre Pluye
- Département de médecine familiale, Université McGill, Montréal, Canada
| | - Karin Hannes
- Belgian Centre for Evidence-Based Medicine and Joanna Briggs Institute Australia, Leuven, Belgium
| | - Katherine Deane
- Edith Cavell Building, University of East Anglia, Norwich, UK
| | - Michel Labrecque
- Département de médecine familiale, Université Laval, Centre hospitalier universitaire de Québec - Hôpital St-François d’Assise, Québec, Canada
| | - Vivian Welch
- Centre for Global Health, Institute of Population Health, University of Ottawa, Ottawa, Canada
| | - Peter Tugwell
- Centre for Global Health, Institute of Population Health, Department of Medicine, University of Ottawa, Ottawa, Canada
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Hannes K, Norré D, Goedhuys J, Naert I, Aertgeerts B. Obstacles to implementing evidence-based dentistry: a focus group-based study. J Dent Educ 2008; 72:736-744. [PMID: 18519604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
In many countries, questions have been raised about the use of evidence-based practice (EBP) in oral health care. The call for an increase in EBP seems to face many obstacles. Only limited empirical studies address these obstacles. We present a qualitative study that explores the obstacles that Flemish (Belgian, Dutch-speaking) dentists experience in the implementation of EBP in routine clinical work. We collected data from discussions in focus groups. Seventy-nine dentists participated. The data were analyzed using constant comparative analysis. Three major categories of obstacles were identified. These categories relate to obstacles in 1) evidence, 2) partners in health care (medical doctors, patients, and government), and 3) the field of dentistry. Our findings suggest that educators should provide communication skills to aid decision making, address the technical dimensions of dentistry, promote lifelong learning, and close the gap between academics and general practitioners (dentists) in order to create mutual understanding. The obstacles identified are considered useful to support future quantitative research that can be generalized to a broader group.
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Affiliation(s)
- Karin Hannes
- Belgian Centre for Evidence-Based Medicine, Belgian Branch of the Cochrane Collaboration, Belgium.
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